Examining State Abortion Policy: Punctuated Equilibrium & Narrative Policy Framework
By Anna Brown & Carli Johanson
After nearly two centuries, the United States has yet to come to a consensus on the right of abortion for pregnant women. Historically, states have been in control of abortion policy; however, long-standing debates on moral and medical needs brought the matter of abortion to the U.S. Supreme Court. In 1973, Roe v. Wade dramatically shifted abortion policy in the United States by revoking state power to ban abortion. Before this decision, state legislation would go through periods of incrementalism and punctuation motivated by narratives and frameworks to criminalize abortion. As recently as 2011, states have found a way to challenge Roe v. Wade and restrict abortion access to women, a change that has not been seen since the 1850s.
In 2021, abortion-restrictive legislation has reached an all-time high, with 106 abortion restrictions passed in state legislatures. Additionally, for the first time in 48 years, the constitutional right to the procedure is under debate as Texas passed the most restrictive bill yet — banning abortion at six weeks. The Guttmacher Institute predicts that if Roe v. Wade is overturned, 26 states will likely ban abortion. What is contributing to the recent high volumes of abortion restrictive legislation and how might past punctuations in state abortion restrictions inform the policy debate today?
This essay uses punctuated equilibrium theory (PET) and narrative policy framework (NPF) to examine periods of significant change in state abortion policy. Through the lens of PET and NPF, we identify and explain periods of increased legislative action. Below, we first outline PET and the NPF and apply them to a historical outline of state abortion policy.
Punctuated Equilibrium Theory (PET)
The PET model of policymaking is predicated on long periods of relative stability with short periods of rapid, large scale change. There are two clearly defined periods in this theory. The first period considers the stability of government dominance created by the framing of a policy problem or balance between political forces. The second is a challenge to that stability. In PET, these challenges can create “punctuations,” by framing policies in new perspectives and gaining the attention of previously uninvolved actors. PET attempts to explain these intervals of intense periods of attention, or lack thereof, by investigating the policymaking complexity affected by human cognition and the power of policy actors on framing issues. Below, we look at the setbacks of bounded rationality, policy subsystems, and the elements of the policy process through the lens of PET to map the fluctuation in abortion policy.
Bounded Rationality
A prominent component of PET are the constraints of bounded rationality. This idea emphasizes that decision-makers are faced with cognitive limitations in making choices. As problems arise and information is presented to an institution or policymaker, they can only focus on a proportion of the data to generate a response. This causes the political actors to either underreact to information or overreact, impacting new policy for that given period. In theory, a solution to bounded rationality would be more information. However, policymakers are unable to process all of the facts at once, making an oversupply of information challenging. This causes decision-makers to adopt serial processing rather than parallel processing and consider only one issue at a time.
Policy Subsystems
Bounded rationality becomes a larger issue when considered in policy subsystems; considering Congress, bureaucracy, and interest groups are composed of individuals with limited human cognition, serial processing is likely to occur. Although policy subsystems, such as sub governments and institutions, are meant to attend to specific problems delegated by a great authority, they are composed of like-minded policy experts who cannot always expand the scope of processing. These communities will work in harmony, sharing viewpoints and establishing a closed policy system that produces incremental change. In PET, this is considered negative feedback where policy images are framed in the scope of traditionally accepted preferences. However, when an attention-demanding event takes place, these closed systems are challenged by individuals that once were not involved in the process. This is known as positive feedback and is caused when multiple outside venues and viewpoints are mobilized and demand extreme change. PET would define this event as a “punctuation” and cause for a more inclusive, parallel process of multiple issues.
A Different Way of Looking at PET
Typically, PET explains stability and incrementalism, followed by punctuations, through the magnitude of the policy change. Before 1973, abortion policy in the U.S. followed this theory as legislation shifted from common law to complete bans on the procedure. However, looking at recent trends in abortion policy, there may be a possibility that the punctuations are caused by increasing numbers of policies passed. Figure 2 below shows the number of abortion restrictions enacted in the states since Roe v. Wade and provides a visual for the most recent developments in the discussion. The increase seen in 1973 reflects the adoption of policy reform following the stagnation seen in the early 1900s and building to the decision made by the U.S. Supreme Court. During this punctuation, new policy actors were advocating for change and participating in drafting policy that considered a wider range of information and necessities of pregnant women. This punctuation was met with a steep decline in policy that remained low until 2011, when new officials with pro-life agendas took office. Interestingly, the punctuations in 2011 and 2021 were made by policy subsystems without the involvement of the general public which may be considered a closed system. However, the individuals taking office were previously uninvolved actors pushing for the dramatic change indicating that new information is being considered in the model even though it may seem retroactive.
Although these recent trends do not strictly follow PET, they suggest that an increased number of policies passed indicates impending punctuation. This is clear looking at the number of policies passed in 1973 when the U.S. Supreme Court joined the discussion and in 2021 when Texas passed the most restrictive bill banning abortion at 6-weeks of pregnancy.
Narrative Policy Framework (NPF)
The NPF posits “narratives” as a way of framing policy problems that includes specific elements that define the form of a narrative, such as settings, characters, morals, and plot. For example, the policy-setting could consist of geographical, social, legal, and economic conditions that encompass the policy area. A policy narrative should have characters, such as a hero, victim, or villain. The policy solution derives from the moral of the narrative, and the plot is the arc of the narrative, connecting the setting, characters, and morals. Policy content is the beliefs and strategies that shape the opposing sides of a policy issue. Coalitions, citizens, and policymakers are absorbing and creating policy narratives. They can strategically use narratives to achieve their policy goals. Policy preference, beliefs, cognition, emotions, and relationships can shape policy narratives.
Core Assumptions
The NPF works across three levels of analysis; Micro (the individual), Meso (group or coalition), and Macro (institutions or culture). There are five core assumptions for NPF that apply to all levels of analysis. First, social construction posits that individuals or groups can assign different meanings to policy processes or objects. Second, bounded relativity says the other meanings are not random but constrained by ideology, norms, and beliefs. Third, generalized structural elements suggest that NPF analysis uses the general structure of setting, character, morals, and plot. Fourth, simultaneous operation at the three levels assumes policy narratives operate simultaneously at the Micro, Meso, and Macro level of analysis. Finally, fifth, the homo narrans model assumes the narrative plays a significant and influential role on the individual.
NPF & Abortion Policy in the United States
To further examine the punctuations in abortion policy, we can evaluate the policy subsystem’s narratives that informed or contributed to the discourse around abortion policy. The following section will explore the characters, setting, plot, and morals in different policy punctuations that led to significant policy change in the United States from the late 1850s to today. In addition, this section considers the narrative’s influence on creating a focus around abortion policy which led to punctuations in the amount of abortion legislation. First, we will examine narratives during the late 1850s, when many states enacted substantial abortion restrictions. Next, we examine the shift in narratives before Roe v Wade and after Roe v Wade.
State Abortion Policy in the United States through PET and the NPF
Looking at abortion policy trends through the lens of PET, there are clear periods of incremental change followed by mobilization of political actors and punctuations in policy. The legal status of abortion in the United States has gone through several distinct phases since the country’s founding. Prior to the mid-1800s, the United States relied on “common law,” which deemed abortion legal until the pregnant woman could sense the fetus in her womb. Under this law, only the pregnant woman could determine whether terminating the pregnancy was permissible because it was based on her awareness and feeling of the fetus. In the New Jersey case, State v. Cooper, it became apparent that the governing bodies across the country were in a consensus of this common law. The state court rejected the prosecution’s claim that an attempt at abortion was an offense against the fetus and explained that no authority recognized abortion as a crime under the common law. This stance was widely accepted into the 1800s. Still, there was a brewing debate on when the life of the fetus began and how long into the pregnancy abortion should occur, ultimately leading to policy changes.
The late 1800s
The first punctuation was in 1840 when Maine overrode common law, making abortion punishable with five years in prison. Likewise, in 1845, Massachusetts responded to the death of three women caused by abortion by criminalizing the procedure at any stage during the pregnancy. Following these two states, abortion restrictions became increasingly common nationwide, and movements against abortion began to gain the general public’s attention. In 1859, medical associations began speaking out against the procedure and campaigned for more restrictive laws. Their concern lied in their lack of understanding of infection and general surgery complications; they viewed the procedure as too dangerous for the women. This inspired other political forces, such as anti-immigrant groups advocating for higher birth rates among native-born women and religious groups whose beliefs opposed abortion, to voice their support for the restrictive laws. This movement created a positive feedback system that considered the multiple viewpoints of the new political participants and pressured all but eleven states to reform their laws on abortion.
The late 1800s brought about significant abortion restrictive legislation, and by 1849, 18 states had pro-life legislation, and in 1864, 30 states. In addition, policy subsystems, coalitions, and groups had different narratives supporting their stance on abortion, including physician associations and the press. The death of Alice Augusta Bowlsby, who was found dead in New York after an abortion procedure, was a catalyst for the increased attention on abortion policy.
Physician groups, including the American Medical Association and the New York Medical Association’s, adopted an pro-life narrative in the late 1850s. The characters in the physician’s narrative include the victims, the women harmed or killed by unlicensed people performing procedures, and traditional maternal roles. Alternatively, the villains, the unlicensed people performing medical procedures, and women rejecting traditional maternal roles. Physicians groups published articles in medical journals with pro-life statements and described a woman getting an abortion as (as cited by Rickie Solinger in Pregnancy & Power):
…unmindful of the course marked out for her by Providence, she overlooks the duties imposed on her by the marriage contract. She yields to the pleasures — but shrinks from the pains and responsibilities of maternity; and, destitute of all delicacy and refinement, resigns herself, body and soul, into the hands of unscrupulous and wicked men.
The moral or solution of their narrative included discrediting and absorbing the gynecological medical field and maintaining the patriarchal order. The physician associations considered pseudo practitioners to be endangering the lives of women and unborn children and that women’s traditional roles were under attack. In addition, some articles suggest the physician’s associations did not want white women to get abortions due to fears over declining birth rates among white women and anti-immigration sentiment.
In addition, the press, including the New York Times and New York Herold, aided in informing the narrative surrounding abortion policy at the time. In 1871, The New York Times started researching abortion clinics and non-medically trained practitioners offering services. The villains of the New York Times narrative were the unlicensed practitioners and their victims, the women harmed and aborted fetuses. The New York Times sought to uncover the underground abortionist practices and ultimately expose the issue to the general public. The research was led by New York Times reporter Augustus St. Clair, finding many had little in the way of credentials leading to the deaths of women seeking an abortion. Alternatively, advertisements in The Herald predominantly featured contraceptive and abortion service advertisements:
The Mid-1900s
However, following the dramatic changes in state abortion policy, the political environment fell into a period of incremental change. With governments and political actors all in agreeance, abortion policy stayed restrictive and only debated about levels of punishment. In the 1940s, prosecutions began to increase and fewer physicians were comfortable providing abortions for women in need. This led to mortality and morbidity being more commonly associated with abortion, an issue that caught the attention of medical and legal fields and started a second movement that would punctuate the stagnant political system.
In 1962, American Law Institute recommended that abortion should be legal when the pregnant woman’s life or health would be at risk if the pregnancy were carried to term, when the pregnancy resulted from rape or incest, or when the fetus had a severe defect. This new model for abortion policy gained the attention of advocates and the general public leading to 13 states adopting new policy and establishing a positive feedback system once again. By 1973, all but five states had reformed their abortion policy and adopted a version of the American Law Institute’s proposed policy. The dramatic change in state abortion policy caught the attention of the U.S. Supreme Court. In 1973, the Supreme Court decided in Roe v. Wade that the constitution protects a pregnant woman’s liberty to choose to have an abortion without excessive government restriction. This was the first action taken by the federal government regarding abortion legality since, historically, these decisions were left to the states.
Analysis: Pre-Roe v. Wade
Before Roe v. Wade, political party alignment did not always indicate pro-choice and pro-life ideologies. However, in the decades after Roe v. Wade, there was significantly greater alignment between political party ties and abortion attitudes. Roe v. Wade’s ruling bolstered the abortion policy fight in state legislatures and the courts.
Pro-choice movements were on the rise and gaining support prior to Roe v. Wade, with many different coalitions and groups supporting pro-choice policy. Some narratives centered around women’s health and health education, such as the Jane Collective, Our Bodies Ourselves Collective, and The Federation of Feminist Women’s Health Centers. In their narratives, women’s access to health services and education would be part of the policy solution.
We are for every woman having exactly as many children as she wants, when she wants, if she wants — Jane Collection Founder
On the other hand, some of the narratives before Roe v. Wade centered around the pro-choice movement included support for a narrative focused on population control and eugenics.
In 1947, the “Declaration of Human Rights,” drafted by the National Catholic Welfare Conference, included the “right to life and bodily integrity from the moment of conception.” Events like this Declaration led to increased attention and cumulated in major pro-life movements leading into ROE v. Wade. In the late 1950s and 1960s, several, often religiously associated, pro-life groups galvanized, such as the Minnesota Citizens Concerned for Life (MCCL), New York Right to Life, National Right-to-Life Committee. These groups mobilized across the United States with a pro-life, pro-life narrative. The moral of the narrative they portrayed was to prevent abortions and the loss of human life. The setting for this narrative took place in grassroots movements in many places around the country, including conferences, lobbying state legislatures, and courts. Mostly beginning as religiously backed groups, such as State Catholic Conference organizations, the pro-life movement spread and gained broader participation as pro-life and pro-choice activism increased.
Analysis: Examining Post-Roe v. Wade
Roe v. Wade legalized abortion in all states and for 37 years only small amendments and policies were passed in states to either strengthen or weaken the right to the procedure. In 2010, pro-life politicians took over Congress and state legislators, leading to another shift in policy. In the decade to follow, policies on state funding for planned parenthood targeted restrictions of providers (TRAP), and bans on abortion at 20 weeks swept across states. However, despite the increasing restrictions on abortion across the nation, Guttmacher Institute reported that public opinion on abortion had remained stable since the mid-1990s. Closed subsystems were passing the pro-life measures with less participation from the general public. This build-up led to a third punctuation in 2021, with U.S. states enacting over 100 abortion restrictions in less than a year and challenging Roe v. Wade with the most restrictive abortion ban at six weeks.
After Roe v. Wade, there was some fragmentation in the pro-choice movement as mainstream movements often failed to advocate against the unequal harm placed on women of color and low-income women. Following Roe v. Wade, The National Abortion Rights Action League and Planned Parenthood stuck closer to ruling with the narrative centered on the right to privacy. On the other hand, the National Black Women’s Health Project, Asian Communities for Reproductive Justice, and SisterSong Women of Color Reproductive Justice Collective are advocacy groups with a narrative focused on abortion as a human rights issue. Furthermore, most pro-choice advocacy groups moved towards a reproductive rights narrative away from the population control politics seen earlier in the pro-choice movement. In addition, they broadened the setting of the abortion policy narrative to include education, demonstrations, and grassroots activism. Further shifts in the narrative after Roe v Wade included the fight for access to abortion and the representation of the pro-life activist as aggressively threatening access to legal abortions.
The pro-life movement continued to gain momentum, shifting the narrative to preventing access to abortions and villainizing those who supported abortion. This focus on restricting access to abortion and creating obstacles for women seeking abortions via legislation has led to a decrease in abortion providers. As a result, an unprecedented amount of abortion restrictive legislation was passed between 2011 and 2015. The narrative put forth by pro-life policy groups focuses on women’s health and emotional well-being as the reason for restrictive regulations such as requiring abortion providers to have hospital privileges or mandatory wait times. The narrative is also shaped by cultural beliefs about fetal personhood, meaning the rhetoric describes the fetus as a person in an attempt to garner support and reduce legal abortion time-frames.
Looking forward
This blog has sought to explain the trends of abortion policy in the U.S. using PET and NPF. The periodic shifts in attention on the matter follow the general pattern of incrementalism preceded by punctuations creating major change. However, between 1973 and 2021 we see a different form of punctuation characterized by increasing numbers of policy passed, leading to potentially seismic shifts.
With the augment PET’s explanation of how and why political subsystems prioritize information with the NPF. NPF adds to the conversations by showing how media sources and organizations frame policy movements to gain the attention of new actors to lead to punctuations.
As the future of Roe v. Wade becomes more uncertain and more abortion restrictive legislation is passed in states, it will be interesting to see how the next challenge at the Supreme Court could have an effect on the state of abortion policy in the United States. If Roe v. Wade is overturned, narratives at the state level for both pro-choice and pro-life subsystems will undergo major transformation. Similar to how pro-life groups increased their efforts at the state level post-Roe v. Wade, it seems likely that similar increased efforts will be seen on the pro-choice side pending any changes at the Supreme Court.
