Abortion: beyond rhetoric to access

Ellen W. Freeman, Ph.D., is Research Associate, University of Pennsylvania Hospital, Philadelphia. A version of this article was presented at the NASW Twentieth Anniversary Pro fessional Symposium, Hollywood, Florida, October 1975. Abortion is an aspect of population and disadvantaged, and points to some and human fertility—issues that are examples of social work involvement traditionally in the domain of scientists in the abortion issue. She argues that and priests, philosophers and kings, skill in social work means more than However, as economic pressures, sorhetorical support for individual cial mores, and political distributions choice. It demands a critical analysis change, the issue of abortion is reachof the broad social policies that neces ing the awareness of the broad base sarily affect the realities of individual of society. Rapid changes have been choice, taking place in the use of abortion by the general population. In 1969 the CURRENT POLICY legal abortion ratio was 6.3 abortions per 1,000 live births. By 1973—the The right to abortion in this country year in which the U.S. Supreme Court was supported by the U.S. Supreme legalized abortion—the ratio had inCourt in January 1973, in a decision creased to 195.1, nearly 20 percent that concluded that state laws restrict of the frequency of live births.1 In ing abortion deprive a woman of her 1975 approximately one million constitutional rights. The Court ruled women in the United States obtained that a state could not intervene in an legal abortions.2 abortion decision between a woman There is evidence that the acceptand her physician during the first three ance of abortion has also increased, months of pregnancy. The state may In 1968, in response to a question mandate health regulations for abor whether abortion should be permitted tion services between the third and when parents already had all the chilseventh months of pregnancy, but the dren they wanted, the Gallup Poll decision for abortion services remains found 15 percent approval. By 1971, solely between the woman and the in a national survey by the Commisphysician. Only after the seventh sion on Population Growth, 49 percent month may the state assume interest responded affirmatively to a similai in the rights of the unborn child. In question.3 June 1975 the Court further strength In social work, there is new percepened access to information by ruling tion of abortion as a professional conthat the First Amendment of the Con cern. At the 1967 Institute for Family stitution, which protects freedom of Planning, abortion was given little the press, cannot restrict the advertise attention.4 The institute concluded that ment of abortion services, "the complex subjects of abortion . . . Neither government support for deserve some mention here. . . . Areas abortion services nor the availability need to be explored . . . systematic of private services have kept pace with study is indicated." The concern, howthe demand for abortion that has fol ever, was for "psychiatric justification" lowed its legal sanction. The federal of abortion; the array of social, ecogovernment decisively entered the area nomic, and political issues was largely of birth planning with the passage of ignored. By 1971, the National Assothe Family Planning Act of 1970, ciation of Social Workers' Delegate which it backed with considerable Assembly had issued a policy statefunding, particularly for low-income ment in support of abortion services, households. However, although a This article will view abortion as broad range of birth control proce a health care service sought by women dures from the rhythm method to who are attempting to manage their sterilization are allowed, the Family lives effectively. Questions of control Planning Act specifically excludes in abortion services—which denies acabortion as an option, cess to many individuals, particularly The deletion of abortion services the poor—are examined. In addition, becomes more conspicuous when one the author outlines the current status notes that reports of the U.S. Depart of abortion policy, indicates several ment of Health, Education, and Wel controversies surrounding the implefare (HEW) included abortion as a mentation of this policy for the poor method of contraception a decade