The Spark

the Voice of
The Communist League of Revolutionary Workers–Internationalist

“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx

A Terrible Choice Made Necessary by Capitalism, an Inhumane Society

Aug 14, 2022

On June 24, the Supreme Court tore up Roe v. Wade, the 1973 ruling which had affirmed that a woman, in consultation with her doctor, could make the decision to have an abortion in the first two trimesters of pregnancy, without risk of state intervention.

Legally, the 1973 Court had based its ruling on two provisions of the federal Constitution: the 9th Amendment and the 14th Amendment. The 9th declared that individuals did not surrender other rights only because those rights were not “enumerated” in the Constitution. The 14th, passed during Reconstruction, affirmed that the individual states, short of a “fundamental interest” in a question, could not abridge the rights to “life, liberty and property” granted by the federal Constitution to citizens.

Resting on these Constitutional provisions, Roe struck down the laws of those states that had totally banned or severely limited access to abortion. At the point Roe v. Wade was issued, four states generally allowed abortion, 16 more allowed it under specified situations, relating to the life, health and well-being of a woman. The remaining 30 banned it.

Roe recognized that there were competing claims to “life”—between the woman and what it characterized as the “potential life” of the fetus, whose interests, Roe said, were protected by the State. It drew the balance between these competing claims by establishing a time frame during which abortions could be performed: the first two trimesters of pregnancy, which in 1973 were believed to be the period before which a fetus was not viable outside the womb.

The 2022 Supreme Court decision, Dobbs v. Jackson Women’s Health Organization, threw out that ruling on two grounds. First it emphasized, with many historical examples, that abortion was nowhere mentioned in the Constitution, nor in the letters and supporting texts of those who had written it. (The Court forgot that women weren’t mentioned either, considered by the writers of the Constitution to be, along with the slaves, a part of “the people” whose rights could be abridged—a concept with which this Court apparently agrees.)

The second grounds Dobbs used to invalidate the 1973 Supreme Court ruling rested on what Dobbs called, “the fundamental moral question,” that is, the existence of what Roe had called the “potential of life,” but what the Mississippi law called “the unborn human baby,” whose right to life, this Court said, the state was bound to give priority.

Effectively, the 2022 Supreme Court had laid the groundwork for a complete national ban of abortion. But it did not go that far—at least for now. It claimed only to be putting the issue back in the hands of the separate states and their legislatures (what the court called, “the people and their elected representatives”). The Court, in Dobbs, argued that the “people” is not a monolith, having many conflicting views on an issue as morally difficult as abortion, and that these differences often had a geographically distinct character. Thus, the different states were seen to be the best vehicle for ensuring that the rights that do exist reflect the wishes of the majority of the population. (Using the same reactionary rationale—what the Southern segregationists called “states’ rights”—earlier Supreme Courts had upheld for nearly three quarters of a century the openly racist and discriminatory Jim Crow laws that reimposed a near slavery in the wake of Reconstruction’s end.)

Such, essentially, were the legal issues argued by both sides. But there was another issue left untouched by both sides of this judicial debate. In the decades leading up to Roe v. Wade, there had been an expansive development of overlapping social movements: the mobilization of the black population for civil rights; the struggle against the Vietnam war and the draft; women’s fight to gain the rights men have, embodied in the ERA, as well as the demand for legalization of abortion and other aspects of reproductive justice; and finally the urban rebellions. The massiveness, determination and explosiveness of those movements dragged a recalcitrant government to recognize many popular demands, including the one for legalization of abortion.

The Court never acknowledged the existence of those movements in Roe v. Wade, and only indirectly in Dobbs, where the Court let it be known that it had not taken into account “public opinion.” But those movements played their role, massively present in the period leading up to Roe, increasingly absent leading up to Dobbs.

The Dobbs decision had an immediate concrete effect: facilities providing abortion were closed. Texas, Oklahoma, Arkansas, Missouri, Mississippi, Alabama, and South Dakota implemented the near-total bans on abortion they had passed in anticipation of Roe falling. Five other states in short order will implement such bans, awaiting only the completion of administrative measures. Five more states have old pre-1973 bans still on the books, most of which the courts are now expected to uphold. Beyond that are states whose laws are so restrictive as to make abortion impossible on the practical level. Taken altogether, 27 states, with over half the country’s population, already are or will shortly become what has been called “abortion deserts”, that is, states without any abortion facilities.

Today, only six states put no limit on when abortions can be performed: Oregon, Vermont, Colorado, New Mexico, New Jersey and Alaska. The remaining 19 have limits usually tied to “viability,” the point when a fetus should be able to survive, with medical help, outside a woman’s womb. But as this patchwork of state laws shows, such a phrasing opens the door to political evaluations, not medical ones. And, as the case of Indiana shows, legislatures in some states which had a “viability” limit were only awaiting the Dobbs decision to enact a total ban.

We may not yet be completely back in the situation that existed at the time of Roe v. Wade, when a woman’s possibility for obtaining an abortion rested on the financial means she had more than anything else, particularly if she lived in the states that completely banned the procedure. But we are not far away from the pre-Roe situation, either, with abortion illegal or unavailable in an immense swath of the country, and access to abortion determined by a woman’s place in the social structure of this class society. As Monica Simpson, the executive officer of SisterSong, a reproductive justice collective, put it, “To be pro-choice you must have the privilege of having choices.”

Religious “Conscience” and Bombs

The first attempt to undo Roe v. Wade came almost as soon as the ruling was issued in 1973. But in the face of the movement which had pushed for abortion rights, early restrictions came almost unannounced, in the form of a seemingly innocuous “rider” to the 1974 budget. Senator Frank Church, reputed to be one of the most liberal of Democratic senators, proposed the so-called “conscience amendments.” Private hospitals that assert that abortion or sterilization violates their religious and/or moral beliefs could be exempted from the requirement that they must provide all reproductive services, including abortion. Buried in all the minutiae of budgets, it drew little notice, and almost no opposition. The Senate, which was controlled by Democrats, passed the first “conscience” amendment by a vote of 92 to 1. The force pushing for this amendment was the Catholic church hierarchy, which in 1973 was still intimately tied to the Democratic party.

Senator Church said this would “defuse” opposition to the new Roe v. Wade ruling, thus, supposedly securing abortion access. Of course, it didn’t “defuse” opposition, it encouraged it. Hospitals run by the Catholic church began to “opt out,” slowly at first, but then in a rush as dioceses across the country signed on. The Catholic church hierarchy established and funded the Committee for the Right to Life.

The original “conscience amendment” was followed by more “amendments,” which expanded exemptions to other hospitals, their clinics, and to individuals working in clinics and hospitals, including public hospitals.

The “Right to Life,” going through the parishes, sought out Catholic individuals working in other hospitals, giving them legal support so they could claim the exemption for themselves. It didn’t take many individuals claiming the exemption to disorganize a hospital’s way of providing its medical services. Public hospitals were subjected to a growing rash of demonstrations, individual opt-outs, harassment of medical personnel, and civil law suits by families of women who had undergone an abortion in these facilities.

In order to avoid the chaos brought on by the tactics of the anti-abortion movement, many hospitals expelled the procedure to specialty clinics. Today, according to the Guttmacher Institute, roughly 95% of all abortions are carried out in specialty clinics, two-thirds of which are abortion-only clinics, funded by parts of the movement to defend women’s access to abortion. Abortion is the only medical procedure for which something like this exists.

As hospitals quit the scene, clinics specializing in reproductive services found themselves transformed into stationary targets for the “right-to-life” zealots.

Within a few years, a real wave of terror swept through some parts of the country, directed for the most part against medical providers. Harassment in front of facilities was widespread, as were death threats issued against people working at the facilities. From 1977 to 2020, there were 34 actual assassination attempts, 11 of which ended in the death of someone. One doctor was killed on a Sunday morning in his church, another at his home. Several dozen clinic personnel suffered serious injuries and disfigurement. Forty-two clinics were firebombed, with 194 clinics suffering other arson attacks; 667 were shut down by bomb threats, some on a repeated basis. (Figures in this section come from reports by the National Abortion Federation.)

A 2018 documentary, “Reversing Roe,” interviewed Troy Newman, an official of Operation Rescue, one of the organizations which openly claimed responsibility for the overt harassment of clinics. He explained Operation Rescue’s goal this way: “The weak link in the abortion chain is the person doing the actual abortions. We’ve been very effective in targeting particular abortionists. If they don’t have an abortionist, the place closes down.... We have probably closed down hundreds of abortion clinics, and it’s the one thing I’m most proud of.”

Patients were not exempt. They were harassed as they came to a clinic, intimidated by pickets from entering until the cops finally came to clear a way—if cops ever came. Some women were photographed, their photos circulated, a few even printed in local newspapers.

Although the violence has continued all the way up to the present, most of it was concentrated from the late 1970s all through the 1980s, trailing off somewhat after the mid-1990s. But the overall attack on abortion widened.

The Right to Decide on Abortion Does Not Equal the Right to Get an Abortion

Only three years after Roe v. Wade, Congress passed the Hyde Amendment, another “rider” to the federal government’s annual spending authorization. The first version of this amendment prohibited Medicaid, which was funded mostly by the federal government, from paying for abortion, except when a woman’s life is endangered. The governments of most states that had their own medical program for the poor soon cut off funding for abortion.

It was an enormous attack on the poorest women. In 1976, the last year before the Hyde Amendment took effect, 300,000 low income women had obtained abortions with the help of Medicaid. In 1977, with Hyde in place, only 3,000 women could do so. This “rider” didn’t prevent poor women from obtaining an abortion. They still could—if they could scrape together the money needed fast enough, foregoing rent payments or scrimping on food or school clothes for their kids. Hyde meant a further impoverishment of the poorest women—either because of what they had to do to pay for an abortion or because the inability to get one meant even greater difficulty to support all their children, including the new one.

By 1976, with the social movements appearing mostly in the rear-view mirror, the assault on abortion rights had become more overt, based on the most reactionary ideas. Women on welfare were depicted as sexually promiscuous, “sluts” with their hand out awaiting a government bonanza. The push for Hyde pervaded the nightly TV news. All those respectable networks spit out the racist and misogynist garbage rolled out by the anti-abortion forces about the supposed “kind” of woman who would stoop to seek an abortion.

The Hyde amendment may have been sponsored by a Republican. But it had to pass through a Congress completely under Democratic control: 60 to 37 in the Senate, and 291 to 144 in the House. Each succeeding budget year, the amendment was re-authorized—from 1977 right up to 2022—regardless of which party controlled Congress and the White House. Even after Democrats began to criticize Hyde, they produced enough votes every year to pass it. Finally, in 2022, Biden “confessed” that he had made a mistake voting for Hyde. It was not a one-time mistake, and not inconsequential. He supported Hyde during all his 32 years as a Senator, then shepherded it through for seven more years while vice-president.

Hyde was expanded under other names to become a much wider prohibition: no federal funds could be spent on the provision of abortion through any program. Government funding was cut off to any public health clinic that provided abortion, or even referred patients to a facility that provided abortion. Someone covered by Medicare disability insurance could not use it to pay for an abortion. Federal government employees were banned from using their government funded medical insurance to cover abortion. Still more people were cut out: people whose families got CHIP (Children’s Health Insurance Program), women incarcerated in federal prisons, Native Americans using clinics established on reservations, Peace Corps volunteers, active duty military personnel, veterans coming back from service, and people living in the District of Columbia, whose funding is provided by Congress.

In 2008, Obama promised repeatedly during his presidential campaign that abortion would be his number one priority, that he would immediately push for legislation enshrining women’s right to abortion, removing it from the whims of the judicial system. It never happened. The push wasn’t even started. Instead, in 2009, the Democrats, in solid control of Congress, agreed to let states ban funding for abortion in the plans offered in the Affordable Care Act’s marketplaces. It was supposed to be a trade-off, a sop thrown to those Democrats who otherwise would not have supported the ACA. As a token of his willingness to work with Republicans, Obama issued an executive order guaranteeing that under his administration no federal money would be used to pay for abortion.

It was the typical ploy of the Democratic Party. Give up something, pretending it would guarantee something else. Ceding “a pittance” to gain the “prize.”

For the working class women who lost the possibility to access abortion through all the variations of Hyde, it was not a “pittance.” It was an enormous assault.

The organized women’s movement in many cases was oblivious to Hyde when it first appeared. Was it because that movement, which was essentially concentrated in organizations filled with and especially led by white, middle-class women (or men) didn’t feel much solidarity with those under attack? Hyde at first seemed to be directed against only a small section of the population, unmarried women on welfare—women who were poor, many of them black. Maybe the middle-class women’s movement didn’t want to get its hands dirty in such a fight. In any case, Hyde elicited little response at first from the wider women’s movement.

That reaction to Hyde once again made clear that when a movement doesn’t seek to protect the first small part of the population to come under attack, it opens the door for the attack to broaden and reach many more. And this is what happened.

Hyde made explicitly clear that even if abortion is a right, access to it isn’t guaranteed. The Supreme Court said so in so many words in a 1980 ruling (Harris v. Hyde): “A woman’s freedom of choice does not carry with it a constitutional entitlement to the financial resources to avail herself of the full range of protected choices.” In this class society, the rights one can enjoy are the rights one can afford.

Searching for a Base, Republicans Discover They Are “Pro-Life”

In 1967, Ronald Reagan, then California governor, signed one of the most liberal abortion laws in the country. In 1970, New York State, led by Republican Governor Nelson Rockefeller, eliminated all restrictions on women seeking to terminate a pregnancy in the first 24 weeks. Men who would be the party’s presidential candidates in the future—Richard Nixon, Gerald Ford and George H.W. Bush—had each declared themselves pro-choice. Even Barry Goldwater was pro-choice. Peggy Goldwater, his wife, was one of the founders of Planned Parenthood in Arizona. Some people might be surprised to hear all that today, but in the 1960s, even early 1970s, Republicans were more openly supportive of women’s right to abortion than were Democrats. In 1972, 68% of registered Republicans, when polled by Gallup, said they believed abortion was a matter best left up to a woman and her doctor, more than the number of Democrats.

Only four years later, the Republican 1976 platform included the call for a constitutional amendment to protect the “right to life of the unborn.”

The Republican Party went from being the strongest supporter of women’s right to decide for themselves, to being the political instrument which fastened on women a range of laws restricting abortion, eventually in almost half the states in the country. It was a sharp U-turn, and it was based on a cynical political calculation.

The Republican Party made an open pitch to the hierarchy of the Catholic church, which before then had been in the camp of the Democratic Party, and to the big “mega churches” that pervaded TV. It sought out all those religions which could be persuaded to have “moral issues” with abortion. And it enlisted the white Southern Baptists, by promising to oppose school integration, and other measures related to that. The Baptists, along with the Evangelicals, shifted grounds on the question of abortion. By linking those religious hierarchies to itself, the Republican party had gained a base of many millions. Where it could, it pushed through funding measures that transferred public money, directly and indirectly, to various religious bodies.

To mark its shift to the anti-abortion camp, the Republican party adopted the rhetoric of the so-called “pro-life” movement, calling for the “right to life” of the “unborn.”

“Right to Life”—what a cynical term coming from such life-despising people! The very states that most restricted abortion coincided almost absolutely with the states that offered the least support to children and women in need. The greater the restriction on abortion in a state, the greater the rate of poverty for the state’s children—that is, the already-born children—as well as the worst levels of infant mortality, the worst levels of maternal mortality, the highest levels of uninsured women, and the highest levels of births to teenage mothers, a guarantee of future poverty. (Documented by the New York Times, drawing from the American Community Survey and the CDC.)

The Republican Party parlayed promises to restrict abortion and to block integration of schools into votes, and thus gained control over a certain number of state legislatures. Control of legislatures in turn allowed Republicans to fulfill promises, passing laws to restrict abortion.

Certainly, ever since 1973, laws had been passed seeking to limit or ban abortion. By the beginning of this year, the Guttmacher Institute had recorded 1369 laws, which either limited or outright banned abortion, going back to 1973. The first laws, in fact, were sponsored as often by Democrats as by Republicans. But the largest number of those laws coincided with the gradual Republican takeover of state legislatures beginning in the 1990s.

The push to limit abortion legally expanded greatly after a 1992 Supreme Court decision, Casey v. Planned Parenthood of Pennsylvania. Casey declared that the State has a “compelling” interest in protecting the unborn from the very beginning of pregnancy. That ruling upheld four of five restrictions passed by the Pennsylvania legislature. (Its Senate was controlled by Republicans, its House by Democrats, and the bill was pushed through and signed by the Democratic governor.) The bill had been written by the law firm that represented the Catholic Conference of Pennsylvania, working with a handful of legislators. (The same law firm advised the oh-so-moral Catholic church during all the years it worked to hide sexual abuse of young children by some of its priests.) Many of the most significant laws against abortion were written in this way for the Catholic bishops, and funneled through Pennsylvania and Missouri, two states that originally led the way with limitations on abortion—and where the Catholic church played an outsized role.

The Casey decision held that states may restrict abortion at any time in a pregnancy, not just in the third trimester, as Roe had held, and that it can do so as long as the restriction does not establish an “undue burden” on a woman seeking abortion. Obviously one well-off judge’s idea that a restriction is not an “undue burden” can be a poor woman’s unscalable barrier.

The accumulation of such restrictions over time turned Roe v. Wade into a dead letter in many parts of the country. And it made the practice of reproductive medicine fraught with legal complications. A doctor working at a woman’s clinic was required to have admitting privileges at a nearby hospital, even while other state regulations denied such privileges to a doctor not regularly practicing in the hospital. A doctor’s license could be suspended in some states if he or she did not provide information to all their patients that they knew to be medically false, for example, the claim that abortion causes breast cancer. Abortion clinics were required to meet the same requirements as complete hospitals, while other outpatient clinics were not. Some states required two doctors in attendance on any procedure, including those that simply involved dispensing of medicine for a pharmaceutical abortion. Waiting periods, combined with the requirement for multiple visits not based on medical necessity, tied up clinic personnel, making appointments less available. There were all sorts of nitpicking, inane regulations—such as the requirement that hallways in clinics be eight feet wide—wider in fact than hallways in many hospital emergency facilities. There were hundreds and hundreds of such restrictions—many of which were tossed out on review by the courts, but that required the clinic to expend time and money to get a court ruling. The cumulative effect was to tie up women’s clinics in bureaucratic legalisms that occupied more time and resources than the actual provision of abortion.

There were also laws directed specifically at someone who sought an abortion, making her life more onerous: waiting periods, sometimes as long as 72 hours; ultrasounds that were not medically necessary; the requirement to look at a sonogram picture of the patient’s own fetus, while a doctor explained its various parts.

Carol Tobias, the president of “National Right to Life”—which originally had been created by the National Conference of Catholic Bishops shortly after Roe v. Wade—was interviewed in the same 2018 documentary. She explained what they intended: “We’ve had a game plan for many years ... to make the barriers to abortion so high that Roe will be nullified by default.”

And that’s exactly what happened.

Hospitals had been closed because of “conscience” clauses. Clinics had been targeted for violence. Restrictive laws closed down more facilities.

By 2000, 87% of all the counties in the country had no provider—no hospital, no clinic, not even one physician able to perform an abortion. The problem was worse in rural areas of the country, where counties often cover a wider space. More than 97% of those counties had no provider.

From 1982 to 2017, the number of facilities was cut almost in half, going from 2908 facilities down to 1587 in the whole country. Many of the facilities that remained had only one doctor, in some cases a doctor from out of state who traveled there and worked only one or two days a week, sometimes sleeping in the clinic because no one could risk to offer him a room.

By 2020, two years before Dobbs was issued, there was only one facility providing abortion care in the whole state of Missouri; only one in North Dakota; only one in South Dakota, and only one in Mississippi. The whole Upper Peninsula of Michigan, which is bigger than nine states in the country, had only one facility. The city of Cincinnati, Ohio, with more than 300,000 people, had none. Ten cities in Texas with more than 50,000 inhabitants each had none. Despite the claim of California’s Democratic governor that the state will be a “sanctuary” for women from other states, more than half the counties in his state have no facility providing abortions to the women who already inhabit California.

Of course, the lack of facilities afflicts all types of medical care in this country, whose medical system rests squarely on the profit motive. But with abortion, there is an additional factor unknown to other medical procedures. The freedom to have the procedure is constrained by State action, responding to the influence of organized religion.

The Consequence of Dobbs for Women

It seems likely that Dobbs will close the clinics still remaining in more than half the states in the country. And that can only add to the distance required to get an abortion. When a previous law in Texas passed, with severe restrictions on clinics that forced many to close, the average distance traveled by someone seeking an abortion increased from 17 miles to 70 miles. One-fourth of all women lived at least 139 miles from the nearest clinic.

Distance means time and money, both in short supply for many women, who must take time off work—for most women, unpaid time—the problem magnified by waiting periods, and requirements for multiple appointments in the states where they travel to, which translates into the need for lodging, that is, more money. And they must find the money to pay for the abortion. Almost certainly the number of legal abortions will go down again.

Consider what happened in the reverse direction when Roe overturned all these kinds of laws. It did not lead to an explosion of abortions. It essentially only changed their legal status. As legal abortions became much more common, the number of illegal abortions fell proportionately. The number of deaths fell precipitously. According to the CDC, the number of reported deaths tied to abortion in 1980 was barely over one percent of what it had been in 1965.

The rate of legal abortions reached its highpoint in 1981, when it was 29.3 per every 100,000 women of childbearing age. By 2020, the legal rate had plummeted to 14.4 per 100,000 women, not much more than just before Roe, when it was 13 per 100,000 in 1972. Of course, the number of abortions can be influenced by factors other than political ones: the availability of and improvement in birth control, for example, as well as demographic considerations, like the proportion of women who are of childbearing age.

Nonetheless, the severe decrease in the rate of abortion raises the question of how many illegal abortions, under unsafe and unsanitary conditions, have already been resorted to by women today, women unable to obtain a legal one. How many more will there be now with Dobbs in place? The easier availability of antibiotics today hides this reality to some extent—since one way of estimating the total number of illegal abortions in the past was to start with the number of women who died from septic reactions.

Estimates of illegal abortions can only be educated guesses, given the tendency of many medical personnel to hide such things. But we do know something about the number of women who arrived each year before Roe in some hospital emergency rooms after botched abortion attempts. Harlem hospital admitted 1600 women in 1962 for such attempts. UCLA Medical Center in Los Angeles admitted 701 women in 1968 for septic abortions. Cook County hospital in Chicago recorded 4000 over three years.

Beyond what can only be an increase in abortions carried out under septic conditions, there will be untold other consequences. Dobbs validates the criminalization of doctors and other medical personnel involved in providing abortion, or even information about it. It validates the possibility that a pregnant woman who does not deliver a live baby may be held criminally responsible. Any loss during a pregnancy can potentially be investigated as a crime. And although all of the bans at least allow the procedure to be used when the life of the mother is at risk, that judgment opens up for prosecution the medical personnel making it. And because the medical procedure for dealing with the aftereffects of a stillbirth is almost always the same as the one used in an abortion, whether surgical or pharmaceutical, doctors in one of the states that ban all abortions will be confronted with the possibility of prosecution for treating women with a stillbirth. Will this mean that doctors wait longer, hoping that the existence of the stillborn fetus or an ectopic pregnancy will not kill the patient—at what greater risk?

The possibility of prosecution is not just some idle speculation about what might happen. From 1973 to 2020—that is, before Dobbs—close to 1800 people were prosecuted for intervening in a pregnancy, in many cases charged with murder—this according to National Advocates for Pregnant Women. In some cases, those charged were women. Even in California, whose state law prohibits charging women who lose a pregnancy with murder, two women who were suspected of self-aborting were charged with homicide.

Who Stands for Life?

The religious and political forces that have contrived to create this situation pretend to act in defense of the sanctity of life.

It’s true that a fetus is endowed with life. The fetus develops following a sequence of events that ultimately can produce a human being able to exist in the world on its own. That development occurs both inside the womb and after delivery into human society. Human nurturing is then necessary over a number of years before the new life is independent. New life is certainly involved, and even from the moment of conception. But the fetus and the woman bearing it are profoundly interconnected.

It’s also true that the woman who carries the fetus is herself endowed with life—current, actual, right-now, adult human life. The pro-life forces act as though this fact can be obliterated. They ignore the fact that all the steps in this human process are endowed with life.

The pro-life forces assume for themselves the right to decide which life is more important. And because they inhabit a world and defend this class society which long ago relegated women essentially to the role of child-bearer, they find it easy to make that choice: in their world, life should belong to the fetus.

Capitalist society does not offer the means for most children’s essential needs to be met, nor does it offer the possibility for most of the adults who live in it to have their daily needs fully met, much less their potential fulfilled. It does not offer many women the possibility to raise the new child without sacrificing the future of their existing children, or of themselves. In such a society, the right to choose abortion is a necessity. And yet it is a barbaric choice. The need to make such a choice, to decide between the competing claims on life exists because the society we live in is barbaric.

In the midst of a society which allows no decent choice, the choice can only belong to the woman, who is the most intimately engaged with the life involved: her own and that of the fetus. She is the only one who fully knows the pain that such a decision costs, no matter what the decision may be. The choice must be hers. Communist revolutionaries, even while recognizing the awfulness of abortion, have always fought so that women could be able to make that choice, no matter what the legal situation is.

It’s important that those who would defend women’s right to choose abortion recognize this reality, that abortion is a terrible choice. To pretend, as some in the pro-choice movement have done, that abortion is merely a minor procedure avoids the basic issue—that is, that life is inextricably involved with the choice. To refer to the fetus as merely a “clump of cells” denies that reality and reinforces all those who oppose abortion.

We should not deny basic material reality, tricking ourselves or other people into believing it is easy to make the choice for abortion. It is not.

To pretend that it will be easy, without any medical help, to self-abort, using the relatively new drugs, the internet, and a semi-clandestine international delivery network, misses an important fact of life: this society criminalizes women who self-abort. In such a society, a woman who self-aborts without medical help invites serious consequences, both legal and to her own health, if something goes wrong. And something does go wrong a certain number of times.

To pretend, as the makers of the documentary, “The Janes,” do, that people, without medical training, without medical support, can organize to train themselves, then carry out abortions themselves, is to make a mockery of medical science. Even apart from all the legal limitations on abortion, medical science today does not serve working people in the same way it serves more privileged people. What has to change is not to convince ourselves that we can do without the most advanced level of medical science, but to organize a fight so that the best of medical science can be available to everyone. That means to fight to change the society in which medical science is carried out today. The women who lived an underground existence in Chicago before Roe in order to help other women abort may have been heroic. But such collectives do not provide an example of what the fight needs to be. And the film, finally, offers only a reactionary perspective.

The goal needs to be, in the first instance, to force this society to recognize women’s possibility to choose—the very thing that was recognized in 1973. That possibility was won by struggle, even if Roe v. Wade never acknowledged it. The problem in 1973 was that too many people believed that the fight had accomplished the goal, that Roe v. Wade had turned a possibility into a right.

The problem today comes from people hoping the Democrats will defend women’s rights because, in the midst of an election campaign, they make abortion an issue. This is the same party that, from 1976 right up to 2022, eliminated the possibility that poor women could easily access abortion. It is the same party, starting in 1973, that closed down hospitals, opening the door for the terrorism that then closed clinics. It is the same party that engineered a deal in 2003, suspending the rules so Republicans could pass a law severely restricting late-term abortions. Explaining the deal, Hillary Clinton said that few abortions happened in that time, and that the deal would protect the big majority of women whose abortions come early in pregnancy.

Another chipping away at the tree of access to abortion that finally brought it down.

To believe, as some people do, that the issue will be solved again by the Supreme Court, and to that end that it is necessary to vote for the party that promises to change the composition of the Supreme Court into a pro-choice court, is to not only play the ostrich, but to bury oneself right up to one’s butt. The issue was never solved by the Supreme Court. These two courts, one in 1973, one in 2022, merely reflect the existence of or the absence of a powerful and living mobilization by the population.

The first country to make abortion a simple legal right, with easy access, was Russia in 1920, the first country in which the working class started down the road to throw out capitalism and build socialism. That was not an accident of history. The fight for socialism is intimately tied to the fight of women to live with full rights as human beings. The Bolsheviks who led the working class to power called abortion a “sad right,” but an essential right for women so long as the conditions of life created by capitalism continued to exist, and so long as women continued to be relegated to domestic slavery.

Ultimately, the issues that revolve around the question of abortion will be overcome by fighting to get rid of a society that makes the choice of abortion necessary, a society that creates poverty alongside, and as a consequence of, the growing accumulation of wealth in the hands of a tiny minority that live off the exploitation of labor, capitalist society. But that fight can be begun in a multitude of ways—including when working people, or part of the working people, working women, for example, begin a struggle to impose what they want right now. That’s how the Russian Revolution began, with the demonstrations by women workers on International Women’s Day, insisting their voices would be heard. They pulled along the rest of the working class after them.