How the Pro-Choice Movement Saved America

Freedom, Politics, and the War on Sex


By Christina Page

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A pithy polemic bolstered by solid research, intellectual heft, and firsthand reporting, this is a book poised to change the debate over reproductive rights in this country wholesale. As activist and writer Cristina Page shows, the gains made by birth-control advocates (historically) and pro-choice organizations (currently) have formed the bedrock of freedoms few Americans would choose to live without. Now, not only is the future of legal abortion far from guaranteed, in many parts of the country ready access to many forms of contraception is in jeopardy as well. And that development, Page argues, should have everyone, regardless of moral or political persuasion, deeply concerned. For these basic freedoms are not just for the freewheeling gals of “Sex and the City,” but are central to the lives of working mothers and fathers from Phoenix to Duluth, churchgoers and nonbelievers alike. Page crystallizes the thoughts and attitudes of a generation of women and men whose voices are seldom heard in the political arena. How the Pro-Choice Movement Saved America is the first book to address the positive transformation our society has undergone because of our ability to plan when and if to have children. It also exposes the anti-choice movement’s far-reaching-and dangerous-agenda. Fresh, bold, and stocked with counterintuitive arguments, this is a book bound to form the basis for heated conversations nationwide.


Praise for How the Pro-Choice Movement Saved America
"At a time in our national life when so many vital issues seem to be deliberately obscured by lies and half-truths, this book delivers the kind of clarity, backed by research and insight, that comes as a welcome relief."
—VIVIAN GORNICK, author of Fierce Attachments
"Cristina Page, at long last, unmasks the dirty little secret of America's right wing fanatics. They don't like sex. They don't support birth control. Their nutty obsessions pose a very real threat to a century's worth of social and economic progress. All who cherish freedom must read this original, compelling, and carefully documented work."
—ELLEN CHESLER, author of Woman of Valor: Margaret Sanger
and the Birth Control Movement in America
"Finally, a history that accords the women's liberation struggle its rightful place at the center of the times in which we live. Every political reporter and pundit should read this powerful and insightful book. It'll wake them up."
—LAURA FLANDERS, author of Bushwomen
"The Christian Right is often pilloried, but seldom understood. Cristina Page shows us that pro-lifers aren't just waging war against abortion; they're targeting contraception and even sex itself—abusing science, and causing considerable societal damage in the process."
—CHRIS MOONEY, author of The Republican War on Science
"From the very first sentence of her book, it's clear that Cristina Page is looking for common ground—profound understanding—between those frightened to interrupt biology in motion and those determined to control their own destiny."
—ARIEL LEVY, author of Female Chauvinist Pigs
"Cristina Page has written a powerful, persuasive and well-documented account showing how the policies of the Pro-life movement result in millions of unintended pregnancies and abortions—not to mention hundreds of thousands of deaths."
—CRAIG UNGER, author of House of Bush, House of Saud:
The Secret Relationship Between the World's
Two Most Powerful Dynasties
"In a well-researched and pointed critique of prolife excesses . . . her defense of the sexual revolution in upbeat—even patriotic—terms makes this a spirited, thought-provoking addition to the culture wars."
Publishers Weekly
"A provocative salvo in the abortion wars."
Kirkus Reviews
"The issues Page puts forth directly concern the women on the University campus, whether they believe that life is sacred in any form or that we have the right to decide. In fact, they concern men as well. They concern politics, freedom and an entire country's future."
Minnesota Daily
"A powerful condemnation of the pro-life movement's influence and methods."
Sun-Sentinel, Fort Lauderdale, Florida
"A well-researched and thoughtful look at the politics behind reproductive issues and the implications for all Americans, whatever their position on abortion."
"Page does what most liberal Democrats in elected office are afraid to do; she goes through the eye of the storm and comes out the other side victorious."
Buzzflash Reviews

To my mother,
my husband
and my son

Preface to the 2012 Edition
WHEN I BEGAN research for this book in the early 2000s, the war on contraception was hidden in the background of America's political wars, which is how the anti-contraception forces wanted it. Their campaigns were covert by design, allowing the anti-contraception "pro-life" movement to quietly work to roll back access without broadcasting their plans to an American public that, both pro-life and pro-choice, strongly supports (and near universally practices) family planning.
Back then the public, as well as partisans, focused mainly on the battle over abortion. But after several years of research it became abundantly clear to me that pro-lifers were pursuing another camouflaged and comprehensive (and frightening) goal: banning contraception. The evidence was there to uncover in local media coverage; it was even posted at times on the websites of local prolife groups. One of the surest signs of an organized movement is the consistency of its message. And everywhere I looked, I could see the same talking points bubbling to the surface: contraception is abortion. It's a false statement, but it was being sold with force and skill, and I could see it subtly creeping into public debate.
Since then, the political landscape has changed in one crucial way. The war on contraception is now out in the open. Indeed it seems to be unfolding before our eyes. It is a central battleground issue in the 2012 presidential election, an election that will determine the degree to which women will have access to contraception as well as the immediate fate of the largest family planning provider in our country: Planned Parenthood.1
The leading Republican candidates have taken a stand—many forced to by an increasingly powerful right-wing movement. And each has proudly proclaimed him or herself to be against contraception. Presidential contender Rick Santorum is most proud of his opposition to contraception. And why not? As I learned last time around, he had hoped to be the architect of the anti-contraception cause while in the Senate. During his presidential campaign Santorum said that states should be allowed to ban contraception2 and, more frightening, while he'd been a US senator he defined the most common forms of contraception to be "abortifacients."3 Santorum went even further. He targeted not just birth control but sex, which he views as an activity fraught with moral danger. He explained recently, "One of the things I will talk about that no other president has talked about before is, I think, the dangers of contraception in our country. The whole sexual libertine idea that many of the Christian faith have said, 'Well, it's OK, contraception is OK.' It's not OK. It's a license to do things in a sexual realm that is counter to how things are supposed to be. They're supposed to be within marriage, for purposes that are, yes, conjugal and unitive, but also procreative."4
Of course, as this election year proves, one doesn't have to be a long-term or true believer to join the anti-contraception forces. The once-moderate Mitt Romney, the likely 2012 Republican presidential nominee, is now running to the front of the anti-contraception parade. As governor of Massachusetts, Romney had staked out the once-honored Republican positions against government intrusion into our private lives. He was pro-privacy, and yes, pro-choice and pro-contraception.5 This election year, the anti-contraception forces have become so powerful that, as with his Mormonism, Romney tries to distance himself from his pro-contraception past. At campaign stops he tries to outdo his GOP competitors, even promising to kill Title X—the nation's contraception program for the poor launched by Republican President Nixon.6 Once, Romney vied for the support of Planned Parenthood. Now he's intent on burying it. "Planned Parenthood?" he said. "Oh, we're gonna get rid of that."7
The takeaway is clear: the fervent anti-contraception minority of the Republican party—the group that I document in my book—now controls an important part of the party's agenda. Once upon a time Republicans were champions of contraception—from Nixon through the first Bush.8 Indeed, nearly a century ago, they were the chief proponents of Planned Parenthood. A 1927 poll found Planned Parenthood's membership (then called the American Birth Control League) was more Republican than the rest of the country.9 It's not just those with values as flexible as Romney's that kowtow to this extreme group. This year the Republican Party is uniting behind an openly anti–birth control plank.
The great irony of this position is that 99 percent of women ages eighteen to forty-four use or have used contraception.10 But the real lives and real needs of Americans hardly seem to matter. Ideological, religiously inspired purity is what counts now. The most frightening aspect of this new development is that a president has tremendous power to almost single-handedly reduce access to contraception. The federal government has relatively modest influence on abortion policy, which is still mainly battled out in the states and the courts. But the feds all but control policy on contraception. The federal government approves new birth control methods, decides the level of federal funding available for family planning services for poor Americans, chooses whether employers can refuse employees contraception in health insurance coverage for ideological reasons, and determines what and whether teens learn about contraception in school.
And with contraceptive policy, decision-making power is not equally distributed among the branches of government. Almost all of these decisions can be taken by one federal official: the president. This year, if President Obama's Affordable Care Act remains law, the federal government will provide unfettered access to contraception for those who want it. But the victory for women could be short-lived. The Department of Health and Human Services, at the discretion of the president, defines which medications are considered "preventive" and thereby covered.11 With an anti-contraception minion in the Oval Office, any medication considered a contraceptive could simply be highlighted and deleted.
In just one illustration of how this could play out, it's worth noting that President George W. Bush, as I point out in my book, realized much more of the anti-contraception agenda than the anti-abortion agenda. Meanwhile, President Obama, if he succeeds with contraceptive coverage in health care reform, will have done more to expand access to contraception than any president before him. It's no exaggeration to say that the election of the president has become a referendum on the right of Americans to plan their families.
Since the publication of my book in 2006 and the anti-contraception movement's emergence from the closet, I've noticed an interesting and important characteristic. They are taking lessons from their decades of experience in limiting access to safe and legal abortion. With abortion, they discovered that incrementalism, distraction, and distortion are a powerful potion to serve the public. As detailed in Chapter 1, it is the same poisonous drip they're feeding Americans about contraception. And so, despite the fact that access to contraception is now as accepted a public health policy as vaccination, the anti-contraception movement continues to make headway.
One important example of this is the brazen (and hostile) way that some are willing to decry contraception. Two recent sound bites illuminated—the way lightning does—the self-confidence of anti-contraception forces. After President Obama announced that women would have contraception coverage in the Affordable Care Act, Rick Santorum's top donor to his presidential bid, Foster Friess, in an interview with Andrea Mitchell of MSNBC, offered American women a contraceptive proposal of his own.12 Friess explained, "Back in my day, they used Bayer aspirin for contraception. The gals put it between their knees and it wasn't that costly." Needless to say, keeping one's knees shut rarely works in practice, as the failure of abstinence-only programs reflect (detailed in Chapter 3).
This casual paternalistic insult was followed quickly by the overwrought, overpowering voice of Rush Limbaugh, the childless three-time divorcee who likes to speak for Republican family values. Rush as much as anyone has brought this issue before the public, revealing if not the core beliefs then the true emotions of many of his right-wing listeners. The apparent trigger for Rush's contribution was the testimony of a Georgetown University law student, Sandra Fluke, before a Congressional hearing on the contraceptive coverage bill. She explained that during three years spent in law school, birth control could cost $3,000.13 She added that 40 percent of the school's female population suffered financial hardship as a result of having to pay for birth control. These seemingly anodyne statements got Rush into a near-steroidal rage. "What does it say about the college co-ed Sandra Fluke, who goes before a congressional committee and essentially says that she must be paid to have sex, what does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex. She's having so much sex she can't afford the contraception." Like Friess, Rush had a proposal for American women too, explaining, "So, Ms. Fluke and the rest of you feminazis, here's the deal. If we are going to pay for your contraceptives, and thus pay for you to have sex, we want something for it, and I'll tell you what it is. We want you to post the videos online so we can all watch."14 Rush's idea did not go over well with the American public. But over the course of a few days, as the rebuke of Rush grew more intense, he dug in deeper. Rush claimed Fluke to be "a woman who is happily presenting herself as an immoral, baseless, no-purpose-to-her-life woman. She wants all the sex in the world whenever she wants it, all the time, no consequences. No responsibility for her behavior."
Here in bold, almost cartoonishly chauvinistic terms was a revelatory insight into the views of the anti-contraception extreme. Anyone who uses contraception is a sexpot, a libertine, a social miscreant. It is a bit of Victorian morals channeled through an angry 1950s patriarch. Through his megaphone Rush was proclaiming loudly what I'd found whispered six years ago; that many people in the anti-contraception movement believe at their core that sex for pleasure is wrong and anyone using contraception, particularly women, should be shamed. It is difficult to escape the view that what they most pine for is a world in which the role of women is simple and straightforward. Women should stay home and raise children. This is a bedrock pro-life ideal.
And so, the research and perspectives herein are more (de)pressingly relevant than ever—indeed, more urgent to understand than ever. And one can best understand the current agenda, and its sinister appeal, by knowing its organizational roots as well as the personalities and influences that shaped it, and probing the devilishly clever stratagems this movement has concocted to advance its radical agenda. For even though the issue has burst onto the public square, it has been and will be camouflaged as something else, just as it was when I first dug into the subject. The deft masters of spin will present the issue of contraception as something more resonant, with message-tested talking points that cause the public to think it's about something other than hijacking our most important of life decisions and sabotaging our ability to plan a family. It will be disguised as a supposed question of religious liberty—that your attempt to plan whether or when to have a child violates a total stranger's individual conscience—or, more disingenuously, under the fig leaf called abortion.
This campaign has begun. The Catholic bishops oppose a law providing contraceptive coverage to women because of its supposed infringement on the rights of the Church. And Charmaine Yoest, president of the national pro-life organization Americans United for Life, speaking on a panel at CPAC, the influential right-wing conservative conference, of a winning strategy, advised the party brass in attendance (and everyone watching the video of the panel posted on YouTube) to conflate contraception15 and abortion when discussing the president's contraceptive coverage. "Our organization is going to really start being very disciplined about talking about the abortion mandate"—rather than what it really is: insurance coverage of contraception—"coming from HHS (the U.S. Department of Health and Human Services) and I would encourage everybody to do the same." Conflation, such as calling run-of-the-mill contraception abortion, is a technique that has proven as reliable for pro-life operatives as distraction is for pickpockets.
And so perhaps we should welcome the strident voice of anti-contraceptive forces. The debate is now public, the stakes open, the sides drawn. This is a long-overdue national conversation and we're having it just in the nick of time. Hopefully, this book will help broaden and inform that conversation. What needs to be understood, and what I hope this book makes clear, is that the anti-contraception movement has arisen in direct response to societal changes set in motion by the pro-choice, pro-contraception movement over the last fifty years; societal changes that represent a set of gains that most Americans will not live without. As Gloria Feldt, former president of Planned Parenthood Federation of America and author of The War on Choice, explains, "This is not about abortion, it's not about birth control, those issues are the tip of the ideological iceberg. It's about women's changing place in the world. The changing power structure terrifies them."16 The anti-contraceptive movement is not merely a personal choice; it is, in essence, an attack on our way of life.
It's the pro-choice, pro-contraceptive world in which we actually live today, and we're lucky for that. It's in this world that, thanks to family planning, women can be lawyers, doctors, pilots, whatever, as well as mothers. The wide use and distribution of contraception has been a building block of the revolution in how women live. And the benefits have spread far beyond women. Yes, women taking advantage of changes wrought by the pro-choice, pro-contraception movement, go to college in greater numbers than men, earn as much, decide elections. As Cecile Richards, president of the Planned Parenthood Federation of America, boldly puts it, "Women are the majority of voters now, and we have the power to decide the future of this country. Women are watching and we vote." And others have much at stake too. Generations of children have prospered from better-educated, worldlier, more independent, and wealthier mothers. The expanded lives women enjoy have in turn allowed a generation of men to be better and more involved fathers, lovers, friends, and colleagues. (Some of the greatest damage to the pro-choice cause comes from friendly fire, from those who cast this issue as one that exclusively concerns women.)
Pro-lifers tend to believe, as Rick Santorum has recently articulated, that sex should be for the sole purpose of producing a baby. Pro-choicers tend to accept sex as something that people do for intimacy and for pleasure too. And because of that, they work for wider use of contraception. More than that, pro-choicers celebrate the power of family planning in our lives, the power to choose when and if we want to have a family (and to decide, once we've begun one, how large it should be). And this, let's face it, is in step with the way Americans live. The average American woman spends thirty years of her life trying to prevent pregnancy.17 Even 85 percent of Catholic women,18 in defiance of Church doctrine, support expanding access to artificial birth control (and 98 percent of sexually active Catholic women have practiced it as well19). The pro-choice side rejoices in every societal advance that has come from this simple control, which is nothing short of a flowering of equality in school, at work, and at home.
The pro-choice movement may have ceded much of the rhetorical advantage to the "pro-life" movement, but it's the pro-choice movement that has helped construct and that now defends our dearest values, those that Americans largely identify as their own. We value control over our destinies, independence, equality. These are pro-choice values, and they have come to represent the best values of our culture. What this book details is how the pro-life, anti-contraceptive movement is trying to undo all the gains, particularly for women, that we now take for granted.
April 2012
For dispatches from the war on contraception, please follow me on Twitter at @cristinapage and become part of the conversation in the Facebook group Feminism on Facebook.

chapter one
Rights in Jeopardy
January 2004: A woman is released from the emergency room. She's just been raped. After treatment, she is given a prescription for emergency contraception (EC) to prevent her from getting pregnant by the attacker. This is standard procedure. EC is just two birth control pills, but taken up to seventy-two hours after sex it is effective at averting a pregnancy. A friend takes her to an Eckerd pharmacy in Denton, Texas, to fill the prescription. Though the pharmacist had declined five or six times in the past to fill such prescriptions, this is the first time a rape victim has requested the medication. The pharmacist goes to the back room, prays, and calls his pastor before deciding not to fill the prescription. The two other pharmacists on duty decline to fill the prescription as well.1 The friend of the rape victim explains, "I had been watching my friend, her emotional state going down and down and down. And I knew I was going to have to . . . say, 'Sorry, you know, morally they say you're wrong.'" 2
March 2004: Julee Lacey, a thirty-two-year-old first grade teacher and mother of two, is told by her local CVS pharmacist, "I'm sorry, but I personally do not believe in birth control, so I will not fill your prescription." Lacey's husband and the assistant manager of CVS cannot persuade the pharmacist to change her mind. "I think my doctor should make these decisions," Mrs. Lacey says. "If they're going to decide not to do birth control pills, where are they going to draw the line? A lot of doctors don't believe in transplants," she adds. "Where will this go?" 3
July 2004: Idalia Moran attempts to fill her prescription for birth control pills at a Medicine Shoppe pharmacy in Fabens, Texas. The pharmacist, after having recently listened to a radio program that claimed birth control pills cause abortions, tells Moran he will not fill her prescription because it is against his religion. Moran then drives thirty-three miles to El Paso, the next nearest pharmacy willing to fill her prescription for standard birth control pills.4
September 2004: On a Saturday night, twenty-one-year-old single mother Suzanne Richards tries to fill a prescription for emergency contraception at the drive-through Brooks pharmacy in Laconia, New Hampshire. The pharmacist declines to fill her doctor's prescription and tells her, "I believe this will end the fertilization of the egg and this conception was your choice." Richards pulls her car over in the parking lot and cries. She returns to the pharmacy later that night with her father; the pharmacist again refuses to fill the prescription and will not tell her where she can get it filled. Richards explains, "He said I was irresponsible. Well, I think it's irresponsible to have kids you can't take care of and raise."5
MOST OF US HAVE LONG ACCEPTED the terms of one of the central debates of American culture, the debate over abortion. The first thing that we accept is what it's about, which is supposed to be abortion. On one side, a movement that cleverly calls itself pro-life (suggesting that its opponents must be, needless to say, pro-death) says it opposes the right to abortion. On the other side, a movement that less cleverly calls itself pro-choice supports the right to abortion.
But when you take a closer look, these simple views of what the two sides stand for hardly begin to describe what lately is, and really always has been, at the heart of this growing American conflict. These movements encompass far more; abortion isn't the keystone issue anymore. It's birth control and, more to the point, Americans' sex lives. Abortion has been the attention-getting focus, the easy divider, a convenient way to rally troops, but the pro-choice and prolife movements are essentially about competing ways of life. Indeed, to be pro-life today means to be inside a movement that finds fault with every kind of birth control, from the Pill, which revolutionized women's (and men's) lives, to the condom, which in our era is the last stand against the most virulent sexually transmitted diseases (STDs). To be pro-life means to favor abstinence until marriage, in part because they believe that sex is supposed to be for one purpose only: to procreate.
Those vigilante acts of obstruction-by-pharmacist, which grow in frequency each year, appear on the surface independent from one another. And as such, they seem a little kooky, a little outrageous. Who is this wayward pharmacist defying a doctor's order? Who, because of his own dubious religious notions, takes a patient's medical destiny in his own hands? But these are not random acts. Behind each are the force and rhetoric of the pro-life movement, taken directly from their newsletters and downloaded off their Web sites.
And there's more than just rhetoric involved. Every time these acts have been challenged (who knows how many times they have not been), the pro-life movement has responded with legislation to protect, lawyers to defend, and spokespeople to spin for the pharmacists who have denied women the chance to prevent pregnancy. Why, one might ask, would the pro-life movement invest itself in such extreme acts, not against abortion but against birth control? If the movement's only aim is to stop abortions—and stop them by any means—then why attack people who say they don't want to get pregnant? If you don't want people to have abortions, then why not help them prevent unwanted pregnancies? After all, studies have shown that the use of contraception reduces the probability of having an abortion by 85 percent.6


On Sale
Jul 31, 2008
Page Count
256 pages
Basic Books

Christina Page

About the Author

Cristina Page is Vice President of the Institute for Reproductive Health Access of NARAL Pro-Choice New York. She lives with her husband and son in New York City.

Learn more about this author