Abortion: A Public Health and Social Policy Perspective

Introduction

On January 22, 1973, the Supreme Court ruled in the companion cases of Roe v. Wade and Doe v. Bolton that state statutes prohibiting or narrowly restricting abortion were unconstitutional. Although a number of states had already revoked their restrictive abortion policies in the late 1960’s and early 1970’s, the sudden and dramatic legalization of abortion on a national scale was an unexpected and profound shock to those committed to the right-to-life cause. Since then, the single-minded objective of the pro-life movement has been to overturn the Supreme Court rulings by constitutional amendment. There is, however, no right-to-life consensus as to the form which the proposed amendment should assume. The reason is that anti-abortion advocates are not housed in a single body, speaking with one voice. What binds them together is their shared commitment to the fetus, and from that common bond have emerged two proposals for amending the Constitution. The more radical sup-ports an amendment that would directly reverse our national policy on abortion by specifically guaranteeing the fetus’s right to life. The more modest proposal calls for an amendment that would define the subject of abortion as jurisdictionally reserved to the states, with each individual state empowered to set its own policy free from federal restraint.

Although this quest for a constitutional solution has not yet made any perceptible headway, the pro-life movement has recently scored significant gains on other fronts. On June 20, 1977, the Supreme Court handed a stunning victory to the foes of abortion, when it announced its decisions in Maher v Roe, Beal v. Doe, and Poelker v. Doe. In Maher and Beal, the Court held that neither the Constitution nor the Social Security Act requires states to pro-vide Medicaid funds for elective abortions; while in Poelker it decided that municipalities are not constitutionally obliged to provide or even to permit such abortions in their public hospitals. This judicial response to the abortion controversy was quickly echoed by the legislative branch when the Senate joined the House of Representatives in voting to restrict sharply the use of Medicaid funds to provide abortions for indigent women. Since both President Carter and Secretary of Health, Education and Welfare Joseph Califano have gone on record as opposing publicly funded abortions, the three branches of the federal government have presented a united front on this emotionally charged and bitterly contested political issue.

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