Jul 28, 2011

Reclaiming the medical narrative around abortion

Since the election of a Conservative led government in June 2010, we’ve seen a series of attacks on women’s rights, from the economic to the legal to the medical. The one that scares me, personally the most is the campaign against abortion and contraception, because it has the potential to increase human suffering not only for the current generation of women, but for the next generation of unwanted or severely disabled children they are forced to bring into the world.

The trend is a legitimate worry: in the US there were 80 different laws passed this year restricting access to abortion. Several states, chief among them Kansas but others as well, have become de-facto zones where abortion is illegal, in that it is impossible to obtain. And this enormous spike in legislation didn’t just come out of the blue – it is the culmination of decades of insidious and well organised work to prepare the ground through steady erosion of public support for women’s health through a campaign of polemic, misinformation and obfuscation.

We are not immune to this stream in public thought in the UK, and in fact I would argue that US-based propaganda has substantially prepared the ground for a similar move to legally restrict abortion over here; already the public, chiefly through the collusion of the right wing press, holds a mostly unrealistic conception of abortion as a traumatising, sordid experience undergone by feckless, chaotic teenagers who are too stupid or lazy to worry about contraception and who get to near end of their pregnancy before they remember to seek help “evading their responsibility”.

This is of course a wildly distorted and histrionic picure, and yet the Department of Health is actually considering changes to the way abortion support is provided today that may make it easier for anti-abortion groups to corner and abuse vulnerable women, on the strength of “common sense” objections from two MPs who have no sense at all, common or otherwise, and who seem to me to be arguably acting in bad faith on the behest of overseas Christian organisations intent on recriminalizing abortion.

One of the paths to success and public support these two MPs are taking is the path of framing the debate n language they can control the meaning of. This is a well known tactic, and we see it in operation in all kinds of areas of public discourse. After the misleading and disingenuous term “pro life”, of course, my favourite is the fascinating history of the phrase “politically correct”, so beloved of right wing columnists like Richard Littlejohn. 

This tactic is more common in the right than on the left; I say this not to disparage the ideological right, but as a simple statement of the fact that we on the left are often hampered by our own aspirations to intellectual rigour, and can therefore find ourselves unable to mount an effective response to things like outright denial of science being self-servingly labelled “scepticism”, or a refusal to accept science teaching in the science classroom presented as a “controversy”. We are getting a bit better at heading off these rhetorical traps and dealing with them when they appear; the terms “climate change denialist” has gained some currency for example.

Similarly, I would like to propose a change in how we talk about abortion. Rather than the awkward and easily distorted construction “women seeking abortion”, “women considering termination”, “women with unwanted pregnancies” etc., I suggest we consolidate all cases of medical intervention in pregnancy under the umbrella term “crisis pregnancy patients”.

To me this captures the essence of what a woman in all situations potentially resulting in a termination: that there is a human being with a problem here, and a medical procedure as part of the solution. After all, we don’t call cancer patients “people seeking chemotherapy”, do we? In all other cases of people seeking legal medical treatment, we concentrate on the problem/condition the treatment is supposed to address; it’s only when we talk about what we consider trivial concerns of silly women that we centre on the procedure, as in the case of cosmetic surgery and, well, abortion.

There are two main objections that I can anticipate to this approach:

        1. That switching to “crisis pregnancy patient” is no better than right wing propaganda in obfuscating and masking the real issue with consensus-seeking language.

This is an important objection and I want to deal with it very seriously. I don’t think what I’m doing here is putting a “spin” on abortion to make it less controversial. That is certainly not my intent. I think, rather, that we have swung too far into the rhetorical ground favoured by the opposition, of masking the realities around abortion in order to create a faux-controversy under cover of which it is easy to sell restrictive and cruel new proposals (like girls saying no to their abusers) to the public.

When we agree to talk about “women seeking abortions”, we implicitly agree that an abortion is what women in this situation want. This is obviously irrational – why would anyone want an invasive medical procedure? – and supports the wider portrayal of women who have abortions  as feckless, irresponsible, stupid and in need of protection from their own moral failings. The reality is that women undergoing abortions don’t want abortions: they’d rather not be having an abortion at all thank you very much, because they either a) don’t want to be pregnant or b) want to be a mother very badly but something has sadly happened to make that an impossible option.

Abortion is not the “goal” of women accessing the service of BPAS or Marie Stopes; the goal is to not be pregnant. The condition from which a woman wants medical deliverance is not the condition of “not having an abortion” – it is the condition of “having an unwanted or unviable pregnancy”. Abortion, like all medical procedures, is the way of getting from A (crisis pregnancy) to B (no pregnancy).

Tracey Emin I think said it best: “When you’re pregnant, you don’t make up your mind that you want an abortion – you make up your mind that you can’t have a child. Which is a very different thing”.
I hope I’ve convinced you that I am not proposing a rhetorical sleight of hand, but a serious realignment of the discourse that puts women and their medical needs at the centre. Which brings me to my next possible objection

2. That the term “crisis pregnancy patient” dehumanises women by taking them out of the narrative of abortion.

Rather what I intend is to undo the damage caused over decades by the over-concentration of anti-choice propaganda on “the baby”, and bring the woman back into the centre of the debate.

If you hang out on abortion related online discussion threads as much as I do (for general mental wellbeing, I don’t recommend it), you come across surprisingly many people whose main objection to the availability of abortion is openly and nakedly the discourse of choice and rights for women. Protected by the anonymity of the internet, they freely admit that what chiefly offends them about reproductive rights is the notion that a woman’s “right to choose” is something to take into consideration in the first place. They quickly drop, if they ever upheld, the pretence that this is about the rights of the unborn or any genuine debate about viability, when life begins and so forth.

These people are beyond the reach of mere persuasion; you have to plumb I don’t know what depths of dehumanisation before you can baldly claim that a whole class of people don’t deserve their bodily autonomy, or should be punished with a lifetime of unwanted parenthood for engaging in basic human functions like sex. The people who I am trying to reach with this proposal are those bamboozled by these fulminations into forgetting that abortion, contraception, antenatal care and so on are all in the same class of things enabled by modern medicine as root canals and chemotherapy, and that all human beings have an equal right to access these benefits.

This is not as uncontroversial an idea as you may think; many people, who in my view lack empathy, wish us to restrict medical access for those who are seen as being the architects of their own health problems, such as those suffering from obesity, or smokers. And of course we already lock up drug addicts in jail rather than treat their disease. The government policy wind is blowing very much in the direction of taking more and more entitlements to basic human dignity away from people, be it reducing mobility allowances for the disabled or cutting care and respite services at local level. I don’t want women as a class to slip under this descending portcullis of malice, and if I can help towards that just a little by reminding people that women are NHS patients too, then I think it’s worthwhile to try.

So to reiterate: I propose that henceforth, when we talk, write, tweet, blog, comment or argue about abortion provision and access, we refer to the people impacted by any change in the existing legislation as crisis pregnancy patients.

Thoughts? Comments? Will you do it, and if not, why not?


  1. I take your point on this, but can't quite get round the feeling that applying the term 'crisis' to *all* cases of elective termination may be seen as unnecessarily dramatic and therefore be counter-productive in some cases. Problem is, I've been unable to come up with anything better. I toyed briefly in the small hours with "elective outcome pregnancy", but looked at it again in the morning and saw why I shouldn't sit in front of the computer in the small hours...

    So, I support your initiative (unusual, I know), but am neither able to commit to your proposal or come up with a better one (more usual).