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Why we need to talk about abortion

Professor Lesley Hoggart discusses her work to lift the veil of silence around abortion in the UK and challenge the stigma that people it affects can feel.

Almost half of pregnancies in England are unplanned, and one-third of women* across the UK will have an abortion during their reproductive lifetime. It is something that as many as 200,000 women in England and Wales go through each year. So, it is shocking that the topic remains shrouded in secrecy and silence, which can lead to stigma and shame.

Speaking to women across the UK, I've seen how attitudes towards abortion, which suggest it is morally questionable or socially unacceptable, can lead women to internalise a sense of stigma and shame rather than accept abortion as a reproductive health issue. My work with Dr Victoria Newton, also shows how young women particularly experience shame and stigmatisation, and these emotions are magnified for women who have more than one abortion.

Thankfully, we’ve also seen how non-judgemental social support and challenging secrecy can help women resist and reject abortion stigma.

*I want to note that I use ‘women’ here as this term is used in the available statistics and as participants in my research all identified as such. Nonetheless, I recognise that not all people who can and do become pregnant identify as women and that their needs also require our attention.

Telling true stories of abortion

We used our research - and that of the Universities of Glasgow, Edinburgh, Ulster and UCL - to build a consortium dedicated to challenging abortion stigma and misinformation and raising awareness about the ordinariness of this experience. This consortium includes abortion providers, the British Pregnancy Advisory Service (BPAS), MSI Reproductive Choices UK, and policymakers from Public Health England, the Faculty of Sexual and Reproductive Healthcare and the British Society of Abortion Care Providers (BSACP). Sexual health and contraception providers, Brook and the Family Planning Association also played a vital role.

Together we created My Body My Life, a travelling interactive exhibition that shines a light on women's lived experiences of abortion. Built by creative agency, The Liminal Space, to look like a high street store, our 'shop' features racks of clothing printed with quotes from women about their abortion experiences. It also includes changing room-style video booths, which play films of actors telling real women's stories.

Between 2017 and 2018, more than 1,200 people visited the exhibition as it travelled between venues across England, Scotland and Northern Ireland. People also visited the website more than 13,000 times and watched our YouTube videos more than 1,000 times.

Media coverage about the exhibition, in outlets such as Buzz Feed and the Metro, also spread our message to an audience of millions across the UK. While feedback from attendees was overwhelmingly positive.

I found the experience eye-opening. [It] got me to consider issues I wouldn't usually.

I had never thought about how abortions could happen as a result of medical issues and finance. Before this I assumed it was young girls who had made a mistake, I didn't think it was as common in older people who already have children.

Anonymous feedback from attendees

Supporting women who have experienced abortion

The exhibition also profoundly impacted women who had gone through abortions and those close to them. More than 140 people shared their abortion stories on a public storyboard and testified to the power of the project.

It made me feel less alone, that so many other women go through this.

I am grateful to the exhibition and this portal which has helped me heal. It made me feel I am not the only one. It made me feel connected to strangers who have had this experience and I am ever grateful to you for this.

Storyboard feedback from women who have experienced abortions

Enhancing abortion providers' practice

BPAS now shares the exhibition's accompanying booklet with more than 90,000 women on their first contact with the service each year. It also makes the material available on its website and in hard copy in each of its 40 UK clinics. BPAS clinic staff who use the booklet have told us how the project helped them better understand the different circumstances which lead to an abortion.

The booklet helps counsellors at BPAS answer a lot of the questions that women have about abortion and allay their fears. ~ Jane Calvert. Lead Client Care Coordinator at BPAS.

MSI Reproductive Choices UK stocks the booklet in its clinics and runs a #SmashAbortionStigma campaign to collect and showcase women's abortion stories on its website and social media.

In 2018 we took My Body My Life to the International Federation of Abortion and Contraception Professionals Conference in Nantes, France, to engage directly with even more medical professionals. In a survey after the event, a high proportion (83%) of respondents agreed the exhibition was helpful for their work, and 76% said it helped enhance their understanding of women's abortion experience. We also exhibited at the 2019 Royal College of Obstetricians and Gynaecologists Global Congress in London, which more than 4,000 practitioners attended.

Campaigning for the decriminalisation of abortion in Northern Ireland

Perhaps one of our proudest achievements was contributing to the campaigns leading to change in Northern Irish law in October 2019, which saw abortion legalised for the first time. In addition to presenting our research to the Northern Ireland Assembly twice, I was pleased to use our work to support the Northern Irish civil movement, Alliance for Choice (AFC), in its campaign to decriminalise abortion.

My Body My Life contributed to the campaign to end abortion criminalisation in Northern Ireland and continues to contribute to the campaign to end abortion stigmatisation and discrimination.

Emma Campbell, AFC co-convenor

Educating young people about abortion and unintended pregnancy

Education in our Schools is vital to tackle misinformation and challenge stigma. Yet, according to the Sex Education Forum, teachers lack confidence in teaching pregnancy choices, while 33% of young people say their abortion education is either non-existent or inadequate.

In September 2020, Relationship and Sexuality Education (RSE) became mandatory in all secondary schools in England and relationships education became compulsory in all primary schools. In line with the new Department for Education statutory guidance, schools must now provide 'accurate, impartial information on all pregnancy options, including keeping the baby, adoption, abortion and where to get further help'.

We recently launched a new partnership with sexual health and wellbeing experts, Brook, to develop an online course to support teachers in providing abortion education in schools. Available on Brook's free-to-access online learning platform Brook Learn, the programme sits alongside a comprehensive suite of RSE resources for professionals to improve the knowledge and confidence of those teaching young people aged 13 and over about pregnancy decision-making and abortion. It features My Body My Life stories, precise information, videos and guided classroom activities. Unfortunately, the coronavirus pandemic delayed the programme's rollout, but we expect around 900 teachers to participate each year when it is up and running.

The fight against stigma continues

Like so much to do with reproductive and sexual health, it can be challenging to talk about abortion. Still, we will all know someone affected by unintended pregnancy and abortion at some point in their lives. So we must continue to separate fact from fiction and challenge damaging myths and prejudices.

My Body My Life has been a privilege to be part of, and we have exciting plans for the future, first on the list being to support the new charity, Abortion Talk. Just launched, the charity will develop online resources to challenge abortion stigma in society, provide a helpline and tailored discussion space, and support people affected by abortion.

Written by: Lesley Hoggart, Professor of Social Policy Research and Deputy Associate Dean Research in WELS.