Abortion research by CPCS Associates

Dissemination event: Doctors, Conscience and Abortion Law and Practice, Thursday 29 June 2017

Abortion doctors, professional identity and the law

This piece of research is based on a detailed interview study with 14 doctors who have spent at least a decade working as abortion providers. It is led by Ellie Lee, working with Jan Macvarish and Sally Sheldon, all of the University of Kent.

The aims of the project are:

  1. To make a contribution to discussion of abortion provision, in the context of the 50th anniversary of the 1967 Abortion Act in 2017.
  2. To develop methodology and tools for a larger scale study about the work of, and issues confronting, abortion providers.
  3. To develop sociological analysis of professional identity through this (and future) work.

Read background to our research

The research considers the following:

  1. Perceptions of recent debates about abortion provision in Britain

In what ways, if any, have recent debates on the provision of counselling before abortion; ‘sex selection’; and procedures for authorising abortion (signing HSA1 forms) influenced how interviewees consider and approach their work?

  1. Professional identity of the abortion doctor

What do study participants consider to be the most important contribution of the work they do as a clinician, including in relation to the local population, and what are the key threats/limitations they experience to being able to make that contribution?

  1. Opinions on the abortion law

What are the strengths and weaknesses of the present law? Does it facilitate abortion provision in line with professional opinion on meeting the needs of patients?

Preliminary Findings (PDF)

‘The 1967 Abortion Act fifty years on: Abortion, medical authority and the law revisited’, by Lee, Sheldon and Macvarish (journal article, Social Science and Medicine) here

Also on this page, abortion research by CPCS Associates:

Geraldine Brady

An exploratory study using mixed methods to consider the availability and quality of support prior to and following termination and miscarriage for pregnant teenagers and young parents Coventry: Coventry University

This is a report of an exploratory study focusing on young people’s experience of termination and miscarriage, paying particular attention to family, friends and partners’ reaction to pregnancy; the kind of advice, information and support received; young people’s perceptions of professionals, practitioners and services; the effect which termination or miscarriage had on individuals and the influence of wider societal attitudes towards teenage pregnancy and young parenthood. The research was carried out by G Brady, G Brown, G Letherby, J Bayley and L Wallace in 2006 and was commissioned by Coventry Teenage Pregnancy Partnership. Findings and recommendations have direct relevance for health and social policy.

Brady, G. Brown, G. Letherby, G. Bayley, J and Wallace, L M. Young women’s experience of termination and miscarriage: a qualitative study. 2008. Human Fertility 11(3): 186-190

The authors argue that in Britain, teenage pregnancy is seen as both a cause and a consequence of social exclusion. The emphasis on ‘prevention’ of teenage pregnancy and a limited conception of ‘support’ within the Social Exclusion Unit’s 1999 Teenage Pregnancy Strategy positions parenthood for young people as a negative choice and this dominant discourse is likely to influence young people’s reproductive decisions and experiences. The article focuses on a key findings from a multi-disciplinary empirical pilot research study, conducted in a city in the West Midlands of England, which was concerned to explore young people’s experience of support before and following termination and miscarriage.  These findings were also presented at York University, Toronto, Canada in 2007, at the Association for Research on Mothering conference in a paper entitled ‘You can’t even keep your room tidy, how do you think you’ll cope with a baby?’: when termination or miscarriage appear to resolve the problem of teenage pregnancy’.

Lesley Hoggart

Feminist Campaigns for Birth Control and Abortion Rights in Britain. 2002. London: The Edwin Mellen Press.  

This book is based on a PhD thesis, which discussed the relationship between feminist political campaigns for birth control and abortion rights, and changing government policy in the UK. Its main research area is the tensions involved when radical demands for women’s reproductive control are likely to be only partially met.

Subsequent publications have explored the ways in which policy-making on abortion is a site of political struggle, but the research focus has been extended to include analysing the effects of these tensions on sexual health services and women who use these services:

‘“I’m pregnant … what am I going to do?” An examination of value judgements and moral frameworks in teenage pregnancy decision making.’ 2012. In Press,  Health, Risk and Society.

L. Hoggart and J. Phillips. 2010. ‘Teenage pregnancies that end in abortion: what can they tell us about contraceptive risk-taking?’ Journal of Family Planning and Reproductive Health Care 37: 97-102.

L. Hoggart and J. Phillips. 2010. Young People in London: abortion and repeat abortion research report. Government Office for London.

This research was commissioned by the Young London Matters Teenage Pregnancy Work-Strand group of the Government Office for London. The purpose of the research was to explore factors associated with what was viewed as disproportionately high proportion of under-18 conceptions that end in abortion and repeat abortion in London.

L. Hoggart. 2007. ‘Young women, sexual behaviour and sexual decision-making’ in eds. Thom, B., Sales, R. and J. Pearce, Growing Up with Risk, The Policy Press.

L. Hoggart. ‘Risk: Young Women and Sexual Decision-Making’. 2006. Forum Qualitative

Sozialforschung / Forum: Qualitative Social Research [On-line Journal], 7(1), Art. 28.

Available at: http://www.qualitative-research.net/fqs-texte/1-06/06-1-28-e.htm

L. Hoggart. ‘Teenage Pregnancy: the Government’s dilemma’. 2003. Capital and Class. February: 147-167.

Ellie Lee

Abortion, Motherhood and Mental Health: Medicalizing Reproduction in the U.S. and Britain. New York: Aldine de Gruyter, 2003

This book is the main outcome work for a PhD thesis that considered the development and effects of the claim made by those who oppose legal abortion that many women suffer from a “post abortion syndrome” after they terminate a pregnancy. This claim is intriguing because it seems to suggest that a moral argument (that abortion is wrong) had given way to an apparently medical argument (that abortion makes women ill). The PhD thesis – and the subsequent book – explore why this shift in rhetoric happened and whether this sort of medicalised argument against abortion has influenced abortion law and policy-making. The book thus offers a comparative analysis of the abortion issue in the US and Britain, an investigation of what has been termed “the syndrome society”, and a consideration of the ways in the emotional effects of  birth and the early stages of parenthood have been “medicalised’. Through the last area of analysis, the book therefore assesses the selective medicalisation of reproduction, and the conclusion is drawn that childbirth and early parenthood have in fact become pathologised to a greater extent than abortion.

Book chapters/papers about some areas covered in the book are published as:

‘Psychologising abortion: women’s ‘mental health’ and the regulation of abortion in Britain’. In A. Morris and S. Nott (eds). 2003. Well Women: The Gendered Nature of Health Care Provision. Aldershot, Ashgate. Pp. 61-78.

‘Regulating the Pregnant Body’. In E. Lee and M. Evans (eds). 2002. Real Bodies. Basingstoke, Palgrave. Pp. 115-132.

‘Post-abortion syndrome: reinventing abortion as a social problem’. In J. Best (ed.)2001. How Claims Spread, The Cross-National Diffusion of Social Problems. New York, Aldine de Gruyter. Pp. 39-68.

The demoralisation of abortion

 A Matter of Choice? Explaining National Variation in Teenage Abortion and Motherhood, published by Joseph Rowntree Foundation, 2004. This is a report of study by Roger Ingham, Ellie Lee, Nicole Stone and Steve Clements, looking at and comparing teenage pregnancies that end in abortion and maternity. An article detailing some aspects of the study is available here: http://lawfam.oxfordjournals.org/content/18/3/283.abstract

Second Trimester abortions in England and Wales, 2007 published by University of Southampton

This is a report of a further study by Roger Ingham, Ellie Lee, Nicole Stone and Steve Clements, about why women delay having abortions beyond the first trimester of pregnancy. Articles based on the study are published as:

‘Why do women present late for abortion’. 2010. Best Practice and Research in Clinical Obstetrics and Gynaecology 24: 479-489.

‘Reasons for second trimester abortion in England and Wales. 2008. Reproductive Health Matters 16(31 Supplement): 18-29.

Sally Sheldon

Beyond Control: Medical Power and Abortion Law. 1997. London: Pluto

Abortion is now recognised as primarily a medical issue, rather than one of political and social importance; its regulation determined by the authority of doctors and other medical professionals. In the first comprehensive historical study of the regulation of abortion, Sally Sheldon examines the causes and effects of the medicalisation of abortion, focusing on the role that law has played in this process. Sheldon traces the history of the modern law on abortion, examining regulation in Britain prior to the 1967 Abortion Act, following with a detailed study of the Act itself and the values which underpin it, and locating the British law in a comparative context. Taking a theoretical approach to the subject, Sheldon draws on the work of Foucault and on feminist theory to challenge common perceptions that the law has evolved to embrace a more permissive stance on abortion and that in so doing Britain, in particular, has now ‘solved’ the ‘abortion problem’.

This set of book chapters and papers discusses a wide range of aspects of the medicalisation of abortion:

S Sheldon and S Wilkinson. 2001. ‘Termination of Pregnancy for Reason of Foetal Disability: Are There Grounds for a Special Exception in Law? 9(2) Medical Law Review 85-109.

This paper evaluates the ethical merits of having specific provision for abortion for reason of foetal disability in the law.

S Millns and S Sheldon. 1999. ‘Delivering Democracy to Abortion Politics: Bowman v United Kingdom’ Feminist Legal Studies 7(1): 63-73.

S Millns and S Sheldon. 1998. ‘Abortion’ in Cowley, P. (ed.) Conscience and Parliament: Moral Issues in British Politics, (Ilford: Frank Cass) 6‑23.

Part of a book looking at how Parliament has traditionally voted on issues of conscience, this chapter provides a discussion of how the issues play out in the context of abortion.

S Sheldon. 1998. ‘The Abortion Act 1967: a Critical Perspective’ in Lee, E. (ed.) Abortion Law and Politics Today? Basingstoke: Macmillan, 43-58.

S Sheldon. 1997. ‘Multiple Pregnancy and Re(pro)ductive Choice’. Feminist Legal Studies 5: 99-107.

A consideration of the ethics and legality of selective reduction of multiple pregnancy, focussing on the case of Mandy Allwood.

S Sheldon. 1996. ‘”Subject Only to the Attitude of the Surgeon Concerned”: Judicial Protection of Medical Discretion’. Social and Legal Studies 5: 93-109.

A look at the UK case law around abortion, focussing on how courts have historically been very protective of medical discretion in this area.

S Sheldon. 1995. ‘Abortion Law and the Politics of Medical Control’, in Bridgeman, J. and Millns, S. (eds) Law and Body Politics: Regulating the Female Body, (Aldershot: Dartmouth Publishing Company), 105-24.

S Sheldon. 1993. ‘”Who is the Mother to Make the Judgment?”: Constructions of Woman in UK Abortion Law’, 1 Feminist Legal Studies 3-22. Reprinted in H. Barnett (1997) A Sourcebook on Feminist Jurisprudence, London: Cavendish.

An examination of the gendered assumptions that underpin the current regulation of abortion.