“Abortion is not a private issue but collective and public. It doesn’t happen in a void. Throughout history it has been sought within a network. Abortion is an activity that benefits society. Restricting and prohibiting it won’t stop it but will increase morbidity and mortality. It’s shrouded beneath layers of disinformation. And women who tell their stories are still isolated,” said Rachel Hurst of the Department of Women’s and Gender Studies, St. Francis Xavier University, Nova Scotia.
“The way we talk about abortion needs to change. Abortion is a safe medical procedure that has a significant impact on one’s life, is emotionally and materially experienced in different ways, and must be recognised as fundamental to bodily sovereignty,” she said. “Even in contexts where abortion is decriminalised or legal, stigma, misinformation and unequal access continue to pose significant barriers to achieving reproductive justice as a human right. My argument is that focusing on ordinary experiences of abortion promises valuable insight into best practices for abortion access and care, as well as non-legal barriers to accessing abortion, which can inform activist struggles for reproductive justice as well as more robust policies and legal approaches to abortion care.”
Hurst believes there is an urgency to rethink how we represent abortion in the contemporary moment when abortion rights and laws are in flux globally, and that artists, writers, activists, performers and clinicians can offer critical insights. “We need to broaden how we talk about it,” she said.
She emphasised that the realities that people experience when seeking and undergoing abortion are not helped by seeing abortion as a ‘debate’ between pro-choice and pro-life positions – often backed by savvy, well-funded US anti-abortionist groups with global reach.
“We need to normalise, make visible and express motivation for abortion access beyond the narrow framework of pro-choice,” she continued. “The US dominates how abortion is talked about globally. But it’s not one size fits all – context is important.”
“Abortion is both ancient and urgent – artefacts from medieval Europe and before show it was a legitimate medical practice and an acceptable practice of family planning. Abortion was always part of reproductive life and will continue to be.”
She also emphasised why it’s not just a woman’s issue. “People of all genders access abortion and need safe, free, on-demand access. Trans and non-binary people face additional difficulties to access including misgendering and incorrect naming of body parts. Insisting on positioning it as a women’s issue is problematic – erasing the benefits and creating additional barriers.”
The World Health Organization estimates that there are 121 million unintended pregnancies per year. Of these, 60% end in abortion and of these 45% are unsafe with 97% of those occurring in the developing world. Half of abortions in Africa are under least-safe circumstances with unsafe abortion the leading cause of maternal death.
“But abortion will continue even when it’s unsafe and illegal,” she added.
“Risk of infertility, death and caused by rape should be compelling arguments for safe access. It’s hard to argue that a 12-year-old should have a child based on rape, but the US shows us that some do.”
She also emphasised though that a focus on the direst circumstances often enhances the challenges. “Some unintended consequences of emphasising the worst circumstances under which abortions are sought to advocate for abortion rights (e.g. rape, incest, risk of death) include widespread myths about abortion, stigma and a lack of understanding about the most common circumstances under which people seek abortions which are much more mundane.”
Progressive laws but persistent challenges
Turning to South Africa and Canada, Hurst indicated that abortion was decriminalised in Canada in 1988 but activists continue to work to mainstream abortion as a healthcare issue.
“South Africa has a robust, progressive law which recognises state provision of reproductive healthcare for all, bodily autonomy and abortion access as fundamental to women’s social and psychological health. This is the result of visionary activism.”
But, she noted, despite these progressive approaches, access and stigma still strongly influence decision making and experiences. “Both South Africa and Canada have legal circumstances that should facilitate universal access but there remain barriers,” she said. This includes access to healthcare facilities as well as access to drugs for at-home, self-managed medical abortions (South African has not yet licenced cheaper generics) and basic requirements like water and sanitation.
“This cannot only be fought at legal and state level but must also be fought at social and community level,” she added.
She emphasised the strength of the reproductive justice approach to situate abortion in a social and historical context, and acknowledge the range of responsibilities. Reproductive justice is a key theoretical and activist framework that asserts the right to have children, the right not to have children, and the right to raise and care for one’s children in a healthy, safe environment.
“The framing of reproductive justice is important to normalise abortion as a central component of reproductive healthcare – ending stigma from healthcare workers and barriers to access.”
She also noted other relevant theoretical framings including the work of Stuart Hall which, influenced by Frantz Fanon, looks at the critical relationships between representation, ideology and dominance; as well as bell hooks who emphasises representation as a site of struggle, and the need for intervention and self-transformation.
Artistic depictions
Hurst believes that the work of artists, writers, activists and healthcare providers to represent ordinary abortion experiences is “a radical intervention into dominant (largely American) ways of understanding abortion and holds potential for expanding the global movement for safe access to abortion”.
She opened her seminar with the Paula Rego’s ‘The Abortion Pastels’, created in 1998 and 1999 in response to the defeat of a Portuguese referendum to legalise abortion, to demonstrate the potential of representing abortion as an ordinary experience.
She also highlighted the work of South African artist Zola Ndimande – ‘Entering the Void’ – part of the Body of Work: Abortion Conversations Exhibition and an interactive work that encourages viewers to think about the void in capturing the experience of abortion as well as the personal versus public decision making and importance of context.
Lastly, she turned to collages by Catherine Mellinger featured in Marianne Apostolides’ book Deep Salt Water narrating her experience of abortion. “This aims to not show the uterus as a hostile environment. This refiguring renders abortion within the context of all life on earth and refuses the separation of body and foetus called for by anti-abortionists,” explained Hurst.
Hurst believes that such creative and liberatory retelling has the “capacity to tease out excess meaning and inspire a more comprehensive conversation about abortion”.
The South African Body of Work: Abortion Conversations Exhibition included groups like the Sexual and Reproductive Justice Coalition at Rhodes University, the Sex Workers Education and Advocacy Taskforce (SWEAT), Soul City and the Human Rights Commission. Hurst is inspired by this collaborative work and is working towards arts-based research workshops with artists, activists and people who have had abortions as the next step of her project.
Her project aims to “contribute to the upsurge of writing and art about abortion that normalises the procedure, while also drawing attention to unequal access to safe and legal abortion, shaped not just by geography, but also racism, transphobia, homophobia, ableism and classism”.
“Artists expose positions that are often silenced or invisible,” she concluded. “That’s what draws me to artists. I’m inspired by their bravery in saying things that are difficult to say.”
Michelle Galloway: Part-time media officer at STIAS
Photograph: Ignus Dreyer