Bad things don't happen to her, Tiffany Campbell used to think. She was a mother of two, enthusiastically pregnant with twins, a churchgoing Republican living a good middle-class life. Why should she care about a political battle over abortion?
Then Campbell discovered that the twins were relying on one beating heart. Doctors told her that neither would survive if she carried them to term, and that the strong one was fading fast. If one were aborted, they said, the other would probably make it.
"I was not going to bury two of my babies," Campbell remembers thinking. "If I can intervene and save one of my babies, I'm going to do it."
Campbell had the abortion at 17 weeks. The survivor, whom she named Brady, is now healthy and 19 months old. When she learned that an antiabortion referendum on South Dakota's Nov. 4 ballot would prevent other women from having the same choice, she threw herself into the fight.
For the second time since 2006, South Dakota voters are being asked to outlaw almost all abortions. A ballot initiative called Initiated Measure 11 would ban the procedure except in cases of rape, incest and a narrow interpretation of the health and life of the woman.
Voters rejected a more restrictive measure in 2006, but polls suggested that South Dakotans would have voted yes if it had included exceptions. A group called Vote Yes for Life soon pushed the new version, which they hope will prevent more than 700 abortions a year and produce the case that will overturn Roe v. Wade, the 1973 Supreme Court ruling legalizing abortion nationwide.
Abortion foe Leslee Unruh calls Measure 11 "urgent for the babies who are aborted."
Unruh likes to say that more than 90 percent of the women who have abortions are using it "as birth control." She said the new version of the measure should be attractive because it is "more moderate, more reasonable, more of a middle ground."
Marvin Buehner, a pro-choice Rapid City doctor who specializes in high-risk pregnancies, said the law "would amount to a total ban."
"If there's a risk of a Class 4 felony if I don't meet the ambiguous standard of 'serious risk of substantial and irreversible impairment of a major bodily organ or system,' there's no way I would consider doing an abortion for health reasons," Buehner said. "This represents incredible government interference in the practice of medicine."
South Dakota already may be the most difficult state in which to access abortion.
The legislature passed a law requiring doctors to tell women that an abortion would "terminate the life of a whole, separate, unique living human being." Each woman must be told that abortion increases the risk of "suicide ideation and suicide," a medically disputed assertion, and must be offered the chance to view a sonogram. A 24-hour waiting period is required.
There is one abortion clinic in South Dakota, located in Sioux Falls, hours by car from much of the state. Because no South Dakota doctor is willing to perform elective abortions, Planned Parenthood flies in doctors once a week from Minneapolis. Protesters often picket.
One of those doctors is Carol Ball, who makes the trip once a month.
"What we see is that women undergo a great deal of hardship to get here. Every time we have a clinic, we see women who have come five or six hours," said Ball, who cited the case of a woman in western South Dakota last year who tried to perform an abortion on herself. The implement the woman used broke off.
Ball described "another layer of access problems" stemming from opposition to abortion, especially in small towns. Patients have told her of their fear of discussing crisis pregnancies, sometimes with their own doctors who oppose abortion, for fear their care will suffer.
"That is a fear based in reality," Ball said. "The fact is, they don't think they can talk about it with anybody, or with very few people."
Mary Jones, a pro-choice therapist who works with women and families, said, "It's a lot more difficult than it was 10 or 15 years ago." A teenage client, whom she described as a "straight-A type of student," recently had an abortion and heard the script mandated by the legislature. It must be delivered no earlier than two hours before the procedure.
"She was incensed, was the word she used," Jones said. "She told me that she felt subhuman, like she couldn't possibly understand what was happening to her."
However, the restrictions are seen as safeguards and as tactical steps designed to make abortion extremely rare.
"We are insulted when we hear the Planned Parenthood folks say . . . that women in the middle of the state have nowhere to turn, because it's not true," said the Rev. Steve Hickey, who opposes abortion rights. "There are churches full of people all around the state who will help."
Hickey is a leading organizer of the Lampstand Project, which is rallying churches to provide a haven for women in crisis pregnancies and to persuade them not to have abortions.
In an open letter on Sept. 4, Lampstand ministers wrote that "abortion is unnecessary in part because the church is a significant part of God's provision to women and children in crisis." Hickey says he believes South Dakota has been chosen by God to challenge Roe v. Wade.
At a time when the United States allows "the shedding of innocent blood," Hickey said in an interview in his office at Church at the Gate, "He is giving the nation a window of opportunity to address this. He's picked the state that can pull it off."
If the country makes the "right decision," Hickey said, "we'll see God's blessing come back."
The Lampstand information packet suggests 35 ways to mobilize church members to back Measure 11.
No. 1 is to make sure the church welcome center is stocked with Vote Yes buttons and bumper stickers. No. 3 is to make time during services to provide updates and make requests. No. 12 is to collect "a special offering for VoteYesForLife.com."
No. 15 is to ask Sunday School classes to volunteer to canvass. No. 28 is to "cancel other activities to make this a priority." No. 29 is to "set a 100 percent goal for getting church members registered to vote." No. 35 is to use church vans on Election Day to get voters to the polls.
Vote Yes leader Unruh was in Rapid City last week to open the largest of her group's three offices. Asked why, she said, "We lost here last time. . . . A lot of libertarians."
She said a key component of the Vote Yes effort is the campaign trail testimony of women who regret their abortions and want to stop others from having them.
"The 'candidates' of this particular initiative are the women who have been harmed, those who feel they had a right to have a relationship with her child," said Unruh, who had an abortion. "The people of South Dakota are standing up and giving those babies a voice."
Tiffany Campbell sees the issue very differently and is providing testimony of her own. The thought that a woman would be forced by legislators to carry a fetus to term, even if the child could not survive more than minutes or hours outside the womb, is abhorrent to her, she said.
Buehner calls the provision "unconscionably cruel."
"So what if it's rare? If it's happening to you, it's not rare," said Campbell, an energetic 32-year-old whose eyes begin to tear when she tells her story. "If it can happen to me, it can happen to you, your sister, your neighbor, your daughter."
After Campbell appeared in an Internet advertisement sponsored by the South Dakota Campaign for Healthy Families, which opposes the referendum, the Vote Yes group said she was the victim of "shameful exploitation." A news release also said her abortion would not be illegal under the proposed law, because it was "an unintended death."
"We knew exactly what we were doing. It was full intent," Campbell said firmly. "I live with it every day, that I had a role in my son's death. But I had to do it to save a life." The Washington Post, via Catholic Culture