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When the 1994 elections gave control of Congress to a conservative, Christian Coalition-dominated, Republican majority, what some had over-optimistically touted as a critical mass of women became a token group, notwithstanding a slight increase in numbers. Nowhere was that more evident than in the ability of that new Republican majority to re-define the agenda, raising new issues (Partial Birth Abortion Ban) and challenging seemingly non-controversial, bipartisan, well-established programs (funding for the Title X Family Planning program and international family planning programs). The continued evidence of the gender gap in prochoice support, along with the critical role played by the shrinking cohort of prochoice Republican women in challenging their leadership’s anti-reproductive rights agenda, reinforce the importance of increasing descriptive representation. Nevertheless, the gendered roles assumed by a growing vocal cohort of female Republican reproductive rights opponents, reluctance by some ostensibly prochoice Republican women to challenge their leadership, a shrinking gender gap in prochoice support within Congress, and the frustrations of those who attempted to fight these often futile battles, all highlight the critical role that institutional environments, increased ideological diversity among women, and extra-institutional forces play in shaping the probabilistic relationship between descriptive and substantive representation, in strengthening or weakening perceptions of legitimacy surrounding gender difference, and in defining and redefining the meaning of substantive representation of women and realizing the potential for difference. These case studies explore gender differences in perspectives of reproductive rights opponents, provide insight into the value of bipartisan support for reproductive rights policy agendas (despite Republicans being less prochoice than Democrats), and point to the important role of women voters in maintaining bipartisan support and political resolve.

The escalation of anti-abortion violence and killing of abortion providers and clinic staff in the early 1990s raised tensions within the abortion provider community. Frustrated with what they perceived as inadequate support, NAF members began to leave the organization and established the November Gang and the National Coalition of Abortion Providers. Much smaller than NAF and made up of mostly independent clinics, both the November Gang and NCAP encouraged more open conversations about the difficult questions in abortion care such as the role of violence and fetal death. Members of the November Gang also introduced head and heart counselling to offer women greater support as they dealt with the increasing stigmatization of abortion. The development of intact D&E and debate of the so-called partial birth abortion ban further increased tensions in the abortion provider community as abortion providers and their supporters disagreed over whether and how to defend intact D&E procedures. When the US Supreme Court decision upheld the ban of intact D&E in its decision Gonzales v. Carhart, anti-abortion activists had, for the first time, successfully banned an abortion procedure. Despite these developments, patients continued to affirm their right to choose abortion.

This chapter traces how crisis pregnancy center volunteers popularized medically inaccurate information about the health risks of abortion beginning in the 1970s. Anonymous tracts purportedly written by women who had abortions and regretted them circulated in prolife circles. By the 1980s, women who called themselves “abortion survivors” traveled the nation, speaking to church and prolife groups about their regret over having had abortions. Prolife physicians legitimized these anecdotes by writing articles that falsely claimed that abortion caused breast cancer and psychological trauma. By the twenty-first century, prolife physicians and women “abortion survivors” had convinced jurists—incorrectly—that the medical community was divided over the question of whether abortion harmed women. This constructed debate framed the Supreme Court’s 2003 majority opinion in Gonzales v. Carhart