Mathieu Deflem

Book ReviewsDoctors of Conscience: The Struggle to Provide Abortion Before and After "Roe v. Wade."By Carole Joffe. Boston: Beacon Press, 1995. Pp. xvi+250.

Debated time and time again as one of the most divisive issues in American society, abortion in its many sociologically relevant dimensions remains poorly understood. The state of abortion research is a rather sad instance of our discipline’s occasional lack of attention for issues that passionately move broad segments of society. With Doctors of Conscience, sociologist Carole Joffe has added to the sparse scholarly informed abortion literature. We should be grateful for the author’s effort. But, unfortunately, there remains much to be desired about the results. Based on interviews with 45 abortion providers, Doctors of Conscience presents an analysis of abortion services in the years before and after the Supreme Court decision of Roe v. Wade in 1973. The central argument of the book is that abortion was an inevitably risky enterprise before Roe and that it stayed an activity at the margins of mainstream medical practice in the period thereafter. The author presents various case studies as illustrations to indicate how abortion providers worked before and after 1973 and how they sought to legalize abortion in the days before Roe. Most striking is that the medical treatment of abortion after legalization of the practice did not gain much attention in professional health training and never received much support from within the medical profession. Thus, the freestanding abortion clinics represent the failure as much as the success of legalized abortion because they are as specialized in their work as they are marginalized from mainstream health care. The author concludes that, in order to secure women’s rights to abortion, the medical community should be more actively involved in supporting abortion services. This book has its merits. It supports the argument that the history of abortion in the United States is surely not alone a history of Roe v. Wade. However relevant, the Supreme Court’s decision cannot be assumed to have had the impact on abortion access a legalistic outlook would naively imply. An analysis of the profession of abortion, indeed, adds to the value of the notion that rights are never secured through court activity and legislation only. The relative continuity in the medical profession’s ambivalence towards abortion, furthermore, suggests how misleading the histories are that portray a one-sided picture of greedy abortion butchers before 1973 and of respected professionals thereafter. Regrettably, the weaknesses of this book are many. Most clearly demonstrating the tremendous bias and methodological flaws of this work, the bold conclusions and predictions follow an analysis that is based on interviews with only abortion providers who were doing their work for reason of a self-proclaimed compassion for women seeking abortion.