Intimate Partner Violence, Pregnancy and Abortion

The World Health Organisation defines Intimate Partner Violence (IPV) as “one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviours by an intimate partner”. IPV has been shown to increase during pregnancy. Women’s Aid states that 30% of IPV starts during pregnancy and that between four and nine women out of every 100 are abused during their pregnancies and/or after having given birth. Women’s Aid identifies IPV as a prime cause of miscarriage, still-birth and of maternal deaths following childbirth.

One form of IPV is termed ‘reproductive coercion’ – where abuse relating to contraception or pregnancy decision-making is exercised by a woman’s partner. For example, the abuser may sabotage contraception, refuse to use it, or pressurise a partner into continuing or ending a pregnancy against their wishes. Perhaps unsurprisingly, a recent study found an association between IPV (naming rape and sexual assault, contraceptive sabotage and pregnancy coercion as examples) and termination of pregnancy. The study found that women in violent relationships were three times more likely to conceal an abortion from their partner as women in non-violent relationships and that “women undergoing terminations of pregnancy welcomed the opportunity to disclose their experiences of intimate partner violence and to be offered help”. What this tells us is that pregnancy support services need to be attuned to the risk factors for IPV and to be able to provide signposting and support where required. Domestic violence support services in turn, need to be equipped to provide accurate information on pregnancy choices and impartial support with pregnancy decision-making.

We were concerned to see that information about IPV and pregnancy is being misrepresented by anti-abortion organisation LIFE, in its recent ‘Finding Hope’ campaign. In a glossy animation LIFE claims that “the association between abortion and violence towards women is strong”. LIFE claims that one in four women seeking abortion are “victims of domestic violence” and “at least one in every four women seeking abortion, therefore, (is) not doing so freely but from a position of fear.” LIFE makes a causal relationship between IPV and abortion which is simply not in the data, implies that abortion itself is a form of violence, and states that “women who have abortions can become more self-destructive, and remain in or seek out abusive relationships as a form of self-punishment.” It is highly offensive to suggest that women have abortions, or remain in violent relationships as a form of ‘self-punishment’. It is also inaccurate to extrapolate this data to claim that a quarter of women seeking abortion do so out of ‘fear’.

It is not surprising that a large proportion of women who have abortions have also, at some point, experienced IPV. Both are very common within a lifetime. A third of women have an abortion. A quarter of women experience IPV. It is therefore inevitable that a significant number of those accessing abortion services will have also experienced IPV. What we know about IPV increasing during pregnancy, and about reproductive coercion as a form of IPV, means that there is of course a link between IPV, unplanned or unwanted pregnancy and therefore abortion, but this link is not one of simple causation as the LIFE Finding Hope campaign implies.

LIFE’s suggestion that “no one even asks them (pregnant women) if they are ok...let alone, why do you want an abortion...not even the health professionals tasked with caring for them” is particularly misleading. The Finding Hope campaign claims to, “draw attention to abortion providers' conveyor-belt service and their failure to adequately support women vulnerable to abuse”, the implication being that women seeking abortion are not assessed, supported or fully consenting to the procedure. In fact, bpas, a leading abortion provider and charity, takes a ‘routine enquiry’ approach to domestic abuse, which means staff routinely ask women about safety in their relationship. All staff are trained on domestic abuse issues and bpas provides information in formats which are accessible to a range of people and signposts to relevant agencies. The Royal College of Obstetricians and Gynaecologists advises medical professionals to work to identify those at risk of IPV and provide appropriate support.

LIFE’s campaign culminates in a fundraising appeal for its helpline service. LIFE, which campaigns against legal (and therefore safe) abortion does not appear to be promoting genuine advocacy on domestic violence issues, but rather conflates abortion with abuse in order to argue against abortion. We are particularly concerned that LIFE’s ‘counselling’ services have been shown to be misleading and biased, for example, one LIFE counsellor falsely claimed that abortion leads to an increased risk of breast cancer. Giving women false information in an attempt to influence their decision about a pregnancy is unethical. The narrative provided by LIFE, that women seek abortion only out of ‘fear’ or coercion, is simply not accurate, and negates women’s agency when it comes to making sometimes difficult choices about pregnancy. The connections between IPV and abortion are perhaps best looked at through the reproductive justice framework, which recognises that sometimes our 'choices' are restricted by factors such as economic status, race, class, location and so on. This useful factsheet from the National Women's Law Center, 'If You Really Care About Preventing Domestic and Sexual Violence, You Should Care About Reproductive Justice' makes clear the need to improve material conditions surrounding pregnancy and IPV and points out that restrictions on access to contraception and abortion services will only further constrain a person's ability to exercise bodily autonomy.

*****There is a confidential 24-hour National Domestic Violence Helpline on 0808 2000 247. This helpline is free and run in partnership by Refuge and Women's Aid who can provide information and support to those experiencing domestic violence. ******

Slide from LIFE's 'Finding Hope' animation which places abortion within a 'cycle of abuse'.

'Pro-choice' - what’s in a name?

Lisa shares her thoughts on the use of the term 'pro-choice' to describe organisations which campaign for reproductive rights.

Planned Parenthood this week decided to stop using the term ‘pro-choice’ to describe its position on abortion. I’ve read some excellent pieces on this and agree with many of the points made in favour of this change. Maybe it’s only a sentimental attachment to the term, but personally I don’t think I can ever stop being ‘pro-choice’.

Many people are arguing that the idea of choice is a misnomer because for some people there is no choice. For me this is like arguing that being pro-equal pay is a misnomer because currently there is no equal pay. Planned Parenthood has also argued that abortion should be de-politicised, and framed as a personal health decision that an individual should be able to make. Of course it is an entirely personal decision, but until certain conditions are met, de-politicising abortion seems to me like wishful thinking. The closest example I can see to this is the way in which Canada has taken abortion out of the criminal law altogether. However, even in Canada the political attacks on abortion as a legal procedure keep on coming. And importantly, as Tracy Weitz writes, shifting abortion from the public into the personal sphere does nothing to address or eradicate stigma or help to tackle obstacles to access: 'to say abortion is an individual woman's business absolves us of our obligation to create a more just world.'

It feels a lot like this change of terminology is an admission of failure: it acknowledges, implicitly, that the movement never managed to convey to the world what pro-choice should really mean (which of course includes the fact that abortion is a personal, medical decision). Also that the movement never adequately acknowledged, or fought to address the lived realities of all those in the community who wanted a real choice over their reproductive lives and parenting, and have been denied one, whether because of their age, class, race, gender, sexuality, disability, religion or other factor.

The reproductive justice movement was formed partly in response to the fact that poor women of colour in the US are damned if they do and damned if they don’t when it comes to parenting. Condemned for being disproportionately represented in the abortion statistics – though simultaneously represented as passive victims of a racist abortion ‘industry’ with no moral agency of their own; or condemned for having children when they are perceived as not having the means to support them.In fact, reproductive justice is about more than parenting choices. Reproductive justice activism embraces the whole conversation about how people define themselves, how they choose to live, and how they choose to have or not have sexual relationships, recognising the cultural, economic and social limits imposed on those choices.

For me the reproductive justice movement represents a lot about what being pro-choice should be about and what it means to me. Being pro-choice is not just about saying abortion is morally acceptable or should be legally available. Like any word, or phrase that is designed to be a shortcut to a philosophy, ethos or political position, 'pro-choice' may well not be up to the task, but I’m not convinced that inadequacy equates to inappropriateness and that we should ditch it just yet.

Until we have achieved the utopia in which real choice exists, we have to accept that it is an aspirational term, a goal to be fought and campaigned for. For me it’s about saying that complete sexual and reproductive choice – the fundamental right of a person to bodily autonomy, to have sex or not, to decide who to have sex with and how to have it, to have sex without having children; and of course the right of people who can get pregnant to decide the number, timing, and spacing of their children - is what we are aiming for. It necessitates recognising that some people’s choices are influenced by more than their desires in relation to parenting, but are constrained and directed by the culture in which they live, their economic circumstances, the social and political support or lack of support for certain pregnancy choices and much more.

Real choice can only exist in the context of:

• A society which values and provides equality, respect and security to people of all sexes, sexualities and gender identities and all people regardless of race, class, disability or religion

• Comprehensive and universal sexual health education and access to comprehensive sexual health services including safe and legal abortion and fertility services

• The destigmatisation of all pregnancy options, not just abortion and adoption but all sorts of parenthood including teenage parenthood, single parenthood, older parenthood, disabled parenthood, same-sex parenthood, transgender parenthood

• Rights to parental leave and flexible working conditions for parents

• Real economic and social support for parents caring for children including a living wage policy, accessible affordable childcare, affordable housing, VAW services and more

• Good free quality healthcare for all

In short: a society in which we can be optimistic that our children will thrive, wherever they are born and whoever they are born to...

Maybe the US context is so different that it would be laughable to aspire to any of the above conditions (free universal healthcare, adequate welfare etc), but in the UK we once achieved a few of these or were close to achieving them, and we’re fighting hard to achieve more and to stop the gains we have made slipping through our fingers.  If being pro-choice is an aspirational rather than a descriptive term I’m happy to aspire.