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The issue of abortion has been problematic in United States domestic policy because of how it ties into America’s political structure of special interest groups trying to shape abortion policy, ongoing debates about the Constitution, and the lack of access to a national healthcare system. The debate on abortion goes back to the formation of America. Yet, in early America, abortion was not an issue. According to Mary Ziegler’s book entitled Abortion and the Law in America: Row v. Wade to the Present, doctors used to practice abortion procedures on white middle-class or wealthy pregnant women daily in the mid-1800s (12). However, the legalization of abortion soon ended as the American Medical Association (AMA), the first special interest group to lobby against abortion, took interest in regulating abortion. The issue of abortion became further problematic when America’s racial demography came into question after the Civil War. The white population feared that America was going to turn non-white if white women kept getting abortions. Later, religious special interests have been another contributor to the debate of abortion, where pro-lifers, as well as other religious and special interest groups, choose to fight for the life of the fetus, claiming that the fetus should have Constitutional rights. Pro-choice advocates fight for women’s rights to privacy and the free will to do whatever they want with their bodies, including having abortion procedures done. An attempt to settle the abortion issue was made through Roe v. Wade, a 1973 Supreme Court case, where the justices found that the Constitution protected pregnant women’s decision to have an abortion without any restriction from the government. Roe v. Wade should have settled the issue of abortion, however, the Hyde amendment was created to limit access to abortion. The United States of America’s healthcare system is privatized, which can result in limited access. The Hyde amendment was designed to ban the use of federal Medicaid funds from the state and government programs to pay for abortion, except if it was to save a woman’s life or if their pregnancy was the result of rape or incest. A way to settle the debate on abortion would be to allow a single-payer healthcare system to allow more access to healthcare in general. The abortion debate in America has revolved around America’s special interest groups, the ambiguity of the Consitution, and limited access to America’s healthcare system.  

The debate on abortion dates back to the mid-19th century, where abortion was first legalized, but eventually got challenged through the establishment of special interest groups in the mid-1800s. “Prior to 1841, Mohr [claimed], abortion was acceptable in public opinion and in law, at least if it occurred before ‘quickening,’ the woman’s first awareness of movement and the point at which the fetus was regarded as a separate human being” (Walters, 1981). In the 1840s, abortion was not an issue because it was commercialized and “commonplace”, where doctors would perform it regularly (Ziegler, 2020, p.12). Most of these patients were described as “white, married, middle class or wealthy” (Ziegler, 2020, p.12). In the mid-1800s there were laws created to revolve around the safety of pregnant women with the usage of abortion drugs and other antibiotics. However, Dr. Horatio Storer, an anti-abortion activist and American physician in the American Medical Association (AMA), campaigned about how abortion can result in negative outcomes. The AMA, a special interest group, wanted to use the government’s ruling on banning abortion to their advantage by making sure pregnant women only seek doctors to do the procedure instead of homeopaths. The issue on abortion can date back to America’s history of slavery. With more white pregnant women getting abortions, there came a question on what the racial demography was going to look like in the country after the Civil War. White Americans feared the racial makeup of the country post-freedom. They feared that America’s racial demography would turn non-white if white women continued to have abortions. By having more white women seek abortion, the white population feared that America would turn non-white. This racist mentality led Storer to ask “Who would populate the future United States?” he wrote “‘This is a question our women must answer’” (Ziegler, 2020, p.13). Later, Roe v. Wade, a Supreme Court case, ruled for the constitutional right allowing pregnant women to seek abortion without government restriction; however, the case did not settle the abortion issue. As we look into modern politics after Roe v. Wade case, religious groups and other special interest groups took matters into their own hands and started lobbying against abortion. In the United States, special interest groups have a huge influence on American politics. Because of these special interest groups and religious groups, the issue on abortion in America has been more fiercly debated. 

The interpretation of the American Constitution has also played a major role in shaping abortion policy. According to pro-choice advocates “legal abortion…should be an individual, Constitutional right protected against political winds, rather than simply good policy reflected in a state’s laws…” (West, 2009, p. 1396). In Roe v. Wade case, the justices ruled that the Constitution of the United States of America protected pregnant women’s right to privacy and liberty to choose to get an abortion without governmental restrictions. However, pro-lifers fought for the right of the fetus and argued that we should Constitutionally consider the fetus as a person because it falls under the umbrella term of “person” in the Constitution. How do we know when the fetus is considered as a baby or just a fetus? Kristin Lurker, an American professor, argues “…that the moral status of the fetus has generally been ambiguous throughout Western history” (Himmelstein, 1987). On the other hand, the pro-choice movement has been fighting for the women’s right to choose what to do with their body and are full support with abortion. The ongoing debate between pro-lifers and the pro-choice movement can tie to the fight for religious rights as protected by the Constitution vs. personal freedom as also protected under the American Constitution. In the Constitution, every citizen has the ability to practice their own religion and also has the right to freedom. Both pro-lifers and pro-choicers are asking for primacy of interpretation in the Constitution. 

One of the unique reasons why the issue of abortion has been fiercely debated in the U.S. is due to America’s lack of a single-payer healthcare system. There is a correlation between having a free public health care system and having access to abortion. Today, the healthcare system in the United States of America is ineffective, because it does not give the same reap of benefits that other countries, such as Canada, give to pregnant women, especially lower-income individuals who are seeking abortions. America’s healthcare system is privatized where the majority of people are covered by private insurance plans, while in Canada it is publicly funded and free. Because of this flaw, the Hyde amendment was created by pro-lifers in a way to limit the access of abortion procedures for pregnant women. Henry Hyde, an anti-abortion activist, established the Hyde amendment to ban federal funds going into abortion clinics. The Hyde amendment falls under the appropriation bills and is required to be renewed every year. The amendment has been problematic for helping women to seek abortion procedures because it has “…block[ed] federal funds from being used to pay for abortion outside of the exceptions for rape, incest, or if the pregnancy is determined to endanger the woman’s life, resulting in dramatically limited coverage of abortion under Medicaid and other federal programs” (Salganicoff et al. 2020). The amendment has also resulted in the polarization of parties in the United States. “…Republican Party slowly tied itself both to pro-life politics and to fiscal conservatism, antiabortion leaders reframed their argument for the Hyde Amendment” (Ziegler, 2020, p.42). The Hyde amendment has limited lower-income individuals’ access to the health care system because it falls under Medicaid, which is funded by the federal and state governments. Therefore, not only has the Hyde amendment restricted access to abortion but has made it difficult for lower-income pregnant women to afford health care. Comparing the healthcare system with other western democracies has shown that the majority have abortion either on-demand or abortion for cause. Countries like, “Austria, Denmark, France, Greece, Netherlands, Norway, Sweden, Canada,” and including the United States all have on-demand abortion access, meaning without explanation pregnant women are able to get their procedures done (Brooks, 2005). However, countries such as “Germany, Spain, Australia, Belgium, Britain, Finland, Iceland, Luxembourg, Portugal, and Switzerland” have abortions for cause, where pregnant women are allowed to get an abortion only under specific circumstances (Brooks, 2005). A few being, rape, incest, birth defect, mental health, and so much more. Going back to the healthcare system in the United States, a few factors of how the system is ineffective are the “…fragmentation of care, higher administrative costs, and patterns of care that vary inappropriately with race, geography, and financial barriers” (Garber and Skinner, 2008, 28). A way the abortion debate could be dealt with is by having free health care in the U.S. just like Canada. If the government funds free health care, then the government would need to provide a standard of care determined by doctors and guaranteed by the Constitution. 

In conclusion, the debate of abortion has been controversial in the United States domestic policy because of how it relates back to America’s special interest groups and religious groups, the ambiguity of the Constitution, and the restriction of access to the nation’s healthcare system. Even though abortion was not an issue back in the 19th century, it is now an issue because it carries the debate between pro-lifers from special interest groups as well as religious groups and the pro-choice movement. The AMA, a special interest group, lobbied against abortion by campaigning about how it was harmful to pregnant women. Despite their efforts, white women kept getting abortions and that raised another red flag amongst racists about America’s racial demography after the Civil War. There was a fear of the country’s racial make-up of becoming non-white. The issue of abortion made it is way to the 1973 Supreme Court case, Roe v. Wade, where the court ruled in favour of the pro-choice movement. The justices believed that pregnant women should have the right to privacy without restriction from the government. The debate between pro-lifers and pro-choice hinged on the interpretation of the umbrella term of “persons” in the Constitution. Pro-lifers tend to sway more on the religious side and fight for the right of the fetus as a person, while the pro-choice fight for the women’s liberty to seek an abortion. Eventually, Roe v. Wade could not permanently settle the issue, because it was soon challenged by the Hyde amendment. The Hyde amendment was mainly designed to ban federal funds going into abortion clinics, with few exceptions, such as incest, rape, or if the pregnant woman was at risk. This resulted to be problematic for pregnant women who wanted an abortion because the healthcare system in the United States is privatized through private insurance plans, including religious groups and special interest groups. A way the abortion issue could have been dealt with was by having a free healthcare system.