Abstract
This book is an inspired feminist examination of how a global analysis using social justice perspectives creates opportunities for a wiser journey towards systemic action for abortion access. The discourse created through the authors’ work aligns within a reproductive justice narrative in which people’s human rights are uplifted when they not only have control over their own capacity to bear or not bear a pregnancy, but also are able to live in communities that are economically and socially just. The writing engages with a wealth of resources to empower critical activist scholars to continue the analysis for action in new and emergent directions as the dynamic political landscape of abortion access shifts within and across jurisdictions.
The first chapter introduces readers to the concepts and ideas that will be explored in subsequent chapters, with an aim to set the stage for their critical comparative synthesis of knowledge about abortion access in the Global North and South. The book’s focus is on the broad-ranging set of themes that are central to the politicisation process surrounding abortion, such that each of the six chapters develops not only a review of the literature concerning those themes but also field research and case studies exploring: criminalisation, biomedicalisation, abortion discourses, international interventions, activism and reproductive justice. Sylvia Estrada Claudio, in reflecting on the values underlying this collaborative project between Fiona Bloomer, Claire Pierson and herself, succinctly captures the essence of how it can inform the future: … political integrity lies not just in refusing to strip our issues of the contexts in which we live, but also in recognizing the contexts of others. It is by recognizing the convergences and divergences, the parallels that will never meet or the separations that may eventually becoming unifying, that we are best able to forge our strategies. (p. 6)
The evidence that criminalising abortion tends to increase abortion rates is explored in Chapter 2, along with processes to consider decriminalisation. The compelling arguments against criminalisation reveal how the impacts are dire for human rights by drawing from global evidence to demonstrate such futility and exploring two case studies of the Republic of Ireland and Uruguay to illustrate how people experience abortion in these two distinctive contexts. The authors provide a comprehensive, thoughtful and sensible approach to key arguments against maintaining laws on abortion and provide the reader with a coherent set of arguments for abortion as a healthcare issue.
Readers will find the biomedicalisation of abortion chapter particularly helpful to review the historical aspects as well as to contextualise the political nature of self-abortion medications. Table 1 (p. 36) in Chapter 3 shows the year each country approved mifepristone, ranging from 1988 for China and France to 2017 for Columbia—striking is the absence of what people might consider democratic nations—demonstrating that access to the technologies for self-abortion are also about ongoing control of women regardless of the outward appearances of democracy. A powerful aspect of the biomedical approaches to abortion is creating the potential to enable bodily autonomy for women—especially where restrictions have made abortion access a dire necessity. The authors are brilliant in their analysis of the risks of abortion medication in restricted settings and especially the lack of post-abortion care. The case study of Brazil in this chapter highlights the issue of the Zika virus.
Chapter 4 examines abortion discourses in religion and in the broader cultures within nations undergoing significant transitions—two case studies of Northern Ireland and South Africa bring the ideas of the chapter together into a clear illustration of important processes. The authors explore the fascinating, complex interrelationship of religion with nationalism and how that gives rise to specific forms or ways of thinking and talking about the values of the entire nation. These taken-for-granted understandings form the various discursive positions around abortion within a particular nation state. Political rhetoric is examined for ways in which unifying positions that support the nation in divided states sacrifice the well-being of particular groups—often gendered and racialised bodies—and, in the case of abortion, the health needs of half the population in the service of a politics of unification. While the cultural hegemonic positionings of a conservative ethno-religious form of national unity stifled legislative reform in Northern Ireland, the South African context exploited community cohesion and postcoloniality to harden opposition to abortion, causing entrenched stigma and greatly diminished access to safe abortions despite legislative reforms. Countering belief systems operating through hegemonic cultural understandings of women’s role requires an uprising of voice and experience to create resistance discourses to ensure that access to safe abortion is not only legal but also sociopolitically guaranteed.
Chapter 5 is an examination of how abortion controversy within independent nations has been countered through international interventions designed to secure a right to this basic healthcare service. In a thorough and inspired exploration of how feminist academic scholarship and activism have made steady gains over the last twenty years in sexual and reproductive healthcare that includes access to safe abortion services, the readers are shown evidence of two forms of interventions that can work through human rights or humanitarian pathways. Readers are guided through an explanation of how the Universal Declaration of Human Rights (UDHR) in 1948 saw a human right as starting from birth, and how subsequent international human rights law has taken up the issue of abortion in the current Convention on the Elimination of Discrimination Against Women (CEDAW). Importantly, while international treaties can highlight standards, they cannot enforce compliance or compel states to address discrimination and inequality. To illustrate, the case study of the Philippines explicates how despite concerted efforts and repeated censure, the total ban on abortion persists and the efforts for post-abortion care are the necessary current focus for activists wishing to save lives. Shifting focus from law to humanitarian intervention, the second half of the chapter examines how the global crisis of the greatest number of displaced people since the history of record-keeping on this topic—currently more than 65 million people—impacts women and girls. The impact of the Global North—specifically the Mexico City policy of the US referred to as the ‘global gag rule’—to remove funding and support for safe abortion access is central to the discussion. The case study of the humanitarian unit of the International Planned Parenthood Federation provides insight into the dire situation for women and girls that compelled the emergence in 2007 of their crisis unit SPRINT: Sexual and reproductive health in crisis and post-crisis situations. The most contested area for human rights remains women’s bodily autonomy and the security of our humanity.
Activism is at the heart of Chapter 6. At this point in the book, readers are treated to an inspirational global exploration of a menu of options for abortion advocacy and action that are currently operating to make a difference. Taken together with the next chapter, which explores reproductive justice, the authors create a compelling motivation for readers to engage with systemic changes that entrench not only bodily autonomy and abortion access but also widespread systemic shifts in the social and political worlds in which we can live well with dignity. Chapter 7 foregrounds the work of African American women in the vision for reproductive justice as the right to decide if and when we have a child and the resources to live without poverty or other forms of violence. Importantly, the ‘choice analysis’ as a stand-alone tactic is shown to be relevant to a relatively small group of women so that the focus or energy for inspiration in global change must come from an orienting framework of reproductive justice. The case study of a transnational Global South feminist activist group—Realizing Sexual and Reproductive Justice (RESURJ)—affirms how the linkages between gender, environmental and economic justice are critical for activism and enduring change.
As the authors conclude their explorations of the various facets of the global politicisation of abortion, they leave the reader with powerful notes and recommendations for future work. Across their book, they see the theme of reclaiming the morality of safe abortion as a central call to action against the obscenity of women and girls being injured or dying. Lived experience is a powerful change agent to give voice to the reality of abortion as an essential component to a reproductive justice approach. Inviting an intersectional understanding of how we create social and political changes to address poverty, racialisation, gender violence and other forms of oppression as we do the important work of advocacy and activism is at the heart of the call to action in the book. They end with clarity that the ongoing systemic power dynamics attempting to control women’s reproductive lives may be tightly held, but also that understanding and insight from solidarity and action can be used to shift the power to justice.
In conclusion, I strongly recommend this book as an important resource for classrooms, advocacy organisations and citizens interested in better understanding global issues. At the outset of their book, the authors acknowledge that they ‘use the term “women” to denote those who are of reproductive age and have the reproductive capacity to become pregnant’ (p. 6), and affirm that they include trans men in their considerations, who may experience additional barriers. This book does not explore the facets of those concerns, so readers are advised to augment their understanding of reproductive care and trans inclusion by sourcing materials specifically addressing the forms of discrimination and injustice experienced by trans people in local and global jurisdictions. In fact, this would be an excellent companion text for someone to author, and I hope this gap will be addressed by future authors.