Book Club: Generation Roe

Like many in her generation, Sarah Erdreich thought the freedoms that Roe v. Wade guaranteed were secure. A child of the post-Roe era, she learned that the landmark decision had legalized abortion, striking down many of the state and federal restrictions that had previously forced countless women to risk their lives and health in the hands of underground abortion providers — providers whose work was not accountable to any professional medical standards.

What Erdreich learned was true, but it wasn’t the entire truth. Legalizing abortion was one thing. Guaranteeing access to it was another. After college, graduate school, and a series of abandoned career starts, Erdreich ended up in Washington, D.C., working for the hotline for the National Abortion Federation. Her job changed her perspective, opening her eyes to the extent that restrictions and barriers still diverted many people from the legal procedure of abortion. It was that experience that inspired her to write Generation Roe: Inside the Future of the Pro-Choice Movement (Seven Stories Press, 2013).

Generation Roe is worthwhile reading for those who want to build on the legacy of Roe v. Wade.

Generation Roe assesses where we are today, 40 years after Roe, with a sobering look at the continuing threats to reproductive freedom. In the decade that Roe was decided, 77 percent of all U.S. counties lacked an abortion provider. Today, that figure has jumped to 87 percent, while the number of women of childbearing age in those counties has increased from 27 to 35 percent. That’s one of many indicators Erdreich uses to capture the contradictions of the post-Roe era. Those like her who grew up after 1973 have never known what it’s like to live without the availability of legal abortion. But that availability has been curtailed by everything short of overturning Roe, from legal means, such as statutes mandating medically inaccurate pre-abortion counseling — plus waiting periods of 24 hours or more — to illegal means, such as threatening abortion providers and their patients.

Unfortunately, while so much significance can be pegged on Roe v. Wade, and while those few syllables can serve as a sort of shorthand for reproductive freedom, there isn’t a counterpart that succinctly captures its myriad curtailments. As a result, many of those curtailments are left out of the conversation. It takes a news hound to follow what’s happening in the 50 states on the abortion front and to have a thorough sense of where that leaves people who seek abortion services. “I absolutely think most people are not aware of what the realities are in terms of barriers to access,” says law student Kyle Marie Stock, one of the many people Erdreich interviewed for her book.

For many born in the post-Roe era, the death of Dr. George Tiller, the Kansas-based abortion provider who was assassinated in 2009 by an anti-abortion extremist, was a wake-up call. Erdreich quotes activist Abbey Marr: “[W]hen [people my age] saw what happened to Dr. Tiller, they realized this isn’t an issue that was fifteen, twenty years ago, this is an issue happening today … So maybe some sort of awful silver lining [is that] people will realize that it’s still a really big issue right now.”

For her book, Erdreich interviewed activists from both the pre- and post-Roe eras to explore why threats to reproductive freedom are still such a big issue. Those activists who know what it was like before that landmark Supreme Court decision can recall in vivid detail the nights they had to drive friends to illegal clinics, worried on the drive back that their friends could die from hemorrhages — or die later from infections. With those images etched in their minds, many see the post-Roe generation as taking their freedoms for granted and being too slow to pick up where past generations left off.

Erdreich, however, sees strengths and weaknesses in the activism of both eras. Far from taking too little action, younger activists are, in many cases, simply forging their own path, using media and messaging that resonates with their own realities. They’ve embraced the Internet as a tool for demystifying abortion, a procedure commonly veiled in secrecy and privacy because of the threats so often directed at it. With websites like I Am Dr. Tiller and The Abortioneers, they “provide places for people to share their experiences, celebrate victories, and vent about setbacks.”

While those younger activists have inherited the victory of Roe v. Wade, they’ve also inherited the unintended consequences of many past decisions by veteran activists. “Abortion clinics,” Erdreich writes, “originated as a response to the hospital-based model of abortion care that dominated provision up until the early 1970s.” Clinics devoted to abortion services gave women a place where they knew their decisions would be respected and understood, but they also removed abortion from other health care settings, meaning any physician who decides to be an abortion provider is making a decision to do little else but provide abortions. If that alone doesn’t deter would-be providers, freestanding abortion clinics also provide clear sites of protest — and often extremist violence — for anti-abortion groups. Such clinics are also not as viable in rural areas as they are in urban areas, which is part of the reason 97 percent of rural counties lack an abortion provider.

Putting aside her examination of pre- and post-Roe activism, Erdreich also takes a closer look at the anti-abortion movement. She plays the role of investigative reporter and visits a crisis pregnancy center with her partner, and she deconstructs and debunks the arguments behind some of the worst anti-abortion legislation in recent years.

Erdreich uses her final chapter to look at the work of national advocacy organizations and those at the grassroots level. Although she acknowledges that “[e]very movement needs a variety of voices,” she argues that well-established, national organizations like Planned Parenthood, NARAL Pro-Choice America, the Center for Reproductive Rights, and her former employer, the National Abortion Federation, often have their hands tied trying to “balance the interests of their supporters, donors, political allies, and the women whose rights they work to safeguard.” Erdreich argues that under those circumstances, they often rely on cautious messaging that speaks to the center instead of pushing the movement forward.

Erdreich offers little in the way of express examples to make her case, and she doesn’t offer responses from any of those national organizations for the sake of balance. Furthermore, although she alludes to it, she doesn’t discuss the fact that for organizations like Planned Parenthood, the millions of people they serve with health care is their first priority. By providing many of these services, they are making what the movement advocates an accomplished fact. That’s not something to minimize. It’s also not something that’s negotiable.

Readers will get the sense, though, that Erdreich’s objective isn’t to have the last word, but to spur dialogue among reproductive rights advocates and, at times, make them reevaluate their approaches. In addition to providing testimony from activists, throughout much of the book she presents the stories of women who have had abortions, positing as she presents them that reproductive rights advocates too often stress aspects of abortion like its safety, without acknowledging the “ambivalent feelings” and “range of emotions women may experience.” Ignoring this gray area, argues Erdreich, lets anti-abortion groups explain their meaning, offering scare terms like “post-abortion syndrome.” There are no easy answers when it comes to addressing the complicated feelings abortion seekers have. While Erdreich’s idea makes some sense, statements addressing those complicated feelings could easily be taken out of context and abused by anti-abortion groups.

While Generation Roe might not have all of the answers, it’s a readable and informative conversation starter that might just bring advocates closer to those answers. A contributor to Jezebel, Feministing, RH Reality Check, and other websites, Erdreich has made a debut in book publishing that is worthwhile reading for those who want to build on the legacy of Roe v. Wade.