The Historical Influence of Politics and Society on Women's Experiences of Abortion

447 Pages·2016·1.96 MB·English

University of Wisconsin Milwaukee
UWM Digital Commons
Theses and Dissertations
May 2013
The Historical Influence of Politics and Society on
Women's Experiences of Abortion
Sandra Ruth Schumacher
University of Wisconsin-Milwaukee
Follow this and additional works at:https://dc.uwm.edu/etd
Part of theNursing Commons,United States History Commons, and theWomen's Studies
Commons
Recommended Citation
Schumacher, Sandra Ruth, "The Historical Influence of Politics and Society on Women's Experiences of Abortion" (2013).Theses and
Dissertations. 158.
https://dc.uwm.edu/etd/158
This Dissertation is brought to you for free and open access by UWM Digital Commons. It has been accepted for inclusion in Theses and Dissertations
by an authorized administrator of UWM Digital Commons. For more information, please [email protected].
THE HISTORICAL INFLUENCE OF POLITICS AND SOCIETY ON WOMEN’S
EXPERIENCES OF ABORTION

by

Sandra R. Schumacher

A Dissertation Submitted in
Partial Fulfillment of the
Requirements for the Degree of

Doctor of Philosophy
In Nursing

at
The University of Wisconsin-Milwaukee
May 2013
ABSTRACT
THE HISTORICAL INFLUENCE OF POLITICS AND SOCIETY ON WOMEN’S
EXPERIENCES OF ABORTION

by

Sandra R. Schumacher

The University of Wisconsin-Milwaukee, 2013
Under the Supervision of Professor Patricia E. Stevens

One out of every three women in the United States will experience abortion (Guttmacher
Institute, 2008). The purposes of this feminist qualitative research were to: 1) examine
historically the context of legal abortion in the United States, 2) describe and explore
women’s experiences of abortion and 3) better understand the historical impact of the
sociopolitical climate on women’s perceptions of their abortion experiences. An historical
review of political, legislative, and social contexts surrounding legal abortion revealed an
increasingly hostile environment toward women seeking abortion since 1973. By
challenging existing abortion laws in state and federal courts, anti-abortion legislators have
removed federal and state funding for abortions, including insurance coverage. States have
imposed mandatory waiting periods, biased counseling and consent procedures, parental
involvement and/or notification for minors, and bans on funding and insurance coverage.
All of these intrusions on women’s right to choose abortion have resulted in the need for
more than one clinic visit and delays in obtaining abortion services. Through violence,
intimidation, and harassment, pro-life activists and extremists have successfully driven
medical personnel out of the practice of abortion and intimidated women seeking abortion by
exposing them to fetal images, calling them “baby killers”, and forcing them to believe that
life begins at conception. Within this historical context, a purposive sampling of ten women,
ii
recruited via snowballing techniques, participated in repeated in-depth interviews. A multi-
stage narrative strategy was used to analyze textual data. Participants’ narrative summaries
emphasized dismay at being pregnant, telling others, and making the decision for abortion.
Women thoughtfully made the decision for abortion based on the circumstances of their lives
at the time of the unintended pregnancy. Seventy percent of participants experienced
abortion in the 1980s and recalled the ways in which religion, politics, and society have
imposed shame, guilt, and judgement on them, constraining them from talking about their
abortion experiences. Silenced, women only revealed their abortion when forced to do so by
circumstances or to gain acceptance and understanding from others. Participation in the
study allowed women an opportunity to talk about their abortion experiences, initiating
conversations with friends, and raising consciousness.

__________________________________________________________________________

iii
© Copyright by Sandra R. Schumacher, 2013
All Rights Reserved
iv
DEDICATION
My deepest appreciation goes to the women who participated in this study. With
slight trepidation and some hesitancy, they eloquently voiced their abortion experiences,
allowing me, others, and themselves to gain insight and understanding. Women voiced a
desire to tell their stories, for others to hear and listen, and to be understood and accepted.
Their willingness to assist me demonstrated their generosity of spirit and their longing to
connect with other women who have experienced abortion. I hope I have faithfully and
respectfully presented the stories they shared with me.
I am eternally grateful to my family for their unwavering love, their faith in me, and
their financial, physical, and emotional support: Fern Rueppel, Orville and Darlene
Vitzthum, Sharon and Todd Marks, Jay and Joann Arthur, Christine Phillips, Fran Weisensel,
and Bob Marks. Your kindness, caring, and generosity helped me to complete this journey.
Additionally I am thankful for Rose Marks and Beverly Weisensel who taught me about
compassion and resilience in facing untimely death; they are with me in thought and spirit.
I am grateful to Pat Stevens, my major professor and committee chair, for mentoring
me through the dissertation research, and especially for her knowledge and leadership in
multi-staged narrative analysis strategies. I am thankful to Merry Wiesner-Hanks and Teresa
Johnson, my committee members, for reading, reviewing, and providing me with feedback
and support. I am also thankful to Barbara Daley and Heather Royer for reading my final
dissertation and providing me with insight, support, and accolades.
A huge thank you to my dear friends who supported me along this journey, listening
and encouraging me when I doubted my own abilities: Amy Morton-Miller, Leanne Carson-
Stoker, Susan Schumacher, Judy Dallman, Bonnie Anderson, Bonnie Connolly, and Joan
v
Burr. I cannot imagine the completion of this project without your love and assistance; you
made me laugh, gave me reality checks, listened when I needed to talk, helped me find
balance in the chaos, and preserved my sanity. Thank you. A special thank you to Carol
Wrabl, Chief Nursing Officer (retired), who encouraged me to begin this educational
endeavor and mentored me as a nursing leader.
And last, but not least, a heartfelt thanks to my four-legged companions, Remington,
Tag, Jake, and Duke, who so graciously stayed by my side, took me on walks, hogged the
bed, helped reduce my stress, gave me peace, forgave my inattentiveness, and reminded me
to take time to play and be joyful.

vi
TABLE OF CONTENTS
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii
Copyright . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii
List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Chapter 1: Introduction
Statement of the Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Significance of the Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Purpose of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Research Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Theoretical Framework. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Feminist perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Feminist standpoint theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Theoretical assumptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Feminist standpoint theory summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Operational Assumptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Definition of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Overview of Subsequent Chapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Chapter 2: Background
Legalization of Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Recriminalization of Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Human life amendment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Informed consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Restrictions on funding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Political party interests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
More challenges to Roe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Continued restrictions on funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Restrictions on the practice of abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Anti-abortion movement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Anti-abortion violence and politics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Anti-abortion violence, denunciation, and pro-abortion responses . . . . . . . .34
Judicial, legislative and political responses to anti-abortion violence . . . . . 36
Change in Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
Availability of Abortion in the United States in 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Abortion providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Provider training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
vii
Limitations on who can perform abortions. . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Advanced practice clinicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
State mandated counseling and waiting periods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Bans on abortion funding and insurance coverage . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Parental involvement and consent for minors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
The results of legislative, judicial, and political anti-abortion strategies. . . . . . . . . . 56
Medical abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Chapter 3: Review of Literature
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66
Overview of identified sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Organization of this chapter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Studies about Women’s Experiences of Surgical Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Summary critique of studies about women’s experiences of surgical
abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Implications for my study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85
Studies about Women’s Experiences of Medical Abortion. . . . . . . . . . . . . . . . . . . . . . . . . . .87
Summary critique of studies about women’s experiences of medical
abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Implications for my study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
Studies about Women’s Perceptions of the Long-term Significance of Abortion. . . . . . . . .103
Summary critique of studies about women’s perceptions of the long-term significance
of abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Implications for my study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Paucity of Studies about Under-Represented Women’s Experiences of Abortion. . . . . . . . 120
Summary critique of the paucity of studies about under-represented women’s
experiences of abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
Implications for my study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
Mental Health and Women’s Experiences of Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Philosophical perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Examination of reviews of empiric literature about abortion and women’s mental
health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129
Summary critique of reviews of empiric literature about abortion and women’s
mental health and abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139
Final Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140
Need for the Current Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142

Chapter 4: Methodology
Study Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144
Sampling Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Planned Parenthood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
viii
Free and low-fee clinics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Public Health Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Change in recruitment goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Word of mouth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Participant referrals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Stage one . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Stage two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Stage three . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162
Stage four . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Protection of Human Subjects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Rigor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Organization of Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Chapter 5: Findings and Interpretations, Within Case Analysis
Donna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Elizabeth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Kathleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200
Rebecca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .217
Barbara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Shirley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .243
Carolyn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Maria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
Lindsey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Amanda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .286

Chapter 6: Findings and Interpretations, Across Case Analysis
What are Women’s Experiences of Abortion? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294
“This (pregnancy) wasn’t supposed to happen.” . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
“I had no support (to continue the unintended pregnancy).” . . . . . . . . . . . . . . . . . . 296
“I did what I had to do.” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
What women’s narrative didn’t say . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
What Historical Influence has Political and Social Events had on Women’s Experiences of
Abortion?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .305
Religion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
“I understood that my parents thought abortion was wrong.” . . . . . . . . . . . . . . . . 306
“Getting an abortion is about the last thing that a good little Catholic girl would do.”
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
“You don’t grow up steeped in Catholicism for 18 years and be able to just throw that
off.” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .308
“You can’t belong because of their beliefs.” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309
“I don’t really understand that abortion was a horrible thing.” . . . . . . . . . . . . . . .310
ix