For choice advocates it raises the question of whether President Obama’s efforts to bridge the divide on the issue remain worth pursuing. His call two years ago at Notre Dame for "open hearts, open minds and fair-minded words" on abortion wasn’t much help in negotiating healthcare reform. The major legislative vehicle for expressing common ground on abortion, the pro-life Tim Ryan and pro-choice Rosa DeLauro bill Preventing Unintended Pregnancy, Reducing the Need for Abortions and Supporting Parents Act has never garnered a single Republican co-sponsor -- and with Republicans in control of the House, it's effectively dead. Obama's "common ground" allies were defeated by pro-life Democratic members of Congress and the Catholic bishops. Restrictive state bills continued to be introduced, especially in the wake of healthcare reform. At the White House policy office, interest in finding common ground has come to a halt. A promised common ground strategy paper was never issued.

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Good things will happen for women and men who have no health coverage as a result of this bill. Not as much as Democrats claim, but it will lead to important changes for women's health and sense of security. It would have been difficult to deny women those benefits, when such a denial would not have yielded any advance on funding for abortion.

And so the question becomes: What next? For me the answer is simple and straightforward. I will not vote for or provide financial support for any candidate for public office until the Hyde Amendment is repealed. I will not contribute to any pro-choice or women's organization that does not make the repeal of the Hyde Amendment its major political priority.

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At one point I looked at DeLauro and both of us welled up with tears over the dilemma we knew she and others would face. About 20 antiabortion Democrats, mostly Catholics, with the full lobbying power of the Catholic bishops behind them, were very likely to force the inclusion of Rep. Bart Stupak's antiabortion amendment to the Affordable Health Care for America Act, the inaptly named House bill. I did not envy the choice DeLauro and others would have to make. I knew the likeliest, and probably the right choice, would be to vote for passage of the bill.

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In some ways this is nothing new. The U.S. Roman Catholic Church began reordaining married Episcopal priests in 1981. About 100 married Episcopal priests crossed over into Catholicism. At the time, news reports noted what seemed to be an injustice: Catholic priests who wanted to marry and have children needed to leave the priesthood while these ex-Episcopalians seemed to be getting a pass on the whole celibacy thing because of their conservative theological views. The ex-Episcopalians even had the right to get divorced and remain in the Catholic priesthood; in 1995, Father William Shields became the first married Roman Catholic priest to get divorced. His wife kept the five kids and in the divorce settlement it was agreed that the Roman Catholic Church did not have to pay any support for them.

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The Vatican was even less nimble. Pope John Paul II came in for heavy criticism for his handling of the scandal and for Vatican policies that used diplomatic immunity as well as orders of secrecy to suppress information and limit legal exposure. For John Paul II being pope seemed to mean never having to say you are sorry.

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But if President Obama tries to include family planning in any attempts to address climate change, he's likely to face another thorny battle with the religious activists who supported his election. Religious leaders, even evangelicals, have jumped on the climate-control bandwagon but remain at best unwilling to admit the important role that family planning could play in achieving a smaller human footprint on the environment. At worst, they are actively opposed to expanding contraceptive possibilities for women in the developing world.

A study by Thomas Wire of the London School of Economics, "Fewer Emitters, Lower Emissions, Less Cost," commissioned by the U.K.'s Optimum Population Trust, demonstrates the impact that improved access to birth control could have on the planet:

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It's hard not to detect a note of skepticism and confusion in media reports, as though the prayer is something akin to Scientologists using e-meters to uncover childhood secrets. "The Roman Catholic Church encourages couples to pray before sex to remind themselves that intercourse is a selfless act not driven by hedonism," reads a caption in London's Daily Mail, which illustrates  the story with a cutesy photo of a couple kneeling by a white bed. Those crazy Catholics -- what will they think of next?

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I had been prepared for Obama to close the door on a healthcare reform package that would include funding abortions for women who rely on Medicaid for health coverage. Low-income women already lost that right 30 years ago when the Supreme Court upheld the Hyde Amendment. I believe a principled compromise to maintain the status quo on abortion is justified if it gets us better healthcare for millions of men and women and security from the rapaciousness of the insurance industry. And no pro-choice organization wants to bear the responsibility for healthcare reform failing. And so, tacitly, pro-choice leaders have basically accepted that the Hyde Amendment restrictions, as well as those that deny federal workers, women in the military and women who get healthcare on Indian reservations funding for abortion, would be reflected in the healthcare package.

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For decades the bishops have advocated for universal healthcare -- in fact, for a single-payer system with a strong emphasis on covering the uninsured, the poor and immigrants. The best shot at reform is now. But the bishops are squandering every ounce of moral capital they have, not on the public option, but on ensuring that in any reform bill not one penny of federal funds is used for abortion.

This strategy has put them in the extremist camp among those opposed to abortion. Moderate evangelicals and antiabortion Catholics bit the bullet on abortion four years ago and decided that other issues like ending wars, reducing global warming, and fighting poverty meant it was time to move on from attempting to outlaw abortion. While one can quibble with their strategy, working to prevent the need for abortion was a step forward from working to make it illegal.

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Nuns, it seems, are no longer as obedient as the Vatican would like. One sister I know is a clinic escort at her local reproductive health clinic; others are active in gay and lesbian ministries and one, close to 90, has been a leader in the movement for sex worker rights. They fasted for the Equal Rights Amendment, spoke out in favor of women priests and choice, marched with Martin Luther King, and thought John Paul II was a disaster.

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In an attempt to out trope the "Saturday Night Live" send-up of Masterpiece Theatre, the Post turned loose two popular political reporters, Dana Milbank and Chris Cillizza. The two sat side by side in sleazy smoking jackets and had at us. As you might expect, about half the material focused on schoolboy preoccupations with sex. A White House luau provided the opportunity to put Nancy Pelosi in a coconut shell bikini top; it was suggested that Harry Reid needs to have an affair; Arlen Specter’s sex appeal was dissected and Mark Sanford and John Ensign were pilloried. It was all too stupid for words. 

The fact that neither man nor the Washington Post were embarrassed by such silliness is a sign of the desperation newspapers feel as they fail to compete with or understand new media and the "Hardball" or "Morning Joe" mentality of cable TV. 

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Fever, nausea, cramps and bleeding resulted and 12 hours later Rosie was admitted to the hospital in septic shock. She denied having an abortion, but the evidence was clear. Seven days later she died -- bleeding from every orifice in her body and green from gas gangrene, according to her friends.

I thought about Rosie as I read a letter sent in late June to Speaker Nancy Pelosi by 19 "pro-life" House Democrats affiliated with the organization Democrats for Life in America. Led by Rep. Bart Stupak, D-Mich., the representatives laid down the first major antiabortion challenge to healthcare reform, saying that "Plans to mandate coverage for abortions, either directly or indirectly, are unacceptable." They warned Pelosi "we cannot support any healthcare reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan."

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Apparently everyone could not get along, and the task of lining up supporters for the bill, which was led by the pro-choice Third Way Democratic think tank’s culture program director Rachel Laser, was a bruising experience. Pro-lifers were disappointed that contraception was included. Pro-choicers were concerned the language of the bill sent an “abortion is bad" message. It was a bitter pill for both sides to swallow, though, so far, no one has choked.

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Amid proclamations that common ground has been reached on abortion, a new set of anti-abortion actors has claimed leadership of the movement. They are no longer ultra-fundamentalist Catholics and Evangelicals but anti-war, anti-capital punishment, pro-environment "pro-lifers." Single-issue anti-abortionists thought they diluted the message by claiming abortion and war were equal horrors and other progressives and Democrats thought they were, well, anti-abortionists. But some of them are also opposed to discrimination against women and call themselves feminists.

Before Obama they were voices crying in the wilderness. Now they have emerged as the face of a new and improved anti-abortion movement. And it is improved -- there are few in this crowd who rate abortion issue as the most important moral issue of our time, and they are not single-issue voters. If they were, they would not have supported Obama.

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In the article, Carter explains his painful decision to split with the Southern Baptist Church "when the convention's leaders, quoting a few carefully selected Bible verses and claiming that Eve was created second to Adam and was responsible for original sin, ordained that women must be 'subservient" to their husbands and prohibited from serving as deacons, pastors or chaplains in the military service." 

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She is an active Catholic and, if her office nurse is to be believed, she is one of the more than 90 percent of Catholics who have no problem with birth control. (I have rarely met a devout Catholic working with poor people who is not an advocate of safe and effective contraception -- from nuns in Chile to priests in the Philippines. They get that having children you cannot afford degrades the soul perhaps even more than the body.) This, then, is a near-perfect public face for a president embarking on a controversial last-ditch effort to fix our health care system and serve the poor.

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Why should women give their eggs to Harvard for free? Men have been getting paid for giving sperm for years, and egg donation is far more involved and carries greater risk. Egg retrieval usually involves three weeks of hormone treatment and frequent visits to the doctor for blood and ultrasound. The procedure itself involves using an ultrasound-guided needle to remove the mature eggs. The American Society for Reproductive Medicine estimates the whole process will require about 56 hours of a woman’s time. While researchers agree that not enough is known about its risks, what is known shows low complication rates.

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In one scenario I was the doctor and was asked if I would perform an abortion for a couple -- perfectly ordinary middle-class people -- who had a son and wanted a daughter to round out the family. The woman was pregnant with another boy. I said I wouldn't do it and I thought Planned Parenthood policy should preclude such abortions but be open to referring women to providers whose values may be more in sync with the patient's. I also suggested that institutions as well as individuals have values, and that those of us in leadership positions on reproductive rights had an obligation to let the public know what our values were – in all their complexity.

 Just because something is legal -- and should be legal -- does not mean it is always ethical. And sometimes the right thing to say to a woman is "I am so sorry, I cannot do what you ask."

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