San Francisco’s Women’s Leadership Alliance
Position Paper on Choice


On January 22, 1973, the United States Supreme Court established the fundamental right of a woman to decide whether or not to terminate her pregnancy in its landmark Roe v. Wade decision. In the majority opinion, Justice Blackmun wrote that the constitutional right of privacy includes a woman¹s right to choose an abortion. In Roe, the Supreme Court struck a careful balance between a woman¹s right to choose before fetal viability and the state¹s interest in protecting potential life after viability. That landmark decision ended decades of unsafe, illegal abortions that maimed some women and took the lives of countless others.


In the 27 years since Roe, the right to choose has been eroded so that some women seeking an abortion in 2000 have fewer rights than their mothers held in 1973. This erosion has occurred on several fronts: assaults on access; clinic violence; anti-choice state and federal legislation; and a burgeoning fetal rights movement. In addition, the next President may have the opportunity to appoint enough Supreme Court Justices to decide the fate of Roe v. Wade. If an anti-choice President is elected and the current anti-choice majority is maintained in the Senate, the overturn of Roe will be possible and even likely.

ACCESS ­ Many safe, legal and effective reproductive health services remain inaccessible to many women in the U.S. For example:

  • Nationwide, 86% of all counties have no identifiable abortion provider. In California, 36% of counties have no abortion provider. In fact, California lost 62 abortion providers between 1992 and 1996 – an 11% loss and the most dramatic drop in the country.
  • 64% of states prohibit most government funding for abortion, putting it out of reach for many low-income women and Medi-Cal patients.
  • Only 5% of California¹s hospitals are abortion accessible, making access very difficult for women in rural areas, women with medical complications and women with special translation needs.
  • Catholic hospitals are taking over non-religious hospitals at a record rate, eliminating abortions, tubal ligations, birth control and emergency contraception. By the end of 1999, Catholic Healthcare West was the largest hospital group in California.
  • Only 12% of ob-gyn residency programs in the United States offer routine training in abortion.
  • Wal-Mart, the nation¹s fifth largest prescription provider, still refuses to carry emergency contraception and adequate information about emergency contraception remains elusive. Wal-Mart currently owns 25 stores in California.
  • Mifepristone (RU486) has been accessible to women in Sweden, France and Great Britain for years but still awaits final Food and Drug Administration approval and strong anti-choice opposition.

CLINIC VIOLENCE ­ Anti-choice extremists opposed to Roe v. Wade have carried out a campaign of harassment, intimidation, bombing, arson, anthrax threats, and even murder — and they show no signs of ending their assault on a woman’s right to choose. In late 1998, Dr. Barnett Slepian, an ob-gyn, was shot and murdered in his own home. Within days, his name was crossed off an internet hit-list that targets providers and supporters of choice. In order to counter these assaults, fourteen states, including California, and the District of Columbia have enacted laws designed to protect medical personnel and women seeking reproductive health care from blockades and violence. The U.S. Supreme Court will weigh the issue of sidewalk anti-abortion protests during its 2000 session.

LEGISLATION ­ Restrictions are being enacted at both state and federal levels. In 1999, more anti-choice legislation was introduced and enacted than in any previous year, with 439 measures introduced and 70 enacted. To date, both houses of Congress are solidly anti-choice. Consider the following:

  • 42 states have enacted laws that require a minor to obtain the consent of one or both parents before having an abortion and the law is enforceable in 32 of these states.
  • 30 states have enacted legislation banning so-called “partial-birth” abortion and in 9 states the laws remain unchallenged and in effect.

FETAL RIGHTS MOVEMENT ­ Attempts by anti-choice groups to restrict abortion have increasingly focused on fetal rights. These attempts are designed to criminalize abortion procedures and to elevate the fetus to the status of a person. It is the new “partial-birth” abortion of the anti-abortion movement. A recent example is the Unborn Victims of Violence Act passed by the U.S. House of Representatives last September 1999 by a vote of 254 to 172. The Senate will take up the legislation in the upcoming session of Congress. If enacted, it would be the first federal law to recognize a fetus as an independent victim of crime.


The California Constitution protects the right to reproductive choice to a greater extent than the federal Constitution. However, anti-abortion groups in California are currently advancing measures to amend the California Constitution to restrict reproductive choice. These groups are gathering signatures to place an initiative on the November ballot that would amend the state Constitution by expanding the definition of person to include a fetus. Anti-abortion groups are also seeking approval to gather signatures for a parental notification initiative. Despite these developments, California residents currently enjoy a majority pro-choice Assembly and Senate, as well as a pro-choice Governor. As a result, insurance providers who cover prescription drugs are now required to cover contraceptive drugs and supplies. However, the 2000 elections may yield different results if choice is not a driving concern.


The Women¹s Leadership Alliance (WLA) recommends that the following elements be incorporated into public policy, state and federal legislation, and public education efforts.

1) Support and preserve Roe v. Wade at the federal level and the right to choose within the California State Constitution.
2) Maintain California¹s pro-choice Governor and majority pro-choice Senate and Assembly.
3) Maintain minors¹ access to the full range of reproductive health care services.
4) Ensure the safety and protection of clinics and health care providers against anti-choice violence. Strengthen current clinic protection laws.
5) Increase and expand women¹s reproductive health options, including access to and awareness of emergency contraception and mifepristone (RU486).
6) Maintain and increase the level of funding for reproductive health care and family planning services.
7) Increase and promote public education about access to reproductive health care.
8) Encourage public activism around the choice issue.
9) Oppose any threat to international family planning and increase U.S. assistance to overseas family planning organizations.


Why is reproductive choice critical to women¹s economic security?
One of the most important decisions a woman will face in her life is whether and when to have children. If a woman is denied the power to decide when the time is right and when it is not to become a parent, she really can¹t decide anything else. An unplanned pregnancy will impact all areas of a woman¹s life, including her economic security ­ whether she can earn a living wage, whether she can educate her children and herself, and whether she can afford health care. In other words, women will not be economically empowered unless they can fully control their reproductive lives.

Parental consent is always required for minor¹s medical care, isn¹t it? Why should abortion be treated differently from comparable medical care?
Parental consent is not required for all medical procedures and laws that mandate parental involvement for abortion actually treat abortion differently from comparable services. All states have “medical emancipation” laws that guarantee teenagers confidential access to health care related to intimate behavior, such as sex and drugs. For example, teenagers may obtain treatment for sexually transmitted diseases, birth control, pregnancy, drug or alcohol abuse, AIDS, sexual assault and mental illness without parental notification or consent in California. These laws exist because teenagers simply won¹t obtain vitally needed care if they need to reveal their experience with sex, drugs or alcohol to their parents.

Why have so many so-called partial-birth abortion laws been repeatedly struck down by state and federal courts?
State and federal courts have repeatedly struck down so-called partial-birth abortion laws as unconstitutional because the bans are so vaguely worded that they could apply to many abortion procedures, even in the earliest stages of pregnancy. These laws have also failed to make an exception to protect the life and health of the woman, a direct contradiction to the principles set forth in Roe v. Wade. Voters in Colorado, Washington State and Maine have also rejected these anti-choice measures for similar reasons.

What is emergency contraception (ECP¹s) and why is it important that women have access to it?
Emergency contraception is a highly effective method of preventing unintended pregnancies after sexual intercourse. It is very important that women have access to emergency contraception because it can reduce the number of unintended pregnancies by an estimated 1.7 million and the number of abortions by 800,000 every year. Commonly known as “the morning after pill,” emergency contraception can be used up to 72 hours after unprotected sex. Despite its efficacy, awareness of emergency contraception is limited. Anti-choice groups and anti-choice pharmacists have waged a misinformation campaign falsely claiming that ECP¹s induce abortion. (ECP¹s are not the same as mifepristone or RU486, “the abortion pill” that is scheduled for FDA approval by March 2000).

Why are hospitals important for ensuring abortion access?
For many women, hospitals provide the safety net for abortion care when clinics or private physicians cannot help. Hospitals can accommodate women whose medical conditions prevent clinics from treating them ­ women with asthma, previous cesarean sections, diabetes, severe anemia, heart disease, obesity, and seizure disorders. Hospitals often represent the only viable abortion option for women in rural areas where the nearest clinic may be several hours away. Many hospitals offer translation services, providing a critical resource to California¹s vast immigrant population. Hospitals are also more likely than private doctors and clinics to treat Medi-Cal patients. Finally, hospitals provide the training ground for the next generation of abortion providers. Despite this critical need for hospital based abortion services, 72% of hospitals in California tell women that they do not provide abortions.

What will happen if Roe v. Wade is reversed?
Women and girls will once again be forced into the nations back alleys to seek unsafe abortions that threaten their lives. In addition, abortion rights will be left to individual states to enforce. This will result in a patchwork of laws around the country that protect some women and discriminate against others.

Please refer to the following websites for additional information:

ACLU Reproductive Rights Project:
Alan Guttmacher Institute:
CARAL: and
Catholics For Free Choice: California:
Catholics For Free Choice: National:
Center for Reproductive Law and Policy:
Feminist Majority Foundation:
International Planned Parenthood Federation:
Medical Students for Choice:
National Abortion Federation:
National Asian Women¹s Health Organization:
National Black Women¹s Health Project:
National Latina Institute for Reproductive Health:
Planned Parenthood: