About Abortion Series: 3 - Abortion as a Healthcare Issue

WRITTEN BY School of Sexuality Education’S DR EMMA CHAN.

A friend rang me late the other night. He’s a keen runner and had fallen over while training and hurt his leg. He was now in a lot of pain and extremely anxious that he’d broken it. He didn’t want to go to his local doctor - he’d torn a ligament in his knee training for an Ultra Marathon a couple of years ago.  His GP had made it very clear that she morally disapproved of runners. She’d refused to deal with him herself. Instead, she sent him to a colleague, saying that she ‘conscientiously objected’ to treating people who injured themselves ‘taking unnecessary risks through endurance tasks’. 

Luckily though, he’d found a Walk-In Fracture Clinic that accepted self-referrals. Would I come with him to his appointment tomorrow for moral support? I agreed.

On the day, approaching the clinic was daunting. There was a group of Anti-Athletics Protesters outside. They didn’t try to physically stop us going in, but it was still unpleasant.  One shouted at my friend that he was ‘wasting NHS resources’. Another thrust a pamphlet into my hands. It was full of statistics on how much sporting injuries cost the health service and how many nurses’ salaries this was equivalent to. 

The Clinic staff were all really nice and professional. They asked some odd questions though - for example, had my friend considered switching from running to yoga? The operation was scheduled a few days later and was uneventful. I’m still in touch with my friend, but we don’t talk often about this particular time. 

This story is of course, completely made up. As a description of medical care, it seems pretty bizarre. The blame, the moral judgement, the angry protesters getting between an individual and their treatment - all seem jarring in the context of getting help for a broken leg. These kind of experiences are common however, to those trying to access an abortion. In the UK, as in many countries, we accept standards of care and legislation around abortion that would seem laughable in relation to most other areas of health.

I am a facilitator with School of Sexuality Education, delivering Sex and Relationships Education to young people in the UK. My background is in health: I have trained and worked as a junior doctor, including within services that provide abortion care. As far fetched as the attitudes I have described might seem, we shall see that they neatly describe accessing abortion care in many parts of the world, including the UK.

An abortion is a medical treatment to end a pregnancy. This is done by either taking medication or having a (relatively) minor surgical procedure (1). It is sometimes also referred to as a ‘termination of pregnancy’. It is very common for someone to have had an abortion, much more so than most people imagine. According to the World Health Organisation, one in four pregnancies ends in a termination, with over 55 million abortions taking place a year worldwide (2). It might also surprise some in the UK to learn that providing or seeking an abortion in the UK is still technically a crime. It’s just that there are separate provisions under the law which allow it to take place under certain circumstances (3). 

So, we have a situation where a very common type of healthcare is regulated in a very unusual way. This can create legal and practical challenges in using and providing such services. For example, services have to be designed to accommodate the need for two doctors to agree to a termination. A legal requirement which some practitioners say impacts their ability to provide appropriate care (4). 

Within UK medical practice, there also exists the principle of ‘conscientious objection’. This is a rule that allows doctors to not provide help with terminating a pregnancy if it is at odds with their personal values (5). It is reasonable easy to find examples of conscientious objection around abortion care in the UK (6) whilst I have not heard to it used in relation to other types of treatment. Indeed in my imagined story I gave above, it seems laughable. 

There are, of course, safeguards to invoking conscientious objection, including that using it should not delay a patient’s care (7). But I wonder how this plays out in practice? If your GP refused you healthcare, would you know that they were still obligated to make sure that you had it? How comfortable would you be in approaching other doctors for help, or the same GP for other issues in the future? 

It is not uncommon for healthcare professionals to facilitate people in making decisions about their bodies and care that they think are unwise or downright wrong. Treating someone with a sports injury, so that they could continue to put strain on their body as with my ‘friend’, is a relatively common if less emotive one. 

Pregnant people may have a very diverse set of personal, practical and medical reasons for wanting to end their pregnancy. Medico-legal laws and practices around the world act to question and challenge those healthcare decisions and take away personal health autonomy. 

Worldwide, the laws surrounding abortion vary hugely. Not just in terms of whether or not abortion is allowed, but under what circumstance and under what conditions (8). This map from the Centre for Reproductive Rights broadly outlines these. You can use it to compare and contrast restrictions on abortion laws globally. This gives some indication of health inequalities created by a morals-based attitude to healthcare. A woman in the Ukraine who feels she does not have the resources to care for a child adequately may be able to access a legal abortion. Someone in neighbouring Poland cannot, as they are only legal in cases of conception from rape or to preserve health. Terminations of pregnancy are available ‘on request’ (because the pregnant person deems it necessary) in Mozambique, but under no circumstances in the nearby state of Madagascar (8). 

Human Rights Campaigners often say that criminalising abortions doesn’t stop them from happening, it only stops them from being safe. This refers to the idea that for some pregnant people, terminating their pregnancy feels like the only option, and that this procedure will be sought out, whether it is legal or not. 

It is estimated that 25 million ‘unsafe’ abortions occur a year, globally - most of these in low income countries (9). If we recognised that abortion was a healthcare right, we would see it is a vital service. When this is not provided safely, unnecessary deaths occur. 

Framing abortion care as a moral issue, rather than as a health one, leaves it open to challenge. In law, abortion on request is legal in the United States, but the extent of that is determined locally by each state (8).  Additionally, employers are under no obligation to ensure that abortion care is provided as part of their employee’s work-based health insurance. In 2014 the Hobby Lobby Stores successfully argued that providing contraception amounted to abortion, which conflicted with the company owner’s religious beliefs. As a result they provide neither contraception nor abortion care to their employees along with the rest of their healthcare (10). If abortion is not seen as a basic healthcare need, but a moral issue, it becomes optional to provide it. As abortion is so common, this impacts the health and wellbeing of a huge number of people. 

Why, then, is abortion often framed morally, in a way many other health issues are not? I believe an important factor is misogyny. Whilst people of various genders get pregnant and also choose to terminate pregnancies, historically the burden of reproductive labour has fallen to women. At the same time, the power to make laws has been disproportionately held by men. When looking at the stark difference between the gender of the population (51% women) and the law makers (85% men) involved in the Alabama Abortion Ban, one BBC Journalist posed the question, ‘Should men have a say in the debate (11)?’

Another tendency is for discussion around abortion to get emotive, quickly. Some people argue that the right to pro-life beliefs it is an inviolable and inalienable one. I agree. But importantly, I also recognise that it extends to personal autonomy only. If you believe that abortion is wrong then it is wrong… for you. As already noted, abortion care is hard to access or illegal in many areas of the world. And where it is legal, this often faces pushbacks and challenges. All of this is rooted in historical gender power imbalances. 

The question is: what can we do about it? 

It’s not easy, but perhaps we can start with education. In the first article in this series, Sara Haller outlined her experiences of teaching about abortion in Northern Ireland and the importance to young people of honest and accurate information about their bodies (12). 

There is perhaps some hope in England, with the updated sex education curriculum, which comes in to effect in September 2020 and requires young people to learn about ‘options in pregnancy’ (13). Perhaps allowing abortion to be discussed as a health topic can help to normalise this common procedure. 

That is certainly the hope of Dr Corrina Horan, head of Education for Choice, a group of volunteer medical students and doctors who teach about abortion care in UK schools. Corrina says she was motivated to get involved after learning how common a procedure abortion was, and by her medical school training which emphasised that it should be treated as routine healthcare. 

Perhaps another important strand is reflecting critically about the depictions of abortion we come across.  In the second article in this series, Tanya Horeck discussed 21st Century TV portrayals of teenage abortion (14). Being empathetic and open to the need for many different types of pregnant people to obtain an abortion could be powerful. It can challenge some of the incorrect biases and assumptions we may have. 

Important too perhaps, is educating and discussing abortion outside of schools as well as within them. As we have seen, abortion care really is a ‘live’ and current issue, with reproductive rights seemingly constantly up for grabs. Unlike other issues of gender equality and rights, it is not something that has been won and is over. 

I am writing this from my own home, during the worldwide lockdown due to the Covid-19 pandemic. From behind closed doors the right to access safe and legal abortion care is being challenged. Many countries have used lockdown rules to restrict access to healthcare. For example in the US, travelling to access an abortion has been deemed ‘non-essential’ and therefore not permissable. Other countries have actively used this time to push through anti-abortion legislation, such as Argentina or Poland (15). 

Someone who has voiced particular concern about contemporary abortion reform is Mania Lewandowska, a postgraduate student in Reproductive and Sexual Health in London, who is originally from Poland. Mania has been writing and talking about her concerns over the Polish Government’s actions towards abortion care since lockdown began. Examples include a proposed bill read in Parliament to completely forbid abortions. Abortion is currently only allowed in cases to preserve health. Although the bill was deferred, there are concerns that this was seen as a priority during this time. Mania also reports that a controversial pro-life activist has been officially recognised and honoured by the Ministry of Health during the country’s lockdown. The priorities and aims of the Polish Government surrounding abortion care seem very clear at this time, and they are not to ensure safe and legal healthcare. 

As we have seen, attempts to erode reproductive freedoms abound. We need to recognise that abortion plays an important role in reproductive freedom and start defending it like it matters. We have the medical expertise to improve the wellbeing of literally millions of people around the world, by providing decent abortion care. We wouldn’t accept the current standards of care for fixing broken limbs. We mustn’t accept this for reproductive healthcare.  

Acknowledgements: 

Thanks to Mania Lewandowska, Dr Corrina Horan, Sara Haller and Dr Tanya Horeck for their advice and support with writing this article.

Illustrations by Evie Karkera, unless otherwise credited.

Our book ‘Sex Ed: An Inclusive Teenage Guide to Sex and Relationships’​ ​ is out​ ​now.

About Abortion Series: 2 - Abortion on 21st Century Teen TV

BY DR TANYA HORECK, READER IN FILM, MEDIA AND CULTURE (ANGLIA RUSKIN UNIVERSITY) AND School of Sexuality Education ADVISOR.

Chloe and Zach at the abortion clinic, 13 Reasons Why (Netflix, 2017-).

In Amy Heckerling’s 1982 directorial debut, Fast Times at Ridgemont High, 15-year-old Stacy Hamilton (Jennifer Jason Leigh) gets pregnant after casual (and quite inadequate) sex with Mike Damone (Robert Romanus). Stacy is pragmatic about dealing with the pregnancy and asks Damone to share the costs of an abortion with her. But he fails to help or to even accompany her to the clinic, and it is ultimately her older brother, Brad (Judge Reinhold) who drives her there and brings her home. What stands out now, re-watching this Gen X classic in 2020, is the conversation between Stacy and her worldly wise best friend Linda (Phoebe Cates) after the abortion. Linda, who is outraged over Mike’s dereliction of duty, offers to have it out with him. The ever-rational Stacy tells her: ‘Look, don’t do anything. I don’t even like the guy.’ Linda angrily retorts: ‘He’s not a guy, he’s a little prick’. Cue the following sequence, played to the jaunty soundtrack of the Go Gos ‘Speeding,’ in which a downcast Ramone finds his car and locker vandalized with ‘prick’ and ‘little prick’ respectively. In that scene, and others, Fast Times holds its male characters to account for their bad behaviour and proves it is a film that is not afraid to call a prick a ‘prick’. For all its dated heteronormativity, Fast Times at Ridgemont High is ultimately on the side of its female characters, granting them respect and agency. Stacy and Linda might move within the patriarchal strictures of 1980s American high school life but that does not mean they have to tolerate any substandard treatment. 

Cameron Crowe, who wrote the screenplay for Fast Times, was recently quoted as saying that in today’s political climate in the US, the film’s non-judgemental, pro-choice depiction of abortion would be ‘outrageously controversial…it would be protested, and there would be a mess over it’ (1). This is likely true, especially at a time when Hollywood studios are preoccupied with bringing in mass family audiences and churning out mainstream superhero film after superhero film with U ratings. However, when it comes to contemporary streaming TV, where there is a drive to attract niche audiences, and a laxer ratings system, the second decade of the 2000s has seen a shift to ever more frank and open depictions of abortion. On Netflix Original teen series such as 13 Reasons Why (2017-) and Sex Education (2019-), and on HBO’s Euphoria (2019-), young female characters have abortions and, like Stacy from Fast Times, they are unapologetic for doing so. In ways that are strikingly similar, all three of these teen TV series make political, pro-choice statements about the reproductive rights of women. 

This is a significant shift from network TV teen dramas of the 1980s and 1990s such as Beverly Hills, 90210 (Fox, 1990-2000) and Party of Five (Fox 1994-2000) where abortion was a topic that would be referenced, but not explored. While a minor character on 90210 has an abortion (and regrets it), Party of Five has its central character Julia Salinger (Neve Campbell) go so far as to book an appointment to have one: however, on the drive to the clinic she miscarries, therefore circumventing the need for the show to follow through with the representation (and any potential moral ramifications). Moving forward into the early 2000s, there were other examples of abortion storylines on teen series, including the 2008 second season of the long-running British teen drama Skins (Channel 4, 2007-2013), in which sixth form student Jal Fazer (Larissa Wilson) terminates her pregnancy (off camera). 

In the theatrical film version of Fast Times, the event of the abortion is also elided: Stacy is shown arriving at the clinic and then leaving it afterwards (there is a deleted abortion scene which appeared in the TV version and is now available for viewing on YouTube. What is most striking, then, about the streaming teen series I discuss in this blog, is the pronounced emphasis they place upon showing the abortion procedure in its entirety: before, during, and after. There is a clear effort made to realistically document the procedure in order to destigmatize it. The context of release is deeply significant: the abortion episodes of 13 Reasons Why, Sex Education and Euphoria appear in seasons which dropped in 2019, the year when, as Elizabeth Nash of the Guttmacher Institute has noted, ‘anti-abortion politicians [made] clear that their ultimate agenda is banning abortion outright, at any stage in pregnancy and for any reason’ (2).

Within the context of the abortion bans, and the ongoing threat to women’s reproductive rights in Trump’s America, the rendering visible of abortion on these recent teen TV series is a political act. Two of the series are American (13 Reasons Why, Euphoria) and one is British (Sex Education), though all three shows are designed for broader, transnational audiences and set in indeterminate locales. The abortion episodes centre on three white female characters: 13 Reasons Why’s Chloe Rice (Anne Winters), captain of the cheerleading team and girlfriend of serial rapist and self-appointed ‘king’ of the school jocks, Bryce Walker; Sex Education’s Maeve Wiley (Emma Mackey), intellectual outsider and rogue sex education business operator; and Euphoria’s Cassie Howard (Sydney Sweeney), former figure skater and popular high schooler. All three young women are pregnant by their popular male athlete boyfriends who do not figure much, if at all, in the abortion episodes themselves. Instead, the young women look to other people for support: in the case of 13 Reasons Why and Sex Education, Chloe and Maeve are helped by their male friends, Zach (Ross Fleming Butler) and Otis (Asa Butterfield) respectively, and, in the case of Euphoria, Cassie is supported by her mother and sister. These progressive teen TV shows do not imply that the decision to abort is emotionally easy for its female characters, but nor do they dwell on scenes of melodramatic anguish. Instead, the focus is on the process of the abortion itself. As part of the pre-abortion procedure, the young women are depicted as having to answer a series of intrusive, if standard, questions by a female nurse regarding, for example, their sexual history, their mental health history and whether they have any reservations about the procedure or have considered other options such as adoption. In 13 Reasons Why, the most didactic of the series, the nurse describes the procedure to Chloe (and to viewers): ‘The doctor will come in and insert a very thin tube into your uterus. It is connected to a suction device. That suction device will dislodge and remove the uterine content.’ 

In all three series, the abortion is presented as a vacuum aspiration, the most common type of surgical abortion (3).It is notable that none of the series depict a medication abortion, which involves taking two pills (4). Medication abortions, which can be used up to the first 10 weeks of pregnancy, accounted for 39% of abortions in the US in 2017 (5), and for 71% of abortions in the UK in 2018 (6).

Though the statistics suggest cultural differences regarding which abortion procedures are more typically used in the US versus the UK, all of the TV shows under discussion here opt for depicting surgical abortion, possibly because it lends itself better to televisual dramatization. In fact, the only depiction of medication abortion on teen TV I have come across so far (thanks to Sara Haller) is the British comedy-drama, My Mad Fat Diary (Channel 4, 2013-2015). 

The three series I concentrate on in this blog are remarkably uniform in their visual iconography of surgical abortion. Aesthetically speaking, the abortion scenes are filmed through extreme close ups of the faces of the young women as they lie in hospital beds. There are shots of the women surrounded by medical equipment as doctors and nurses reassure them about the procedure. The diegetic sounds (sounds that are part of the natural world of the film) include the scrape of medical instruments and the whir of the suction machine. All three of the shows overlay these medical sounds and images, at some point, with the added soundtrack of an emotive pop song. The facial close-ups of the beautiful young women as they wince in moments of pain or discomfort, invite identification and empathy from audiences. In the case of Euphoria, we are invited to share Cassie’s psychic space the most closely when she puts her earphones in and listens to Arcade Fire’s ‘My Body is a Cage.’ As we, along with Cassie, listen to the music, the show provides images of her figure skating, her body gliding and spinning across the ice. 

Cassie, Euphoria

Chloe, 13 Reasons Why

Maeve, Sex Education

Significantly, the young women are shown to make it through the abortion without consequence, all three of them relieved to have done it. ‘How do you feel?’ Cassie’s mother asks her. ‘Better’, she replies. Otis gives Maeve flowers, and Maeve (characteristically) responds with a wry joke: ‘Nothing says Happy Abortion like a bouquet’. Chloe breaks up with her abusive boyfriend and makes a new start. There is a noteworthy lack of judgement or moralising as the young women move on with their lives. 

As Sara Haller notes in the first blog in this series, the hardest thing she had to endure in her own personal experience of abortion was ‘public shaming on the street by anti-choice protestors.’ Two of the shows discussed here, 13 Reasons Why and Sex Education, portray anti-abortion protestors and their shaming tactics. In keeping with its strong educational, ‘afterschool special’ vibes, 13 Reasons Why contains the most extensive engagement with anti-abortionists, including a scene in which Chloe goes to a center to find out about funding for her abortion, only to discover that it is a ‘fake clinic’ run by anti-abortionists. This is the most distressing aspect of the abortion process for Chloe, followed by the experience of being confronted at the clinic by a group of anti-choice protestors who shout and yell at her not to murder her baby. One of the protestors, who villainously disguises herself as someone working for the abortion clinic, hands Chloe a fake fetus. 

In making abortion visible as a safe choice for young women, these recent teen TV shows are part of a growing trend for young adult TV comedy-drama to depict abortion without histrionics or moralistic framing. Hulu’s Shrill (available on BBC iPlayer in the UK) is another recent example of a streaming series with an honest and non-sensationalized representation of abortion. In the pilot episode, the lead character Annie (Aidy Bryant) gets pregnant by her loser boyfriend and has a surgical termination. The abortion is portrayed in such a low-key way by the show that I initially forgot it even included any images of the abortion procedure. It is a credit to the show and its respect and love for Annie, that what I remember most about this episode is the image immediately after the abortion: of Annie smiling serenely as she cuddles up to her best friend, Fran (Lolly Adefope), in the window seat of their shared home. 

I have been speaking here about the importance of a politics of visibility, of how these teen shows demystify a medical procedure that is too often blanketed in moralistic commentary. However, just as it is important to ask what is being made visible through more explicit TV portrayals of abortion as a medical procedure, it is also crucial to explore what is being hidden. In the three teen shows discussed above, the abortion storylines focus on young white women from the middle to lower classes. Abortions involving women of colour remain rare on television, as does an intersectional understanding of the experience of pregnancy and termination. To conclude, then, I want to discuss an episode from the second season of the Netflix series Dear White People (2017-), from 2019, which depicts a young black woman, Coco Conners (Antoinette Robertson), coming to terms with the difficult decision to terminate her pregnancy. In contrast to 13 Reasons Why, Sex Education and Euphoria, Dear White People does not depict the abortion itself. But what it does reveal, in a way the other shows do not, are the socio-economic realities – in particular, the confluence of gender, race, and class – that shape Coco’s choice. Coco considers what it would mean for her to become a 20-year-old single mum and college drop out. Originally from the South Side of Chicago, Coco is an economics student at Winchester, the show’s fictional Ivy League university, which she attends on a special scholarship for under privileged young people granted to her by a rich white male benefactor. Coco is depicted as the most ambitious of all the characters on Dear White People, with a dream to become a lawyer and work on Capitol Hill. When talking through the options with her friend, Kelsey (Nia Jervier), Coco compares her experience to that of her mother’s, who became a single parent to Coco at a young age: ‘I came here to take everything the world denied my mother and dared to deny me,’ she tells Kelsey. The set of choices available to Coco is shown to be determined by intersectional class, gender and race positioning in a society dominated by inequality. 

Out of all the shows discussed here, Dear White People is the only one to overtly reference the socio-political context of the abortion bans in the US. As Kelsey says to Coco: ‘At least we’re not having this discussion in Texas…’ followed by both girls chiming in with a list of the other abortion ban states they are lucky not to be in: ‘Or Kentucky. Or Missouri. Or Virginia. Or Utah. Or South Dakota.’ Coco jokingly acknowledges the fact that in light of the current brutal political realities of American life, she ‘really is needed on Capitol Hill!’ The matter of choices, and the stark socio-economic realities and intergenerational legacies and histories that mediate and inflect those choices, constitute the thematics of the episode, which is directed by Kimberly Peirce.

Coco Conners, Dear White People (Netflix, 2017-)

The end of the episode brings Coco, accompanied by Kelsey, to the abortion clinic but it stops short of depicting the abortion. Instead, it shows Coco faltering over her decision to abort and inserts a fantasy sequence, ‘18 years later’, in which Coco imagines having a lovely 18-year-old daughter, Penelope (Diamond White). Coco’s dreams have come true and she is now a successful lawyer. Her daughter has just been accepted into Winchester, and Coco and her ex-boyfriend and the father of her daughter, Troy Fairbanks (Brandon P. Bell), accompany Penelope to her first day at university. The beautiful, joyful Penelope soaks in the Winchester surroundings; as she says goodbye, Coco strokes her daughter’s hair and tells her how she will always worry and think about her. It is important to quote Coco’s words to her daughter in full: 

The experiences you’ll have, the opportunities. And it won’t always be easy. You’ll make mistakes. You’ll have a lot of touch choices to make, but don’t let that stop you from striving. And no matter what happens, remember this: you have a right to be here, just like everybody else. You make your mark at Winchester and the world will be at your feet…The Senate, The White House…the sky is too limiting for what you’re about to do my sweet, sweet girl. 

Coco is pulled out of the dream sequence (as are we) when the abortion clinic worker calls out her name. It is time for her abortion. The final image of the episode is a close-up of a confident and certain Coco walking towards the room where she will have her abortion. What Dear White People provides, in lieu of an aestheticized depiction of the female body on a hospital bed in stir ups, is a sequence depicting a young woman’s self-love and respect. Coco Conners is the sweet, sweet girl in the moving fantasy sequence in which a young black woman imagines the coordinates of a scene in which she is granted agency and autonomy and the space to realise her wildest dreams. Assuming the role of mother and daughter at once, Coco grants both versions of herself immense love, empathy, and understanding. In a world that too often denies and erases black female subjectivity, this sequence is not only poignant, it is radical. Moving forward, it is vital that TV continues to find inventive ways of representing young women’s choices, at the same time as it acknowledges the ways in which those choices are mediated and imbricated in complex structural factors.

Our book ‘Sex Ed: An Inclusive Teenage Guide to Sex and Relationships’​ ​ is out​ ​now.

Acknowledgements:

Thank you to Dr Emma Chan and Sara Haller for their helpful advice and suggestions on this piece. 

About Abortion Series: 1 - Teaching Abortion in Northern Ireland

By Sara Haller, Education Worker at Common Youth, a young person’s sexual health charity in Northern Ireland.

To understand how abortion is taught (or more aptly not taught) in Northern Ireland some attention needs to be paid to the context of the region. To put it briefly, Northern Ireland was founded in 1921, when due to Unionists demands, it was partitioned from what is now known as the Republic of Ireland. To a wider British audience, the conflict we call ‘The Troubles’ may seem confusing and multifaceted (which it is), but what cannot be stressed enough is the nefarious and controlling role of BOTH religions on the development of Northern Irish society and ethos. One of the few things extremist Catholics and Protestants could agree on is what they both perceive as the abhorrent nature of abortion and anyone who supports it. This religious influence is one of the reasons that Northern Ireland (NI) has developed differently from the rest of the United Kingdom (Scotland, Wales, England) and it has shaped how we talk about everything, especially abortion. The 1967 abortion act was not extended to Northern Ireland which meant abortion remained a criminal offence until October 2019.

Delivering relationship and sexuality education to the community is my role in Common Youth, a young person’s sexual health charity in Northern Ireland (we also have a clinic). Faced with stigma (that was basically enshrined in law) our education workers were, in the past, unable to outwardly display anything that looked like a pro-choice stance before October 2019. This was not an organisational stance but rather it came from the very real fear of being faced with a legal challenge if we talked about how to procure an abortion. To be in any way linked to abortion was detrimental to the reach of our organisation. 

Operating under the banner of Brook from 1992 until 2017 we were held in disdain by some of those in the community. We were regarded widely as an abortion referral clinic, despite the fact our funding allowed us to only have a contraception function. Even being ‘accused’ of being a referral organisation was enough to alienate us from those in power. Politician, senior civil servants and other public people all spoke openly against our organisation, spreading the fallacy that we were abortion providers. This had a massive impact. We even had GP’s signposting to us, being sent to our door, bags packed, and shaking with nerves. These people had been told we could ‘put them on boat’ and ‘get them sorted’. In reality we couldn’t even give them a phone number.

Perceptions and opinions trickled down and many refused to work with us. We had people calling in asking for information, really pushing for us to give out numbers or help in any way. We couldn’t do more than tell them about the yellow pages or the internet. This may seem callous, but we had people constantly waiting for us to slip up. We had phone-calls and drop-ins which we suspected were tests for anti-choice organisations. The establishment (both society and governmental) did not want to have us operating in any capacity. They hated our sex positive attitude and regarded the morning-after pill as a form of abortion and it is only in the past couple of years that this has this shifted, slightly. Our senior staff were sent death threats and were accosted on the street on the way to their cars. This petty aggression really only served to strengthen the convictions of those they attempted to scare. 

In 2017, we reorganised and changed our name from Brook to Common Youth. After this we saw a growth in the scope, i.e. the types of organisations who were inviting us to deliver our sessions. We were puzzled initially as we thought rebranding would mean we would have to re-establish trust in the community. After some informal probing, it became apparent our new branding was free from preconceived baggage and this loosened the tight constraints the false perception of us had created. 

We move to the present day, in a slightly more progressive Northern Ireland. Whilst the law has changed it is difficult to say how much attitudes have shifted. Through my work as an RSE Educator I am on the front line between policy and people; teaching the law, and hearing the opinions. The programme we run is for 11-25 year olds and takes the form of three two-hour sessions run across consecutive weeks.  As an educator, I believe I am doing young people an injustice if I do not in some way discuss abortion. For some young people even speaking the word is taboo in their households. I am potentially their first – and only – avenue for fact-based information around the service. If you are reading this and thinking it sounds like hyperbole take a look at organisations like Precious Life, and the vast following they have online (I feel horrendous guilt even giving their socials any traffic). This organisation is also invited into schools to give “educational” sessions.   

Abortion is now something that Common Youth discusses in our sessions.  We leave it to the later sessions when the room dynamics have been firmly established, and when it would tend to organically arise from our discussions on pregnancy. The discussion in the room can range from the celebration of the change in legislation to outright condemnation of the pro-choice movement.  It is when I get the latter reaction that I find myself most excited. What I have found as an educator is that it is the young people who say nothing who are the ones that give me most cause for concern. The young people who bring arguments against abortion to the table are, at least usually, open to a discussion. I always praise their ability to speak in an open and respectful manner, and reinforce that the point of every debate is to reach a conclusion, not to offend. The session is probably the first time they’ve ever independently verbalised their opinions, and giving those opinions space in the room is incredibly important. 

Minds are not changed overnight, or in three two-hour sessions, but I do feel I play a role in helping everyone see the two sides. I have tremendous respect for the young people I work with, and it is easy to see the basis of their opinions when we take into consideration the lack of formal, regulated RSE in schools in NI. This means a lot of beliefs around sexuality and sexual health come from parents (who were often educated on the topic by religious leaders).  Abortion remains a treacherous teaching terrain regardless of location. Alongside our own uniquely Northern Irish barriers to educating around abortion, we also have the more global issues – including how gendered education around pregnancy in its entirety can become. We have a long way to come in Northern Ireland but, as romanticised as it sounds, I do genuinely feel we move a step closer with every discussion. 

My Experience

On 25th March 2020, the Secretary of State published the provisions for Abortion in Northern Ireland; my reaction is thwarted with mixed emotions. 

First of all, there is joy that the grassroots movement, spearheaded by Alliance for Choice, was successful in changing the draconian law in Northern Ireland. I cannot sing the praises of this organisation highly enough, their campaign was inclusive, passionate and reasoned, and it is because of the work of their volunteers that we have even come this far. On 22nd October 2019 a bill was passed by Westminster which decriminalised abortion in Northern Ireland and set out to create a provision for how abortion would be carried out in Northern Ireland. Until the passing of this bill it was a prosecutable offence to facilitate or successfully seek an abortion. This means that when I used abortion services in Manchester in 2016, I was forced to break the law in order to practice my right of bodily autonomy.  

The difficulties in teaching abortion is nothing in comparison to the hurdles one must overcome to actually procure one. My experience of abortion has helped inform how I talk about abortion and has fuelled my activism around the subject. In 2016, I found myself with an unplanned pregnancy.

Being unable to access an abortion in my own country (there were abortions being done in rare cases above board, and also some below board) I was forced to travel to England. This ‘trip’ cost me over £900 and left me in dire straits financially for months afterwards.  I had to opt for the more expensive surgical abortion, due to the fact it took time to get the money together, to organise time off work and to physically travel as well. At the time, I often found myself reflecting that money was the only thing that gave me a choice; no law or statute. Abortion was and continues to be a class issue. 

That same year a young woman was given a suspended prison sentence after she pleaded guilty to procuring her own abortion using tablets ordered online. She was reported to the police by her housemates who defended themselves by arguing “if you break the law you have to be punished”. For me, this story encapsulates what I felt at the time; of being under siege by the community I lived in. I felt like an enemy of the people, unable to even tell my own family or friends for fear of being harshly judged, or criminally convicted. 

My story is like any other, and for me the decision was easy. The hardest thing I had to endure however was the public shaming on the street by anti-choice protestors. How these people have the time, never mind the lack of empathy, to stand on streets and harass strangers is something I will never understand. However, what I do fully understand is the negative impact of their actions, and because of this I vehemently believe they should not be allowed anywhere near these clinics.  

Northern Ireland, through Westminster, has changed the law recently. One of the requests made by Alliance for Choice was to ensure that these people were kept a distance away from clinics. This request was not met. This was just one of many disappointments that came from the recent announcement of the provisions for abortion in Northern Ireland. Alliance for Choice were invited to the table with a clear set of demands: No arbitrary limits on weeks’ gestation; No two medic sign-off; No conditionality on health/mental health reasons; No barriers for victims of sexual assault and rape at any gestation; and Buffer zones requirements implemented before services begin, to name but a few. 

None of these were fully met. As with most things in Northern Ireland, the fight never seems to end, and so continues the fights for free, safe, legal and local abortion services for all. Through my experience of being a service user and my time spent working with young people, I have come to a hopeful conclusion: as Northern Ireland emerges from a dark recent history, I am proud of the steps we have made towards becoming an inclusive, progressive society. Through the work that Common Youth does we are helping to create an open space for people to challenge their opinions and grow. The law only changed last year, and already the air seems clearer.

Illustrations by Evie Karkera, unless otherwise credited.

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