Davidson's chemist, Killin. Women in rural areas often suffer from current laws, which force more travel than necessary. Image, Killin.info
It’s been a depressing year for anyone who cares about a woman’s right to choose (ok, it’s been a depressing year for everyone, but bear with me).
2016 has seen women imprisoned in Northern Ireland for accessing safe abortion pills online, or for helping other women to. Women in Poland have had to take to the streets to prevent a blanket ban on abortion even in cases of rape. And this month, senators in Ohio made progress towards a ban on abortion after 6 weeks – a time period in which many women don’t even discover they are pregnant, let alone have time to consider their options.
So folk in Scotland might be forgiven for simply thanking their lucky stars that we’re not dealing with that here. But the fact remains that in Scotland, the law we have inherited from Westminster means that it is currently illegal to procure an abortion, except where certain conditions are met. One of these conditions is the agreement of two doctors – the most paternalistic aspect of abortion law, and one which undermines women’s autonomy and decision-making about her own body and circumstances.
The 1967 act which sets out this, and other, requirements around abortion remains a landmark piece of legislation, which has made a huge difference to women’s lives in the UK (excluding Northern Ireland, of course, where the 1967 act doesn’t apply and women are currently being prosecuted under an Act from 1861). But underpinning the act is a belief that sexual and reproductive health is an area of medical and state control. It is a product of its time, and while it has achieved its aim, for the most part, of ending back street abortions, it doesn’t, and never intended to, give women the right to have an abortion.
That abortion sits within the criminal justice system rather than healthcare is an insult to the notion of women’s equality and rights. Abortion must be decriminalised, and the Scottish government now has the chance to take the lead in the UK on women’s reproductive rights. The Scotland Act 2016 gave the powers over abortion law to the Scottish government, and if they stick to their publicly stated plan not to alter the 1967 act (almost 50 years old, if you hadn’t noticed), they will be missing a huge opportunity to enable women’s right to choose.
The call to decriminalise abortion isn’t just theoretical or designed simply to make a point. Criminalisation means that in order to end an unwanted pregnancy legally, women must obtain the agreement of two doctors, a unique requirement in routine medical procedures. The current laws also mean that abortions at all stages of pregnancy must be administered in approved healthcare facilities, meaning that women can’t access abortion drugs through a pharmacy, as is common throughout Europe during the first trimester.
For many women in Scotland, particularly those from rural areas, this condition means that abortions frequently occur on their journeys home, having been forced to travel to hospital or clinic simply to swallow a pill. The fact that when women suffer miscarriages and need to take this same pill they are able to do this at home shows that it is not for reasons of safety that women taking medication to induce an abortion must do so away from home.
Abortion, while often discussed in terms of a necessary evil – think Hilary Clinton’s famous ‘abortion should be safe, legal…and rare’ line – is in fact a straightforward issue of women’s equality. It both affects and is affected by other issues like economic inequality and violence against women. And, of course, as with all issues of inequality, barriers to accessing abortions are particularly damaging for people already facing increased stigma or lack of education around sexual health such as young women, disabled women, women from BME communities and LBTI women and men.
There are clear links between unplanned pregnancy and abortion rates, and areas of deprivation. Work done by the Joseph Rowntree Foundation found that young women’s decisions about whether or not to continue a pregnancy are dependent on the economic and social context of their lives. Women must be free to choose whether to continue a pregnancy without this decision being primarily motivated by poverty or inequality.
Women’s unpaid labour in caring is a key reason behind women’s inequality in the labour market; impacting on their career progression, income, and family choices. While of course we must campaign to end discrimination, close the gender pay gap and value unpaid care, while economic inequality persists, women must be able to make decisions about whether and when to have children.
Choosing to have children or not should be one of women’s most basic human rights. And, like all areas of reproductive choices, it is one which is frequently targeting by perpetrators of domestic abuse. Women can be forced to continue or abort pregnancies against their will, as well as suffering other tactics of ‘reproductive coercion’ such as sabotaging birth control methods. Currently practitioners in Scotland don’t have to routinely enquire about the possibility of domestic abuse in abortion services, as they do in other areas of healthcare. Women pregnant as a result of rape often take longer to seek abortion, in part due to fact that pregnancy signs are often masked by symptoms of the psychological effects of rape such as PTSD and eating or sleeping disorders.
And access to later term abortions in Scotland is shockingly bad. Normally, women seeking abortions after 18-20 weeks for ‘non-medical’ reasons – any reason other than grave risk to the mother, or severe foetal abnormalities – must travel to England in order to receive treatment. The reality of this can mean 3 days away from home, work and families, a stressful and tiring journey, and cost (which you can claim back if your health board offers it, and if you can figure out the complex system). 80% of abortion providers support expansion of abortion provision up to the legal limit of 24 weeks, and it’s not really clear why this hasn’t happened yet – with religion, resources and ‘institutional inertia’ all being cited as possible reasons.
As well as standardising services across Scotland, and making key changes like allowing midwife-led services and modernising practices, now is a clear moment for the Scottish government to buck the trend of regression of women’s rights. It must improve services, yes, but it must also go much further. Remove abortion from criminal law; make it clear that abortion is an issue of equality; waive NHS fees for women travelling from Northern Ireland; and enshrine a woman’s right to really choose.
Read the full report from women's and human rights organisations in Scotland.