planning as the ability of individuals to freely "determine the number and spacing of their children" and the family planning services themselves as "any medically approved means" to achieve that end. By inference, at least, this definition would have included not only all of the contraceptive modalities approved by the U.S. Food and Drug Administration but contraceptive sterilization and abortion as well. An immediate controversy ensued, with some groups demanding positive assurance that sterilization and abortion be covered unambiguously and others objecting vehemently to the apparent inclusion of abortion. The final regulations were never promulgated, essentially leaving the states free to provide their own definitions. By 1976, the year of the first Hyde amendment, named after Representative Henry Hyde of Illinois, which prohibited the use of Medicaid funds for abortion, roughly one-third of the states were claiming federal reimbursements for Medicaid abortions under the family planning rubric.

After 1973, the controversy over abortion proceeded along two separate and parallel paths: (1) attempts to reverse the Supreme Court's decision on abortion through the adoption of a constitutional amendment (a prospect that has been dormant since 1983) and (2) a successful ban on the use of federal funds for abortions, first and foremost for Medicaid-eligible women. A by-product of these debates was the intrusion of the abortion issue into what most people viewed as "family planning" or, more narrowly, contraception. In the early legislative proposals to ban the use of federal monies to reimburse the states' expenditures for abortion under their Medicaid programs, the ban would have extended to the use of "abortifacient" drugs and devices. Although the specific drugs and devices were never precisely defined, they were widely claimed to include such artificial methods as oral contraceptives and intrauterine devices (although their modes of action do not normally interfere with the fertilized ovum). In rallying opposition to the proposed ban, pro-choice groups seized on this potential threat to methods of birth control used by millions of American women to help defeat the proposals in their entirety. This issue resurfaced many years later during deliberations of the Supreme Court in the Webster case concerning the continuing legality of abortion. At that time, the pro-choice attorney argued before the Supreme Court that the "bright line, if there ever was one (between contraception and abortion), has been extinguished" by the newer birth control methods. Justice Scalia concurred that it is indeed "impossible to distinguish between abortion and contraception when (abortion is defined) as the destruction of the first join of the ovum and the sperm."

Indirectly, these various maneuvers served to blur what many people and policymakers had heretofore believed to be clear lines of demarcation between contraception, the purpose of which is to prevent pregnancy, and abortion, which is intended to terminate a pregnancy that has already occurred. Underlying the ambiguity of the modes of action of certain types of fertility control is



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