Alexander Sanger to be biologically pro-life, one must be politically pro-choice
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The Candidate's Positions
I am passing on the following announcement from the Kaiser Family Founadtion.

Dear Interested Party:, the Kaiser Family Foundation's health policy news and information website, introduces a new online resource that provides easy access to the candidates' positions on critical health policy issues, as well as election-related news and analysis.

Access the Election 2004 Issue Spotlight at This is the link to the Kaiser Web Site

Features include:
-- Candidate profiles, including issue statements, speeches, audio/video interviews and transcripts, news coverage, and additional resources on all major candidates.
-- A searchable archive of public opinion questions on health issues related to the election.
-- A reference library of election websites and publications.
-- Multimedia resources, including webcasts of interviews, discussions, and debates.
-- Election-related health news headlines.

A first visit to the cite shows that information of the candidate's positions of reproductive rights issues is incomplete. But hopefully this will be remedied.
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On the Road in Phoenix
On Friday Jan 23, 2004, I spoke at the 31st anniversary celebration of Roe v. Wade given by the Planned Parenthood of Central and Northern Arizona. The lunch at the Hilton at Squaw Peak had 600 in attendance and people were being turned away. Governor Napolitano appeared and gave the best speech I have ever heard by a politician--it lasted less than 30 seconds! I'll vote for her anytime!
The Governor stayed for my speech which I take as an couldn't have been the chicken pot pie, but the chocolate cheesecake was quite tasty.
I recounted for the audience the number of anti-choice bills that have been passed by state legislatures around the country, over 300 in the last five years and asked them how many more laws will it take before we begin to rethink how we talk about the issue of choice to the American public. Our political problem is an idea problem. We are not talking in language that the 60% of the American public who are in the "middle" on the abortion issue can relate to. This "muddled middle", I don't think is muddled; I just think we haven't reached them on terms they can relate to.
Hence my book, Beyond Choice.
The audience was, in my not so humble opinion, taking in every word. Tons of books were sold afterwards
The organizers of the event, Oonagh Boppart and Elaine Warner, did a fantastic job, as did the staff of PPCNA. Thanks to all.

Later that day, I spoke at my first bookstore event at Changing Hands Bookstore in Tempe. A very serious crowd of mixed political opinions showed up and, after I presented the book in about 15 minutes, asked very penetrating questions about the book and my opinion on a variety of matters. One man when he was leaving said, "That was more interesting than I thought it would be". The best backhanded compliment I have ever received.
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Reproductive Rights Are for Men Too
In response to Robyn E. Blumner’s column, Reproductive Rights Are for Men Too, in the St. Petersburg Times of Jan 11, 2004 ( I sent the following letter to the editor, as yet unpublished.

Robyn E. Blumner in her column, Reproductive Rights Are for Men Too (Jan 11, 2004) mentioned the case of David Oakley who was ordered by the Supreme Court in Wisconsin not to have any more children while he was on probation for non-payment of child support. The vote was 4-3, but one judge in the majority stated that he supported the order only because the defendant intentionally refused to pay child support and that, if the defendant had been unable to pay child support, i.e. indigent, he would have joined the dissent and permitted the defendant to have more children.

The dissenting judges in the Oakley case correctly in my view argued that the majority’s ruling ‘wrongly supports an economic test for would-be parents,’ adding, ‘The right to have a child has never been rationed on the basis of wealth. The majority has essentially authorized a judicially imposed ‘credit check’ on the right to bear and beget children.’

This credit check was imposed in the Oakley and the other case cited in the article, that of Sean Talty in Ohio, only on the man. Women can have children even if they cannot afford them – our welfare system, such as it is, is supposed to provide for those children who need additional financial support.

The Wisconsin and Ohio courts view poor men as having lesser ‘reproductive rights’ than poor women, even when the right asserted does not conflict with or affect a woman’s right. In fact, Sean Talty’s reproductive interests coincided with those of his current girlfriend, who was the mother of two of his children. She was not pleased with the verdict and complained: ‘It took me 10 years to get two and I would like to have more.’

Men, like women, want to have children and have them survive to adulthood and lead productive lives and if possible in turn have children. Many children start their lives from disadvantaged homes. This should not be a legal disqualification to their mothers or fathers having them.
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The Dog that Didn't Bark
Did you notice that the President did not mention the word "abortion" last night in the State of the Union Address (link in previous blog entry)? Or was I napping? Or maybe recovering from my appearance on The O'Reilly Factor a half hour earlier?

When I was preparing for O'Reilly, I prepared answers to possible questions on the upcoming State of the Union speech. Certainly the President would mention proposals in Congress to forbid minors from crossing state lines to avoid parental involvement laws. But nothing.

This President says nothing off the cuff and he omits nothing off the cuff either. Perhaps he is saving his pro-life fire for the pro-life march on Washington tomorrow, where he hopes middle America won't notice what he says. He didn't even want to trumpet the so-called "Partial-Birth Abortion Act" that he signed in front of a dozen men last fall, surely his proudest pro-life legislative achievement. This only says to me that he is going to avoid the abortion issue until next November, or mention it only in passing. This also says to me that the Democratic candidate has to hammer away at it. The President is vulnerable on this one. He must be held to account.
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The State of the Non-Sexual Union
The President in his State of the Union speech on Tuesday evening January 20, 2004 proposed a doubling of Federal funding for abstinence programs.

The President stated:
"To encourage right choices, we must be willing to confront the dangers young people face -- even when they're difficult to talk about. Each year, about 3 million teenagers contract sexually-transmitted diseases that can harm them, or kill them, or prevent them from ever becoming parents. In my budget, I propose a grassroots campaign to help inform families about these medical risks. We will double federal funding for abstinence programs, so schools can teach this fact of life: Abstinence for young people is the only certain way to avoid sexually-transmitted diseases. (Applause.)

Decisions children now make can affect their health and character for the rest of their lives. All of us -- parents and schools and government -- must work together to counter the negative influence of the culture, and to send the right messages to our children."

This is the link for the State of the Union Address

First, credit to the President for raising the issue of sexually transmitted diseases. I don't recall any President raising this issue in a State of the Union Address. And also credit the President for making the link between STDs and infertility. I cover this at greater length in my book, "Beyond Choice".

The Surgeon General David Satcher issued a report in July 2001 entitled, "The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior".

This is the link to the Surgeon General's report

The report was by no means an abstinence-only report. It discussed comprehensive sexuality education and condom use, as well as abstinence. Abstinence was not demanded until marriage by the Surgeon General, but only until an individual is in a "committed, enduring, and mutually monogamous relationship".

The President has mostly ignored what the Surgeon General called for three years ago. But the President chose his words carefully.

Reading the text of the President's message, he didn't call for abstinence until marriage either. He only said that there be an abstinence message that it is the only certain way to avoid STDs. This is the same message that Planned Parenthood gives in every sexuality educatrion course.

But it is not enough. As I discussed in an earlier entry "Getting the 'No' out of North Carolina, abstinence-only not only does not work, it is dangerous. Abstinence funding will be increased to $270 million in 2005 according to the Washington Post. This is more than doubling by my calculation.

This is the link to the Washington Post.

In a speech where the President barely mentioned the deficit of $500 billion a year and called for tax cuts costing $1.6 trillion over 10 years,a raise in abstinence only funding from $80 million to $270 million is a rounding error. To update Senator Dirksen, "a hundred million here, a hundred million there, pretty soon we're talking real money".

But the President also called upon Congress to be wise with the people's money. Let's hope they are and puts this proposal in the trash can, and raises the amount of funding for comprehensive sexuality education and services.
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Getting the ‘No’ out of North Carolina
Less than a week after the State of Minnesota released a report stating that its abstinence-only sex education program was not effective in preventing or delaying teenage sexual activity, the Wake County North Carolina school board forged ahead regardless and on January 6, 2004 approved by a 5-3 vote an abstinence-only sex education curriculum for the county’s schools. There are two possibilities: Wake County was either uninformed of the Minnesota report or it deliberately ignored it. “Just Say No” is now the law in Wake County schools.

If Wake County ignored the Minnesota report, they also ignored a number of other reports issued previously saying the same thing. The Minnesota evaluation was just the latest in a series of evaluations that show that abstinence-only programs do not work.

The Alan Guttmacher Institute (AGI) issued a report on sexuality education in December 2003 that stated: “To date, no education program in this country focusing exclusively on abstinence has shown success in delaying sexual activity.”

The Minnesota abstinence-only curriculum, ENABL (Education Now and Babies Later), as the Minnesota Star Tribune reported, “teaches the view embraced by social conservatives -- that abstinence is the only sure way to avoid pregnancy and sexually transmitted diseases, and that teaching kids about birth control or safer sex practices simply encourages them to have sex.”

The evaluation report to be found at on the positive side found the ENABL program to be “well implemented”, with good leadership and good visibility in the community. Also on the positive results front, there was a reported increase in parent-child communication on sexual matters, by about 8%, but no comparison on how another more comprehensive type of program might have helped increase parent-child sexual communication. This ends the good news.

On the inconclusive news front, the Minnesota report found that “our analysis found that the percentage of abstinence students was still lower in counties that had no MN ENABL funding (53%) than in counties with MN ENABL funding (49%)”. The report however could not attribute this result to the program.

On the bad news front, the Minnesota report found that the program had little long term impact on youth attitudes, sexual intentions and sexual behaviors. A year later a survey found that the percentage of students who said they would use the refusal skills taught in the program declined significantly, as did those who said they would avoid risky situations like going into a bedroom or drinking. The percentage of students saying that they would decline to have sex also declined, and sexual activity increased during the year after the program as it did for students statewide. For the 3 ENABL counties, one county had a lesser percentage that was sexually active, one a greater percentage and one was the same as the statewide figure (19% for ninth graders statewide and 15%, 19% and 22% for the 3 counties with the ENBLE program).

The Minnesota Star Tribune reported these findings and stated: “The study found that sexual activity among junior high kids at three schools where the program was taught doubled between 2001 and 2002 -- a pattern similar to that exhibited by kids statewide -- and that the number who said they would probably have sex during high school nearly doubled, as well.”

The Tribune also reported: “ ‘So far all of the programs that have been demonstrated to have a positive impact . . . have been comprehensive sex education that emphasize abstinence and talk about condoms and contraception and encourage their use for young people who are sexually active,’ said Douglas Kirby, a researcher on sex education for the National Campaign to End Teen Pregnancy.”

So what did Wake County, N.C. do in response to this report and all the others? They ignored it.

As the Raleigh News & Observer reported:
“Under Wake's most recent policy, comprehensive sex education taught as part of new high school health electives will be dropped.

Lessons about diversity and tolerance for homosexuals and other groups also will be eliminated from the sex-education curriculum that Wake uses in grades seven through nine.

The policy will require all school employees to promote abstinence until marriage as the expected standard for all students."
The News & Observer also reported that “the board on Dec. 16 had voted 5-3 to preliminarily approve a proposal that would prevent any school employee from encouraging or demonstrating the use of contraceptives, a restriction that currently is placed only on health teachers in grades seven through nine.”

One proposed provision was dropped by the school board was a requirement that would have mandated that whenever sex was mentioned, for instance in a novel in English class, teachers would be required to mention abstinence.

This was the only flash of sanity demonstrated by the school board last week. The school board totally ignored the health findings of the county government.

The 2002 Wake County Community Assessment Report stated: “Wake County faces challenges including infant mortality, teen pregnancy, smoking, school dropout rates…”

In Wake County low birth rate babies have increased 27.6% since 1997, as opposed to an increase of 11.9% in North Carolina and a decrease nationwide. Infant deaths have increased 21.3% in Wake County since 1996, and there is a huge disparity between white deaths at 3.7/1000 and African American deaths at 13.0/1000.

Although teen pregnancy has declined by 8.5% since 1996 in Wake County, the teen pregnancy rate has declined far less in North Carolina than in the rest of the nation. According to the Community Assessment report, “Unintended pregnancy is a major concern in Wake County.”

It is axiomatic that contraception prevents pregnancy. Having sex without contraception means that about 85% of women will become pregnant within a year. Whatever the failure rate might be of any contraceptive method, it is less than 85%. There is no indication that teaching young people about contraception leads to more sexual activity. Any arguable increase in sexual activity with contraception will result in far fewer pregnancies than the amount resulting from unprotected sex.

The good news is that teens have been having less unprotected sex since 1990, and since 1990 the nationwide teen birth rate has been declining. The New York Times reported on December 23, 2003:
“Last week, the Centers for Disease Control and Prevention, in its annual tally of birth statistics, announced that the teenage birthrate had declined 30 percent over 10 years to a historic low of 43 births per 1,000. African-American teenagers showed the sharpest declines, down more than 40 percent since 1991.

For young black teenagers, from 15 to 17, the rate was half, to 40 births per 1,000 in 2002 from 83.6 per 1,000 in 1991.These declines, combined with a decrease in abortions among teenagers, points to a promising trend: fewer teenagers are becoming pregnant. According to the Alan Guttmacher Institute, in women 15 to 19, the pregnancy rate dropped from 11.5 per 1,000 in 1991 to 8.5 in 1999, the latest year with available statistics.

"When you see the abortion rate decline in tandem with birthrate, this essentially means that teenagers are being more successful in avoiding pregnancy, both that end in abortion and end in birth," said David Landry, senior research associate at the institute. It estimates that in women 15 to 19, the abortion rate declined, from 40 per 1,000 in 1990 to 24 in 1999."
The Alan Guttmacher Institute has reported that “25% of the decrease in U.S. teen pregnancy rate between 1988 and 1995 was due to the decline in the proportion of teens who ever had sex (while 75% was due to improved contraceptive use among sexually active teens).”

The New York Times report stated that statistics
“show that teenagers are having less sex and using contraception more effectively when they do. According to the C.D.C. Youth Risk Behavior Survey, the percentage of high school students who have ever had sexual intercourse dropped. Among girls, it fell to 43 percent in 2001 from 51 percent in 1991. For boys, it fell to 48 percent from 57 percent in the same period.

The survey found that use of condoms among high school students rose to 57 percent from 46 percent in those 10 years.”
The evidence is clear, according to AGI, that certain programs that combine messages about abstinence and provide contraceptive information “can help teens delay sexual activity, have fewer sexual partners and increase contraceptive use when they begin having sex.”

Comprehensive sexuality education has its limits. No program is effective in delaying intercourse past age 17 until marriage, which now averages when men and women are 27 and 25 respectively.

The danger of abstinence only sexuality education is that it is no sexuality education at all. There is some evidence that teens were more likely to have unprotected sex when they broke their virginity pledge. Other anecdotal evidence indicates that teens who keep a virginity pledge are as good as some adults in redefining “virginity” and “sex” and end up preserving their “virginity” by engaging in unprotected oral and anal intercourse, thereby putting themselves at increased risk of sexually transmitted diseases.

Given that the Wake County Community Assessment Report accurately reflects the health challenges facing the young people of Wake County, perhaps the school board should think about what they can do to help, rather than get in the way and hinder the community from finding solutions to the problems.

The reality that school boards must face is the same reality that parents face every day: their kids are growing up really fast. Mother Nature is playing a trick on us. Given a variety of factors including changes in diet, lifestyle and environment, girls now reach menarche at about age 11 and marry at about age 25 on average. This is a 14 year period where young girls, and boys, are vulnerable to pregnancy and diseases from unprotected sex. They deserve more than “Just Say No”. They need to know what to do when they say “yes” or when “yes” happens.

Abstinence-only sex ed doesn’t work. The lead author of the Minnesota report concluded: “Given how much money is being spent, (the abstinence-only program) seems like a really weak intervention.”

The 2002 Wake County Community Assessment Report on its cover says “On the Right Track”. I suggest that the county adopt a New Year’s Resolution to make that less of a political statement and more of a commitment to the health of the 105,000 school children in the county.
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My Response to John DiStaso
Mr. DiStaso--thank you for your reply. I take it that we agree that under Roe the state may not ban abortions in the second trimester, it can only regulate them for maternal health reasons. Your column indicated otherwise.

I have also sent this to Lieberman's staff.
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Response from John DiStaso
My only comments are these:
1) Lieberman's statement took issue with the headline on the story, not the story itself. Suggest you check with Lieberman's quotes in the statement or his New Hampshire campaign staff on that.

2) My description of the ruling was taken from the court's own syllabus on same, which says in part: "For the stage subsquent 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."
"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 necessary, in appropriate medical judgment, for the preservation of the life or health of the mother. Pp. 163-164; 164-165."
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Senator Lieberman and Roe
The year 2003 ended with a reporter allegedly misrepresenting a candidate’s stance on Roe v. Wade, and then both the candidate and the reporter compounding the alleged error by misrepresenting what Roe actually said. The former may have been the result of an error, or a misinterpretation of what the candidate meant, or a deliberate attempt to create a story where none existed. But the latter error by both the candidate and the reporter was sheer ineptitude. And both have gotten away with it, until now.

The candidate was Senator Joseph Lieberman, the newspaper was the Manchester Union Leader, and the reporter was John DiStaso who writes a column ‘Granite Status.’ DiStaso reported in his Dec. 26, 2003 column, entitled (as reported on the Union Leader website) Roe v. Wade should be updated, says Lieberman,’ that ‘Joe Lieberman said this week that ‘extraordinary advances in medical science’ have forced a re-examination of the 30-year-old Roe V. Wade ruling’s trimester-based approach to the abortion issue.’

Lieberman issued a statement the same day which the Union Leader duly reported on Dec 27:
‘Lieberman said, ‘This morning, there was a misleading headline in the Manchester Union Leader regarding my views on a woman’s right to choose that suggested that I thought the Roe v. Wade decision should be either ‘looked at again’ or ‘re-examined.’
‘I did not say nor do I believe that Roe should be looked at again, revisited or reconsidered,’ Lieberman said yesterday.’
What was the fuss about? Science and what it means for the future of legal abortion.

Lieberman said in his Dec 26 statement:

‘I said in that interview what I have said for years – namely that medical science has advanced the time of fetal viability to approximately 24 weeks. In response, the courts have determined, as the article pointed out, that the viability standard has replaced the original trimester formulation of Roe.’

If a normal pregnancy is 39 weeks in length, then a trimester framework would divide the pregnancy into a first trimester until week 13, a second until week 26 and the third until delivery at week 39. Lieberman noted that medical science has advanced viability so that it ‘is now in some cases 24 or 25 weeks and in a few cases, a little bit less.’

Lieberman is correct to note that viability is advanced in ‘some cases’ to 24 weeks. Some fetuses are not viable at 28 weeks or 32 weeks or more. So what does this have to do with the legality of abortion? Some scientists predict that soon we will have an artificial womb that can sustain a fetus from the beginning of a pregnancy until ‘birth.’ Should viability outside the mother’s womb be determinative of her ability to terminate a pregnancy?

This is the legal legacy that Roe gave us when it tried to balance the rights of the mother against those of the fetus and drew a line at the end of the second trimester. Before then the mother would have the right to abortion, but after that time the state could prohibit abortion except when abortion was necessary to preserve the mother’s life or health. What the framework that declares the rights of the fetus paramount at viability or at the third trimester ignores is the reality of what might be happening to the mother at that point and what might be happening to the fetus.

A woman 24 weeks pregnant will know she is pregnant. Except in rare cases we are not dealing with ignorance of pregnancy here. As one physician who opposes abortions after 24 weeks said, ‘She has plenty of time until then to s___ or get off the pot.’

Well, does she? Given the fact that only about a dozen states will pay for abortions for poor women under their Medicaid program, poor women in three-quarters of the states are left with trying to come up with the several hundred dollars necessary to pay for an abortion, an amount that rises as the pregnancy goes on. Abortions at 24 weeks can cost two or three times or more than abortions in the first trimester.

Pregnancies are dangerous to a woman’s health, and complications can arise as a pregnancy progresses. Who is to say whether the complications will meet some legal test that a committee of physicians will approve of to terminate a pregnancy after 24 weeks. And what of the health of the fetus? Roe does not protect a woman seeking to terminate a pregnancy when the fetus has a serious defect or disease. Shouldn’t the mother be entitled to make this decision?

And what if life’s contingencies and curve balls? Being pregnant is dangerous for a woman socially and economically. The father of the child may leave, not want the child, may beat and abuse the mother. The mother may lose her job. Life isn’t fair. Why does the law permit a mother to react to life’s unfairness before 24 weeks of pregnancy but not after? Just because her child might be able to survive outside the womb? She is the one who has to raise that child, not the state. She is the one faced with a lifetime of mothering and providing. She will not make any decision lightly, especially after she has been pregnant for 24 weeks. On the contrary, she will be loath to end that pregnancy simply because she has invested so much in it already. It seems to me we can rely on mothers to make the right choice for themselves.

This is the weakness of Roe, and all the cases following it. Roe says that after 24 weeks or viability or whatever science says is viability that we no longer trust mothers.

And this is the weakness of Joe Lieberman and the other pro-choice candidates: they don’t challenge the restrictions that Roe and subsequent cases have put on abortion rights.

The Casey decision in 1992 revised the Roe framework almost entirely so that virtually nothing is left of Roe. Roe said three things: that the right to terminate a pregnancy was a fundamental right; that any law restricting it would be reviewed using the highest level of judicial scrutiny, i.e. strict scrutiny; and that there would be a trimester framework to evaluate the legality of state laws. The Casey decision said that the right to terminate a pregnancy was a liberty interest not a fundamental right (a lesser right in the constitutional scheme of things); that any law restricting abortion would be reviewed using an undue burden standard (a lesser standard than strict scrutiny – any law would be permitted unless it imposed an undue burden on the woman seeking an abortion); and that there would be a dividing line at viability not at the trimesters to evaluate the legality of state laws. The overall result of Casey was to permit virtually any state regulation or restriction on abortion, short of banning it or making it really difficult to obtain.

Senator Lieberman and the Union Leader misstated what Roe and Casey mean. The reporter said in his Dec. 26 column: ‘The ruling (Roe) said the state may impose regulations on, and may even ban, second- or third-trimester abortions except when the life or health of the mother is at stake.’ (Emphasis added). Not so. Roe said that the state can impose regulations during the second trimester that are related to maternal health and can only ban abortion during the third trimester, not the second, and then only if it allows exceptions for the mother’s health and life.

Lieberman joined in this error in his Dec 26 statement: ‘And it is critical to note that while these miraculous medical advances have shortened the time to fetal viability, they have also lengthened the time of a woman’s clearly protected right to choose in Roe from the first trimester to 24 weeks,’ he said. (Emphasis added)

A woman’s clearly protected right to choose under Roe was in the first and second trimesters. Roe did not permit the state to ban abortion in the second trimester, only to regulate it for maternal health, by for instance requiring certain equipment to be present and training of physicians.

Let’s go to the video tape. Here is Justice Harry Blackmun in Roe:
‘To summarize and to repeat:

1. A state criminal abortion statute of the current Texas type, that excepts from criminality only a life-saving procedure on behalf of the mother, without regard to pregnancy stage and without recognition of the other interests involved, is violative of the Due Process Clause of the Fourteenth Amendment.

(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 judgment 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 [410 U.S. 113, 165] may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.’

And here is Justice Sandra Day O’Connor in Casey:
‘We give this summary:

(a) To protect the central right recognized by Roe v. Wade while at the same time accommodating the State’s profound interest in potential life, we will employ the undue burden analysis as explained in this opinion. An undue burden exists, and therefore a provision of law is invalid, if its purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.

(b) We reject the rigid trimester framework of Roe v. Wade. To promote the State’s profound interest in potential life, throughout pregnancy, the State may take measures to ensure that the woman’s choice is informed, and measures designed to advance this interest will not be invalidated as long as their purpose is to persuade the woman to choose childbirth over abortion. These measures must not be an undue burden on the right.

(c) As with any medical procedure, the State may enact regulations to further the health or safety of a woman seeking an abortion. Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right. [505 U.S. 833, 879]

(d) Our adoption of the undue burden analysis does not disturb the central holding of Roe v. Wade, and we reaffirm that holding. Regardless of whether exceptions are made for particular circumstances, a State may not prohibit any woman from making the ultimate decision to terminate her pregnancy before viability.

(e) We also reaffirm Roe’s holding that, 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 judgment, for the preservation of the life or health of the mother.’

The issue then is Casey not Roe. Casey restricted a woman’s right to access abortion more than Roe did. Casey is wrong from many points of view, but mainly because it failed to answer the question, ‘whose baby is it?’ Is it the mother’s or the state’s? Who is having the baby, who is going to raise it, provide for it, nurture it? How will the baby affect the woman’s other children and their viability? What about the woman’s right to life? Science is not irrelevant to these questions, but the potential viability of the fetus is.
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Alexander Sanger
Alexander C. Sanger, the grandson of Margaret Sanger, who founded the birth control movement over eighty years ago, is currently Chair of the International Planned Parenthood Council.
Mr. Sanger previously served as the President of Planned Parenthood of New York City (PPNYC) and its international arm, The Margaret Sanger Center International (MSCI) for ten years from 1991 - 2000.

Mr. Sanger speaks around the country and the world and has served as a Goodwill Ambassador for the United Nations Population Fund.

Beyond Choice
Beyond Choice
The new book by Alexander Sanger published by PublicAffairs

Purchase from

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With reproductive freedom in jeopardy, Alexander Sanger, grandson of renowned family planning advocate Margaret Sanger and a longtime leader in the reproductive rights movement, has taken an urgent, fresh look at the pro-choice position—and even the pro-life position—and finds them necessary, but insufficient. In Beyond Choice he offers the first major re-thinking of these positions in thirty years.

“Well researched and readable, Beyond Choice should be required reading for both pro-choice and pro-life supporters.”
—Governor Christine Todd Whitman


» Much more on Beyond Choice, including an excerpt, discussion guides, reviews
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