"I Could Lose My Uterus—and Maybe Even My Life": Abortion Politics, Women's Rights, and the History of Conscience Clauses

In March of 1973, shortly after the Roe v. Wade decision, the Senate passed the Church Amendment, the first federal law allowing medical providers and institutions receiving public funding to refuse to provide or perform abortions or sterilizations for reasons of religious belief or moral conviction, by a vote of 92 to 1. In subsequent years, almost every state passed similar legislation. Today, 46 states allow some health care providers to refuse to provide abortion services; 18 states allow some health care providers to refuse to provide sterilization services; and 13 states allow some health care providers to refuse to provide services related to contraception. Pro-life activists and politicians and the Catholic Church have worked hard to expand and enforce these restrictions, while women’s health advocates, physicians, and reproductive rights activists have worked hard to push back against them. Tracing the proliferation and politicization of these so-called “conscience clauses”, this paper examines the periodic eruption of “conscience wars” in congressional debates, courtrooms, doctors’ offices, pharmacy counters, and public discourse. Focusing in particular on how these restrictions have impacted women’s lives, this paper concludes with an examination of a 2006 Massachusetts lawsuit that resulted in a unanimous decision by the Massachusetts Board of Registration in Pharmacy requiring Wal-Mart to provide Plan B, a form of emergency contraception. Debates over conscience clauses emerge at the fault line of American law, religion, medicine, and politics. Tracing this forty-year history reveals how professional organizations, social movements, and individuals have shaped this fault line in the context of reproductive health.