New Civil War: The Psychology, Culture and Politics of Abortion
Linda J. Beckman and
S. Marie Harvey (Eds.)
Washington, DC: American Psychological Association, 1998.
by Joan C. Chrisler, reprinted from the Psychology of Women
Quarterly , 24, 200-201.
As I began to read The New Civil
War, I was reminded of the feminist slogan from the 1970's:
"Women's health care is political." If you have any
doubt that women's heath care is still political, if you think
that the government's Women's Health Initiative is the solution
to the neglect of women's health needs, if you are too young to
have lived through the full cycle of the gains and losses of the
pro-choice movement or are curious about why psychologists would
concern themselves with a controversial medical procedure, this
book is for you. If you know the answers to these questions but
are looking for ideas for your next research project, want some
advice about assisting women clients with making reproductive
decisions and coping with their ramifications, or want to read
and engaging, comprehensive, and persuasive example of how and
why to do psychology in the public interest, this book is for
Beckman and Harvey have assembled an
interdisciplinary set of contributors in order to place abortion
in its historical, cultural, and sociopolitical context. The authors
are health care practitioners, academics, consultants, and policy
advocates. Most are psychologists; some come from related fields
with important perspectives to offer (e.g., anthropology, law,
medicine, public health). The focus of the book is clearly psychological.
The authors are explicit in their goals to set a research agenda,
to improve counseling and psychotherapy services for women who
are making reproductive health choices, and to urge a return to
the activist roots of feminist psychology. In their concluding
chapter, the editors insist that psychologists have a responsibility
to share their knowledge with legislators, policymakers, and the
media so that accurate information about the psychology of women
and the diversity of women's health care needs will be included
in the ongoing abortion debate.
The book consists of a foreword, introduction,
conclusion, and 15 substantive chapters, which are divided into
four sections. The chapters are primarily literature reviews,
but some contain information that cannot be found elsewhere: data
previously unreported, clinical experience, and accounts of activism.
All chapters contribute to the editors' goals, and the diversity
of the authors' points of view make for interesting reading.
Part I, entitled "The Sociopolitical
Context of Abortion," contains a history of U.S. federal
abortion policy, an examination of the reasons why abortion is
a controversial issue, a discussion of the many barriers to abortion
access even when it is legal, and a consideration of the impact
of antiabortion activities on women who seek services. I found
the last chapter to be particularly interesting and thought provoking.
Antiabortion activities have clearly had an impact on the delivery
of services: many clinic workers have been harassed, threatened,
even physically harmed. News reports of clinic bombings and murders
of physicians have led to difficulty in finding trained personnel
to staff clinics and a major barrier to access is the lack of
service providers. Yet, we know little of the impact that antiabortion
picketers and "sidewalk counselors" have on women who
use the clinics' services. Stress and coping theories suggest
that anything that increases a patient's stress level prior to
medical procedures could influence outcome, yet little has been
done to examine the stress of encountering angry activists at
the clinic's door. Nor do we know whether pro-choice activists
acting as "escorts" can moderate the effects of the
stress. In their chapter, Cozzarelli and Major outline the applicable
theories, make predictions, review the little work that exists,
share some of their own data, and suggest research directions
that one hopes readers will follow up.
Part II, entitled "The Cultural
Context of Abortion," contains chapters on abortion attitudes
of and use of services by African Americans, Latinas, Asian Americans,
and Pacific Islanders. The authors discuss the ways in which ethnic
minority women's attitudes are similar to and different from those
reported in mainstream population surveys. Particularly interesting
were the discussions of the effects of religion, acculturation
(and the legality of abortion in the home country of immigrant
women), and the history of denial of reproductive rights to Black
women on current attitudes and how discrepancies between attitude
and behavior are resolved when women decide to have an abortion
even though they would say that in general they are against it.
I wish this section had contained a few more chapters. I would
have liked for example, to read about Native American women, particularly
because the federal government has refused to allow abortion in
hospitals run by the Indian Health services, and about Jewish
women particularly because so many Jews have provided leadership
in pro-choice movement and as an illustration of how another major
religion affects its followers' attitudes.
Part III, entitled "Intrapersonal
and Interpersonal Contexts of Abortion," contains chapters
on adolescents and abortion, men's attitudes toward abortion,
women's attitudes toward medical versus surgical abortion, the
relationship of violence against women to unwanted pregnancies,
and the testing of a model of psychological sequelae of abortion.
The chapter on men's attitudes concerns an understudied population,
and I found Marsiglio and Diekow's discussion of the political
philosophies of various segments of the men's movement to be enlightening.
The chapter on violence by Russo and Denious was among the strongest
chapters in the book. Although we know that violence is widespread
and related to a lot of women's issues, the authors do an excellent
job of showing how this particular relationship should inform
clinic procedures and public policies.
Part IV, entitled "Abortion in
the Context of Practice," consists of chapters about counseling
abortion patients, clinical approaches to abortion issues in psychotherapy,
and what we can learn from other countries to improve medical
service delivery. I was surprised and pleased to see the international
chapter. Rarely do Americans consider what we can learn from colleagues
in Kenya, Bangladesh, or Nicaragua, yet there are many suggestions
for policy and training that could be very helpful in removing
some of the barriers to access in the United States.
This is a book that will appeal to psychologies,
lobbyists, policymakers, clinic personnel, and students of psychology,
medicine, women's studies, and political science. Most of the
chapters are accessible to students, and I encourage faculty to
consider adding to their syllabi some chapters from The New