Fighting for Reproductive Freedom

Nicki Nichols Gamble chairs the board of directors at the ACLU Foundation of Massachusetts. She has been involved in the reproductive rights movement for over 60 years, including 25 years as the former president and CEO of Planned Parenthood League of Massachusetts. Jessie Rossman is a staff attorney at the ACLU of Massachusetts.

2021 was a big year for abortion rights—from Texas, to Mississippi, to our neighbors in New Hampshire. What is the state of abortion rights in our country, right now?

Jessie: 2021 was a historically challenging year for abortion access. State legislatures passed more than 100 abortion restrictions—the highest total in the 49 years since Roe v. Wade was decided. This includes SB 8, the Texas law that bans abortion as early as six weeks of pregnancy and creates a bounty-hunting scheme for private citizens who successfully sue anyone who helps a patient get care after this cutoff. The law was designed to evade judicial review, and states are already introducing copycat bills across the country. These restrictions disproportionately burden people of color and low-income people seeking abortion access. At the same time, the Supreme Court heard Dobbs v. Jackson Women’s Health Organization, a challenge to a Mississippi ban of almost all abortions after 15 weeks. Based on oral arguments, a majority of the Court seems poised to either entirely overturn Roe or significantly gut its protections.

Looking back on your lifetime of experience in this field, how did we get here?

Nicki: From the beginning in 1973, following the landmark Roe v. Wade decision, I have ridden a political rollercoaster regarding the legality and availability of abortion in the United States and throughout the world. I have spent many years “talking to the enemy” regarding the moral, legal, and public health aspects of abortion rights. I have devoted almost all of my professional career debating the importance of and providing safe, legal, affordable abortion care to women regardless of their ability to pay.

I began my Planned Parenthood career in 1974 with a commitment to give five years to the movement and ended up giving closer to 50. Initially, I thought the Roe decision was an inflection point that would change the course of history—permanently creating an area of personal privacy for women to make their own decisions about childbearing, free from government intervention and protected by democratic principles of equality and justice for all.

Within days of my becoming head of Planned Parenthood and a co-conspirator with ACLU, parental consent legislation was approved by the state legislature; Kenneth Edelin was indicted and convicted of manslaughter for an abortion performed at Boston Medical Center (he was subsequently acquitted); Medicaid restrictions on abortion funding for low-income women were defeated in Massachusetts by an ACLU-led state constitutional challenge; heated anti-abortion protests outside of provider offices led to clinic break-ins and vandalism; and extreme violence culminated in the maiming and killing of abortion providers and clinic staff members including two young women in Brookline. One of these women was my staff member, Shannon Lowney.

Hardened facilities included bulletproof glass, electronically-controlled locks at doors, armed guards, identification cards, badges. COVID precautions seem mild in comparison; protections against school shootings are a more appropriate metaphor. Fear, hate, and intimidation were de rigueur. The assaults ran a spectrum between nuisance challenges and serious blows that could destroy the provision of abortion services for almost all women. Each of them fell into a set of attacks requiring costly, protracted litigation. The external environment became increasingly hostile, dangerous, and demoralizing. Every executive judicial appointment, especially appointments to the Supreme Court, became opportunities to kill Roe.

Now, we are on the precipice of having the Roe decision either struck down completely or diminished substantially. We have arrived in a place where the battles will be engaged over access to medical abortion, where out-of-state travel becomes essential to preserving reproductive health, where small impediments become immoveable objects, where grassroots organizing becomes key to preserving reproductive health and dignity. We must continuously be alert and vigilant. We can never forget the past. We can never rest on our laurels.

If Roe v. Wade is overturned, what would it mean for the already super restricted abortion rights in states like Mississippi? And what would it mean for states that don’t have restrictions?

Jessie: Such a decision would have an immediate impact on abortion access in this country. Nearly half of the states are already poised to ban or significantly limit abortion if Roe is overturned. Several more states are likely to quickly follow suit. Here in Massachusetts, the ACLU and the ROE Act Coalition worked with leaders in the Massachusetts legislature to pass the ROE Act in December 2020. The ROE Act strengthens access to abortion care and ensures that abortion will remain safe, legal and accessible in Massachusetts—even if the Supreme Court undermines federal protections for reproductive autonomy. Given the nationwide landscape, we are working now to ensure that legal access translates into real-world, equitable access to reproductive health care for all who need it.

How is the ACLU fighting back?

Jessie: Every step of the way, the ACLU is fighting back. We are challenging abortion bans, including SB 8, and barriers to care in dozens of state houses and courts across the country, including the Supreme Court. And we are achieving some hard-fought victories: In response to a 2017 ACLU lawsuit, the FDA in 2021 permanently repealed its medically unnecessary restriction requiring in-person dispensation of mifepristone, used for miscarriage care and medication abortion, allowing patients to receive the medication by mail or delivery. This decision will increase access to abortion care in many states across the country. Our fight will continue until we can put an end to every restriction that blocks people from getting the care they need.