Editor's note — A related interview with Michelle Trupiano, public affairs manager and lobbyist for Planned Parenthood of Kansas and Mid-Missouri, is available here.
Abby Johnson stands before the crowd, hips cocked, a hint of defiance in her voice:
“I’m just here to get birth control."
A man pipes up about health risks of the pill.
Johnson counters: “I’ve used birth control for years. I’m fine.”
Another man chimes in: “Do you know this is an abortion clinic?”
“Yeah, I know." She sounds defensive. "I’m pro-choice."
A woman calls back: “Can you explain why you’re pro-choice?”
Johnson's response is clipped: “I don’t want to be a slave to my uterus for the rest of my life."
A pause, then another voice from the crowd: “There are other places you can go for birth control.”
For a few minutes of role playing in early April, the Cathedral of St. Joseph in Jefferson City stood in for the entrance of an abortion clinic. A group of anti-abortion advocates became “sidewalk counselors.” And Abby Johnson played Any Woman, stopping in at Planned Parenthood to renew her birth control.
In this tableau, Johnson was both teacher and star. For eight years, she worked at a Planned Parenthood clinic in Texas, eventually becoming director of the clinic. She quit two years ago, after watching an ultrasound during an abortion, in which she says she saw a 13-week-old fetus “fight for its life."
This spring, she was in mid-Missouri coaching pro-life advocates on the use of effective dialogue in anti-abortion campaigns. The role-play exercise in Jefferson City was a chance for activists to practice the strategies Johnson taught:
- When a woman approaches, ask open-ended questions. Engage in a conversation.
- Don't use extreme or accusatory language. It turns people off to the message.
- Ask if the woman knows Planned Parenthood performs abortions. Not everyone knows that.
- Most important, steer people away from Planned Parenthood to get birth control or needed support elsewhere. Take business away from the facilities that perform abortions.
The workshop was not only a lesson in persuasive dialogue but a chance for Johnson to share her conversion journey, from abortion provider to passionate debunker of what she says are the facts and myths that have fueled 40 years of America's abortion war.
A change in strategy
Johnson speaks the modern language of the anti-abortion movement, coaching activists around the country who consider themselves the mainstream of that movement. In Missouri, that means the well-established Missouri Right to Life and a relative newcomer, the faith-based 40 Days for Life.
Over the years, these groups have moved beyond massive demonstrations and aggressive, sometimes violent, civil disobedience to embrace a softer, more sophisticated war strategy. They no longer aim to outlaw abortion in one fatal blow by overturning the crucible case of Roe v. Wade.
Instead, they are settled in for the long haul, determined to whittle away at abortion year by year, action by action, dollar by dollar, law by law.
MU law professor and researcher Rigel Oliveri says the success of such anti-abortion efforts comes from working within the framework of the law and pushing the cause to state legislators. But the topic of abortion continues to be a litmus test for politicians and has created a cautious point-counterpoint approach in most news coverage.
Even the terms of the debate – pro-life vs. anti-abortion, pro-choice vs. pro-abortion, dilation and evacuation vs. partial-birth abortion – are charged. The subject is so sensitive that officials of Planned Parenthood of Kansas and Mid-Missouri, which runs the state's only abortion clinics in Columbia and St. Louis, were hesitant to speak for this story.
"Anything in print can be taken out of context," a regional spokeswoman said.
Oliveri, who says she personally leans "pro-choice," credits the anti-abortion movement with keeping the issue in the public eye and making progress with a "death by a thousand cuts" strategy.
“They were really smart in turning away from overturning Roe v. Wade outright and instead just chipping away at it incrementally,” she says.
Polls find support to ban abortions growing
There have been as many as 50 million abortions performed in the United States since 1973, when the U.S. Supreme Court ruled that a woman's constitutional right to privacy extends to reproductive choice. The ruling, while not absolute, put severe limits on state and federal laws that restrict abortions.
It also created one of the deepest schisms in U.S. history. And from the beginning, Missouri has been an active player in that schism. A year after Roe v. Wade, the Missouri General Assembly passed a statute of intent: Abortion here would be regulated to the fullest extent of the law.
It has kept that promise.
The state has consistently received an "F" on women's reproductive rights from NARAL Pro-Choice America, which ranks Missouri 48th in the nation for supporting those rights.
It is difficult to find reliable numbers that show how many Missouri citizens oppose or support legalized abortion, either as an absolute or with conditions.
The Gallup Organization reports that since 1975, a majority of Americans – about 53 percent – have consistently favored the right to abortion under certain circumstances, primarily in cases of rape or incest or when there is a threat to the life of the mother.
But the anti-abortion movement has been gaining ground, according to polls. In 2009, for the first time, Gallup counted a slight majority (51 percent) among those who identify with the self-described pro-life movement, which opposes abortion for any reason.
Those close numbers harden the resolve of Missouri Right to Life and 40 Days for Life.
Indeed, as they gain laws that limit access to and funding for abortion, their targets have expanded to what they perceive as other attacks on human life, including euthanasia and embryonic stem cell research.
Their ultimate goal, they say, is to bring an end to America's sexualized society and what is often referred to as a “culture of convenience."
“We have evolved in that we’ve become better in what we’re doing,” says Pam Fichter, president of Missouri Right to Life. “We’ve become stronger.”
Visibility now main tactic of anti-abortion efforts
The evening of March 8 was quiet except for a steady drizzle and the rush of passing cars. A line of mismatched rain jackets and umbrellas and battery-operated candles formed along North Providence Road, outside Columbia's Planned Parenthood clinic.
Members of 40 Days for Life usually face the clinic as they pray. Tonight they faced the street. At an earlier rally at Our Lady of Lourdes Catholic Church, 40 Days member Donna McCullem told them: “Impact! Don’t think by just standing there you aren’t having an impact.”
The vigil, held the night before Ash Wednesday, marked the beginning of demonstrations outside Planned Parenthood clinics nationwide through the 40 days of Lent. During the Columbia campaign, replicated at 247 clinics around the country this year, sidewalk counselors approached patrons with information about pregnancy resource centers. Others held signs for passing motorists to read:
“Life is precious!”
“Free pregnancy test/or ultrasound. Ask us!”
And they prayed.
On this first Tuesday, a wet evening, their presence was greeted by honks from five cars. One woman smiled and waved out a passenger window. Most cars passed in silence. But heads turned, taking note of the solemn line of candles that defied the darkness.
Some demonstrators were back at 8 a.m., an hour before Planned Parenthood opens. They wanted to be seen as people drove to work.
Visibility is a primary tactic of the pro-life movement. But while some factions of the movement favor aggressive intervention, even to the point of condoning violence against abortion providers, 40 Days says it wants to be a positive, physical prayer presence and to urge women to consider options other than abortion that support motherhood.
Members sign a contract not to break the law, block the entrances to facilities or use hateful or threatening language. Signs should be limited in number so they aren't perceived as a protest; three is considered right for a Columbia street action. Rather than accusatory, signs should be big, simple, hopeful. "Baby Killer" is out. More effective: “It’s not too late to change your mind.” Graphic images are not allowed.
“We believe in those (graphic) signs," Johnson said at the April workshop in Jefferson City. "We believe they have a place.
"But it’s not in front of an abortion clinic.”
Johnson says the dead fetuses she saw on protest signs outside her Planned Parenthood clinic in Texas were a gruesome match for the body parts reassembled after abortions. But she says it wasn’t until she watched an ultrasound of a baby fighting to escape a probe that she had her own change of heart.
“We need to grow and change. Compassion is more effective,” Johnson says. “That’s the approach we are trying to send to every abortion clinic.”
Anti-abortion groups weigh 'morality' of issue
Donna McCullem can often be found on the sidewalk outside Columbia's Planned Parenthood. Sometimes she holds a sign. Other times she prays. She says many of the women who come here are surprised to be offered support as opposed to a lecture in morality.
“They’ve been led to believe that we are there to harass them,” she says.
McCullem, who grew up in Columbia, has been on the other side of the abortion line. Her first visit to this clinic was in the 1970s to get birth control. She was 19 and in love.
She married the young man and stopped taking birth control after experiencing bad side effects. They had three children, but their marriage began to crumble and her husband asked her for a divorce. When McCullem became pregnant twice more, she felt depressed and unfit to be a mother and worried how she could support more children as a single mother. She returned to Planned Parenthood twice more, this time for abortions. Alone and in crisis, she says she didn't know where else to turn.
She eventually remarried and had another child. But she never was at peace.
“I never stopped praying, but I was a horrible mess,” she says. “I didn’t think there would be any acceptance or forgiveness.”
Then years later, a close family member confided that she was pregnant and considering abortion. McCullem found herself unable to help.
“I wasn’t in a place to be there for her,” she says.
She continued to pray throughout those years but says her emotional numbness finally started to eased when she joined the first 40 Days for Life campaign outside Planned Parenthood in 2009.
While both 40 Days and Missouri Right to Life maintain that abortion is the killing of innocents, many members say that their strategies of compassion, forgiveness and support should extend to those who have made that choice.
“We’ve helped so many people with grief,” says 40 Days for Life director Kathy Forck. “And I would rejoice if an abortionist became pro-life. We're not here to judge people. They have a heavy load.”
But what if abortion is eventually outlawed? Then views on punishment grow murkier.
Fichter says a woman who has multiple abortions probably should be incarcerated. “There’s a point where you have to say a woman is responsible for the death of her child,” she says.
Yet most in the movement agree that the real enemies are those in the "abortion industry." The added “malice” of repeatedly causing the death of children sets abortion doctors apart from women making a tragic decision in crisis.
“There’s a lot of outside factors that make (a single abortion) a less free decision than someone who decides to set up shop as an abortionist,” says the Rev. Dylan Schrader of Our Lady of Lourdes Catholic Church. “That’s a very deliberate decision — there’s a real malicious character to that.”
Groups divided on use of birth control
During the Lenten campaign, when cars pulled into the Planned Parenthood parking lot, Forck usually stood alone on the edge of the driveway while fellow prayer activists moved away; a crowd can seem threatening. She urged women to consider pregnancy resource centers, such as the My Life Clinic across the street, which offers free ultrasounds and pregnancy tests, parenting classes and some donated items such as diapers and formula.
Forck also recommended prayer groups, healing hotlines or counseling.
But the options offered by 40 Days members in Columbia do not include birth control. The Columbia organization believes contraceptives encourage casual sex, which in turn encourages abortion. Its literature includes information on side effects of the birth control pill and claims a connection between abortion and breast cancer – a connection disputed by most current medical studies.
Birth control is the one area where 40 Days of Columbia disagrees with the coaching provided by Abby Johnson, who calls it a "sticky" issue. She says it's unlikely a woman will be convinced in a brief sidewalk conversation to stop using birth control. She would rather refer those women elsewhere for contraception if it takes their business away from Planned Parenthood.
Missouri Right to Life has its own stance on birth control, says Fichter, its president: It doesn't comment unless the form of birth control used destroys life rather than prevents it. Under that philosophy, the organization opposes the pill because there is no way to be sure if the pill prevents ovulation or implantation.
But among local members of both 40 Days and Missouri Right to Life, there is no disagreement about this: The two remaining Planned Parenthood clinics in Missouri must be closed down.
Members don't buy the argument that, by law, no tax dollars go to abortion services at Planned Parenthood. As long as the money pays for rent and electricity and building maintenance, they say, it funds abortion. And they frequently repeat Johnson’s assertion that money for family planning and money for abortion go into one big pot at the end of the day.
This fight is a personal one for Forck.
She tells of the day in 1995 when her 17-year-old daughter told her she was pregnant. Forck had noticed her daughter was gaining weight. But news of the pregnancy stunned her.
Forck couldn't help but think of her own mother who, at 16, was raped, became pregnant and was pressured to have an abortion. The experience only deepened Forck's mother's desire to have a large family; Forck is one of 10 children.
Forck remembered what her mother always said and she now told her pregnant daughter the same thing:
“A baby is a blessing. Hold your head up high.”
That day began a whirlwind of doctor’s appointment and baby shopping. That night Forck and her daughter held each other and cried.
It wasn’t until after her grandchild was born, Forck says, that her daughter confided she had considered having an abortion.
“Abortion has touched many generations of my family,” Forck says. “I hope it ends with this one.”
The growth of the anti-abortion moment
Pam Fichter was bathing her newborn son when she heard the news on the radio: In the 1973 case of Roe v. Wade, the U.S. Supreme Court, supporting a woman's right to privacy and due process, had just legalized abortion.
Fichter, distraught, called her minister. Something had to be done.
He told her not to worry. As soon as people learned what abortion was, he said, they would never stand for it. The case would be overturned. At the time, both thought they were talking about a matter of months.
But Roe v. Wade wasn't overturned. Instead, it created an army.
In Missouri, that army sprang from the grass roots, beginning in small meetings where people were rattled to learn how abortions were performed.
“There was the immediate outrage, and there were a lot of people whose response was more of demonstration,” Fichter says. “That’s where you saw people blockading entrances to abortion clinics and chaining themselves to doors.”
But even as gruesome stories of termination procedures fueled the ranks of anti-abortion activists, abortion-rights advocates countered with their own stories of desperate women who endured illegal and dangerous back-alley procedures to end their pregnancies.
“Something I saw from a housewife’s point-of-view is how it was sold to the American public through the women’s magazines,” says Mitzi Linsenbardt, a Sedalia resident who has been with Missouri Right to Life since it formed in 1974. “Very emotional — always with a very tragic case that almost anyone would favor the woman having an abortion.”
The early abortion battles were fought at a fever pitch. Some factions of the anti-abortion movement have continued that strategy, laying claim to the harassment of abortion doctors, the bombing of clinics and even murder.
Other groups soon realized they needed a more tenable, long-term strategy — one designed to change hearts and minds, not inflame them.
Missouri Right to Life settled on a three-prong mission: change through legislation, educational outreach and grass-roots advocacy.
“A lot of those people who engaged in (more aggressive) activities realized that they were spending all of their resources on lawyers getting them out of jail, and that’s not productive,” Fichter says. “They also saw at that time that they did not help public opinion on the issue.”
Organization leaders say graphic pictures of aborted fetuses still belong in some of their materials and workshops. But they have abandoned those images in public ad campaigns, such as on billboards and in subway trains. They instead show the development of the fetus — “gentle things just showing the child is a human being or that the mother can work through this,” Linsenbardt says.
“You have to be sensitive to the young ones that might see that,” adds Bonnie Diefendorf, secretary of Missouri Right to Life and chairwoman for the mid-Missouri region. “It needs to be something that isn’t offensive but speaks to a person who may really be thinking about having an abortion.”
Diefendorf's first action in the movement was working a booth at the 1973 Missouri State Fair. She still works the booth each year, combining old tools with new. The booth now features a National Geographic video on fetal development, but still uses life-size models or dolls to demonstrate how a fetus grows in the womb. The smallest doll represents a fetus at seven weeks.
Linsenbardt says children often are curious about the dolls, which prove an effective conversation starter about fetal development.
As for the video: “How can you argue with National Geographic?” Diefendorf says.
Charges of racism used in fight, too
As thoughtful as these strategies are, they don't always work. A new Missouri Right to Life campaign targeting blacks and claiming abortion is a tool of racism has threatened to backfire.
The image, featured on a billboard in North Saint Louis City, is in keeping with the pro-life movement's nongraphic mandate: It shows a lovely black baby looking sad or fretful.
A statistic follows: "Over 37% of Missouri’s abortions are performed on African Americans, who comprise 12% of our population."
(Detailed abortion statistics for the state are difficult to confirm. But nationally in 2008, black women accounted for 30 percent of abortions, while white women accounted for 36 percent, Hispanic women 25 percent and other races 9 percent, according to the Guttmacher Institute. The most recent census put Missouri's black population at 11.6 percent, just slightly below the national percentage of 12.6 percent.)
The new billboard campaign is an extension of claims by anti-abortion activists that Planned Parenthood founder Margaret Sanger set up early birth control centers in poor black areas such as Harlem as part of a plan of eugenics — a way to improve the human race by not allowing people with defects or inferior qualities to reproduce.
That belief is reinforced by "Maafa 21: Black Genocide in 21st Century America," a DVD sponsored by Life Dynamics Inc., an anti-abortion organization based in Texas.
Sanger's own writings from the first half of the 20th century advocate that able-minded women be given absolute control over reproduction and that sterilization and immigration laws be used to prevent certain "unfit" populations, such as epileptics, the insane and the mentally retarded to expand.
But while she argued that abortions needed to be made safe, she also decried them as a "taking of life" and urged contraception as a way to avoid them.
Despite that, her views and actions remain the subject of intense debate and have become entangled with the modern abortion wars.
“Their (Planned Parenthood) focus has always been to eliminate certain people from the population,” says Zina Hackworth, a black woman from St. Louis who attended Pro-Life Action Day in Jefferson City in early April.
Planned Parenthood spokeswoman Michelle Trupiano acknowledges that some of Sanger's views are not in keeping with the modern anti-abortion movement. But she vehemently denies that the organization targets blacks.
"We have a very long tradition of respecting diversity and respecting women where they come from," she says.
"There has been outrage in the African-American community over the new St. Louis billboard because it suggests that blacks do not have the moral aptitude to make good decisions for themselves."
But those who believe the eugenics plot cite this logic: Blacks make up only about 12 percent of the U.S. population; yet, they say, the majority of Planned Parenthood clinics are in black neighborhoods.
Sanger's writings say she placed early clinics in those neighborhoods because that's where health services were most scarce. And Trupiano says clinics are now located in a wide range of neighborhoods, which can be found on the organization's website.
But some anti-abortion activists still see a more nefarious racial connection.
"To us it's no accident that the clinics are in the black neighborhoods of the big cities,” adds Linsenbardt of Missouri Right to Life. “This is exactly what she (Sanger) was promoting when she was alive.”
The argument doesn't set well with many. The billboard in North St. Louis has been vandalized. Fichter says the Missouri Right to Life office has received many “vile” calls complaining that it is racist. A similar billboard in Manhattan was removed because of complaints.
That's an irony Fichter struggles to understand: “If we were racist, we wouldn’t be working so hard to save black babies.”
The future of the fight
The end of legalized abortion is going to be like the end of the Berlin Wall, Fichter says.
“It’s going to seem like it happened overnight, but in reality we’ve been chipping away at it for many years,” she says.
Oliveri, the MU law professor, doesn't think Roe v. Wade itself is at risk: “Courts don’t like to overturn themselves, particularly if a long time has not passed."
Anti-abortion activists undermine their cause when they push for laws that can't be argued as necessary for a woman's health, such as mandatory ultrasounds or counseling that gives misinformation or is done by nonprofessionals, she says.
And she says opposing birth control is a strategic mistake.
“If there is one thing everyone agrees on it's that there should be fewer abortions," Oliveri says. "To have a group say we’re against one of the best methods for doing that is internally inconsistent.”
Despite that, Oliveri says the evolved pro-life strategy has given the movement small victories in the courts and legislature without inflaming the other side to dramatic action.
Those victories continued this year in the Missouri General Assembly.
In May the legislature passed a bill that outlaws abortions after 20 weeks unless the fetus is deemed not viable by two doctors or the mother faces death or irreversible harm. Violation is a Class C felony, punishable by at least a year in jail and a $10,000 to $50,000 fine. Gov. Jay Nixon has until 11:59 p.m. July 14 to sign the bill. If he does not, the bill expires on July 15.
If the bill becomes law, Missouri will become one of a growing number of states that are banning abortion after 20 weeks, according to a June 26 New York Times article.
This year, Missouri lawmakers also continued the Alternatives to Abortion Program, which funds pregnancy resource centers, tax-exempt facilities that aim to guide women through unplanned pregnancies, pregnancy testing and counseling.
Anti-abortion advocates were not successful this year in gaining passage of a bill that would provide legal protection for pharmacists who refuse to sell the so-called "morning-after pill" and tighter regulation of RU 486, a synthetic compound that interrupts a pregnancy and is used by Planned Parenthood for early-stage abortions.
But over time, Missouri has tightened the rope around abortion rights.
- A woman seeking an abortion must first be asked if she wants to see an ultrasound of her fetus or hear its heartbeat and be told her fetus feels pain. She is given a pamphlet that reads: “The life of each human being begins at conception. Abortion will terminate the life of a separate, unique, living human being.”
- Women are required to wait 24 hours for an abortion after meeting with a qualified professional.
- Parental consent is required for anyone under age 17 to get an abortion.
- Physicians do not have to provide abortion services, care or referrals if the procedure goes against their moral or religious beliefs. Employers or insurers can remove contraception from their coverage plans for the same reasons.
- Abortion providers must be within 30 miles of a hospital, which limits abortion in rural areas. And, as of last year, those providers must be licensed as ambulatory surgical centers, a statute that has required many changes to Planned Parenthood’s Columbia facility, such as hallway width and changing room sizes.
No abortions were performed at Columbia's Planned Parenthood during this year's 40 Days for Life campaign; the clinic was unable to schedule doctors during that time but resumed procedures in late May. The clinic will start an escort program to buffer clients from protesters, according to Planned Parenthood's Trupiano.
Goals extend beyond abortion bans
Even if all the battles against abortion were won — even if the U.S. Supreme Court overturned Roe v. Wade tomorrow — activists say their fight would not end.
“The goal of the pro-life movement is not even to end abortion," said Schrader of Our Lady of Lourdes. "That’s true, but that’s a mean."
The goal, he said: "For the human person to be respected and valued for what it is."
Back in early April, people fighting for that goal gathered at the Missouri Capitol for Pro-Life Action Day. Activists chattered with excitement as they filled out cards to hand to lawmakers.
They wore red sweaters and T-shirts and 40 Days for Life sweatshirts. Red, the color of the rose and the symbol of the pro-life movement, painted the Capitol rotunda.
At a noon rally they applauded five House members who met with them in support of their cause.
"The House is moving forward to continue to protect life," said Majority Leader Tim Jones, R-Eureka, who helped promote the late-term abortion bill.
Abby Johnson, former abortion clinic director and now an advocate for the opposition, encouraged the crowd to call, write and visit their legislators and to continue to work to shut down Planned Parenthood.
"We will not stop fighting until there are no more abortions in America," Johnson said to a roar of approval.
Pam Fichter, president of Missouri Right to Life, stepped up with her own message: "We will shut them down with love."
A guitarist played "Amazing Grace.” The sea of red scattered back into the world, inspired to continue the fight.