Fans of the show “Mad Men” love it for many reasons, not the least of which is the pain-staking attention to historical detail and love of highlighting aspects of the sixties long forgotten by most people who aren’t historians.  Last Sunday, the writers used this aspect of the show to touch on abortion.  The character Joan goes to a regular visit with her gynecologist, and in a discussion about potentially starting a family in a few years, Joan asks the doctor if her previous two abortions—which she euphemistically calls “procedures”—will harm her ability to have children.  We discover that the doctor has performed one abortion on Joan before (even though it was illegal in New York at the time).  He asks her about the other one, and she says that it was performed by a woman who claimed to be a midwife. 

In your usual overly dramatic Hollywood fare, this would have been an occasion for raising the stakes by implying that Joan was subject to a mythical back alley butcher who left her infertile for life.  But instead, the doctor shrugs and suggests that the odds are that the midwife did a good job, and certainly everything that he could see was in good working order.  He points out that she got pregnant after the first abortion, and so he has every reason to believe she’s fine. 

Believe it or not, this was historically accurate.  In the sixties, many doctors performed abortions for their regular patients and charted them as something else.  If you got an abortion from someone who wasn’t your regular doctor, odds are that it was still a safe abortion.  And, as I’ve written about before, the myth of the back alley butcher is mostly inaccurate.  It’s tempting for pro-choicers to invoke it in an attempt to remind people of the high human cost of banning abortion, but in the end, portraying abortion providers as “butchers” mostly helps the anti-choice cause by stigmatizing the compassionate, hard-working people who have helped women in need, whether or not that help was legal.   

Which isn’t to deny that illegal abortion meant the mutilation and often death of countless women.  It’s both true that when abortion was a crime most providers were professional and that hospitals had an overwhelming number of septic abortion cases.  As historian Rickie Solinger points out in her book Beggars and Choosers, this is because women who didn’t know where to find a black-market abortion provider often resorted to trying to abort themselves, causing injury or even death.  The coathanger is the symbol of women’s desperation when they have no access to abortion.

The lesson in all this should be clear: Access to abortion and to reproductive health care in general should be the priority of the pro-choice movement.  The main reason that the right to abortion is so critical is that it makes access to abortion that much better, especially for poor women and young women who may not have the resources to find an abortion provider on the black market. 

But anti-choicers are well aware there is more than one way to get women away from safe abortion providers and into emergency rooms with coathangers hanging out of their uteruses.  Indeed, you can tell from the actions of anti-choicers that the main goal has always been making sure that women have no access to safe abortion, and if they can’t ban abortion, they will make sure that it’s as hard as possible to get one.  And if they can’t punish you for being sexually active by putting you in a situation where you get an infection and possibly die, they will satisfy themselves by screaming at you as you get that safe abortion they so desperately wish you couldn’t get.

Unfortunately, the steady drip-drip of harassment, terrorism, stigmatization and legal restrictions on abortion gets us closer every day to a situation much like the days when abortion was illegal.  All while maintaining the legal right to an abortion, anti-choicers could very well get us into a situation like the sixties, where only women with resources (like the character Joan on “Mad Men”) can get safe abortions, and other women find themselves desperately turning to coathangers and throwing themselves down stairs. 

This is why we must view abortion rights less as a thing in and of themselves, and more as a means to the end of access.  Sometimes the pro-choice movement fails to do this, putting the war on restrictions on the right over the war on other restrictions to access.  Take, for instance, how most major pro-choice organizations formally oppose the Hyde Amendment but don’t put much of their resources towards fighting it.  Instead of using health care reform as an opportunity to mount a movement that would repeal the Hyde Amendment, we started from a position of compromise, and ended up seeing already-existing access given away as a bargaining chip.

Imagine if we really did focus on access, particularly ensuring it for those who are most likely to lose it, poor women and very young women!  Of course, this is what reproductive justice groups have always advocated, arguing that movements are most effective if they use this strategy.  If you fight for the most vulnerable among you, the logic goes, everyone else benefits as a matter of course.  It’s the method that does the most good for the most people. 

We’re closer to the world of 1965 portrayed on “Mad Men” than we care to admit, where women with resources like Joan still have access to abortions, but women without those resources face a gauntlet of obstacles.  Joan even has a privilege that most women who have abortions nowadays don’t have, which is the ability to have her regular doctor she knows and trusts providing the service.  Not to suggest that abortion access isn’t significantly better than in 1965, but just to point out that we’re backsliding to that level of access all the time.

Luckily, a newer movement that prioritizes access over just rights has emerged, and its leaders and foot soldiers are heavy with the young women we’re often told don’t care about choice. Emily Bazelon wrote about the movement afoot in medical schools to get more doctors trained to provide abortions, and to get the procedure provided by a woman’s regular doctor instead of only by specialists.   Reproductive justice groups like SisterSong are working harder than ever, and youth-oriented groups like Advocates for Youth are concentrating many of their resources on abortion access.  They’re  all fighting to make sure that we don’t have 1965 sneak back up on us, even if Roe stays nominally in place.