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Beyond Pro-life and Pro-choiceThe Changing Politics of Abortion in Britain$

Fran Amery

Print publication date: 2020

Print ISBN-13: 9781529204995

Published to Policy Press Scholarship Online: September 2020

DOI: 10.1332/policypress/9781529204995.001.0001

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(p.177) 8 Conclusion
Beyond Pro-life and Pro-choice

Fran Amery

Policy Press

Abstract and Keywords

This chapter places abortion debates in Britain in the context of both anti-abortion strategy worldwide and the global struggle for reproductive justice, touching on issues of race, ethnicity, migration and nation. There has recently been a twofold shift in the terrain of British pro-choice argument. One the one hand, the British pro-choice coalition has shifted from a politics of protection – which emphasises women’s vulnerability and thereby supports a paternalistic, medicalised regime of abortion regulation – to a politics of liberation, which emphasises women’s authority over their own reproductive decisions. On the other hand, there is a growing need to acknowledge intersectional or reproductive justice claims in abortion politics. The chapter closes by asking whether the pro-choice movement is being pulled in two different directions, and how it can steer between them.

Keywords:   Pro-choice, Anti-abortion, Reproductive justice, Intersectionality, Abortion

The parliamentary politics of abortion cannot now be neatly arranged around the twin poles of ‘pro-life’ and ‘pro-choice’ – but they never could. The Abortion Act 1967 did not, and was never meant to, establish a ‘right to choose’ in law. Instead, it was meant as a partial fix to social problems including poverty, poor housing, and ‘overlarge’ families with tired mothers, but also ‘problem’ families, ‘unfit’ mothers, and ‘delinquent’ children. This was to be achieved not by liberating women to exercise their reproductive rights, but by engaging medical professionals as social agents and delivering (especially working-class) women into their care and control. The passage of the Act relied heavily on the dual image of doctors as socially responsible and of women seeking abortions as vulnerable and in need of paternal guidance.

This has funnelled discussions in a particular way, ultimately producing debates on abortion that are not about ‘life’ versus ‘choice’. Debates have instead hinged on questions of the meaning of ‘health’, the appropriate role of doctors in the governance of ‘social’ concerns, and the correct way to ‘protect’ women often conceived of as vulnerable. Attempts to further restrict abortion rights have rarely been made on the basis of the ‘right to life’ of the unborn, but rather on the basis that abortions are somehow harming women, while doctors are being corrupted by their role in performing them. In the wake of allegations that some women are selectively aborting female foetuses, some have asked questions about the appropriateness of ‘choice’ as a model for making sense of abortion.

Abortion rights advocacy in context

British abortion law is something of an anomaly in requiring such a great level of medical control over abortion (Cooper, 2016: 50–5). Many European countries allow abortion on request; that is, without (p.178) the need for medical grounds to be met. On the other hand, in countries where this is the case, it is usually much harder to access abortion after a certain point in pregnancy (usually 12 weeks’ gestation). This has allowed participants in the abortion debate to claim, variously, that the UK has some of the most restrictive abortion laws in Europe and that it has some of the most permissive. As around 90 per cent of abortions in England and Wales1 are carried out in the first 12 weeks of pregnancy (Department of Health and Social Care, 2018b: 12), the need for two doctors’ signatures and medical grounds to be met are clearly the more pressing barriers for most women seeking abortion, perhaps explaining why increasing numbers have turned to services such as Women on Web.

The Abortion Act 1967 was never straightforwardly a victory for ‘choice’, nor a ‘feminist’ achievement. Yet it was still a significant step forward, and the need to defend it from anti-abortion attack has had a significant impact on pro-choice and feminist arguments in Parliament. These arguments have tended to adopt a similar protective and medicalized frame to the Act itself, emphasizing the supposed vulnerability of women seeking abortion and playing heavily on trauma narratives. When overtly feminist arguments did enter parliamentary debates on abortion in the 1970s, these accepted and promoted the image of women seeking abortion as essentially vulnerable and tended to assume a natural alignment between the interests of women and doctors, even as feminists outside Parliament grew increasingly critical of medicine as an institution.

Initially, this merely involved the representation of such women as traumatized by their situation and in need of paternal guidance. But by the 1980s, feminist parliamentarians were routinely constructing narratives of ‘acceptable’ abortion and representations of women as virtuous, needing abortions ‘through no fault of their own’. In the face of mounting delays in accessing abortion in the 1980s, feminist politicians began to criticize the system of abortion provision. Ultimately, though, such attacks were levelled at failings in the NHS rather than at the medicalization encoded in the Act. Meanwhile, ‘women’s rights’ were discursively transformed into ‘patients’ rights’: a clever framing that on the one hand allowed pro-choice feminists to justify the demands they made of the state in a way that had broad resonance, but on the other hand eclipsed questions of reproductive freedom and bodily autonomy.

Pro-choice MPs have tended to default to statements about the ‘medical necessity’ of abortion, which tacitly reinforce the Abortion Act 1967’s requirement for medical grounds to be met. In doing so, their arguments have often closely resembled arguments made by (p.179) supporters of legal abortion in the US, and can be subjected to the same critiques. US feminists have also tended to prioritize the health impact of illegal abortion and unwanted pregnancy in their arguments. This has meant that ‘the central political battle – arguing that women’s access to abortion is necessary for the kind of self-determination men take for granted – remains unfought’ (Purdy, 2001: 256). Daniel Skinner has developed this argument, advancing a critique of the pro-choice focus on medical necessity:

However well intended, pro-choice advocates who evoke these kinds of arguments unintentionally suggest that abortion rights are substantively necessary only in relation to the social conditions they address, rather than to the existence of a self-authorizing, self-standing right to determine what one does with one’s body. (2012: 12)

As Skinner notes, the focus on medical necessity has had unintended consequences. In the US, it has underlined the withholding of federal funding for abortions deemed unnecessary for physical survival, and the recent extension of such restrictions to private healthcare providers who participate in government programmes (2012: 3–10). The use of medical necessity arguments has also opened up the debate to attempts to demonstrate that abortion is not necessary to health or is in fact harmful (2012: 13–14). Similar claims have been made in debates in the UK. These have generally not made the same impact on either media or political discourse as they have in the US and have largely been ignored by the medical profession (Lee, 2003). However, the reliance on narratives of medically necessary and ‘acceptable’ abortions has also made it difficult to make the case for abortion law that does not require certain medical grounds to be met. It is still extremely rare in political arenas to hear the argument that a woman should be able to have an abortion simply because she wants one.

Until recently, pro-choice actors in the UK Parliament have been unable to set the frame of the debate, having instead to respond to the assumptions about female vulnerability encoded in the Abortion Act 1967 as well as to anti-abortion arguments. Representing women seeking abortions as virtuous-yet-traumatized victims is an understandable response to the claim that women abort for ‘frivolous’ reasons, but risks reinforcing a divide between ‘deserving’ and ‘undeserving’ aborters and distracting from abortion’s importance to the social status of all women. This hinders the normalization of abortion as a relatively common procedure undergone by women (p.180) from all walks of life. Moreover, it has gone hand in hand with the portrayal of doctors as necessary mediators in the decision to abort. It is only now – since two decriminalization Bills have been introduced in Parliament and decriminalization has successfully been enacted in Northern Ireland – that pro-choice MPs have tentatively begun to change the script.

In assessing the prospects of decriminalization, lessons might be learned from other countries. The most obvious of these are Canada, the only country to have fully decriminalized abortion, and Australia (often cited by decriminalization campaigners in the UK), where many states have decriminalized or partially decriminalized abortion. Canada first legalized abortion in certain circumstances in 1969 via a law that required abortions to be performed in hospitals and approved by three-doctor ‘therapeutic abortion committees’. Massive variations in how these committees operated resulted in inequalities in access around the country. The R v Morgentaler decision of the Supreme Court removed abortion from the criminal code due to the ‘unworkable’ nature of the law, although it did not grant a right to access abortion (Studlar and Tatalovich, 1996: 79–80).

In Canada, abortion is now recognized as a matter of public health rather than of criminal law. From a UK pro-choice perspective this may seem like the ideal outcome. However, public policy researcher Rachael Johnstone cautions against too celebratory a reading: the framing of abortion as ‘healthcare’ rather than a human right has in reality had mixed effects. In some cases, this framing has allowed advocates to make the case for more funding for abortion as part of the provision of adequate healthcare. However, it has also allowed individual Canadian provinces to use their authority over healthcare to erect barriers to access, while the federal government and Parliament have evaded responsibility for abortion. The result has been large disparities in access of the kind that Morgentaler was supposed to prevent (Johnstone, 2017). While the UK lacks a federal government, similar evasions at the centre have been observed in both the process of devolving abortion law (Moon et al, 2019) and the activity of commissioning services (APPGSRH, 2015). The UK government is now committed to introducing liberal provisions for abortion in Northern Ireland by 31 March 2020, but Stormont, when it reconvenes, could still introduce regulations that make it difficult for clinics to operate in practice.

A similarly mixed picture emerges from Australia, where abortion was decriminalized as early as 2002 in the Australian Capital Territory and as recently as 2018 in Queensland and 2019 in New South Wales. Barbara (p.181) Baird finds that in states that have decriminalized abortion, improved access has not necessarily resulted. In fact, in some cases access to abortion has been reduced, due to clinics closing or withdrawing certain services. These closures result from pressure due to the increasingly privatized model of provision in these states, and cannot be directly blamed on decriminalization itself. However, Baird also suggests that there is no evidence that decriminalization has had the hoped-for effect of destigmatization, either for women or providers (2017).

The UK differs from Australia and Canada in important ways. The extensive network of charitable provision in Britain supported by NHS funding is well-placed to take advantage of decriminalization to improve access by, for example, introducing more nurse-led care, and clinics are extremely unlikely to close due to pressures from the private sector. Also, with the exception of the Australian Capital Territory, the states surveyed by Baird had only decriminalized abortions administered by medical practitioners (Queensland and New South Wales changed their own laws too recently to be included in Baird’s assessment), obstructing their ability to improve access for women who might struggle to attend a clinic (Baird, 2017: 204–5). This kind of partial decriminalization is clearly not the intent of campaigners in the UK; women’s access to abortion pills has been high on their agenda.

Framing abortion as ‘just like any other medical procedure’, as decriminalization advocates often have, may however have other drawbacks. It risks decoupling the issue of abortion from broader questions of women’s social status: their access to jobs and education, for starters, as well as the ability to be considered as more than just a reproductive body. Without a right to abortion enshrined in law, the ‘health’ framing is also left open to attempts to prove that abortion is not ‘necessary’ to health or is harmful. Johnstone suggests that an expansive definition of health, such as the World Health Organisation’s well-known statement that it is ‘a state of complete physical, mental, and social well-being’ (quoted in Johnstone, 2017: 111–12) always justifies liberal abortion access, as it is necessary for ‘social well-being’. This is true; however, this broad definition has not necessarily always informed government action on reproductive and sexual health (Evans, 2006). None of this ought to discourage advocates: most importantly, decriminalization will remove a huge barrier to abortion provision in Northern Ireland, and has the potential to facilitate improvements to access and services in England and Wales. And crucially, it is socially and culturally symbolic. As suggested by a feminist commentator in Victoria: ‘for the first time women will be recognised as the authors of our own lives. With that comes our full citizenship’ (Wainer, 2008).

(p.182) Anti-abortion politics in context

The Abortion Act 1967 also channelled anti-abortion arguments along a particular path. Early parliamentary opposition to the Act focused not on the question of preserving ‘life’ – indeed, conventional ‘pro-life’ arguments regarding the moral status of the foetus are notable by their near absence – but about whether it was appropriate to expect doctors to intervene in ‘social’ issues. Subsequent anti-abortion challenges have attacked the image of the ‘socially responsible’ doctor on which the Act rests. From the 1970s, these challenges have mainly involved claims about the occurrence of ‘racketeering’ and other abuses in the private sector, with the addition of gory images of medical butchery in the allegations about ‘partial-birth’ abortion in the 1990s. In recent years, this has been accompanied by sustained harassment of abortion providers by anti-abortion activists (McGuinness, 2015). Yet the need to respond to calls for decriminalization has resulted in contradictions in anti-abortion arguments, in which doctors now figure both as irresponsible, untrustworthy butchers and as necessary gatekeepers to abortion (Lowe, 2018: 11).

The Act also introduced a ‘woman problem’ for anti-abortion actors in that it positioned them ‘against’ helping vulnerable women, and since 1967 anti-abortion politics has been characterized by attempts to solve this problem. Primarily, this has been attempted by portraying women who have abortions as victims of unscrupulous doctors and the trauma of abortion itself. However, the portrayal of women as victims has occasionally clashed with depictions of female vice and abortion for ‘frivolous’ reasons. Anti-abortion MPs and peers have nonetheless attempted to deploy feminist language and concepts, complaining, for example, about women’s sexual treatment at the hands of men and arguing that legal abortion lets men ‘get away with it’. Yet this has not been blamed on a history of male societal dominance but on the sexual revolution and loss of traditional values: some even lamented that a ‘sense of responsibility’ had been lost in the uncoupling of sex from the context of the traditional heterosexual marriage. In this way, the appropriation of feminism paradoxically coincided with a backlash politics that identified feminism and social change as the cause of women’s problems rather than the solution.

Claims about the supposed harms of abortion are part of a broader shift towards ‘woman-centred’ (Cannold, 2002) arguments in anti-abortion strategy. As Paul Saurette and Kelly Gordon put it, ‘contemporary “conservative” political discourse is increasingly colonizing and employing explicit arguments, principles and narratives (p.183) that have traditionally been associated with progressive feminist, pro-women and pro-choice movements’ (2013: 158). This trend is certainly not confined to the UK; it has been observed across the Anglosphere in the US (Cannold, 2002; Rose, 2011), Canada (Saurette and Gordon, 2013; Duerksen and Lawson, 2017), Australia (Cannold, 2002; Baird, 2013) and New Zealand (Leask, 2013). Leslie Cannold (2002) suggests that this trend came about due to the failure of strategies centring the foetus and its ‘right to life’. As even the belief that life begins at conception does not necessarily deter people from supporting liberal abortion laws (Cannold, 2002: 172), a change of tack was required. The core arguments are familiar: that women’s mental (and sometimes physical) health is harmed by abortion, that the decision to abort is often coerced, and that organizations claiming to support women’s rights are actually undermining them. Proponents believe the ‘woman-centred’ strategy to be stronger than older strategies as it reverses the script on abortion, placing anti-abortion actors in the position of defending, rather than attacking, women considering abortion. However, both this and foetus-centred arguments ‘seek to undermine women’s decision-making agency’ (Cannold, 2002: 172). Foetus-centred arguments do this by implying that women are morally deficient for choosing to abort. Woman-centred arguments, on the other hand, suggest that women are incapable of making a free and informed choice.

Analyses of anti-abortion movements in other countries generally suggest that woman-centred arguments became popular in the 1980s or later (Cannold, 2002; Rose, 2011; Saurette and Gordon, 2013), and this is certainly when anti-abortion actors in the UK began to borrow explicitly feminist-sounding arguments. However, this book’s analysis has found that a rudimentary woman-centred frame was present in UK parliamentary debates as early as 1970. Recall, for example, Godman Irvine’s accounts of vulnerable ‘girls’ attending poorly-managed abortion clinics and becoming ‘desperately ill’ (Hansard, 1970: 1664–5), or the various narratives of vulnerability and exploitation that drove support for the White Bill (Hansard, 1975). While this did not necessarily reflect the views of anti-abortion activists outside Parliament (Clarke, 1987), it is interesting that arguments used in the UK Parliament may have pre-dated those of other countries. It is sometimes alleged that anti-abortion actors in the UK have ‘imported’ American tactics (Bates, 2016; Braithwaite, 2017). Specific claims regarding the relationship between abortion and women’s mental health do appear to have spread from the US to the UK, although they have found more purchase in the former (Lee, 2003). Nonetheless, ‘woman-centred’ (p.184) frames were a feature of UK abortion debates years before abortion was even legalized in the US.

As stated previously, these strategies have not generally been successful in shifting the legislative agenda in the UK. Claims about sex-selective abortion therefore require extra attention, as legislation that would have criminalized the practice was, unusually, very nearly passed. These claims were also apparently modelled on US anti-abortion campaigns: since 2009, multiple states have banned or considered banning sex-selective abortion, despite a lack of evidence for such abortions taking place among the targeted group, Asian Americans (Kalantry, 2015; 2017). Claims about sex-selective abortion are structured along the lines of older ‘woman-centred’ tropes. Accordingly, in these claims it is women (not only, or even primarily, foetuses) who are framed as the victims of abortion, while abortion doctors are persistently villainized (Lee, 2017). This framing has again spread from the US to the UK.

What sex selection claims add is an explicit racialization of abortion debates. It is not that abortion was not already a racialized issue. However, awareness of race has typically been lacking from abortion debates in the UK Parliament (whereas in the US, for example, the allegation that ‘abortion is black genocide’ has been around for years). Sex-selection claims brought race hurtling into (white) political and public consciousness. Quoting Gayatri Spivak, Sundari Anitha and Aisha Gill characterize recent attempts to amend the law as ‘an example of what feminist postcolonial critiques would describe as an impulse to “save brown women from brown men”’ (2018: 9). Debates on sex selection also refer to the nation and the place of feminism and gender equality within it. As Jennifer Musial has observed, debates in the US have played heavily on ‘the notion that the American Empire is a benevolent, rights-upholding, progressive nation by which others are oppositely cast as coercive, violent, rights-denying and regressive’ (2014: 271). Debates in the UK, as we have seen, similarly rely on the mythologized image of the UK as a haven of gender equality that must be defended from the ‘oppressive’ practices of racial minorities. I suggest that these constructions of race and nation are what propelled the sex-selection ban to near-success where previous ‘woman-centred’ attacks on UK abortion law failed to land.

Interrogating ‘choice’

Narratives of vulnerability and trauma have featured heavily on all sides of the abortion debate. The Abortion Act 1967 is grounded in the idea that women need protecting, and this claim has been made (p.185) over and over in Parliament by those defending the Act. Of course, it is imperative to speak up about trauma, especially in cases of burning injustice such as the criminalization of rape survivors in Northern Ireland. Yet what is lacking in parliamentary abortion debates is any defence of women who are not victims, are not ‘faultless’, but simply do not want to be pregnant. If this is not yet considered permissible speech, we are still a long way from realizing the radical potential of abortion access to liberate women from norms about motherhood.

Feminist politics that focus on appealing to the law to protect women have always come at a price. As Wendy Brown has argued:

Historically, the argument that women require protection by and from men has been critical in legitimating women’s exclusion from some spheres of human endeavor and confinement within others. … Whether one is dealing with the state, the Mafia, parents, pimps, police, or husbands, the heavy, dual price of institutionalized protection is always a measure of dependence and agreement to abide by the protector’s rules. (1992: 8–9)

In the case of abortion law, the price of protection has been that those seeking abortion have had to submit to medical surveillance and control and assessment of them as ‘deserving’ or ‘undeserving’ aborters. But the tone of debate is now shifting, as MPs and even medical bodies have become increasingly critical of criminalization and the strictures of the Abortion Act 1967. Outside Parliament, advocates call for liberation rather than protection, and frame decriminalization as the next step for gender equality.

Yet demands for action on reproductive injustice still often draw upon a politics of protection that clashes with these more liberatory frames. Recent calls for a ban on foetal sex testing in early pregnancy serve well to illustrate these more protective frames and the response they have garnered. The issue was thrown into the spotlight in 2018 when the BBC’s Victoria Derbyshire programme alleged that ‘thousands’ of British South Asian women were discussing using non-invasive prenatal testing (NIPT), a DNA test more commonly used to test for genetic conditions, to screen for female foetuses and potentially abort based on the results. The Labour Party frontbencher Naz Shah subsequently called for a ban on using NIPT for foetal sex, stating that son preference in some South Asian families forced women to use it ‘to live up to expectations of family members’ (Haque, 2018). This drew angry responses from other quarters, with one commentator noting (p.186) that ‘if there is something knowable, particularly about my body, I want to know it’ (Ramaswamy, 2018). BPAS’s Director of External Affairs, Clare Murphy, characterized the proposed ban as an effort to ‘deny every pregnant woman the right to find out information about her own pregnancy’ (BPAS, 2018), and the Voice for Choice coalition of pro-choice organizations has previously resisted calls for a ban (Alliance for Choice, 2017).

Shah herself was clearly motivated by the perception of a need to protect vulnerable women, a perspective that underpins many responses to sex-selective abortion. This clashed with many abortion rights advocates’ emphasis on the need for reproductive choice as a key component of women’s liberation. The fault lines emerging here recall the broader debate about the appropriateness of ‘choice’ as a framework for understanding abortion. The writer and Southall Black Sisters activist Rahila Gupta, for example, has argued that conversations about ‘choice’ in the context of sex selection are ‘a red herring’ (2014: 86) as these may be forced abortions, and called to ban foetal sex testing (an outright sex-selective abortion ban being in her view unworkable).

Gupta’s position on ‘choice’ is reminiscent of other feminist critiques often associated with the reproductive justice movement. Reproductive justice activists have criticized what they see as the mainstream US pro-choice movement’s narrow conceptualization of reproductive rights as legal rights concerning the protection of women from state interference. As the US scholar Zakiya Luna has observed, conceptualizing reproductive rights as a matter of choice may seem to make sense to those women ‘who have evidence that, but for their gender, they could participate fully in society’ (2011: 224). Yet the portrayal of abortion as solely an exercise in legal, individual choice has been questioned by Luna and other feminists, who point out that choices are not made in a vacuum. Susan Himmelweit has noted that women rarely make the choice to abort or keep a pregnancy in ideal physical, material, and emotional circumstances and would often choose differently in different circumstances, meaning that their choice cannot be separated from the context in which it was made (1988: 42). Similarly, for Rhonda Copelon, choices are shaped by social conditions, and ‘cannot be fully free’ in a world of poverty, inequality and discrimination (1990: 28). Choices may be most restricted for those facing intersecting systems of oppression.

These ideas have met with some resistance. Perhaps most forcefully, BPAS chief executive Ann Furedi has condemned them as belonging to a ‘new anti-choice movement’ (2013b). Furedi wrote in response to both the claims of the reproductive justice movement and the news (p.187) that the Planned Parenthood Federation of America (along with other US organizations) was to drop the language of ‘choice’, in response to data that the organization claimed showed that the labels of ‘pro-life’ and ‘pro-choice’ do not accurately represent the views of most US citizens (Holpuch, 2013). Rightly, Furedi pointed out that the data do not in fact support such a shift: a key finding is that while some people avoid labelling themselves ‘pro-choice’, closer examination of their beliefs reveals that they do in fact support the right of individuals to decide according to their circumstances (Marcotte, 2013).

Furedi’s article also criticized the subsequent decision of the US group Physicians for Reproductive Choice and Health (PRCH) to drop the word ‘choice’ from its name and become Physicians for Reproductive Health (PRH). As she noted, reproductive choice and health are not always the same:

Where will the doctors in PRH stand when faced with the controversies about women who base their reproductive decisions on issues that are nothing to do with reproductive health at all? I know what a doctor in PRCH will say about a 35-year-old woman who chooses to have an abortion because she prefers to delay starting her family. That doctor will support her patient’s choice. But if the doctor is only interested in her patient’s reproductive health? Given the increase in risks with maternal age, I’m not so sure what she’ll say in the above situations. (2013, emphasis in original)

So far, I am sympathetic to Furedi’s concerns; this book and chapter have argued that conceptualizing abortion solely as a matter of health has severe limitations. Yet her article muddies the water in associating these particular anti-‘choice’ moves with reproductive justice critiques. ‘Health’ and ‘justice’ are very different concepts: the former depoliticizes reproduction, while the latter politicizes it. The contribution of the reproductive justice movement has not simply been to critique the concept of ‘choice’ in the abstract, but to highlight what they see as important issues missing from mainstream US ‘pro-choice’ politics in practice. This includes the question of access to abortion in practice as well as on statute (the latter, they argue, being the sole focus of much pro-choice activism). It also includes access to contraception, sex education, sexual health services, adequate pre-and post-natal care, sexual and domestic violence services, and social justice more broadly. Advocates argue that these issues can only be adequately addressed by a movement that analyses power systems and centres the most (p.188) marginalized (SisterSong, undated). This is a far cry from the vague and apolitical notion of ‘reproductive health’ that Furedi critiques. It is also not a call for a return to a politics of protection, which relies on the legal system to defend the vulnerable; as indigenous and anti-racist activists, US reproductive justice advocates have been sceptical of any such move. The reproductive justice movement should not be described as ‘anti-choice’ but more ‘beyond choice’ or ‘choice plus’; as SisterSong put it, individual choice is ‘necessary, but not enough’ (SisterSong, undated).

Furedi’s article ends by citing in full the London Declaration of Pro-Choice Principles – developed by BPAS with the group Catholics for Choice and a coalition of activists, practitioners and academics in September 2012 – along with the challenge, ‘To those who wish to drop the C-word: with what, in this declaration, do you disagree?’ The Declaration in fact reads similarly to many reproductive justice movement demands, citing the need for access in addition to the legal right to abortion, as well as the need for access to a broader range of services alongside ‘legal, social, political and economic changes’. It can therefore be argued that there is a fair amount of overlap between reproductive justice movement norms and those of the UK pro-choice movement, at least on paper. This was underlined by discussions at a recent Abortion Rights public meeting.2 For those at the meeting, ‘choice’ clearly stood for more than statutory rights, narrowly conceived: it also stood for the ability to access better and non-judgemental healthcare and for measures to end women’s suffering.

The future of abortion politics

The key question is not whether a movement based on ‘choice’ can speak to a broader set of concerns than simply the legal right to access abortion, but whether it does in practice. What has historically been lacking in UK pro-choice politics is the reproductive justice movement’s explicitly intersectional awareness, broad critique of power structures, and situation of abortion as part of a wider reproductive rights and social justice agenda (Evans, 2015: 183–4). I argue that such an agenda is vital. There is a clear moral case for it, in that, as Crenshaw argues, a movement that does not address intersecting power structures cannot hope to speak for all women (1989; 1991). But there is also a practical case, in that those seeking to restrict access to abortion are already aware of and exploiting differences between women. Without broad, intersectional coalitions, the pro-choice movement will remain (p.189) vulnerable to the charge that it does not care about the rights of South Asian women, for example, or those of disabled people.

There are clear signs of a shift towards such an approach from segments of the movement. The collaborative statement on sex selection produced by BPAS, IKWRO, Southall Black Sisters, EVAW and others is a good example of this. Since 2011, BPAS has made a sustained effort to reframe the organization’s activity as part of a broader social justice movement and collaborate with activist groups beyond the pro-choice sphere.3 Documents produced during this time include reports on disabled women’s reproductive rights (BPAS, 2017), young deaf people’s sexual and reproductive health needs (BPAS, 2014c), pregnancy and maternity discrimination (BPAS, 2016), and support for improved childcare services and affordable housing to make it easier for women to choose to have children (BPAS, 2015b).

Other leading advocacy groups, such as Abortion Rights and the Voice for Choice coalition, have been narrower in their focus. Due to its historical ties with the trade union movement, Abortion Rights has always stressed that abortion is an economic issue and has campaigned against austerity (Jackson, 2011; Abortion Rights, 2015c). However, many in the movement have been reluctant to explicitly organize under a broader reproductive rights or reproductive justice banner. This is in part due to the perception that there is less inequality in access to healthcare services in the UK than there is in the US, and therefore less need for such a movement (Jackson, 2011; Evans, 2015: 183–4). As Chapter 2 suggested, however, there is still plenty of inequality, both in access to services and in health outcomes, and migrant women’s fertility is particularly stigmatized.

There are also structural barriers to doing this kind of work. Building broad, intersectional coalitions takes time, and this is something that can prevent those working and campaigning in the pressured women’s sector from doing as much outreach work as they might like. Campaigners interviewed by the feminist blogger Sarah Jackson also suggested that the movement’s specific aim of defending the Abortion Act 1967 naturally resulted in a narrower focus (Jackson, 2011). Indeed, constant attempts to chip away at the Act have often placed abortion rights advocates on the back foot. But does this mean that, if abortion is decriminalized, the movement might be able to reformulate and broaden its scope? In the wake of the decriminalization campaign and the watershed moment for abortion rights in Northern Ireland, it certainly seems as if the movement has gained agenda-setting power. If time constraints allow, perhaps this can be capitalized upon.

(p.190) What might a reproductive justice movement look like in the UK? It might, for example, seek to tackle the vast discrepancies in maternal health and wellbeing between white and minority women. It might in particular campaign against policies that aim ‘to dissuade “undesirable” migrants from having children’ (Lonergan, 2015: 124) via a combination of strict spousal visa rules and limits on access to maternity services. It might also address the far right and its ongoing mainstreaming (Mondon and Winter, 2018), including scare stories about immigration and fertility amongst migrant groups. As Jackson (2011) notes, it is not that there are not groups already doing this work. However, they have not formulated together as a movement under the same banner.

A UK reproductive justice movement might also revisit arguments about abortion and disability. Abortion rights advocates have tended to defend the Abortion Act 1967’s exemption to the normal 24-week limit to legal abortion for cases of severe foetal disability. However, as Sheelagh McGuinness has argued, this exemption is discriminatory as ‘some foetuses are being stripped of a layer of legal protection they would otherwise have: disability is being used to differentiate legal protections between foetuses’ (2013: 237). For McGuinness, the argument that the clause exists to protect ‘choice’ or pregnant women’s interests, given the need for extra time after discovery of the disability, does not hold. The law does not protect other abortion choices after 24 weeks’ gestation, even when ‘extra time’ is clearly needed to protect the pregnant person’s interests and ability to choose (McGuinness recounts a scenario in which a distraught young woman learned she was 28 weeks pregnant, not 14 weeks as she believed, and therefore would be denied an abortion [2013: 235]). The answer is not necessarily to scrap the relevant clause altogether, as proposed by Lord Shinkwin. The discriminatory element of the law lies in its protection of some choices and not others. McGuinness suggests that an alternative solution would be to reject the requirements of the Abortion Act 1967 entirely (2013: 238). Decriminalization would obviously make a start in this direction. However, as the decriminalization campaign currently aims to preserve the 24-week upper limit in law for abortion on grounds other than disability (and thereby preserve good relations with the medical bodies, which insist on this limit), this discrepancy is not close to being tackled.

Key to reproductive justice organizing is not just what is being addressed, but how and who by. Kimberlé Crenshaw’s famous account of intersectionality suggests that it is not simply about how identities (such as womanhood or blackness) intersect, but about how movements (p.191) (women’s movements, civil rights movements) may be made to speak to one another (1991). We should be wary of the assumption that ‘natural’ coalitions exist among marginalized groups (Cole, 2008). There may be differences between groups that cannot easily be transcended, if at all. Examples are the question of whether foetal sex testing should be banned or whether this is an infringement on the right to know about one’s own pregnancy, and that of whether late-term abortions for disability are discriminatory or necessary to protect pregnant women’s interests. The experience of US activists suggests that the way forward is not to gloss over or attempt to transcend these differences but rather to confront them ‘openly and honestly’ (Roberts and Jesudason, 2013: 315), through a process of coalition-building that involves learning about one another’s movements and developing solidarity. This requires sustained engagement that goes beyond an immediate single issue such as a Bill before Congress or Parliament; it means, for example, ‘co-sponsoring and attending each other’s events’ (Roberts and Jesudason, 2013: 319). This generates long-term shared goals and values even where there is disagreement on individual issues. While UK reproductive rights activism will naturally have different goals and involve different actors, there might be useful lessons here for building a broader movement. (p.192)


(1) As abortion statistics are calculated differently in Scotland, it was not possible to obtain comparable figures. However, the overwhelming majority of abortions in Scotland are carried out at an early stage of pregnancy.

(2) Abortion Rights public meeting, Portcullis House, 10 October 2018.

(3) Abigail Fitzgibbon, personal correspondence, 7 February 2019.