A provocative voice with a vision.

The A Word--Abortion: Real Women, Tough Choices, Personal Freedom Mary Ann Sorrentino (Gadd Books, 2006, 224pp) 0977405338, $17.50

THE MAJORITY OF AMERICANS continue to support keeping abortion legal, and one in three U.S. women will have an abortion at some time during her life. But polls show that many Americans are willing to impose restrictions on women's right to choose. Most state legislatures have antichoice majorities, reflecting an electorate that appears increasingly ambivalent about abortion. Many national prochoice organizations are reacting to this political climate by changing their messages to focus on prevention and contraception.

The A Word opens with a direct challenge to this strategy. Mary Ann Sorrentino, who was the executive director of Planned Parenthood of Rhode Island from 1977 to 1987, identifies the issue of abortion as fundamentally about real women and their right to personhood. Having seen the cost of illegal abortion and watched the erosion of access to abortion since Roe v. Wade, Sorrentino casts The A Word as a call to action by a woman with a deep history in the abortion debate. Sorrentino was a pioneer in the days when only 20 Planned Parenthood affiliates nationwide, including hers, provided abortion services, and this history informs her passion.

The author's stated goal is to inspire the reader with a new or renewed understanding of the women at the core of the reproductive fights debate, in order to motivate new generations of women and men to fight for abortion rights. Sorrentino provides an overview of the abortion issue and rebuttals to many common antichoice arguments, interspersed with her personal experiences defending abortion on the front lines. The A Word includes chapters that, in straightforward language, dispel the myth of the "solution" of adoption, discuss the role of men in the abortion decision, and capture the stories of some of the women who have chosen abortion as their solution to unwanted pregnancy. Through these stories, The A Word returns the experiences of real women to the forefront of the abortion debate.

Sorrentino focuses a clear eye on how women's lives have been eclipsed in the abortion conversation, because antichoice zealots have elevated the position of the fetus above more than 50 percent of the living humans in the United States. She accurately identifies this focus on the fetus as a core tool used to mobilize conservative voters, and identifies how the promotion of the fetus over living people plays out in the current struggle over stem cell research. She describes the surge of laws that seek to protect the fetus by criminalizing the behavior of pregnant women, and how these laws dehumanize pregnant women by making their right to health secondary to that of the potential life that they are carrying. In several parts of her book, Sorrentino highlights the irony that, while using every resource possible to protect the unborn, state and federal governments have slashed spending on child welfare and maternal health.

The book becomes less incisive as Sorrentino suggests next steps for the movement. On the one hand, she argues for tenacious advocacy for legislation that protects abortion rights, and shares her own successful work in confronting the heavily Catholic legislature in Rhode Island. She states that the lack of federal legislation banning abortion points to the lack of national will to further restrict abortion, and that prochoice advocates must push "our" politicians to step out on the abortion issue. This position overlooks a number of significant antichoice laws and regulations passed by Congress recently. The Weldon Amendment, attached to a 2005 appropriations bill, creates conflicts with existing state laws that mandate aspects of abortion (for example, that require that certain abortions be funded from state coffers) by allowing health care providers to refuse to be involved in any way in an abortion. Two states are suing to overturn this amendment, but it remains in effect. Restrictions passed on the use of federal Title X funds deny women access to abortion at many community health centers. The Teen Endangerment Act (also called the Child Interstate Abortion Notification Act or Child Custody Protection Act) would make it a federal crime for any person other than a parent to help a young woman travel to another state to obtain an abortion if she has not complied with the forced parental involvement law of her home state. It also would impose a federal parental notification and mandatory delay requirement when a young woman seeks an abortion outside her state of residence. Different versions of the bill have passed both the House and the Senate. In the face of these laws, it is difficult to argue, as Sorrentino does, that a winning strategy is to pressure Congress to advocate for prochoice legislation, unless, of course, all three branches of government are controlled by prochoice majorities.

In a more controversial vein, Sorrentino urges "prochoice extremists" to move away from advocacy for access to later abortions, identifying the public discourse on the "partial-birth" abortion ban as harmful to the prochoice movement. Although she may be correct that the debate on late abortions has eroded support for abortion rights, this is because the movement has not adequately developed and promoted a broader vision that keeps the lives and human rights of women at the forefront. Sorrentino starts with a strong focus on women, but then develops her arguments in ways that ultimately exclude some of the most vulnerable women, those who need later abortions.

Sorrentino does advocate a Maternal Child Health Initiative that incorporates the right to abortion, the right to medical care and the right to not be victimized. This presents an important alternative to current strategies that focus on prevention or the rights of the fetus, and links the fight to abortion to the right to have healthy children and safe families. However, Sorrentino's proposal could be even more inclusive. A reproductive justice framework that is built on the human rights of all women in our country to health, safety, the right to bear and raise children and the right to abortion--and that makes explicit how race and class intersect with these issues--would lead to a more comprehensive strategy for mobilizing support for the issues that Sorrentino cares about. This framework would move beyond a legislative strategy and beyond the current political climate, embracing a long-term vision that could build a broad organizing base that includes all women, including the young and low-income women who seek to end later pregnancies.

Sorrentino has added a provocative voice to the current debate about how to develop a successful movement for abortion rights. We must build on her vision of linking abortion to other human rights issues, and go beyond legislative advocacy if we are going to effectively protect and expand all women's reproductive choices.

SUSAN YANOW, LICSW, is 17 long-time reproductive rights activist, co-founder of the Abortion Access Project, the Boston Reproductive Rights Network, the Training and Access Working Group, and the Hospital Access Collaborative. She now works as consultant to a number of reproductive rights organizations.