The Volokh Conspiracy

The latest installment of the Washington Post‘s “Five Myths” series takes on abortion. Number three among the “Five Myths about Abortion” identified by author Rickie Solinger is “Roe led to a huge increase in the number of abortions.” Here is Solinger’s explanation for why this is a “myth”:

According to the Guttmacher Institute, at least 1 million illegal abortions were performed in the United States each year before Roe. Today, the number of abortions performed annually is still about 1 million. The Centers for Disease Control and Prevention reports that almost half of U.S. pregnancies are unintended. About four in 10 of these are ended by abortions, according to the Guttmacher Institute, and these are performed in clean, safe, medically appropriate settings.

Roe didn’t mark the beginning of an abortion era — it legalized an already widespread practice.

Solinger purports to be correcting a “myth.” Yet nothing in Solinger’s account is directly responsive to the claim she purports to correct. The number of abortions in 2013 tells us very little about whether Roe v. Wade “led to a huge increase in the number of abortions.” What matters is what happened in the years following the Supreme Court’s decision and whether post-decision trends can be attributable to the Court’s decision, or are better understood as a result of something else.

According to Solinger’s own source, the Guttmacher Institute, the number of abortions performed in the United States did increase dramatically in the years after Roe. As detailed in the Institute’s most recent abortion fact sheet, the abortion rate climbed dramatically from 1973 to 1981. The number of abortions per 1,000 women aged 15-44 rose from 16.3 in 1973 to 26.4. in 1977 to 29.3 in 1981. The Institute also notes that the number of legal abortions increased throughout the 1970s. (See, e.g., here.) This is due, in large part, to the fact that jurisdictions began liberalizing their abortion laws prior to Roe.

Solinger is also a bit fast and loose with the numbers she does present, in that the total number of abortions increased from approximately one million at the time of Roe to over 1.5 million in 1981. The abortion rate, and total number of abortions, have declined since the 1980s, but Guttmacher Institute’s latest fact sheet still cites an estimate of 1.2 million — significantly more than the number performed in 1973.

In response to these objections, Solinger might respond that a fifty percent increase in less than a decade is not a “huge” increase. Fine. Reasonable people may disagree about constitutes a “huge” increase, but that’s hardly the argument made in the piece. A second potential counter-argument is that the trend toward more widespread abortion was well underway before Roe and would have continued. This is plausible, but insofar as any pre-Roe upward trend was due to the liberalization of state abortion laws, it’s hard to argue that a sudden, nationwide liberalization is not at least partly responsible for the continued upward trend. A third potential counter-argument is that pre-Roe data on abortion is incomplete and fails to account for the prevalence of illegal abortions prior to 1973. This is a fair point, but it hardly discredits the documented increase in legal abortions in the years immediately following Roe, and can’t explain away the significant increase between 1975 and 1981.

Other factors may well have contributed to the observed increase in the number of abortions in the decade after Roe, and they probably did. Nonetheless, it is quite hard to argue that the nationwide legalization of abortion in 1973 did not at least contribute to the increase in the incidence of abortion in the late 1970s and early 1980s. To challenge Roe‘s significance, one would have to identify broader trends that are responsible for the increase and explain why these trends — and not the nationwide legalization of the practice — were the dominant factors. If such a case can be made, Solinger did not make it.

UPDATE: Ramesh Ponnuru has additional complaints about Solinger’s essay.

Conor Friedersdorf and Megan McArdle write about this at The Atlantic and The Daily Beast, respectively; an excerpt from Friedersdorf’s item:

The grand jury report in the case of Kermit Gosnell, 72, is among the most horrifying I’ve read. “This case is about a doctor who killed babies and endangered women. What we mean is that he regularly and illegally delivered live, viable babies in the third trimester of pregnancy — and then murdered these newborns by severing their spinal cords with scissors,” it states. “The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels — and, on at least two occasions, caused their deaths.” ...

Until Thursday, I wasn’t aware of this story. It has generated sparse coverage in the national media, and while it’s been mentioned in RSS feeds to which I subscribe, I skip past most news items. I still consume a tremendous amount of journalism. Yet had I been asked at a trivia night about the identity of Kermit Gosnell, I would’ve been stumped and helplessly guessed a green Muppet. Then I saw Kirsten Power’s USA Today column. She makes a powerful, persuasive case that the Gosnell trial ought to be getting a lot more attention in the national press than it is getting.

The media criticism angle interests me. But I agree that the story has been undercovered, and I happen to be a working journalist, so I’ll begin by telling the rest of the story for its own sake. Only then will I explain why I think it deserves more coverage than it has gotten, although it ought to be self-evident by the time I’m done distilling the grand jury’s allegations. Grand juries aren’t infallible. This version of events hasn’t been proven in a court of law. But journalists routinely treat accounts given by police, prosecutors and grand juries as at least plausible if not proven. Try to decide, as you hear the state’s side of the case, whether you think it is credible, and if so, whether the possibility that some or all this happened demands massive journalistic scrutiny....

Here is the grand jury on oversight failures:

Pennsylvania is not a third-world country. There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago. But none of them did...

The first line of defense was the Pennsylvania Department of Health. The department’s job is to audit hospitals and outpatient medical facilities, like Gosnell’s, to make sure that they follow the rules and provide safe care. The department had contact with the Women’s Medical Society dating back to 1979, when it first issued approval to open an abortion clinic. It did not conduct another site review until 1989, ten years later. Numerous violations were already apparent, but Gosnell got a pass when he promised to fix them. Site reviews in 1992 and 1993 also noted various violations, but again failed to ensure they were corrected.

But at least the department had been doing something up to that point, however ineffectual. After 1993, even that pro form a effort came to an end. Not because of administrative ennui, although there had been plenty. Instead, the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all... The only exception to this live-and-let-die policy was supposed to be for complaints dumped directly on the department’s doorstep. Those, at least, would be investigated. Except that there were complaints about Gosnell, repeatedly.

This semester, I am once again teaching Constitutional Law II: The Fourteenth Amendment. I often tell my students in this class that there are three issues on which most people are particularly resistant to rational persuasion: abortion, the death penalty, and affirmative action. And it so happens that the course covers all three.

Actually, there is a general tendency of to discount opposing arguments on a wide range of political issues, not just these ones. It’s a consequence of our general lack of incentive to think rationally about politics. But the problem is worse on some issues than others, and these three strike me as among the worst offenders.

Why are people more close-minded on some issues than others? One factor is intensity of commitment. Obviously, these are issues on which many people have strongly held views. But that doesn’t differentiate them from a lot of other policy disputes. Think of the many people who have intensely held views on health care, taxation, gun rights, and so on. More important, I think, is that these are issues where most people believe that your stance derives directly from your fundamental values, rather than disagreements about empirics. Either you believe that abortion is like murder or you don’t; either it’s inherently wrong for the state to execute people or it’s not; affirmative action is either overdue compensation for historic injustices or it’s a form of invidious racial discrimination. By contrast, most people recognize that disputes over issues like taxes or health care are at least in part driven by differences over empirical questions rather than values. In reality, of course, empirical questions do matter to disputes over affirmative action and the death penalty. How effective are affirmative action programs? How much does the death penalty deter murder? How many innocent people are likely to be executed? But most people don’t think about these issues in such terms. They assume that the real source of disagreement is values rather than facts.

Finally, these three issues are ones on which it’s hard to find a coherent compromise position. You can tell a persuasive story about why tax rates should be higher than conservatives say, yet lower than what liberals want. But it’s hard to explain why we should adopt a policy that’s somehow in between a strong pro-life position and a strong prochoice view. The same goes for affirmative action and the death penalty.

I have not seen any systematic research comparing the degree of close-mindedness on these issues relative to others. So it’s possible that attitudes on these three issues are not as hidebound as I think, or that things are worse on other issues than I imagine. For what it’s worth, I myself have changed my views on two of these three over the years (less pro-choice than I used to be, and less hostile to affirmative action). But I think those changes happened at least in part because I don’t care about these two issues as much as many other people do, and therefore was less emotionally invested in my views about them.

Today South Carolina Republican Senator Jim Demint hosted a forum at which five Republican presidential candidates spoke. The transcript is here.  Each candidate appeared one at a time, and the format allowed for in-depth questions and answers. Among the questioners was Princeton University’s Robert George. Prof. George asked each candidate if he or she would support congressional legislation, under section 5 of the 14th Amendment, to ban abortion. To state the obvious, such legislation would be contrary not only to Roe v. Wade and Penn. v. Casey (abortion rights are protected by section 1 of the 14th Amendment), but also to Boerne v. Flores (Congress cannot use section 5 to protect a right in defiance of direct Supreme Court holding about the particular aspect of the right).  The question explicitly presumed that Roe v. Wade had not been overturned, and that a Human Life Amendment to the Constitution had not been adopted.

The candidates’ answers were as follows:

Bachmann: Yes.

Cain: Yes.

Gingrich: Yes. Cooper v. Aaron‘s assertion of judicial supremacy was wrong. Following the precedent of the first Jefferson administration, I would abolish some federal judgeships. But I am not as bold as Jefferson. “I would do no more than eliminate Judge Barry in San Antonio and the ninth circuit. That’s the most I would go for. (LAUGHTER) (APPLAUSE). But let me say this. That’s part of the national debate. That’s not a rhetorical comment. I believe the legislative and executive branches have an obligation to defend the constitution against judges who are tyrannical and who seek to impose un-American values on the people of the United States.”

Paul: No. Violence and murder should be dealt with by the states. The federal police are already too numerous. I support a bill to deprive lower federal courts of jurisdiction over abortion cases, so that state restrictions on abortion would be immune from judicial review.

Romney: No. I would focus on appointing judges who would return abortion regulation to the states. The George proposal “would create obviously a constitutional crisis. Could that happen in this country? Could there be circumstances where that might occur? I think it’s reasonable that something of that nature might happen someday. That’s not something I would precipitate.”

Personally, I agree with the Romney approach. Moreover, the next President is going to have to address a fiscal crisis that will devastate the United States economy soon if it is not solved. Dealing with the fiscal crisis is going to be quite difficult politically, in part because there are many millions of people who benefit from the current, and unsustainable, levels of federal spending. The tax consumers may be very highly resistant to any reduction in the amount of money that flows to them. So there will be no shortage of national division and acrimony. Thus, 2013 would be an especially bad time to precipitate a constitutional crisis over a social issue. The answers of Romney and Paul displayed prudence, which I think is a very important characteristic for a President, and the answers of Bachmann, Cain, and Gingrich did not.

As for the Ninth Circuit, Gingrich has been saying the same thing since March, according to Politico. I have not found anywhere where he has provided details on this plan, but perhaps it would involve merging the 9th circuit states into the 8th and 10th circuits, since they border the 9th. The Politico article is not entirely clear, but it appears that Gingrich has claimed that he could get rid of the 9th circuit by signing an executive order. This would be plainly unconstitutional, a usurpation of power worthy of impeachment. Article III gives Congress, not the President, the power to “ordain and establish” the inferior federal courts. During the Jefferson administration, the Judiciary Act of 1802 repealed the Judiciary Act of 1801, in which the lame duck Federalist Congress had created many new federal judgeships, to which President John Adams had appointed Federalists in the waning days of his administration. As President Jefferson recognized, the choice to eliminate federal judgeships belongs to Congress, not the President acting by himself. [Update: a commenter says the video (for which a link was not provided) shows that Gingrich was not claiming that he could abolish the 9th Cir. by executive order. I looked on the Internet, and did not find a video of the March 25 Iowa speech by Gingrich. There's a video of a speech earlier that month in Iowa, in which he criticizes the 9th cir. but does not call for its abolition.]

At CNN, Politico, National Review Online’s “The Corner” blog, and at the Susan B. Anthony List website, you can read the developing controversy over some Republican presidential candidates’ refusal to sign the SBA Lists’ “2012 Pro-Life Citizen’s Pledge.”

Signers thus far are Bachmann, Gingrich, Pawlenty, Paul, and Santorum. The items on the pledge are:

FIRST, to nominate to the U.S. federal bench judges who are committed to restraint and applying the original meaning of the Constitution, not legislating from the bench;

SECOND, to select only pro-life appointees for relevant Cabinet and Executive Branch positions, in particular the head of National Institutes of Health, the Department of Justice, and the Department of Health & Human Services;

THIRD, to advance pro-life legislation to permanently end all taxpayer funding of abortion in all domestic and international spending programs, and defund Planned Parenthood and all other contractors and recipients of federal funds with affiliates that perform or fund abortions;

FOURTH, advance and sign into law a Pain-Capable Unborn Child Protection Act to protect unborn children who are capable of feeling pain from abortion.

Of the candidates who have refused to sign, Mitt Romney objects because the wording of the demand to cut on federal abortion funding could be construed to stop federal aid to many hospitals; further, he refuses to make pro-life a litmus test for his executive branch appointments, as long as the appointees are willing to abide by (President) Romney’s own pro-life views. Herman Cain says he would “sign” the pain bill, but will not take the pledge to “advance” the bill, because “Congress must advance the legislation,” and he must have ”respect for the balance of power and the role of the presidency.”

Thus, of the announced candidates, we have only Gov. Gary Johnson who might have constitutional scruples about the federal pain bill.

The Pain-Capable Unborn Child Protection Act, which has been enacted in several states, requires that physicians provide a woman who is at least 20 weeks pregnant, and who is seeking an abortion, with information to obtain informed consent about the pain that the fetus will feel during the abortion.

The PCUCPA is probably constitutional under Planned Parenthood v. Casey, since it does not ban pre-viability abortions, and the lower courts have not generally found other informed consent laws for abortion to be an “undue burden,” as Casey defines that term.

However, a federal PCUCPA is plainly unconstitutional under the “original meaning” of the Constitution, which judges appointed by SBA Pledge signers would presumably uphold. The federal version of PCUCPA is S. 314, introduced by Sen. Mike Johanns (R-Neb.). After the definitions section of the proposed statute, the bill states: “Any abortion provider in or affecting interstate or foreign commerce, who knowingly performs any abortion of a pain-capable unborn child, shall comply with the requirements of this title.”

Federal abortion control under the purported authority of congressional power “To regulate Commerce...among the several States” is plainly unconstitutional under the original meaning of the interstate commerce.

Even under the lax (but non-infinite) version of the interstate commerce power which the Court articulated in Lopez,  a federal ban on partial-birth abortion is dubious, as Glenn Reynolds and I argued in a Connecticut Law Review article. Indeed, in the 5-4 Supreme Court decision upholding the federal ban, Gonzales v. Carhart, Justices Thomas and Scalia, who voted in the majority to uphold the ban as not violating the Casey abortion right, concurred to point out “that whether the Act constitutes a permissible exercise of Congress’ power under the Commerce Clause is not before the Court. The parties did not raise or brief that issue; it is outside the question presented; and the lower courts did not address it.”

In other words, if the attorneys who challenged the federal ban on partial-birth abortions had been willing to raise all plausibile constitutional claims, instead of losing the case 4-5 they probably could have won 6-3, by assembling a coalition of 4 strongly pro-abortion-rights Justices, plus Scalia and Thomas on the commerce issue.

When we get beyond Lopez, and truly look at original meaning, then the unconstitutionality of the federal PCUCPA is obvious. In Gibbons v. Ogden, Chief Justice Marshall explained that “health laws of every description” are outside the scope of the federal commerce power. The statement has been cited with approval by other Supreme Court justices at least 20 times. As Wickard v. Filburn observed, the Marshall opinion in Gibbons “described the Federal commerce power with a breadth never yet exceeded.” Wickard v. Filburn, 317 U.S. 111, 120 (1942). (For more on Marshall’s views about federal health control, see this article by Rob Natelson and me.)

Marshall’s opinion in Gibbon may be considered the outer boundary of any originalist interpretation of the interstate commerce power. What doctors tell patients before providing abortions is obviously not interstate commerce, all the more so since the vast majority of patients do not cross state lines to obtain abortions.

Yale’s Jack Balkin makes the argument that in the original meaning, “commerce” means “intercourse,” and thus the original meaning allows a vast amount of federal regulation of intra-state, non-economic activity. Rob Natelson and I explained the errors in this theory in an on-line article for the Michigan Law Review.

Presumably the Republican signers of the SBA pledge would not assert that the appointment of judges who accept Balkin’s “commerce = intercourse” theory of original meaning would comport with President’s pledge to appoint judges who would follow original meaning. All of the Republican presidential candidates have said that the Obamacare individual mandate to purchase expensive congressionally-designed health insurance from the congressionally-favored insurance oligopoly is unconstitutional. Balkin’s intercourse theory, however, would support the constitutionality of the mandate.

The signing of the SBA pledge by Rep. Ron Paul (R-Tex.) is particularly disappointing, since Paul has usually made a point of being scrupulous about federal powers. Indeed, Paul was the sole “pro-gun” Representative who voted against the Protection of Lawful Commerce in Arms Act, a federal statute which outlawed lawsuits, in federal and state courts, against the manufacturers, wholesalers, and lawful retailers of firearms for guns which were lawfully sold and properly functioning. Paul’s argument was that the law exceeded the federal power to regulate interstate commerce; I disagree, since the undisputed original purpose of the interstate commerce power was to empoower Congress to act against state barriers to interstate commerce. The anti-gun lawsuits were plainly an effort to use fanciful tort theories to damage the entire national market in firearms, by imposing on that market many restrictions which had been considered and rejected by Congress and the state legislatures.

Thus, in regard to the anti-gun lawsuits, Paul’s scruples were mistaken, in my view, but he deserves credit for being sincerely scrupulous. I wish that he, and the rest of the Reublican presidential field, kept their constitutional scruples intact regarding federal anti-abortion legislation.

While the federal PCUCPA does not invoke section 5 of the 14th Amendment as a basis for the legislation, it is possible to construct an argument that some federal anti-abortion laws could be based on that power. However, it’s hard to base such an argument on the original meaning of the 14th Amendment, since there is not a shred of evidence in the 1865-68 history of the creation and ratification of the 14th Amendment (nor in the immediate post-ratification period, nor for nearly a century after ratification) that anyone imagined that the 14th Amendment empowered Congress to enact abortion-control laws, or guaranteed abortion rights.

So if a Republican who signs the SBA pledge is elected President, and he or she adheres to item 1 in the SBA pledge, appointing judges who adhere to the Constitution’s original meaning, then those judges will uphold state versions of the PCUCPA while declaring unconstitutional a federal PCUCPA.