The U.S. Supreme Court will hear oral arguments next week in what may be the most important challenge yet to the landmark Roe vs. Wade abortion decision. Many on both sides of the Pennsylvania case view it as . . . : A Matter of Life and Death

Denise Neary came to grips with abortion long after the Roman Catholic Church taught her it was a sin. A registered nurse, she attended a lecture one night in the gritty coal town of Scranton and saw color photographs of aborted fetuses for the first time.

“I was devastated, because the face of one baby looked like my son, Christopher,” says Neary, who now runs the Pennsylvania Pro-Life Federation.

“I finally realized what this was all about. They were killing babies. They were killing Christopher. And it had to stop.”

About 70 miles down the turnpike, in the rolling hills near Allentown, Janis Glenn learned a different kind of truth. A formerly abused wife who began working in women’s clinics, she held the hands of patients undergoing abortions and was amazed by the strength in their eyes.

“Many of these women have been poor, with little or no education,” Glenn says between patients at the Allentown Women’s Center. “For them, ending a pregnancy is the first time they’ve taken control of their own lives. It’s inconceivable that we could lose that right.”

Inconceivable, perhaps, but it may be more imminent than many Americans realize. Next week the U.S. Supreme Court will hear oral arguments in a controversial Pennsylvania case that could lead to the overturning of Roe vs. Wade, the landmark 1973 decision that established abortion as a woman’s constitutional right.

It may be the most important such lawsuit on the explosive issue to come before the nation’s highest court in nearly two decades of wrangling.

If experience is any guide, Planned Parenthood of Southeastern Pennsylvania vs. Casey will dominate national attention, generating truckloads of legal briefs, press releases and editorials.

But the real drama of the case lies far from Washington. It can be found in the lives of ordinary people like Neary and Glenn, who have taken opposing sides in one of America’s most protracted abortion struggles. For them, the court’s action will mark the end of one campaign and the beginning of another. In Pennsylvania, the war has been uglier than in many other states, and it never ends.

“Should the Supreme Court overturn the Roe decision, we’d see it as only a temporary victory,” says Neary. “The next step will be battling it out in the individual states, which would finally have the power to enact their own laws. And that will be a long, long fight.”

At issue is a Pennsylvania statute that, if upheld, would be the nation’s strictest abortion law. Among many provisions, it would require women to undergo counseling and wait 24 hours before getting an abortion. It also would compel them to notify spouses about an abortion and would require unmarried teen-agers to get parental consent before terminating a pregnancy.

Given the high court’s conservative tilt, activists on both sides expect the Pennsylvania law to prevail. But they are also asking the nine justices to consider the larger question of whether they still support the broad constitutional rights spelled out in Roe vs. Wade.

A decision is expected in July, four months before the November election, and the timing is no coincidence. Abortion advocates put their challenge to Pennsylvania’s restrictive abortion law on a fast track so they could use the issue against President Bush, who opposes the Roe decision. They note that a majority of Americans support a woman’s right to an abortion, according to public opinion polls.

“Politicians can no longer run from this,” says Kathryn Kolbert, the American Civil Liberties Union attorney who will argue the pro-abortion rights side during the April 22 hearing. “We have truly reached a crossroads.”

The stakes are enormous: If the court reverses its earlier ruling, states could freely enact their own laws, including outright bans on abortion. Neary and her allies view this as long overdue.

But for Glenn, such laws would create a nightmarish world of back-alley abortions. Women would have to travel to states with more liberal laws to end their pregnancies, spending a fortune for a clinical procedure that is now relatively inexpensive.

“If we lose, we’ll have to find a way to get women to safer parts of the country, because if we don’t, they will die,” she says flatly. “Believe me, we’d do anything to get them out of this area, which is prehistoric on the abortion issue.”

At first glance, Pennsylvania seems like any other big Northeastern Democratic state. Like New York, it has a tradition of moderate politics and a strong labor movement. The Democratic governor, Robert P. Casey, is popular in the cities of Philadelphia and Pittsburgh, which often turn out large majorities for his party.

But appearances are deceiving. Ever since Roe, anti-abortion forces have seized the upper hand in the Keystone State. Backed by the church and a coalition of evangelical Christian organizations, they have become a potent force in state politics.

Even though polls show that most Pennsylvanians support a woman’s right to an abortion, they are a passive majority. Meanwhile, opponents have built a strong grass-roots organization in the state’s conservative small towns and farming areas.

It makes for odd politics: Although Casey toes the Democratic party line on most issues, he backs restrictions on abortion. Republican Sen. Arlen K. Specter is locked in a tough reelection fight because he supports women’s reproductive rights. His chief opponent in the GOP primary is state legislator Steven Freind, a fiery activist whose book, “God’s Children,” may be the nation’s first anti-abortion political thriller.

If all this seems confusing, just remember the words of James Carville, the political consultant who ran Casey’s last campaign and who now runs the presidential campaign of Arkansas Gov. Bill Clinton. Pennsylvania, Carville has said, is two big cities--with Alabama in the middle.

“In this state, abortion is a deeply personal and political issue,” says the ACLU’s Kolbert. “And eventually, you get to the bottom line: Either women have a right to control their bodies, or they don’t. How you answer that question depends on who you are.”

As a young girl growing up in Scranton, Neary believed abortion was wrong but rarely thought about it. Even after the Roe decision in January, 1973, she viewed it as a private matter. But that changed when she saw the photos of aborted fetuses at a slide show later in the year.

“They had pictures of what happens after a saline solution is injected into the fetus,” she says with a shudder. “What happens is the baby’s skin gets badly burned, and that’s why they call them candy-apple babies. I was changed from that moment on, and I marched right up to a pro-life booth outside the lecture room. I volunteered to do anything I could.”

In the aftermath of Roe vs. Wade, the national anti-abortion movement was in its nascent stages. Neary was asked to speak before high schools and community groups, and she learned how to organize political support as well. She began holding informal meetings in her home and built a network of abortion opponents in the area. Soon a statewide movement took shape, and the Pennsylvania Pro-Life Federation, now an umbrella group with 52 chapters, was born.

“We have a lot of chapters and organizations today,” says Neary, 46, who has become executive director of the influential group. “But the pro-life movement in America came to life in the kitchens of American housewives. That’s been the backbone all along.”

Although the Roe decision guaranteed open access to abortions, Neary and her colleagues began chipping away at the law in Pennsylvania. In 1982, the legislature passed a measure similar to the one now pending before the court. Anti-abortion lawmakers gave much of the credit to people like Neary, who mounted an intense lobbying campaign.

The former nurse had learned how to play political hardball and was ready for the next big battle. It came in 1985, when the Supreme Court threw out the Pennsylvania law, saying it violated Roe. Neary’s side kept fighting and finally won a breakthrough four years later, after new appointments by former President Ronald Reagan and Bush tilted the court firmly to the right.

In deciding a Missouri case, Webster v. Reproductive Health Services, the court gave states a green light to pass new laws regulating abortion. More important, four justices signaled their willingness to undo the Roe decision and throw the issue back to the states.

Confident of the outcome, Neary says she will be in the courtroom next week when the Pennsylvania case is debated. The fight has been nasty, she concedes, and the two sides almost never talk to each other. One reason, she suggests, is that the Scranton area is a “pro-life Utopia,” where politicians, the media and virtually everyone she knows shares her views.

Recently, anti-abortion groups staged demonstrations against a doctor who wanted to open an abortion clinic in nearby Wilkes-Barre, Neary says. To her surprise, the doctor came to the rally and offered to talk with his opponents, to see if there might be any common ground. During a meeting, he urged them to visit a clinic and see how risk-free abortion could be.

“Can you imagine that!” she says, with a hearty laugh. “He wanted me to visit a clinic and watch him perform an abortion. My God, I’d probably grab the scalpel out of his hand!”

With such strong opposition, it’s been hard for abortion clinics to open in Pennsylvania beyond the handful clustered in big cities and suburbs. Today, most abortions are performed in eight of the state’s 67 counties. There are 42 counties where no service is available, and that often forces rural patients to travel many miles for the procedure.

Is it unfair? Neary reminds a visitor that this is war--and that grass-roots power is everything.

“I recently heard my two adopted sons talk about abortion,” she says proudly. “I heard Christopher say, ‘It’s a really important thing. Because if we weren’t adopted, we might not even be here today. We might have just been one of those abortion statistics.’ ”

Every year, there are an estimated 50,000 abortions in Pennsylvania. Those statistics trouble Janis Glenn and her colleagues, but the point is often lost in the heat of the debate. As Glenn sees it, abortion is a woman’s fundamental right, but the numbers could and should be reduced with more intelligent birth control and sex education programs.

It’s been hard for the Allentown Women’s Center to get that message across, however, because the clinic has battled simply to survive, according to director Sylvia Stengle.

Opponents tried to deny the clinic a zoning permit when it opened in 1979, and waves of demonstrators have picketed the center. Two years ago a squad of protesters occupied the small waiting room and began screaming that clinic employees were killing babies. The center is a natural target, because it serves 18 surrounding counties, and some patients have to drive as long as five hours to reach the modest two-story building.

It’s an especially difficult situation for low-income women, who have experienced a 32% increase in births ever since Pennsylvania cut off Medicaid reimbursements for abortions in 1985.

“We can’t let this stuff bother us, because women will suffer if we don’t stand up for our rights,” says Glenn, 42, the mother of three. “We’ll go back to the days of back-alley abortions . . . something that would be humiliating. I know from my own experience that women have to maintain control over their lives. We can’t fall into that trap again.”

At 19, Glenn married a man who became verbally and physically abusive. The product of a traditional Italian-American family, she was pressured by her parents to put up with the abuse, because they believed a woman’s place was in the home. After six years, she couldn’t take it any longer and walked out on her husband. Defying her parents, she pulled her life together, got a secretarial job in Philadelphia and began taking night courses to find a new career.

Eventually, Glenn found work as a doctor’s assistant in a series of women’s clinics. She felt solidarity with mothers who had been treated like her and learned how to counsel people who wanted to terminate their pregnancies. The experience transformed her, and Glenn is angered that women might now lose their rights because of laws passed by men.

“I worked hard for what I have in life, but the right to control your own body is the most important of all,” she says. “Children should be wanted and cherished. You can’t just push through a law and force women to have unwanted babies. It’s fundamentally wrong.”

If Roe is overturned and states like Pennsylvania begin passing restrictive laws, Glenn predicts that women will fight back with a fury that could surprise politicians. Even now, before the court decision comes down, the Allentown clinic is registering patients to vote.

Although employees are not permitted to lobby for one candidate or another, they are telling patients about the April 22 hearing and reminding them that rights are in jeopardy.

“People are going to be held accountable for this,” says Glenn, her voice hardening. “We’re all watching the court, because it’s for real now. This is serious.”

The Pennsylvania Abortion Law: Pros and Cons

On April 22, the U.S. Supreme Court will review a Pennsylvania law that, if enacted, would be the nation’s strictest abortion statute. Among several provisions, it would:

* Require women to receive counseling about abortions, plus the risks and alternatives. After such “informed consent,” they would have to wait 24 hours before getting an abortion.

Pro: Supporters of the Pennsylvania law say abortion is an extremely important decision and that it is not asking too much for women to hear about alternatives and think it over before terminating a pregnancy. If women are given a fair presentation, they say, it will reduce the number of abortions.

Con: Abortion advocates say most women have already considered their options before getting an abortion. They also say the waiting period poses a hardship for rural women, who travel long distances to reach clinics and cannot afford to spend time away from their families and jobs.

* Require women to notify spouses about their plans to get an abortion. Exceptions include medical emergencies, plus cases where women fear assault by husbands or cannot locate them.

Pro: Fathers have procreative rights and should not be excluded from the decision to have an abortion, say anti-abortion forces. The provision does not apply to boyfriends or former spouses.

Con: This requirement, even with its exceptions, exposes women to risk from abusive husbands and treats them like second-class citizens, subservient to men, abortion advocates contend.

* Require unmarried girls under 18 to get written parental consent before ending a pregnancy. To avoid involving a parent, they must seek a special court order.

Pro: Abortion opponents say parents should be involved in such a decision; if teen-age girls need permission to have their ears pierced, the same protections should apply for abortions.

Con: Laws alone cannot improve communication in troubled families, according to abortion advocates, and teen-age girls would be forced into unwanted pregnancies by such a statute.