From Rights to Compassion: The D Case and Contemporary Abortion Politics

This chapter is concerned with exploring the dynamics of contemporary debate on women’s reproductive choices and rights in the somewhat transformed social, political and economic context of the Republic of Ireland. News coverage of the events of April and May 2007 provide the focus of attention, as the case of ‘D’, a 17 year old in the temporary care of the state, seeking to terminate her pregnancy after a diagnosis of severe foetal abnormality, became yet again a focus of public debate on abortion access within the state. The analysis explores how the issues this case raised were framed in the public domain, in order to consider the shifting moral grammar shaping the debate. The paper explores the ways in which this case illustrates the ongoing tensions between changing characterisations of Irishness, and the social dynamics of access to reproductive rights, particularly for national minors in the care of the state.

The current state of abortion law and practice in Northern Ireland

This paper reviews current abortion law and practice in Northern Ireland (NI). It explores the origins of NI's abortion law and its complexity in relation to current practice. it reviews issues relating to women seeking terminations in NI and Great Britain and reviews attempts by the Family Planning Association NI to require the Department of Health and Social Services and Public Safety NI to provide guidance for health professionals engaged in this practice. The paper also discusses some of the issues surrounding abortion in NI and seeks to explain why this subject is causing controversy and debate, especially following a judicial review in February and Marie Stopes opening a termination service in Belfast.

Framing Wrongs, Performing Rights in Northern Ireland: Toward a Butlerian Approach to Life in Abortion Strategising

Feminist strategising on abortion has been dominated by a “pro-choice” frame. Increasingly, however, pro-choice discourse is being viewed as inadequate to meet contemporary and complex feminist aims and analyses, in particular due to the individualising ontological framework upon which it appears to be based. The work of Judith Butler is one location where such concerns have been explored and an alternative approach based upon a renewed analysis of the concept of “life” has been asserted. Foregrounding the fundamental precariousness of intersubjective life and opening the socio-political conditions sustaining precarious life to democratic public engagement carries significant implications for feminist strategising for Butler, and envisages a reconceptualisation of debate on abortion. In this article Butler’s work on life will be combined with her theoretical tool of the frame to explore space which may exist within pro-choice strategising to potentially work towards such a renewed approach to life in social debate on abortion. This space may be used to rethink feminist strategising on abortion beyond pro-choice discourse, and presents an accessible starting point from which to do so. In carrying out this analysis insights will be drawn from feminist advocacy and activism in the contingent location of Northern Ireland where recent employment of a health frame and a rights frame demonstrate instances of pro-choice strategising which may be reiterated to shift feminist activism towards more radical engagement with life as a precarious social process demanding critical attention.

You Can't Always Get What You Want: A Gewirthian Model of Rational Autonomy in Abortion

The law regulating the availability of abortion is problematic both legally and morally. It is dogmatic in its requirements of women and doctors and ignorant of would-be fathers. Practically, its usage is liberal - with s1(1)(a) Abortion Act 1967 treated as a ‘catch all’ ground - it allows abortion on demand. Yet this is not reflected in the ‘law’. Against this outdated legislation I propose a model of autonomy which seeks to tether our moral concerns with a new legal approach to abortion. I do so by maintaining that a legal conception of autonomy is derivable from the categorical imperative resulting from Gewirth’s argument to the Principle of Generic Consistency: Act in accordance with the generic rights of your recipients as well as of yourself. This model of Gewirthian Rational Autonomy, I suggest, provides a guide for both public and private notions of autonomy and how our autonomous interests can be balanced across social structures in order to legitimately empower choice. I claim, ultimately, that relevant rights in the context of abortion are derivable from this model.

Rights, Rationality and Reproduction: Balancing Interests in the Abortion Debate

As medical technology has advanced, so too have our attitudes towards the level of control we can or should expect to have over our procreative capacities. This creates a multidimensional problem for the law and family planning services in terms of access to services – whether to avoid conception or terminate a pregnancy – and the negligent provision of these services. These developments go to the heart of our perception of autonomy. Unsurprisingly, these matters also raise a moral dilemma for the law. Distinctively, discourse in this area is dominated by assertions of subjective moral value; in relation to life, to personal choice and to notions of the archetypal family. Against this, I stress that a model of objective morality can answer these challenging questions and resolve the inherent problems of legal regulation. Therefore, I argue that notions of autonomy must be based on a rational, action-based understanding of what it means to be a ‘moral agent’. I claim that from this we might support a legal standard, based on objective rational morality, which can frame our constitutional norms and our conception of justice in these contentious areas. This paper claims that the current regulation of abortion is outdated and requires radical reform. It proposes a scheme that would shift the choice towards the mother (and the father), remove the unnecessarily broad disability ground and involve doctors having a role of counsel (rather than gatekeeper).

Abortion trends 1990-1999 in a Swiss region and determinants of abortion recurrence.

OBJECTIVE: To assess age- and nationality-specific trends in abortion rates over the last decade, and to describe women's characteristics, identifying risk factors for repeated abortion. METHODS: From 1990-1999, the Health Department of Canton Vaud (Switzerland) received 13'857 abortion requests from residents aged 14-49. Population data were obtained to compute rates. RESULTS: Both the number of abortions (1400 annually) as well as their rate (8.9 per thousand women [95% confidence interval (CI) 7.3-10.5]) were stable over the decade in question. The rate of abortion for foreign women, especially from ex-Yugoslavia and Africa, was twice that for Swiss women. Half of the requests came from single women, 43% had a low education level, and half were childless. The main reason for requesting termination of pregnancy was psychosocial (93%). The mean gestational age was 7.7 weeks (SD +/- 2.3), but 96% of requests were submitted before 12 weeks. Sixty-three percent of women reported that they had used no contraception, 36% the condom and 17% the pill. Among requests, the adjusted risk of repeated abortion (22% of abortion candidates) was greater among divorced/separated/widowed women (odds ratio [OR] 1.9 [95% CI 1.5-2.4]), unemployed women (OR 1.8 [95% CI 1.5-2.1]), and those who had not attended university (OR 1.6 [95% CI 1.1-2.2]). CONCLUSIONS: Although Swiss law only permitted abortion under strict conditions, this procedure was widely available in Vaud, which nevertheless has one of the lowest rates worldwide. Efforts must be intensified to ensure universal access to family planning services, especially for foreign women and adolescents. Professionals should also target "repeaters" to provide personalised counselling.

The relationship between abortion and suicide : a systematic review = La relation entre l’avortement et le suicide : une recension systématique

Essai doctoral présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de Doctorat en psychologie clinique (D.Psy.)

Sex, a one mans show : Perceptions and experience of sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya – A qualitative study

This study aimed to explore perceptions and experiences concerning sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya. The design of the study was inductive with a qualitative approach using personal in-depth interviews. Eight participants (four female and four male) were asked to describe their perceptions and experience concerning sexuality, contraceptives, unwanted pregnancies and unsafe abortion. The result showed that culture and norms, misconceptions and gender based power in sexuality are factors that impact Sexual Reproductive Health among young people in Kisumu today. Unwanted pregnancy was described as a shame, a burden and a destroyed life which lead to many unsafely induced abortions. The findings indicate that youth interventions are important, such as engaging young men in unwanted pregnancy and thus unsafe abortions and to empower young women.

Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India : study protocol and intervention adaptation of a randomised control trial

The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. Trial design The study is a randomised, controlled, non-superiority trial . Methods Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. Discussion In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013