Abortion rights activists have long cheered Barack Obama's presidency as a "historic victory for women's health." But the reality has been rather different. Since 2010, getting an abortion in America has become significantly harder.
States passed a record 205 abortion restrictions between 2011 and 2013, more than the entire 30 years prior. As a result, many abortion providers are closing down. One survey, from pro-life group Operation Rescue, estimates that 87 separate locations ceased to perform surgical abortions in 2013. These changes are a clear result of pro-life mobilization in the Obama era.
"Abortion access has changed dramatically," says Elizabeth Nash, the state issues manager at the Guttmacher Institute. "The debate at the federal level affected what happened at the state level, and accessing abortion is much more difficult in 2014 than it was in 2009."
The fact that abortion rights are shrinking — even with an abortion rights supporter in the White House — doesn't surprise experts who study social movements. They say it's a paradox of having an ally in the White House. Supporters of abortion rights become apathetic, while groups on the other side – like the one producing Planned Parenthood sting videos — have the most visible person in the country to rally against.
"Pro-life groups can organize against the president," says David Meyer, a sociologist at University of California Irvine. "You stick his picture at the top of your fundraising appeals if you're against abortion rights. What does the abortion rights side have that is that powerful?"
Dozens of abortion clinics have closed since 2010
Abortion clinics across the country are shuttering at an unprecedented rate — and one root cause is Obamacare.
In Texas, abortion clinics have shrunk by half, from 40 to 20, since 2011. Arizona had 19 abortion providers in 2010; now it has seven. One clinic that shuttered posted a message on its website directing clients go to the nearest abortion provider, in Houston, 100 miles away.
There's a clear catalyst behind the pro-life movement's newfound mobilization: the Affordable Care Act. The law allows plans sold on the marketplaces to pay for abortions, a provision anti-abortion legislators lobbied hard against but ultimately lost.
State legislators, however, quickly took up the cause, and in the past five years, 25 states have moved to ban or limit abortion coverage in the Obamacare markets.
"State legislatures were becoming more conservative, and momentum [toward restricting abortion] was building in any case," Nash says. "But certainly the health reform debate pushed some states to adopt restrictions that they may not have otherwise adopted. Half the states have some sort of restriction on abortion coverage in insurance now."
States have gravitated toward certain types of abortion restrictions, including those that more stringently regulate providers, often requiring them to have admitting privileges at a local hospital. Pro-choice advocates see this as a back-door way of driving clinics out of business if the local hospital refuses to provide the necessary admitting privilege.
Texas passed a law like this in 2013, and other states are weighing similar options.
"Over the last three years we've been involved in over 70 pieces of legislation that have come to passage," says Charmaine Yoest, president of Americans United for Life. "It's really broad-based and, when you look at the clinic regulations and some other things, it doesn't all come back to the Affordable Care Act."
The trouble with a pro-choice president
Pro-choice groups have no doubt benefited from a strong ally in the White House — and Obama has proved to be exactly that. He reversed a Bush-era ban on providing aid to international organizations that offer abortions on his first day in office.
But that support comes at a cost: When the pro-choice movement appears to be winning, it's harder to rally supporters about a supposed "threat" to reproductive rights.
"When the president seems to be on your side, it's harder to get people out on the streets," says Meyer. "In the case of abortion rights, each side has done better when they could claim they were losing."
One extreme example of this: NARAL Pro-Choice America, the country's oldest abortion rights group, struggled with fundraising after the Supreme Court's landmark Roe v. Wade decision came out. The group's contributions fell off "drastically" when supporters thought the legal right to abortion had finally been secured.
"If you have a president who supports abortion rights, people may think they are protected and [there is] no need to contribute time or money to the movement," says Suzanne Staggenborg, who has written extensively on the pro-choice movement.
The United States has for decades had a strong pro-life movement that has pursued more stringent abortion regulations. In the 1980s and 1990s, states pioneered spousal notification laws and 24-hour waiting periods prior to abortions.
But the 2010s have been a decade of unprecedented success for the movement, as activists rallied against a president they didn't like and his namesake law, Obamacare.
"The frustration level with all the back-room dealing that led to the Affordable Care Act's passage was high," Yoest says. "There was a real sense of betrayal and a sense that the system was broken, so I think that was rocket fuel for us."
What the Planned Parenthood attack means for the future
The reproductive health landscape is decidedly different than it was when Obama took office, before a wave of new restrictions. The Supreme Court decisions exacerbate a trend that has unfolded in states for four years now: greater restriction on abortion and contraceptive access.
Most recently, Planned Parenthood has become the focus of the anti-abortion effort. Since July, the Center for Medical Progress has released secretly taped meetings with Planned Parenthood that it says shows the group sold fetal tissue for profit.
This has created a rallying moment for pro-life groups and legislators, who will hold a hearing on the Planned Parenthood videos on Wednesday. But it's also created a rallying moment for Planned Parenthood: It can point to the tapes as evidence of a threat, and a reason for supporters to become active.
Cecile Richards spoke about this type of mobilization in an interview we did a few years back, in 2011, when Congress attempted to defund Planned Parenthood specifically.
"They went after us from name," she said. "Thinking of it from a political point of view, I think that was a huge mistake. It was a very clear-cut issue and people thought when we were under attack, they were going to come to our aid. If it had been a more theoretical something, cutting programs everywhere, that would be different. This was literally, 'No, you can’t go to Planned Parenthood anymore.'"
It's possible these new videos will have the same effect, too.
"Threat and bad news on policy mobilizes urgency and gets financial aid," UC Irvine's Meyer says. "Go back to when Reagan was president. It was great for raising money for Planned Parenthood."