In March 2016 presidential candidate Donald Trump argued that women who had abortions should be punished if abortion were made illegal. Trump quickly reversed himself, but the previously pro-choice candidate had stumbled into an argument that pro-life advocates have studiously avoided over the last forty years for fear of being labelled antiwoman. Some social observers looked at such statements and wondered if they signaled the declining importance of pro-life politics, and social conservatism more broadly, to the Republican party. Is the antiabortion movement no longer relevant in the United States? Those who would answer yes might suffer from myopia. In fact, the antiabortion movement, in its many iterations, has radically transformed Americans’ ideas about women’s bodies, reproduction, feminist politics, and of course, fetal life. In the two centuries the movement has existed, its constituencies, tactics, and tools have all changed. But what has remained is the effect this movement has had on women’s lives. In the end, the pro-life movement transformed ideas as it also restricted the real ability of American women to access reproductive healthcare.
Before 1840 abortion was a widespread, largely stigma-free experience for American women. During that period, the American legal system used the quickening doctrine from British common law to decide the legality of abortion. Quickening occurred when the pregnant woman could feel the fetus move, typically between the fourth and sixth month of pregnancy. This was the only sure way to confirm pregnancy; before this time, any fetus was considered only a potential life. Women most often used herbal concoctions they had learned from other women, healers, or physicians to cure their “obstructed menses” before quickening. Post-quickening abortion was a crime, but only a misdemeanor. Some historians have suggested that laws against post-quickening abortions were primarily intended to protect the health of the pregnant woman—not fetal life—as it was much more common for women to die during abortions that used instruments rather than herbal abortifacients. Whatever the rationale, few abortions were prosecuted before the mid-nineteenth century because quickening was so difficult to prove. Only women themselves could testify to fetal movement.
This system of legal but quiet abortions fell apart in the mid-nineteenth century. The first “right-to-life” movement was not led by grassroots activists, but rather physicians, anxious about their professional status. Before then, physicians had been a largely unregulated bunch, without the institutional or cultural authority to corner the market on healing. In the early nineteenth century, a variety of other healers competed with physicians for business, especially the business of women’s reproductive healthcare. While many physicians believed that scientific medicine would benefit their patients, some, in order to hurt lay healers’ business, sought governmental licensing and regulation to weed out the competition. Physicians used anti-abortion laws, pushed in state legislatures, to increase their own stature and undermine their opponents.
Of course, many would have narrated this story very differently. Some physicians claimed that this campaign was a product of superior medical knowledge. Many argued that women (and rag-tag group of healers who offered abortion) did not have adequate embryonic knowledge to determine when life began. But historians have noted that this medical insight was not a result of any advancements in embryonic knowledge. In fact, there were none during these campaigns. Instead, the fetus was merely a stand-in for a broader cultural project. Here, the movement tapped into concerns over women’s increasing education, autonomy, and the extension of rights, as it reasserted women’s connection to and limitation by their own reproductive anatomy. Women’s bodies, not their words or actions, confessed to doctors the “naturalness” of uninterrupted reproduction and the “truth” about fetal life. Bodily processes could “speak for themselves,” though they did need doctors to translate.
This effort largely succeeded. By 1900 every state had a law forbidding abortion at any stage, whether through the use of drugs or procedures. Almost all the laws passed during this time included a therapeutic exception, where licensed physicians could provide abortions at their own discretion as long as the abortion preserved the life of the mother. While this loophole allowed many women to obtain abortions, it also made doctors the ultimate arbiters of the morality and legality of abortions. These laws also created a large black market for women who could not access or obtain abortions through medical channels.
There was not much of an antiabortion movement between 1900 and 1965 because the state did its work. Police, courts, and lawmakers prosecuted abortionists and harassed women who procured the procedure.  But in the 1960s, some Americans began to demand change from their states. In 1959 the American Law Institute, a group of professionals that put together model legislation, advocated for the liberalization of abortion law. They suggested that the law should make exceptions for women who were raped, whose fetuses were deformed, and whose mental or physical health was at stake. The abortion reform movement was made possible by a larger cultural shift in Americans’ ideas about reproduction and abortion. In the 1960s Americans witnessed the heartbreak of infant death and extreme fetal deformity. Thalidomide, a sleeping pill, caused thousands of birth defects in Europe and the United States. Later, an outbreak of German measles produced thousands of stillbirths and cases of babies born with major abnormalities. Images of white middle-class women and their deformed infants peppered American media, capturing the imaginations and parental fears of many Americans.  In the late 1960s a nascent feminist movement began to argue that women could not be full citizens unless they could control reproduction. Together these shifts helped push state legislatures to reform their abortion laws. Colorado was the first to amend its law in 1967, followed quickly by others, most famously California in 1967 and New York in 1970.
In the midst of states’ efforts at abortion reform, the modern antiabortion political movement was born. Small groups of Catholic doctors, nurses, lawyers, and housewives joined together to oppose liberalization. In 1967 the National Council of Catholic Bishops aided their campaigns with support, money, and the formation of the National Right to Life Committee. Early Catholic activists were often joined by a handful of non-Catholics, usually Protestants, Mormons, or Orthodox Christians. Supporters of abortion reform argued that “right-to-life” forces were attempting to push Catholic values on a diverse American populace, and consequently many antiabortion groups worked to present themselves as ecumenical or non-denominational. Most of these early groups failed to stop changes in their state’s abortion law but they did have some successes in the early 1970s, suggesting that not every state was ready for abortion reform.
The 1973 Roe v. Wade decision, legalizing abortion in all fifty states, changed everything and nothing. In the 1970s the anti-abortion movement remained heavily Catholic, and they continued to pitch their issue as a rights issue rather than a religious one. But in other essential ways the movement changed. Before Roe, the anti-abortion movement was very small, geographically disperse, and focused on individual state legislatures. After 1973 activists and state legislators alike worried that Roe prescribed a one-size-fits-all abortion law that could only be addressed at the national level. Thus, in the 1970s, activists promoted the Hyde Amendment (which successfully prohibited federal funding of abortions through Medicaid) and pushed, unsuccessfully, a constitutional amendment banning abortion. After 1973 the direction of pro-life activism changed, even as its demographics and core political arguments remained the same.
While antiabortion activists retained their focus on individual fetal rights, they began to develop new ways to convey that message to the public that focused on the fetus and excised the woman. The tools that had the largest effect were graphic pictures of aborted fetuses, the most important drawn from John and Barbara Willke’s Handbook on Abortion. Some later called it the “Bible of the pro-life movement.” The Willkes were a Catholic couple, a doctor and a nurse, who became convinced that pictures would help end legal abortion. The four pictures they put in their book, collected from sympathetic doctors and pathologists, were quickly reproduced and used in all parts of the movement. Their work built on a longer, medical history of viewing and personifying the fetus. Twentieth-century medical advances extended nineteenth-century doctors’ interest in fetal life. After World War II, new medical technologies allowed doctors to view and treat fetuses in new ways, while others examined fetal development for the cures to persistent human problems, ultimately personifying and individualizing the fetus. The Willkes and others simply extended this medical tradition into politics. They became sure that images helped people to understand a fetus, legally and culturally, as a baby. Thus the movement continued to develop new tools and technologies to this end: pictures of fetuses, in utero and aborted, fetal models, and fetuses in jars in the 1970s; fetal pins, dolls, jewelry, and clothes in addition to a proliferation of pro-life movies in the 1980s; and ultrasound visuals of fetuses in the 1990s and 2000s. Using these images, activists made a political pitch and moved fetal bodies squarely into American political culture.
As activists moved the fetus into the political spotlight, they tried to keep the pregnant woman behind the curtain. Increasingly in the 1970s, they attempted to link their campaign to civil rights and human rights work, which led to increasingly heated rhetoric. Some activists said legal abortion was worse than the Jewish Holocaust. Others argued that the Roe decision was akin to the 1857 Dred Scott decision, which ruled that black people—slave or free—were not U.S. citizens and thus not protected by the Constitution. Both decisions, they argued, made some groups “less than human” and degraded life. While not actually working on civil rights and human rights issues, pro-life activists used those causes to make the fetus a sympathetic victim and pro-life activists into modern day abolitionists. (These arguments also helped redeem the Republican party in the aftermath of “massive resistance” in the South.) But activists avoided discussing what would happen to American women if abortion became illegal. They tried to silence those in their midst who voiced the old argument that pregnancy punished women for promiscuity. Activists instead claimed that abortion providers and the feminists who condoned legal abortion were truly to blame.
In the late 1970s and early 1980s, evangelical Christians joined the movement in great numbers, rejuvenating and eventually radicalizing the movement. Previously, in the late 1960s, evangelical scholars, pastors, and physicians could not agree on whether or not abortion was sinful. But by late 1970s and early 1980s, this sentiment had changed. Many evangelical laypeople and clergy opposed legal abortion and joined the fight to end it. Some simply joined existing pro-life groups; others formed new, more radical groups that rejected the politics of legislative reform. The most famous of the latter cohort was Operation Rescue, which sought to end abortion by “any means necessary.” Operation Rescue pioneered the pro-life “rescue,” in which thousands of activists created human blockades in front of clinics. In the 1980s and 1990s, Operation Rescue performed such rescues in cities across the nation, tying up the city’s police departments, filling local jails, and making it incredibly difficult to get an abortion. Their national media spectacle sought to attract reporters and stun the American public. Extremists in the movement went even further. Between the early 1980s and the 2000s, there were 153 assaults, 383 death threats, 3 kidnappings, 18 attempted murders, and 9 murders related to abortion providers.
As rescues captured the imaginations, enthusiasm, and anger of many anti-abortion activists, others continued to do the quiet work of incremental legal change. In the 1980s and 1990s, many pro-lifers, especially those who remained in more mainstream right to life groups, focused on making access to abortion more difficult on the state level. Due to their efforts, states across the country passed laws that required parental notification, “informed consent” (mandating women view materials about fetal development and the risks of abortion), and waiting periods between the initial consultation and the abortion. In 1992 the Supreme Court validated the legality of such laws in Planned Parenthood of Southeastern Pennsylvania v. Casey, crafting a new rationale to determine the constitutionality of laws regulating abortion. Restrictions were legal as long as they did not place an “undue burden” on women seeking the procedure, validating the work of anti-abortion activists and making abortion increasingly difficult to access—especially for rural or poor women. The radical and moderate groups differed in terms of strategy, but together they succeeded at reorienting the conversation about abortion. Both types of groups worked to make pro-life politics central to social conservatism and by extension the Republican party. They made fetal life central to how many Christians viewed their religion and their politics. They asked conservative children to think of themselves as “survivors of the Abortion Holocaust.” And they helped new “family values” constituents consider the fetus a member of the family and legal abortion the biggest challenge facing the modern family. In all these efforts, activists were successful, not for all Americans but for enough to build an expansive movement with the defense of fetal life as its core.
Perhaps most importantly, activists from the 1980s onward reinterpreted women’s relationship to abortion. They brought back the old argument about the “truth” told by women’s bodies and gave it a modern twist. Feminists, they argued, had persuaded women to deny the fundamental truth of fetal life. Abortion damaged women’s bodies, but also their psyches. Women, they argued, were traumatized by abortion and like veterans, suffered from a form of post-traumatic stress. Only the pro-life movement could turn the tide against the psychological and physical damage of abortion and feminism. In the 1980s and 1990s pro-life activists recast themselves as both the protectors of women and the true women’s rights movement. Increasingly, they claimed to be an individual rights movement, a civil rights movement, a family values movement, and a women’s movement. So Trump’s faux pas made two fundamental errors: it denied the fetus the political spotlight while also highlighting the movement’s vexed relationship with American women. But his words also gave the misperception that this movement is increasingly unimportant. Women living in poverty, in rural areas, and in red states, trying to use their constitutionally guaranteed right to an abortion, would tell you a different story.
 James C. Mohr, Abortion in America: The Origins and Evolutions of National Policy, 1800–1900 (1978).
 Kristen Luker, Abortion and the Politics of Motherhood (Berkeley: University of California Press, 1984).
 Brian Stormer, Articulating Life’s Memory: U.S. Medical Rhetoric about Abortion in the Nineteenth Century (Lanham: Lexington Books, 2002).
 Leslie Reagan, When Abortion Was A Crime: Women, Medicine, and the Law, 1867-1973 (Berkeley: University of California Press, 1996).
 Leslie Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America (Berkeley: University of California Press, 2010).
Gillian Frank, “The Colour of the Unborn: Anti-Abortion and Anti-Bussing Politics in Michigan, United States, 1967-1973,” Gender & History 26, no. 2 (August 2014): 351-78.
 Dr. and Mrs. J.C. Willke, Handbook on Abortion (Cincinnati, OH: Hiltz Publishing Co., 1972).
Monica J. Casper, The Making of the Unborn Patient: A Social Anatomy of Fetal Surgery (New Brunswick, NJ: Rutgers University Press, 1998); Sara Dubow, Ourselves Unborn: A History of the Fetus in Modern America (New York: Oxford University Press, 2011).
 National Abortion Federation, “NAF Violence and Disruption Statistics: Incidents of Violence and Disruption Against Abortion Providers in U.S. & Canada,” 2009, http://www.prochoice.org/pubs_research/publications/downloads/about_abortion/violence_stats.pdf
JENNIFER L. HOLLAND is an assistant professor of history at the University of Oklahoma. She specializes in the histories of the North American West, gender, sexuality, and race. She is currently writing a book about the modern anti-abortion movement in four western states.