Abstract
Abortion Pills Go Global is about the transformative capacities of medication abortion (MA—pregnancy termination with medication/pills) within and across borders. Sydney Calkin has produced a carefully researched and beautifully written book that is detailed and thorough in its presentation of evidence, yet at the same time very readable. The chapters traverse the globe, covering Latin America, the United States, India, Poland, Ireland, Northern Ireland, and England, with sophisticated explanation and comparison. Throughout the book, Calkin presents four main arguments: (1) That MA activists prioritize “practical accessibility of abortion in the short term as a means to achieve longer-term social and political change” (p. 3); (2) “MA is able to transgress social and political boundaries” (p. 3) because it challenges ideas about the nature of abortion, where abortions can take place, and how they happen; (3) MA is difficult for authorities to control because it is part of both licit and illicit globalized medicine flows; and (4) MA makes it difficult for authorities to restrict abortion by imposing or enforcing laws because such restriction has proven politically unpopular.
Calkin’s work is interdisciplinary; as such, the research is sensitive to the ways in which abortion is linked in important ways to geographical and socio-political contexts. In Latin America, for example, where feminist networks for MA originated, activists demonstrated that “social decriminalization” was an essential strategy for ensuring access and creating avenues for legal change. In India, where abortion pills are legal and exported all over the world, they are not always accessible to local women/pregnant people seeking termination. Yet pills from India can mean reproductive freedom for women/pregnant people in countries where abortion is criminalized, restricted, or stigmatized. Calkin explains that, “a relatively liberal abortion law, however, exists in a country of profound inequalities where it can be harder to get the prescription than the pills. This economic context, combined with anti-abortion stigma and highly stratified fertility politics, means that there is a large gray market for MA inside India that leaks abroad” (p. 32).
While Calkin does a great job of explaining the nuances of an endlessly complex U.S. case, one of the main contributions of the book is that it de-centers the global significance of American abortion law and politics. While the 2022 Supreme Court decision to remove constitutional protections for abortion has regional and global implications, this single case often eclipses discussion of important developments elsewhere. Calkin’s research is an important corrective in this tendency to overemphasize the American case which, as Calkin herself acknowledges, offered seriously curtailed abortion rights to women/pregnant people prior to Dobbs.
Another major contribution of Calkin’s research that deserves recognition is its de-centering of legal and constitutional approaches to abortion access. She includes so many great quotes from interview participants to make the point that access and feminist (activist) networking can be more important than pressuring for legal change. One Polish activist plainly states that, “access creates law” (p. 114). An activist from Northern Ireland explains, “changing a law isn’t necessarily that feminist. It doesn’t always put the means to access abortion back in women’s hands” (p. 168). And my favorite quote from another activist in Northern Ireland: “the law is an ass, so we’ll do whatever we can around, above, and beyond it” (p. 175).
One question that remained for this reader is whether MA was, in fact, a “demedicalized” approach, as Calkin characterizes it (202). To be sure, it is distinguished by its self-acquired (in many instances) and self-administered features, but it is a regulated pharmaceutical product (or series thereof) and is sometimes/often supported by or dispensed by medical personnel. I also wonder if it might be counterproductive to draw distinctions between surgical (medicalized) and self-managed (demedicalized) approaches to abortion, as in reality, it seems to be the case that the two (medical-demedical/molecular-social) are integrated.
Overall, this book is a triumph of research and storytelling. I would recommend it to anyone interested in reproductive politics, abortion, and political activism; it would be useful to graduate and undergraduate courses in gender and politics, law and politics, and political geography. Anyone who wants to know what is at stake or what is possible in current debates about global abortion politics should read this book.