For almost 16 years, legalized abortion has been the law of the land, established by the Supreme Court in a case known as Roe vs. Wade.
That decision's principle--abortion on demand in the first six months of pregnancy--has withstood bombing of abortion clinics and verbal bombasts from those who call abortion murder.
But some suspect the principle may not last much longer than the next round of appointments to the Supreme Court, especially if any of the elderly justices who have voted for abortion on demand die or retire and are replaced by a President strongly opposed to it.
In the first presidential debate this year, Republican George Bush and Democrat Michael Dukakis disagreed squarely on the issue: Dukakis said he personally opposes abortion but believes the choice should be left to the woman. Bush said he opposes legal abortion, except in cases of rape or incest or to save the mother's life, and added: "I oppose abortion and I favor adoption . . . let (these children) come to birth and then put them in a family where they'll be loved."
Abortion versus adoption. What is the reality? Would there be homes in Los Angeles County waiting for those children? What might be the impact on the county's adoptions system, which since 1973 has shifted its focus to the needs of "unadoptables?"
What would be the effects on medical care and other public social support systems if abortions were no longer legal? What would be the fate of "drug babies," AIDS babies and others born afflicted? Does society need to revise its attitudes toward women who place children for adoption?
Most answers are, at best, educated speculation--and enormously contentious.
Pro-choice advocates do a slow burn over what Carol Downer, founder of the Feminist Women's Health Center in Los Angeles and executive director of the national Federation of Feminist Women's Health Centers, calls Bush's "Marie Antoinette, let-them-eat-cake" approach to dealing with unplanned pregnancies.
"If George Bush were willing to make a society where a woman could assure her child of what it needed without having to be dependent on a man, or without having to interfere with her education or without having to destroy her career . . . he and I wouldn't have much disagreement," Downer said. "And, believe me, we would reduce abortion considerably."
Right-to-life proponents take an equally outraged stance: Abortion is murder, they contend, and a society that condones killing a fetus is sick.
"It's really a sad commentary when we take our unadoptables and murder them," said Susan Carpenter-McMillan, president of the Right to Life League of Southern California and of the national Feminists for Life. "You might as well go into all the old folks homes, all the hospitals where people are unwanted, all the prisons, and take a gun and shoot them."
She is irate that "it always gets down to money. We live in the wealthiest country in the world. All we have to do is cut back on our defense and we'll have a lot of money for unwanted human beings."
About 1.5 million abortions are performed each year in the United States, the National Abortion Rights Action League reports. In some people's vision of an ideal world, these children would be born and swiftly find homes with some of the 2 million American families waiting to adopt.
But the reality, said Mollie Cooper, chief of the adoptions division of the Los Angeles County Department of Children's Services, is that the vast majority of the 1,000 or so youngsters now awaiting adoption through the county are "not the most easily adoptable children."
The demand is for infants, especially white babies. In the early 1970s, before abortion was legal, the county was placing 200 to 250 infants for adoption monthly. Now, Cooper said, "our department probably does not place more than 20 to 30 newborns a year."
The agency now functions primarily for "special needs children" who because of their age, race or physical or mental handicaps are hard to place, she explained.
Increasingly, they have been physically or sexually abused or they carry the scars of their mothers' drug addiction.
If Roe vs. Wade were overturned and a bounty of healthy white babies resulted, Cooper wants to be sure that the "older children would not suffer"--that more money and staff would be provided to continue time-intensive services to them.
The statisticians can deduce which women choose legal abortion. But statistics do not tell which women would opt for illegal abortions, which would have their babies and keep them, which would place them for adoption.
Two new extensive surveys by the Alan Guttmacher Institute, a private New York foundation that studies family planning issues, indicate that young, poor, black unmarried women are the most likely to have abortions.
The surveys found that the rate for nonwhite women, most of them black, was 5.3 abortions per 100 women in the childbearing ages of 15 and 44; the lowest rate, for non-Latino white women, was 2.3 per 100. Overall, in each year between 1977 and 1987, almost 3 of every 100 American women in that age group had an abortion.
Why? The reasons given varied, with most women citing more than one. But the most common reasons women gave were that a baby would interfere with work or school or they could not afford a child.
Downer believes that adoption is often an imperfect answer: "It has such a nice little ring to it, it sounds so easy--'Oh, they can just adopt.' But all too often this is a harsh punishment for the (birth mother). The way our society handles adoption amounts to eternal punishment."
She spoke of the "torture" of always being reminded of a relinquished child's birthday, of the lifelong struggle by some adopted children to find their birth parents.
"I don't think the tragedy of people who can't have children justifies forced pregnancy. . . . Let's not make (women) into these little baby factories for affluent white couples who can't have babies," Downer said.
Exploitation of poor women who would be denied legal abortions is "a real possibility," agreed Right to Life's Carpenter-McMillan. "No matter what law you pass, there's always a downside. . . . But you don't justify killing human beings because there are problems."
What Life Awaits Unwanted Kids?
An unwanted baby does face an uncertain future.
The experts believe that a disproportionate number of the children who would be born, not aborted, would wind up abused or neglected, and, ultimately, some would join the cadre of "unadoptables." Others would require other forms of public assistance.
Those who support legalized abortion note that many abortion opponents are political conservatives who also oppose any increase in public spending for social support services for poor mothers.
The NOW Legal Defense and Education Fund cites a shortage of affordable, quality child care of "crisis proportions," estimating there are 7 million "latchkey" children under 13, 1 million ages 3 to 6. There are few spaces in low-cost public day care and tax credits for those who must pay out of pocket for child care do not begin to cover actual costs.
Cuts in federal budgets since 1981 for items such as family planning, sex education, parental counseling, nutrition programs and adoptions have further hurt poor women raising families.
More recently, Congress shelved a parental and medical leave act, which would have guaranteed unpaid medical leave for pregnant women and unpaid parental leave for a man or woman caring for a dependent child or parent.
If saving public money were the only criterion, abortion is, from the outset, the less expensive alternative.
According to 1986 State Department of Health Services data (the most recent available), 25,645 Medi-Cal-funded induced abortions were performed in Los Angeles County. Cost: $9.5 million. Statewide, 80,525 abortions were performed at a cost of $27.7 million. (The Hyde Amendment, in effect since 1978, prohibits federal funds for abortions except where the mother's life is threatened).
In 1986, public funds paid for 40,073 Los Angeles County births costing $75.1 million and for 111,799 births statewide costing $213.5 million.
But Dr. Ellen Alcon, medical director and deputy director of public health programs for Los Angeles County, emphasizes that it is impossible to project the effect on public programs, which she said function now "above capacity," if legal abortion were limited to cases of rape, incest or life-threatening danger to the mother.
It is not valid, she said, to assume that women would carry fetuses to term: "Before the legality of abortion, they would try to abort themselves, and we had lots of illness from that problem. It would depend upon the difficulty of getting an abortion."
Adoption: Principle Versus Reality
Pro-choice and right-to-life advocates agree on one thing: Adoption, in principle, is good.
But given reality--as of June, county foster homes held 9,050 children, 1,000 of them cleared for adoption--those who favor legalized abortion question the wisdom of bringing more babies into the world.
At any given time, said Emery Bontrager, executive assistant to the director of the L.A. County Department of Children's Services, the county is about 1,000 short of the optimum number of foster homes.
The increase in the number of women working outside the home has affected foster home availability, Bontrager said, as has failure of the state to increase reimbursements for foster parents. The monthly allotment for a child 15 or older, for example, is $433.
"Try to buy designer jeans with that," he said.
Bontrager added: "The kind of children in our adoptive system, by and large, have come from the protective service system, where the child was removed by the court or the parent abandoned the child and the court took jurisdiction."
For a year, reunification is attempted and by the time children, even infants, get into the adoption system, they are apt to be 2 or 3 years old--already hard-to-place "older" youngsters.
Emphasizing that the county takes no position on the abortion issue, Bontrager said: "I'm very ambivalent. On the one hand, there are those families who really want to adopt. On the other hand, we see so many children in our system that were not wanted but are here. And then we have to deal with them because no one else will."
Counting the Many Costs of Care
Older children are apt to come with baggage.
Kate Michelman, executive director of the National Abortion Rights Action League, which has endorsed Dukakis for president, contended that, if legal abortion is overturned, "there's no question, you will absolutely see an increase in child abuse, family dysfunction, the deepening of poverty."
Michelman, who has a master's degree in developmental psychology, spoke of the "unbelievable effect on the psychosocial development" of a child who is unwanted.
Further, she said, for every publicly funded abortion performed on a poor woman, "we save about $4 in public medical welfare costs. The hard facts are that abortions cost taxpayers less than supporting a family on welfare."
Caring for children left for adoption may become an even more ominous responsibility. Many will have mental and physical abnormalities and will spend their early years in shelters or foster homes.
Dr. H. William Taeusch, director of neonatology at King/Drew Medical Center in Los Angeles, said 45 drug-involved infants are among the 600 or so babies born there each month, and, "it rises to about 15% of babies admitted to the neonatal intensive care unit. Mothers who abuse cocaine are much more apt to have a premature baby."
Another "horrendous" problem, he said, is the high proportion of premature births, some of which are tied to lack of prenatal care.
Matching Babies, Willing Families
There is no shortage of people to adopt certain kinds of babies, said Jeffrey Rosenberg, director for adoption services for the Washington-based National Committee for Adoption, an association of private nonprofit adoption agencies.
He estimated there are 25,000 healthy infant adoptions each year in the United States, all but a few of these through private agencies or independent arrangements. (In California, lawyer-arranged adoptions are believed to account for 80% of placements.)
"We estimate just infertile couples with no kids, there are 2 million of those (waiting)," Rosenberg said. "There literally is a baby chase mentality out there."
Each year, Americans adopt 10,000 children from other nations, 6,000 of those from Korea.
Meanwhile, thousands of unwanted American children wait in foster homes. The typical "unwanted," he said, is male, 10 or 11 years old, with a history of abuse, usually sexual, a child who's been "bounced around the foster care system too many times."
Part of the problem, as he see it, is that many agencies, especially public ones, will not place a minority child with a white family despite research that shows kids in such placements "will grow up just fine. And there are lots and lots of folks who don't care about the ethnic or racial background of the child."
State guidelines dictate that county agencies try first to match the child and adoptive family by race as well as other criteria. If a minority family cannot be found to take a child, a "transracial" adoption may take place.
But Bontrager said: "It's a very delicate situation. You have to be convinced that that family is really understanding what they're into and willing to accept that." This effectively eliminates Anglo families who have had only limited contact with anyone outside their own race.
Mollie Cooper of the county adoptions agency does not know the exact extent to which legalized abortion has been responsible for the drop in the number of infants for adoption; she lists it as a factor, with birth control, burgeoning independent adoptions in California and "societal changes in mores about children born out of wedlock."
But, she says, the decrease has been "more critical" since Roe vs. Wade. The average wait for an infant is three years.
Los Angeles County placed 528 children for adoption last fiscal year, the most of any county in the nation; 55% of them were black and about 98% of those went to black families. A special unit is recruiting black adoptive families; some black children are placed in other counties and states.
It would be folly, Rosenberg said, to pressure people to give up their dream of adopting a healthy white infant and accepting a child with special needs. Whereas virtually all infant adoptions prove permanent, the "disruption" rate with special-needs children is, he estimates, 13% to 15% of all such adoptions.
Many Never Think About Adoption
The virtual disappearance of adoptable children has come about because "97% of young people facing a crisis pregnancy never even consider adoption," put off by a system that makes them feel like "criminals," said Bruce M. Rappaport, director of a new Bay Area-based group, the National Federation of Open and Independent Adoption Centers.
More than two-thirds of unwed mothers keep their children, he added, "though that often makes little sense for themselves, their child or our society."
Rappaport's group arranges adoptions in which the birth mother, not a social worker, chooses the adoptive family; both parties meet, names are exchanged and ongoing relationships encouraged. His group does not take possession of babies but goes into schools to encourage pregnant girls to consider adoption, then functions as matchmaker.
His group also focuses on giving adoption a positive image. "Women on TV who have their children adopted are almost always sleazy or sluts," said Rappaport, whose group takes no stand on abortion.
But he noted that if it were no longer legal, the result would be to "just push more women into keeping their babies and going on welfare. . . . It might increase the number of adoptions somewhat but mostly it would increase the number of women on the streets."
Michelman of NARAL said: "I'd like us to work more on eliminating the need for abortions. We're so hung up about sex and sexuality. . . . why aren't we advertising contraceptives for human beings instead of contraceptives for roaches?"
Who Will Place All the Babies?
If there were suddenly many more adoptable infants, Bontrager speculates, the independent adoption industry would "just multiply," as it would react faster than would the public segment.
"And that's a totally unlicensed, unregulated industry. The things that can happen in that situation, whatever your imagination can think of, that will happen."
If the county were to again be in the business of placing infants, he said, there would be real strains placed on the agency without a substantial increase in its now-static budget of roughly $9 million a year.
The county agency will have to deal with fetal alcohol syndrome babies and with two phenomena of the '80s: drug babies and babies born with AIDS acquired in utero.
Drugs have been "the most significant single factor" in the broad picture of foster care and adoptions, Bontrager said. In June of this year, "we filed court petitions on 154 drug-addicted babies." (Such infants remain hospitalized in a county facility until stabilized.)
So far, Bontrager said, no more than 12 children with AIDS have come into the system but an increase is "inevitable . . . something we have to be ready for."
When Michelman of NARAL projects the costs of limiting legalized abortion, she includes possible effects on women's lives and health.
Before Roe vs. Wade, she said, "at least 5,000 women died every year" having abortions; any change in abortion's legal status would give rise to a "back alley industry" that would be impossible to watchdog. "Poor and young women will risk their lives to have abortions."
But Carpenter-McMillan, responding to predictions of dire consequences to women risking illegal abortions and referring to the 1.5 million fetuses aborted each year, said, "We have almost 2 million human beings dying right now. What about these babies? . . . I hear the stuff about rape, I hear failed birth control.
"Come on, there just aren't 2 million failed birth control pregnancies every year in the country. We have women now using abortion as their birth control."
(The Guttmacher Institute surveys of women who have had abortions showed that only half were using contraceptives in the month they conceived).
Ten years ago Carpenter-McMillan went to get an abortion but "was just so blown back by my own reaction" that she decided not to, and later gave birth to a daughter, "the joy of my life."
The Human Factor Remains Unknown
In the event of a rollback of Roe vs. Wade, everyone agrees, the full impact on society is an unknown. Based on imprecise statistics, NARAL estimates that in the 1960s, before legalization, at least 200,000, perhaps as many as 1.2 million, pregnancies were terminated each year.
Some women will have their babies and keep them but will only be able to survive with government assistance. Others will place them for adoption, requiring a refocusing of priorities and budgets by social service agencies.
The human factor is the biggest unknown.
As Rosenberg put it, "An unwanted pregnancy does not necessarily mean an unwanted birth."