Abstract
A hu(wo)man rights error: Gender injustice in abortion rights
Reimagining Global Abortion Politics comes to the shelves at a time when backlash against abortion rights is heightened and resources to support women’s right to safe and medical abortion are dwindling. Gross violation of human rights as a result of restricted access to abortion, as well as social backlash against advocates and providers, are noted across the globe. Despite the downward trend in church attendance in many parts of the world in the last three decades, religious beliefs are still largely used to bar access to abortion in many settings. Against this global backdrop, this book investigates the contemporary global abortion politics and the factors explaining variations in access to abortion between and within countries. It covers the de/criminalization of abortion (Chapter 1), the biomedicalization of abortion (Chapter 2), the influence of discourses of religion, culture and nationality (Chapter 3), abortion discourses: religion, culture and nation (Chapter 4), international interventions (Chapter 5), abortion activism (Chapter 6), and reproductive justice (Chapter 7). The authors present case studies from different countries, bringing the discussion of global reproductive politics alive with data and evidence and driving home a message about the urgency of social justice and redress for women.
Bloomer and colleagues begin by discussing the ongoing criminalization of access to abortion and the difficulties citizens experience in gaining access to this health service. In many instances, abortion-seekers travel transnationally to seek services elsewhere. An example is provided in the book about Irish women travelling to England to access abortion; travel to access healthcare, especially abortion, is a common experience across Africa, Europe, and the Americas. This is not a viable option for many women due to prohibitive travel costs and difficulty acquiring travel documents, making them vulnerable to being trafficked in destination countries. The book raises questions about access for various abortion seekers including asylum seekers and undocumented migrants. This is an important question, especially in the contexts of COVID-19 and lockdowns which complicate access to sexual and reproductive health services, including abortion.
The criminalization of abortion continues in the face of progressive international and regional legal instruments. To some extent, limitations that are contained in abortion clauses in human rights instruments allow states to withhold the right to abortion on request. For instance, the African Charter on Human and People’s Rights on the Rights of Women in Africa (the Maputo Protocol) is ratified by more than 30 African Union member states and yet it restricts abortion to special circumstances. The exclusion of women’s rights in human rights tools is part of global politics and social injustices and requires intensified advocacy. Thus, the authors correctly advocate for the decriminalization of abortion and for abortion to be sanctioned as a health issue globally.
In contexts where abortion is available on request, the book asks an important question about “choice” in the choice of termination of pregnancy provisions vis-à-vis the concept of reproductive justice. In the book, the authors interrogate the discourse of choice and provide an extensive list problematizing the “choice” discourse. This list is very important as it begins to push the discourse of access beyond the individual and locates it in the complexities of women’s socioeconomic lives and the politics of population control and morality. Even in countries with progressive gender laws, gender injustice still prevails and is seen in services such as abortion. For instance, some women contribute to private medical aid schemes, but these do not cater for abortion, so women must have disposable cash to pay private abortion service providers who are not state funded. The authors argue that to mobilize a movement that is “capable of winning clear and consistent victories” we need to move beyond the framing of health rights such as the right to abortion as individual choices.
In this vein, a key argument in this book is that access to abortion is embedded in many other developmental issues. Based on my personal experiences and scholarly work, I fully concur with the assertion by the authors that “abortion cannot be treated as a single-issue battle”. Indeed, I live in South Africa, where abortion is legal and available in the public health sector, but in reality accessible only to those with resources. The first time I needed to have an abortion, I drove about 200 kms and for nearly three hours, during the week, to the nearest Marie Stopes clinic that provided termination of pregnancy on choice and for a fee. Most South African women do not have a personal car, and the privacy and convenience to be able to discretely arrive at a destination, get an abortion, drive back another three hours, get home and sleep and allow their medical procedure to take its course. For the majority of South African women, a visit to the clinic is a whole day trip from dawn to dusk and their movements are always known to others, especially if they are young.
Even in societies like South Africa where abortion is decriminalized, the neglectful state of health services and permissible conscientious objection make the service inaccessible (Ngwena, 2003; Teffo & Rispel, 2017). Abortion remains stigmatized and ideologies of “selfless” womanhood continue to impact on how women seeking abortion are viewed on their decision-making. Further, the tension between the pro-help/sympathetic dispensation of access to abortion under restricted circumstances may seem to increase access for women, but this is not universal as only a subset of women may access the service and the granting of abortion is subjective and dependent on the provider. The pro-help/sympathetic dispensation of abortion (usually in rape cases or when the health of the mother or the child is at risk) does not offer a major shift from the status quo.
Given the difficulties in accessing safe, legal abortion care, the authors acknowledge that women continue to use a variety of methods to terminate pregnancies. It is unclear though where the authors place traditional and other practitioners’ roles as these are widely used and are not always recognized and regulated by mainstream health standards. These providers are found in so-called “backstreet” abortion services – a term deployed to express disapproval of this service. While this book, like much other scholarly work on the topic, may not include the role of these abortion providers, they remain widely used even in countries where choice as to termination of pregnancy is legally and freely available in health centres (Hodes, 2016). A discussion of abortion politics should include all providers and all (potential) users.
Access to the internet of things has opened opportunities for abortion services to be produced online. The authors discuss the value and use of social media and other online spaces for global abortion advocacy. The internet makes sharing of information possible, and even for people who reside in countries that have restrictions in terms of information sharing can access information online. An example of such an undertaking in South Africa is the organization Section 27’s platform for tracking and providing data and information about abortion in East and Southern Africa – this is a website for all to use to gather evidence for advocacy. Although this is good for women, again, these services are generally available to only a very small proportion of women, mainly those who reside in urban and developed contexts. Internet access remains a problem for most people in many parts of the world, largely due to costs.
This book persuasively shows that the discourses and factors shaping women’s access to abortion and their experiences thereof are varied and contextual. Whilst there are neoliberal and practical considerations as to inclusion of voices in any project, including book publishing, in feminist work there is prioritization of the inclusion of a range of voices, especially voices that are usually marginalized. This was not the case in this book. Granted there are regional similarities, there are also peculiarities and culture and country-specific challenges that marginalized voices represent.
To remain true to its feminist epistemological stance, the book could have focused more on the risks that are embedded in women’s rights activism and advocacy for abortion. It is important that experiences of backlash and threats to personhood for advocates of women’s sexual and reproductive health and rights in the Global South are brought to the fore. Whilst the authors highlight the risks for women who procure abortion, similar notions and constructions of advocates, providers, and funders of abortion as transgressors put people at risk. These people risk their careers, dignity, and safety as enablers of unacceptable, immoral, and sanctioned behaviours. This is very clear in the developmental world where some funding may come with gag rules that bar organizations from work that promotes abortion or from funding from organizations that overtly support abortion rights.
This book is an important scholarly addition because stories and scientific data on abortion are rare. In the book A Magnifying Glass and a Fine-Tooth Comb, which focuses on adolescent girls and young women’s sexual vulnerability (Nduna, 2020), I only mention abortion three times, reflecting how “not in our face” abortion stories are.
In conclusion, this book is a useful tool to the global movement for abortion care services. This movement advocates for various aspects of access in different contexts, from legislation and application of policies to comprehensive service provision. Advocacy should continue to demand unrestricted, universal, and free abortion services and the recognition and support of all abortion providers. Using the Sustainable Development Goals as a catalysis, advocacy for abortion should focus on the lifting of special provisions in human rights law and frame access to abortion within an intersectional approach. This book is a reminder that decriminalization of abortion needs to be accompanied by comprehensive sexual and reproductive health, relationship education and adequate access to a diversity of contraceptive methods. This is important because these factors mediate access for many abortion service users. This is a book for scholars, human rights, advocates and policy-makers.
