Abortion in Massachusetts

The number of abortion clinics in Massachusetts has sharply declined in recent years: 78 in 1982; 64 in 1992; and 14 in 2014. In 2014, there were 19,354 legal abortions performed in the Commonwealth. Massachusetts has an active abortion rights community and also an active anti-abortion community.  In May 2019, a march took place in support of abortion rights.  The state was a leader in anti-abortion activities in the late 19th century and into the 1920s.  The state has also seen anti-abortion violence resulting in deaths.

Abortion in Massachusetts is legal.

Terminology

The abortion debate most commonly relates to the "induced abortion" of an embryo or fetus at some point in a pregnancy, which is also how the term is used in a legal sense.[note 1] Some also use the term "elective abortion", which is used in relation to a claim to an unrestricted right of a woman to an abortion, whether or not she chooses to have one. The term elective abortion or voluntary abortion describes the interruption of pregnancy before viability at the request of the woman, but not for medical reasons.[1]

Anti-abortion advocates tend to use terms such as "unborn baby", "unborn child", or "pre-born child",[2][3] and see the medical terms "embryo", "zygote", and "fetus" as dehumanizing.[4][5] Both "pro-choice" and "pro-life" are examples of terms labeled as political framing: they are terms which purposely try to define their philosophies in the best possible light, while by definition attempting to describe their opposition in the worst possible light. "Pro-choice" implies that the alternative viewpoint is "anti-choice", while "pro-life" implies the alternative viewpoint is "pro-death" or "anti-life".[6] The Associated Press encourages journalists to use the terms "abortion rights" and "anti-abortion".[7]

Context

Free birth control correlates to teenage girls having a fewer pregnancies and fewer abortions. A 2014 New England Journal of Medicine study found such a link.  At the same time, a 2011 study by Center for Reproductive Rights and Ibis Reproductive Health also found that states with more abortion restrictions have higher rates of maternal death, higher rates of uninsured pregnant women, higher rates of infant and child deaths, higher rates of teen drug and alcohol abuse, and lower rates of cancer screening.[8]

According to a 2017 report from the Center for Reproductive Rights and Ibis Reproductive Health, states that tried to pass additional constraints on a women's ability to access legal abortions had fewer policies supporting women's health, maternal health and children's health.  These states also tended to resist expanding Medicaid, family leave, medical leave, and sex education in public schools.[9] According to Megan Donovan, a senior policy manager at the Guttmacher Institute, states have legislation seeking to protect a woman's right to access abortion services have the lowest rates of infant mortality in the United States.[9]

History

Madame Restell opened a business that performed abortions in the 1830s in New York City.  Her business remained open for around 35 years and openly advertised its services, including in newspaper advertisements.  She had branches in several other cities including Boston and Philadelphia, as well as having traveling agents working for the company who sold her "Female Monthly Pills."[10][11]

Legislative history

By the end of the 1800s, all states in the Union except Louisiana had therapeutic exceptions in their legislative bans on abortions.[12] By the end of 1972, Mississippi allowed abortion in cases of rape or incest only and Alabama and Massachusetts allowed abortions only in cases where the woman's physical health was endangered. In order to obtain abortions during this period, women would often travel from a state where abortion was illegal to states where it was legal.[13] Massachusetts passed a law in the early 1980s requiring parental consent for minors seeking abortions.  This resulted in minors delaying of up to 6 weeks before seeking an abortion.[14][15] Parental consent laws passed by Massachusetts and Minnesota in the 1980s created over 12,000 petitions to bypass consent.  Of these, 21 were denied and half of these denials were overturned on appeal.[14][16]

In 2007, the legislature passed a law that established a 35-foot buffer zone around abortion clinics.[17] As of 2017, Washington State, New Mexico, Illinois, Alaska, Maryland, Massachusetts, Connecticut, and New Jersey allow qualified non-physicians to prescribe drugs for medical abortions only.[18]As of May 2019, state law prohibited abortions after the fetus was viable, generally some point between week 24 and 28. This period uses a standard defined by the US Supreme Court in 1973 with the Roe v. Wade ruling.[19][20] The law stated, “no abortion may be performed except by a physician and only if it is necessary to save the life of the mother, or if a continuation of her pregnancy will impose on her a substantial risk of grave impairment of her physical or mental health.”[20] Roe's Bill was scheduled to be debated in the fall of 2019.[20][21] In January 2019, Bill S.1209 was introduced in the state's Senate where it was known as "Roe's Bill".  The proposed bill would remove parental consent requirements for minors seeking abortions.  It would also allow women to have abortions after week 24 if a woman's doctor said an abortion “is necessary to protect the patient’s life or physical or mental health, or in cases of lethal fetal anomalies, or where the fetus is incompatible with sustained life outside the uterus.”[20][22] As of mid-May 2019, state law banned abortion after week 24.[23]

Judicial history

In the 1972 US Supreme Court case Eisenstadt v. Baird, the focus was on the issue of physicians' ability to prescribe contraceptive medications only to married couples.  The US Supreme Court ruled that single individuals had a right to buy contraceptives, and the law could not be used to limit distribution based on marital status.[24]

The US Supreme Court's decision in 1973's Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester.[12]

Bellotti v. Baird was before the US Supreme Court in 1979.  The Court ruled that attempts by Massachusetts to limit the ability of minors to get abortions by requiring parental consent or judicial reviews were unconstitutional.  This was because it removed the ability of minors to make decisions about their well-being, and giving the decision exclusively to their parents or the court; minors needed to be able to actively consent to the procedure and as such could make a request without first seeking parental approval.  The US Supreme Court ruled that minors, in getting permission from the courts, needed to be able to do so using a confidential process that dealt with the situation quickly.[24]

In 2014, the US Supreme Court struck down a Massachusetts bill that had legalized a 35-foot buffer zone around abortion clinics in the state in 2007.[17]

Clinic history

Number of abortion clinics in Massachusetts by year.

Between 1982 and 1992, the number of abortion clinics in the state decreased by 14, going from 78 in 1982 to 64 in 1992.[25] In 2014, there were 14 abortion clinics in the state.[26] In 2014, 43% of the counties in the state did not have an abortion clinic. That year, 14% of women in the state aged 15 – 44 lived in a county without an abortion clinic.[27] In 2017, there were five Planned Parenthood clinics in a state with a population of 1,614,490 women aged 15 – 49 of which three offered abortion services.[28]

Statistics

In the period between 1972 and 1974, the state had an illegal abortion mortality rate per million women aged 15 – 44 of between 0.1 and 0.9.[29] In 1990, 864,000 women in the state faced the risk of an unintended pregnancy.[25] In 2001, Arizona, Florida, Iowa, Louisiana, Massachusetts, and Wisconsin did not provide any residence related data regarding abortions performed in the state to the Centers for Disease Control.[30] In 2014, 74% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[31] In 2017, the state had an infant mortality rate of 3.7 deaths per 1,000 live births.[9]

Number of reported abortions, abortion rate and percentage change in rate by geographic region and state in 1992, 1995 and 1996[32]
Census division and stateNumberRate% change 1992–1996
199219951996199219951996
Total1,528,9301,363,6901,365,73025.922.922.9–12
New England78,36071,94071,28025.223.623.5–7
Connecticut19,72016,68016,23026.22322.5–14
Maine4,2002,6902,70014.79.69.7–34
Massachusetts40,66041,19041,16028.429.229.33
New Hampshire3,8903,2403,47014.61212.7–13
Rhode Island6,9905,7205,4203025.524.4–19
Number, rate, and ratio of reported abortions, by reporting area of residence and occurrence and by percentage of abortions obtained by out-of-state residents, US CDC estimates
LocationResidenceOccurrence% obtained by

out-of-state residents

YearRef
No.Rate^Ratio^^No.Rate^Ratio^^
Massachusetts 40,660 28.4 1992 [32]
Massachusetts 41,190 29.2 1995 [32]
Massachusetts 41,160 29.3 1996 [32]
Massachusetts18,63013.625919,35414.12693.72014[33]
Massachusetts 17,294 12.6 242 17,901 13.0 251 3.6 2016 [34]
^number of abortions per 1,000 women aged 15-44; ^^number of abortions per 1,000 live births


Abortion financing

State Medicaid coverage of medically necessary abortion services.Navy blue: Medicaid covers medically necessary abortion for low-income women through legislationRoyal blue: Medicaid covers medically necessary abortions for low-income women under court order Gray: Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment.

Seventeen states including Massachusetts use their own funds to cover all or most "medically necessary" abortions sought by low-income women under Medicaid, thirteen of which are required by State court orders to do so.[35] In 2010, the state had 4,100 publicly funded abortions, of which were 0 federally funded and 4,100 were state funded.[36]

Women's abortion experiences

Actress Amy Brenneman had an abortion when she was a 21-year-old junior at Harvard University.  She had become pregnant as a result of her birth control failing; she had been taking birth control to control when she became a mother as she did not believe she was ready at that age because among other things, she had no job, was not married, and did not want it. She chose to have an abortion and did not regret the decision.[37]

Intersections with religion and religious figures

Politicians who have been targeted in such controversies include Lucy Killea,[38] Mario Cuomo,[39] John Kerry,[40] Rudy Giuliani,[41] and Joe Biden.[42] California's Killea's case was the first recorded.[38] Kerry's led to comparisons between his presidential campaign and that of John F. Kennedy in 1960. While Kennedy had to demonstrate his independence from the Roman Catholic Church due to public fear that a Catholic president would make decisions based on Vatican commands, it seemed that Kerry, in contrast, had to show obedience to Catholic authorities in order to win votes.[43][44][45][46][47]

Abortion rights views and activities

2017 Boston Women's March

Protests

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.[48]

Anti-abortion views and activities

Activities

Boston University and Harvard University both were universities that led the early anti-abortion campaigns in their areas.  Their efforts came out of another effort at the time to try to prevent women from enrolling in their medical schools.[10] Harvard Medical School graduate Dr. Horatio Storer led anti-abortion efforts at the American Medical Association starting in the late 19th century until is death in 1922.[11]

Violence

Between 1993 and 2015, 11 people were killed at American abortion clinics.[49] On December 30, 1994, two receptionists, Shannon Lowney and Lee Ann Nichols, were killed in two clinic attacks in Brookline, Massachusetts. John Salvi was arrested and confessed to the killings. He died in prison and guards found his body under his bed with a plastic garbage bag tied around his head. Salvi had also confessed to a non-lethal attack in Norfolk, Virginia days before the Brookline killings.[50][49][51] Salvi died in prison in November 1996 of suspected suicide.[49]

Footnotes

  1. According to the Supreme Court's decision in Roe v. Wade:
    (a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgement of the pregnant woman's attending physician. (b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health. (c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgement, for the preservation of the life or health of the mother.
    Likewise, Black's Law Dictionary defines abortion as "knowing destruction" or "intentional expulsion or removal".

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