Abortion

Written by Dr Sydney Calkin

Access to abortion is understood by many to be a key aspect of women’s human rights, although it is often portrayed as a divisive ‘social’ or ‘identity politics’ issue. It is also, in fact, profoundly economic. This is something which feminist political economy can illuminate, given its insistence on exposing the invisible activities undertaken by women – from childcare to domestic work – and showing how these affect both the fate of individual women and the fortunes of the wider economy.

In this respect, gendered political economies of abortion can be located at many different ‘scales’. There is a woman’s individual decision about whether or not to terminate a pregnancy that relates to her financial situation, and that of her family, including whether or not she is able to use such money at her discretion – which is unlikely where controlling and abusive relationships exist. At the community scale, access to abortion and contraception can be related to economies of unpaid work and caring labour – in particular, the dominant assumptions in society about who should raise children, family size, and what type of women ‘ought’ to raise children. At the national scale, abortion care and reproductive healthcare is bound up in state decisions about social policy, service provision, and access to healthcare. Finally, at the international scale, the issue of abortion sits at the heart of the political economy of development, where policymakers’ desires to reduce population growth comes into conflict with others’ desire to restrict access to abortion and contraception. The focus here is on the national and international scales of abortion, starting with the cross-border journeys that many thousands of women feel compelled to make each year.

Abortion-related travel

Abortion laws are set and enforced at the national level, so differences in policy between states create a patchwork of regulations. What is legal in one state might be illegal just over the border. As such, abortion-related travel (sometimes called ‘abortion tourism’) is a widespread tactic used by women to obtain terminations. International travel for abortions has been a strategy for access for many decades, at least since the 1960s when the first cases were recorded. Wealthy American women who could not access abortion in the USA travelled to Canada, the UK, Sweden, and even Poland for abortion.

Today in Europe, abortion tourism takes place along well-worn routes that women have followed for decades. Women in the Republic of Ireland, Northern Ireland, Poland, Italy, and Malta (among others) travel across Europe for abortions; England is the most popular destination, followed by the Netherlands. Abortion related travel is also linked to wider patterns of EU enlargement. Studies have documented that migrant women who move for economic reasons use similar cross-border strategies to access abortion care. At the same time, the availability of abortion elsewhere in the EU has been used by courts to uphold restrictive laws in individual member states. In other regions of the world where access is highly restricted and mobility is low, women are forced to give birth or undergo dangerous illegal terminations, and they often face harsh criminal punishments for doing so, as shown in the video below.

The regulatory borders of abortion access are reinforced by economic inequalities: women’s ability to access abortion depends not only on the laws of the state, but on their resources and networks. For women to travel abroad for abortion, they must pay for travel, accommodation, and the procedure itself. This is not always possible for women in dire poverty. For women who must raise the money to travel for an abortion, they face an agonizing process of gathering the money as quickly as possible. The longer a woman takes to raise the money for her trip, and the later in her pregnancy she travels, the more expensive the procedure becomes and the fewer locations she can go to access abortion. Speaking about the Irish case, Mara Clarke, head of the UK-based Abortion Support Network, puts it simply: “When faced with an unplanned, unwanted pregnancy, women with money have options and women without money have babies – or take desperate measures”.

The kinds of economic considerations required by abortion-related travel can severely constrain access for many women, regardless of the formal legality of abortion in her country. In certain cases, these are deliberately exploited by policymakers to prevent abortion altogether. In some American states with few or no clinics, women are required to travel long distances and stay overnight to attend multiple appointments with waiting periods in between. This can mean many hundreds of dollars of lost wages, travel costs, hotels, and medical bills; these costs act as a deterrent for many women who would otherwise choose to terminate a pregnancy.

Video from the US-based Guttmacher Institute

Privatised healthcare

Abortion care is part of the wider political economy of healthcare and social provision. For example, in the case of Ireland, the legal scholar Ruth Fletcher has argued that Ireland’s refusal to provide abortion care is partly a strategy to outsource healthcare costs abroad and prevent expensive investments in reproductive healthcare infrastructure. Abortion-related travel, of course, requires women to pay in private clinics for a healthcare procedure that citizen women can often receive for free (as in the case of Irish women in England). Restrictions on abortion often force women to pay privately for medical treatments and medications, whether they can legally obtain them at home or must travel across borders. This issue has gained attention recently in the UK, where the government has agreed to allow Northern Irish women access to abortion through the National Health Service in England; previously, Northern Irish women had to travel to England and pay privately, although they are UK taxpayers and therefore contributors to the NHS.

Image from a pro-Choice coalition in Ireland that campaigns to repeal the eighth amendment to the constitution, which criminalizes abortion in all cases except where continuing a pregnancy would result in death to the mother.

Reproducing the nation

Everyday decisions about pregnancy are also shaped by domestic statecraft. Across the world, states have sought to manage their population’s demographics for economic and political reasons, often closely tied to repressive nationalist projects of state-building. In Ceausescu’s Romania, leaders understood steady population growth – the production of ever more workers – as essential to the success of socialism. A near total ban on abortion from 1966-1989, with highly invasive surveillance and control of pregnant women, sought to provide enough workers for the planned economy. By contrast, in 1979 China implemented the One-Child policy, in response to Malthusian fears about overpopulation and resource scarcity. The One-Child policy was coercively enforced with forced abortion and sterilizations for many women, although wealthy families were often able to circumvent the policy by paying fines for extra children. Again influenced by the need to renew the workforce given the country’s aging demographics, China relaxed the policy in 2015.

Ceausescu portrayed as father of the nation and a 1986 Chinese propaganda poster which states ‘Do a good job in family planning to promote economic development’

State population policies often represent pregnancy and reproduction as resources for the construction of the national workforce or fodder for the production of nationalist myths. Pro-natalist (promoting a high birthrate) and anti-natalist (promoting a low birthrate) policies operate to varying extents in most states, ranging widely from financial incentives for working mothers to forced sterilizations. Moreover, pro-natalist and anti-natalist policies often work in tandem, to encourage a high birthrate among certain groups and discourage births among other groups; these policies are frequently racialized and aim to discourage ethnic minority women from having children.

Population control

As Kalpana Wilson points out, the campaigns for ‘a woman’s right to choose’ in Europe and American ignore the realities facing many women in the global South, who have historically experienced contraception, abortion, or sterilization as coercive interventions forced upon them. International development policy has been central to this. During the 1960s and 70s, as in China, anxieties about a Malthusian crisis shaped the priorities of development policymakers. The President of the World Bank at the time, Robert McNamara, openly supported population control programmes and was reluctant to finance healthcare insofar as it would bring down the death rate and hasten ‘population explosion’. During the 1980s, aid workers from the UN World Food Program withheld food relief from Bangladeshi women unless they agreed to sterilization. Faulty contraceptive technologies, like the infamous Dalkon Shield IUD, were also ‘dumped’ into the global South: USAID, through surrogates like the International Planned Parenthood Federation, shipped 700,000 units of the Dalkon Shield to 42 countries, mainly in Asia and the Middle East. These IUDs were unsterilized and carried only one instruction leaflet per 1,000 devices: their application was highly dangerous.

Today, debates about population growth and fertility control still sit at the center of development policymaking. In the United States since 1984, on his first day in office, each Republican President has re-instated the Mexico City Policy: this prohibits family planning organizations who receive American development dollars from using any funds to provide abortion, share information about abortion or advocate for the decriminalization of abortion. Subsequently, each Democratic President, on his first day in office, has rescinded this order. Under the Trump administration, the Mexico City Policy was extended to cover all global health organizations that receive US funding; where it previously applied to £600 million worth of funding, it now covers $9 billion. These policy reversals have enormous implications for NGOs around the world and the people who use their services, because it restricts access to information about reproductive healthcare, HIV, abortion services, and more.

In response to Trump’s expansion of the policy, the Netherlands announced its intention to act as a global promoter of reproductive rights and to make up funding shortfalls for organizations who lost access to American money. Feminists have long encouraged us to understand the personal as political: we should also add that the personal is economic, too.

Abortion Resources

Fletcher, R. (2005) Reproducing Irishness: Race, gender, and abortion law. Canadian Journal of Women and the Law, 17(2), pp. 365-404.

King, L.  (2002) Demographic trends, pronatalism, and nationalist ideologies in the late twentieth century, Ethnic and Racial Studies, 25(3), pp. 367-389.

Sethna, C. and Doull, M. (2012) Accidental Tourists: Canadian Women, Abortion Tourism, and Travel,Women’s Studies, 41(4), pp. 457-475.

Spar, D. (2005) For love and money: the political economy of commercial surrogacy, Review of international political economy, 12(2), pp. 287-309.

Guttmacher – a research and policy organization committed to advancing sexual and reproductive health and rights in the United States and globally.

The Handmaid’s Tale – the recent television production of Margaret Atwood’s classic dystopian tale has inspired a number of recent campaigns against limiting women’s reproductive freedoms around the world.

4 Months, 3 Weeks and 2 Days – Romanian film about illegal abortion set in the Ceaușescu era.

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