Four Decades Later, Roe v. Wade Is Still Monumental

An estimated 5,000 people, women and men, march around the Minnesota Capitol building protesting the U.S. Supreme Court's Roe v. Wade decision, ruling against state laws that criminalize abortion, in St. Paul, Minn., Jan. 22, 1973. AP

On January 22, 1973, a landmark decision by the Supreme Court in the case of Roe v. Wade legalized abortion in the first three months of pregnancy across the United States.

More than four decades later, the issue of abortion and its availability to women is still the subject of heated debate, in homes and in the public sphere. It was an issue that made its way into President Barack Obama's State of the Union speech on Tuesday and in the GOP response by Iowa Sen. Joni Ernst.

"We still may not agree on a woman's right to choose, but surely we can agree it's a good thing that teen pregnancies and abortions are nearing all-time lows," Obama said.

"We'll defend life, because protecting our most vulnerable is an important measure of any society," Ernst responded.

Abortion coverage also became a flashpoint during the passing of the Affordable Care Act passing of the Affordable Care Act. In recent years, several states have passed laws restricting abortion, more between 2011 and 2013 than in the preceding decade, according to the Guttmacher Institute. On Thursday, exactly 42 years after the Supreme Court's decision, the House of Representatives considered debate on a bill that would ban most abortions after 20 weeks. They delayed the bill after deciding they were short of votes.

The words of Justice Harry Blackmun from the 1973 majority opinion still resonate today: "We … acknowledge our awareness of the sensitive and emotional nature of the abortion controversy, of the vigorous opposing views, even among physicians, and of the deep and seemingly absolute convictions that the subject inspires."

The February 5, 1973 issue of Newsweek covered the landmark decision that had been handed down two weeks prior, and questioned what its impact would be on women, doctors and nurses and the healthcare system at large.

Abortion: What Happens Now

One day last week, a pregnant 20-year-old Wayne State University coed visited the offices of a Detroit agency to arrange for an abortion. Such operations were illegal in Michigan except to protect the life of the mother, so for $200 the agency would fly her to a clinic in Buffalo, N.Y., where abortion on demand has been available since 1970. But as soon as she walked in the door, the young woman received some surprising news. Because the U.S. Supreme Court had just overturned all restrictive state abortion laws, she could receive her abortion that very day in the offices of a Detroit physician.

So it went across the U.S. last week as the reverberations of the Court's monumental ruling were felt in doctor's offices and hospital hallways. Inquiries from women seeking abortions swamped the switchboard at Chicago's sprawling Cook County Hospital. In Beverly Hills, a respected gynecologist, who had been violating California law by doing abortions in his office, drank a cold-duck toast over a newly arrived vacuum extraction device with which he would perform his first legal abortion in two years. At Planned Parenthood-World Population in New York, staffers made plans to help establish nonprofit clinics in 40 states, all linked by a toll-free nationwide telephone referral system.

In its sweeping decision, the Supreme Court ruled that abortions in the first three months of pregnancy are a matter to be decided upon by a woman and her doctor and not subject to any scrutiny by the state. The decision thus voided restrictive laws in 31 states that permit abortions only to save the life of the mother; it also requires revision of the "liberalized" laws in fifteen states that permit abortions, subject to qualifications. (In the remaining four states, abortion on demand is already the law.) In many areas, however, it may be some time before the decision is felt. "We're waiting to see what our legal counsel advises," says a spokesman for a suburban Atlanta hospital where only a dozen abortions were done last year, "and we're sure our legal counsel will proceed slowly.

Most lawyers active in the abortion field think that the Supreme Court decision makes it incumbent on municipal and public hospitals that have obstetrical facilities to make them available for abortions. "But you can bet," says Lawrence Lader, director of the National Association for the Repeal of Abortion Laws, "that we're going to have trouble when it comes to heavily Catholic areas."

Funds: Even Catholic hospitals, which do not now permit abortions, may begin to feel pressure, particularly in rural institutions with obstetrical facilities. A precedent may already have been set in Billings, Mont. There, St. Vincent's Hospital is under a temporary injunction pending the outcome of a case in Federal court to permit sterilization procedures in violation of Catholic doctrine. In imposing the injunction, the court noted that the hospital had once received Federal funds and also that it was the only area hospital with a maternity service.

Hospital policies against abortion may not, however, prove decisive in the long run toward determining the availability of abortions, since the Supreme Court decision clearly permits such operations to be done in the doctor's office in the first trimester. "If we find an area where hospitals legitimately refuse to perform abortions," says Lader, "then we'll have to get doctors who will perform them on their own."

Some pro-abortion physicians are concerned about the Supreme Court's green light for office abortions. "It's possible with this ruling," says Dr. John Marshall, chief of obstetrics and gynecology at Harbor General Hospital in Torrance, Calif., "that every Tom, Dick and Harry out in the woods can start doing abortions and we'll be back where we were before abortion was legal."

Quick: Some observers believe the decision will even permit abortions by paramedical personnel, working under the supervision of a doctor. Harvey Karmen, a Los Angeles clinical psychologist who has been arrested numerous times for performing abortions, announced last week that he had found a physician who would act as his backup. Karmen has already trained some 60 lay women in the use of the Karmen cannula, a simple device he has invented for performing quick abortions by suction.

In an effort to eliminate the potential hazards of office abortions, NARAL and Planned Parenthood plan to run seminars around the country on how to set up outpatient abortion clinics like those in New York City. There strict regulations have produced a remarkable safety record: there have been no abortion deaths in New York City since July 1971. Many of the clinics, such as one about to open at Harbor General, will offer abortions as part of a comprehensive family-planning service that includes advice on contraception. "If a woman comes into the office and all you do is empty her womb, all you've treated is the symptom," notes Marshall. "You have to treat the disease—irresponsible sexuality—as well."

With clinics and in-office procedures, the price of abortions will undoubtedly come down. An abortion in some hospitals currently costs about $400 to $600, even in the first trimester. Outpatient clinic abortions cost as little as $100.

Another of the positive results of last week's decision, some observers think, will be to put profitmaking abortion-referral entrepreneurs out of business. One such operator, Henry Dubin, made $100,000 last year, acting as business agent for at least five Los Angeles-area hospitals which offer abortions (Newsweek, Nov. 13, 1972). Members of the radical Feminist Women's Health Center in Los Angeles have been getting $50 in return for referrals.

Profit: "The handwriting is on the wall," admits Wayne Lamont, director of an Orange County, Calif., referral service. Lamong believes, however, that he can stay in business by insuring that he steers women to good hospitals offering safe abortions at reasonable cost. But Calfiornia State Sen. Anthony Beilenson plans to introduce legislation to prohibit abortion referral for a profit, on the ground that "referral belongs in abortion no more than in tonsillectomies."

Finally as abortions become increasingly available across the country, the need for women to travel far and wide to states with liberal laws will disappear. At least two-thirds of the abortions performed in New York City involve out-of-state women. Until now, Dr. James Ham of the Garberson Clinic in Mile City, Mont., has been referring eight to ten women a month to Calfornia and Washington for abortions. "What has been happening," says Ham, "is that if you can afford it you get an abortion, and if you can't you have the child and go on welfare. The decision will be more fair to the individuals and also to the states that have had to take the brunt."