Abortion Law Reform Research Articles

Knowledge of current abortion law and views on abortion law reform: a community survey of NSW residents

Objective:To report results of a community survey of NSW residents’ knowledge of current abortion law and views on abortion law reform. Methods:A total of 1,015 men and women participated. Recruitment and questionnaires were completed anonymously online using survey panel sampling. Results:Seventy‐six per cent of respondents were unaware that abortion remains a criminal offence in the Crimes Act 1900 (NSW) and 73% thought it should be decriminalised and regulated as a healthcare service. Support for decriminalisation was consistent across genders, age groups, residents of metropolitan/regional and rural areas and levels of education. Support was strong for women seeking abortion to be protected from harassment (89%) and for protester exclusion zones around clinics (81%), with support for these measures significantly stronger among regional/rural residents than Sydney‐based respondents. Conclusions:Abortion law in NSW is out of step with contemporary community views. Residents are largely unaware that it remains a criminal offence and, when informed, support decriminalisation. There is strong support for legal changes to protect women from harassment and to provide protester exclusion zones around abortion clinics. Implications for public health:Abortion law reform would reduce current inequities of access, be democratic and support women's autonomy and reproductive rights.

Conscientious objection to abortion, the law and its implementation in Victoria, Australia: perspectives of abortion service providers

BackgroundIn Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause (‘Section 8’) was introduced requiring doctors with a conscientious objection to abortion to refer women to another provider. This study reports the views of abortion experts on the operation of Section 8 of the Abortion Law Reform Act in Victoria.MethodsNineteen semi-structured qualitative interviews were conducted with purposively selected Victorian abortion experts in 2015. Interviews explored the impact of abortion law reform on service provision, including the understanding and implementation of Section 8. Interviews were transcribed verbatim and analysed thematically.ResultsThe majority of participants described Section 8 as a mechanism to protect women’s right to abortion, rather than a mechanism to protect doctors’ rights. All agreed that most doctors would not let moral or religious beliefs impact on their patients, and yet all could detail negative experiences related to Section 8. The negative experiences arose because doctors had: directly contravened the law by not referring; attempted to make women feel guilty; attempted to delay women’s access; or claimed an objection for reasons other than conscience. Use or misuse of conscientious objection by Government telephone staff, pharmacists, institutions, and political groups was also reported.ConclusionSome doctors are not complying with Section 8, with adverse effects on access to care for some women. Further research is needed to inform strategies for improving compliance with the law in order to facilitate timely access to abortion services.

Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries

BackgroundUnsafe abortion is one of the commonest causes of maternal mortality. Abortion-related maternal deaths are higher in countries with the most restrictive abortion laws. We assess whether maternal mortality varies within and between countries over time according to the flexibility of abortion laws (the number of reasons a woman can have an abortion).MethodWe conducted an ecological study to assess the association between abortion laws and maternal mortality in 162 countries between 1985 and 2013. Aggregate-level data on abortion laws and maternal mortality were extracted from United Nations (UN), and World Health Organization’s (WHO) database respectively. A flexibility score of abortion laws (Score 0–7) was calculated by summing the number of reasons for which abortion was legally allowed in each country. The outcome was maternal mortality ratio (MMR), which represented maternal deaths per 100,000 live births. MMR was modelled as a continuous variable and flexibility score as an ordinal ranked variable (categories 0–7 with 0 as the reference, and < 3 vs > = 3). We used fixed effects linear regression models to estimate the association between flexibility score and MMR, adjusting for gross domestic product per capita (GDP per capita), and time in five-year intervals.ResultsCompared to when a country’s flexibility score was < 3, maternal deaths were reduced by 45 per 100,000 live births (95% CI: -64, − 26) when the flexibility score increased ≥3, after adjusting for the GDP per capita and five-year time intervals. With the exception of a flexibility score 6, MMR was lower when higher than zero. This may indicate the role of other country- specific effects.ConclusionThis study provides evidence that abortion law reform in countries with restricted abortion laws may reduce maternal mortality.

Reproductive justice: A framework for abortion law reform

Australia has seen a number of efforts at reform of abortion laws in recent years. Some jurisdictions have decriminalised abortion entirely, and other states have made efforts to reform abortion law without complete decriminalisation. At the other end of the spectrum, Queensland in 2018 listed abortion as a criminal offence. This article uses the framework of questions in the Queensland Law Reform Commission consultation paper to reprise the need for abortion law reform in Queensland specifically, and Australia generally. While answering the Queensland Law Reform Commission questions, we frame our inquiry around empowering women’s self-determination to make decisions about their reproductive health as a hallmark of their equality as citizens.

Realizing abortion law and policy reforms: Lessons from six country case studies

Realizing abortion law and policy reforms: Lessons from six country case studies

Reproductive Rebellions in Britain and the Republic of Ireland: Contemporary and Past Abortion Activism and Alternative Sites of Care

This paper explores how feminist movements in contemporary Ireland and the Women’s Liberation Movement in Britain in the 1970s and 1980s have subverted state domination and have struggled for self-governance of the female bodies in ways that represent a continuum of responses to restrictive legislation. We address how discourses of liberatory knowledges and autonomy can give rise to ‘illegitimate’ forms of self-care as well as extra-state care (or ‘exile’) across historically-situated points in time. Moreover, we illustrate how social resistance can influence political action surrounding abortion law reform, which can be understood as an attempt to bring the ‘illegitimate’ into the realm of state control and guardianship. Our comparative approach illustrates how campaigns around reproductive rights in contemporary Ireland and in 1970s and 1980s Britain continue to share three crucial strategies: to raise consciousness and awareness; to encourage mobilisation and self-organising of care at the individual and collective levels; and to seek legislative change. Mapping the continuities in how feminist campaigns configure reproductive health and the body as a site of activism in the body politic heralds renewed feminist encounters with the medical humanities, by (re)situating women’s bodies in a historically contiguous struggle for reproductive justice.

Feminism on the frontier: the history of abortion law reform in 1973 in the Northern Territory, Australia

ABSTRACTIn 1973, the Northern Territory (NT) criminal law relating to abortion was reformed. The NT was one of only two Australian jurisdictions where the 1970s liberalisation of abortion was enabled by legislative reform. Unlike the 1969 South Australian reform, the NT bill was sponsored by a female, and feminist, parliamentarian, Dawn Lawrie, assisted by a small group of supporters. This article recovers the narrative of this pioneering reform achieved in a place dominated by white men. It argues that this achievement was enabled by the NT’s individualistic culture, its history of white women’s activism and the mood for progressive change in 1970s Australia. It contextualises the reform by keeping the position of Indigenous women, including the public opposition of some to abortion reform, clearly in view, thus keeping race at the centre of the analysis of liberal feminist reforms and of white feminism in the NT in the early 1970s.

Abortion law reform: Why ethical intractability and maternal morbidity are grounds for decriminalisation.

In this paper, we present two grounds for arguing that abortion should be decriminalised. First, we consider the implications of the fact that the long-standing ethical debate concerning the morality of abortion has to date proven intractable. We maintain that because the philosophical literature has failed to demonstrate conclusively that views either for or against abortion's moral acceptability are false, the matter remains at a stalemate in terms of rational debate, contributing to the ongoing absence of political and popular consensus about the issue in our society. In these circumstances, we argue, the law should adopt a minimalist position by not imposing criminal sanctions for abortion. Second, we present evidence, often neglected in the moral debates about abortion, that the risks of carrying a fetus to term and of delivery are substantial for a woman. Most laws recognise that, should her life be endangered by her pregnancy, a woman's right to life shall prevail. However, the impacts of carrying a fetus to term and delivery on a woman are not restricted to the risks to her life, but extend to significant permanent changes to her body, and include risks of injury that are not negligible. We argue that a woman should not be compelled to take these risks by laws prohibiting abortion, when no conclusive argument exists against the morality of abortion. We also address, albeit briefly, the issue of late-term abortion.

Reforming Abortion Law in Ireland: An Analysis of Submissions to the Citizens Assembly

For decades, questions of whether, how, and when pregnant people living in Ireland can access abortion have been a matter of contention. The Constitution recognised the right to life of unborn and first step to meaningful law reform is unavoidably a referendum to remove this provision (the 8th Amendment). That referendum will take place in 2018. This paper analyses a sample of submissions from public made to a 'Citizens Assembly' established to consider constitutional reform, in order to identify kinds of arguments that inform submissions in favour of, and against, repeal. This analysis shows that, rather than technical and technocratic arguments that now dominate elite discourses about abortion law reform in Ireland, first principles arguments about fetal personhood and rights, on one hand, and women's autonomy on other dominate these submissions. If this is reflective of popular discourse on reform, it may be taken to indicate shape of debates that will dominate 2018 referendum to repeal 8th Amendment.

The 50th Anniversary of the Abortion Act.

The 1967 change in the law on abortion (therapeutic termination of pregnancy before viability, TOP) was driven both by the medical establishment and the Abortion Law Reform Association (ALRA). The doctors wanted confirmation that it was lawful for them to terminate a pregnancy that threatened the life of the woman or would result in grave injury to her health, and ALRA wanted a law that made safe termination by doctors so accessible that dangerous back-street TOPs would be eliminated. A new ‘Abortion Act’ would have to meet the aims of both. Happy chance led to the election to Parliament of David Steel at a time when several senior members of the Labour government were pro-choice, and ALRA, led by Vera Houghton, had an efficient lobby that had been actively supporting Lord Silkin's Abortion Reform Bill. Steel, a talented politician with a zeal for reform, agreed with ALRA that his legislation should aim to eliminate the need for women to seek help outside the law but realised that ALRA's proposals reflected the thinking of the 1930s: the incentive to seek clandestine TOP would be removed only if doctors were given discretion to provide TOPs when the women themselves considered it necessary. He realised that this would be possible if the object of his legislation was the protection of the future health of the women – Dugald Baird, Professor of Obstetrics & Gynaecology in Aberdeen, had convinced him of the close link between social circumstances, health and the need for TOP. This is why the Abortion Act 1967 requires ‘…two doctors, acting in good faith, to certify that the abortion is legal when a pregnancy of less than 24 weeks threatens the physical or mental health of the woman and her children, taking into account her actual or foreseeable environment’. The woman may be healthy at the time she is assessed – the indication for the TOP is ‘social factors threatening health’. Sadly, then as now, many MPs regard themselves as guardians of the morality of the Nation. Fearing that TOP would be used instead of contraception, they insisted on an onerous system of certification (with the signatures of two doctors required), together with statutory notification and the individual approval of clinics. Nonetheless, the Act was a success. Legal TOPs for women resident in England and Wales increased to about 110 000 in 1973 but rose no further until 1980. Deaths due to criminal abortion fell to 1 to 2 per decade and women no longer damaged their vision from quinine used as an abortifacient. Politicians and the media were horrified – ’women must be getting abortions far too liberally’. In fact, the number of legal TOPs was similar to estimates of those that would have occurred outside the law before the Act. Facilities that had been providing illegal TOP used the 6 months before the Act became effective to obtain approval from the Department of Health, and the charities, British Pregnancy Advisory Service and Pregnancy Advisory Service, opened their first clinics. Although women in the UK no longer had to seek help in the back-streets, and the Abortion Act has prevented thousands of deaths in the UK, sadly there are many countries globally where women still risk dying if they feel they cannot cope with an unwanted pregnancy. Modern medical methods of termination are so safe it seems criminal to deny them to women in countries where their reproductive rights are still not recognised. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Fetal genetic difference and a cosmopolitan vernacular of the right to choose

We engage with feminist and critical disability studies and cosmopolitan ethics to search for a cosmopolitan vernacular of the “right to choose” among people faced with the predicaments surrounding fetal genetic difference. Our argument is grounded in reflections on a decade of ethnographic fieldwork on everyday decision-making in these circumstances in Aotearoa/New Zealand. We argue that the ethical notion of “obligations to strangers” rather than the dialectic of “right to choose”/“right to life” has a greater capacity to recognize a shared horizon of meaning between publicly polarized positions on reproductive choice among various activist groups. These groups include the Abortion Law Reform Association New Zealand, Saving Downs, Parent to Parent and the New Zealand Organisation for Rare Disorders. We also debate the merits of a more superficial (cosmopolitan) engagement with others in discussions of these highly politicized topics versus the deeper engagement more commonly associated with feminist research projects such as this.

Abortion Law Reforms and Cognitive Abilities of Teens in Romania

We exploit the drastic liberalization of abortion laws in Romania in 1989 to examine long-term unintended consequences of abortion law reforms for the educational performance of children. Using test scores from PISA surveys conducted among the 1990, 1993, and 1996 birth cohorts, we employ a before-after strategy and a differences-in-differences approach to identify the effect of abortion law liberalization on children’s cognitive abilities. Children born under a liberal abortion policy score significantly higher on tests, with the effects being higher in reading and science scores. Children born after abortion law liberalization are also more likely to attend an academic high school compared to those born under the old abortion law. Boys and children born in rural areas are more likely to benefit from the liberalization of abortion law. These outcomes can mainly be explained by the fact that these children were more likely to have been planned and wanted at the time of conception.

My reflections on abortion law reform

We all bring our personal views to our practice, as this journal's new section, ‘Person in Practice’, highlights.1 My position on abortion is challenging to hold as a consultant in...

Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia

IntroductionIn Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the...

“In the Image and Likeness of God”: Christianity and Public Opinion on Abortion inThe Globe and Mailduring the 1960s

During the 1960s, Canadians were grappling with the social and legal changes that directly affected women’s reproductive lives. One of the contexts in which these changes were occurring was the growing secularization of society. The authors’ analysis of letters to the editors of the Globe and Mail on abortion, however, reveals that over 70% of the letters referenced religious beliefs or institutions. The authors use these letters to explore the ways that readers who commented on abortion referenced religion to legitimize their positions. Specifically, they explore the expressions of the place of Christian beliefs and institutions in discussions of law reform and ideas about women’s roles in a modernizing Canadian society. Examination of the readers’ letters on abortion illuminates perceptions of the churches’ place in a modernizing society, and the degree to which churches were seen as responsive and responsible to their constituents. While religion was a contested field in the abortion law reform debate of the 1960s, it was not ignored; this analysis helps to complicate our understandings of secularization in Canada during the 1960s.

Reform of abortion law in Uruguay: context, process and lessons learned

In October 2012, a new law was approved in Uruguay that allows abortion on demand during the first 12 weeks of pregnancy, 14 weeks in the case of rape, and without a time limit when the woman's health is at risk or in the case of foetal anomalies. This paper analyses this legal reform. It is based on 27 individual and group interviews with key informants, and on review of primary documents and the literature. The factors explaining the reform include: secular values in society, favourable public opinion, a persistent feminist movement, effective coalition building, particular party politics, and a vocal public health sector. The content of the new law reflects the tensions between a feminist perspective of women's rights and public health arguments that stop short of fully recognizing women's autonomy. The Uruguayan reform shows that, even in Latin America, abortion can be addressed politically without electoral cost to the parties that promote it. On the other hand, the prevailing public health rationale and conditionalities built into the law during the negotiation process resulted in a law that cannot be interpreted as a full recognition of women's rights, but rather as a modified protectionist approach that circumscribes women's autonomy.

Abortion Law Reform Needed

Abortion is an important health issue for Australian women. Each year an estimated 100 000 women undergo an abortion. In Australia there are eight different sets of abortion laws across state and territory jurisdictions resulting in great discrepancies in the legal provision of abortion services and hence women's access to abortion. This Brief outlines the problems and limits of current laws and recommends reform.

RISKS, REASONS AND RIGHTS: THE EUROPEAN CONVENTION ON HUMAN RIGHTS AND ENGLISH ABORTION LAW.

Although there is no right to abort in English law but rather abortion is a crime, the lawful grounds for which are instantiated in the Abortion Act 1967 (as amended by the Human Fertilisation and Embryology Act 1990), the regulation of abortion is sometimes perceived as being fairly ‘liberal’. Accordingly, the idea that aspects of English law could be criticised under the European Convention on Human Rights, with which the UK must comply following the Human Rights Act 1998, may seem unlikely. Indeed, English law is compatible with the consensus amongst contracting states that abortion should be available on maternal health grounds. However, analysis of the UK's negative obligations under Article 8 shows that section 1(1)(a) of the Act is problematic as it operates in the first trimester. Further, given the European Court of Human Rights' emphasis on the reduced margin of appreciation once a state has legalised abortion to some degree and its jurisprudence relating to a state's positive obligations, the analysis shows that, while English law may not be problematic in relation to the lack of guidelines relating to the lawful grounds for abortion, it may well be in relation to the lack of a formal system for the review of any two doctors' decision not to grant a termination. Notwithstanding the morally serious nature of the decision to abort, the analysis overall raises questions about the need for at least some degree of abortion law reform, particularly in relation to the first trimester, towards a more autonomy-focused, though time-limited, rights-based approach.

‘Are We Going to Stand By and Let These Children Come Into the World?’: The Impact of the ‘Thalidomide Disaster’ in South Africa, 1960–1977

Thalidomide is in many ways the archetypal drug of our era. Produced in the mid 1950s by the German firm Chemie-Grünenthal GmbH, and sold directly by them or by licencees, it was one of a multitude of medications industrially created during the post-Second World War boom in synthetic drugs and aggressively marketed for multiple uses on a global scale. Most notoriously given to pregnant women suffering from morning sickness, without adequate testing for either toxicity or effectiveness, thalidomide was advertised as being ‘completely non-poisonous, completely safe’. Instead, in what became known as the ‘thalidomide scandal’, it caused malformations resulting in at least 10,000 children being born with severe disabilities. Previous research has shown that thalidomide was given out as samples, sold over the counter, or distributed via national health facilities in at least 46 countries around the world. It has become conventional wisdom that there are no histories to be told of thalidomide in South Africa, or in the continent more widely. We challenge this view. We focus specifically on South Africa, and describe how the country narrowly missed an ‘epidemic of deformity’ in the late 1950s and early 1960s. We then demonstrate that the international thalidomide scandal affected South Africa in at least two significant ways. First, it informed the passage of the Medicines and Related Substances Control Act (No. 101) of 1965, which established the Medicines Control Council of South Africa. Second, it played an important role in the debate over abortion law reform in the early 1970s, in particular regarding the desirability of a eugenic clause in South Africa's first statutory law on abortion, the Abortion and Sterilisation Act (1975).

Medicine and abortion law: complicating the reforming profession.

The complicated intra-professional rivalries that have contributed to the current contours of abortion law and service provision have been subject to limited academic engagement. In this article, we address this gap. We examine how the competing interests of different specialisms played out in abortion law reform from the early twentieth-century, through to the enactment of the Abortion Act 1967, and the formation of the structures of abortion provision in the early 1970s. We demonstrate how professional interests significantly shaped the landscape of abortion law in England, Scotland, and Wales. Our analysis addresses two distinct and yet related fields where professional interests were negotiated or asserted in the journey to law reform. Both debates align with earlier analysis that has linked abortion law reform with the market development of the medical profession. We argue that these two axes of debate, both dominated by professional interests, interacted to help shape law's treatment of abortion, and continue to influence the provision of abortion services today.