11 September 2018

Terminations, Privacy and Protests

'Knowledge of current abortion law and views on abortion law reform: a community survey of NSW residents' by Alexandra L. Barratt,  Kevin McGeechan,  Kirsten I. Black,  Julie Hamblin and  Caroline de Costa in (2018) Australian and New Zealand Journal of Public Health reports results of a community survey of 1,015 NSW residents’ knowledge of current abortion law and views on abortion law reform.
Some seventy‐six per cent of respondents were unaware that abortion remains a criminal offence in the Crimes Act 1900 (NSW) and 73% thought it should be decriminalised and regulated as a healthcare service. Support for decriminalisation was consistent across genders, age groups, residents of metropolitan/regional and rural areas and levels of education. Support was strong for women seeking abortion to be protected from harassment (89%) and for protester exclusion zones around clinics (81%), with support for these measures significantly stronger among regional/rural residents than Sydney‐based respondents.
 The authors conclude
Abortion law in NSW is out of step with contemporary community views. Residents are largely unaware that it remains a criminal offence and, when informed, support decriminalisation. There is strong support for legal changes to protect women from harassment and to provide protester exclusion zones around abortion clinics.
The authors state
Women's access to abortion is regulated according to different legislation in each Australian state and territory.  In most states and territories, criminal laws have been reformed to provide statutory explanations of the circumstances in which abortion is legal. In the Australian Capital Territory (ACT) only, abortion has been removed completely from criminal law and is managed under health‐related laws. In New South Wales (NSW) and Queensland (QLD), however, the legal situation remains ambiguous and unlawful abortion remains a crime in both states. 
In NSW, unlawful abortion is a criminal offence for a woman and for her doctor (or person administering the intervention) and is punishable by up to 10 years jail (Crimes Act 1900 [NSW] Part 3 Division 12). Subsequently, case law has established that abortion is lawful in NSW if the doctor has an honest opinion that continuing the pregnancy would be seriously harmful to the health of the woman.1 This test of lawfulness remains the basis on which abortion may be provided in NSW. Several efforts over time to remove abortion from criminal legislation have been unsuccessful, leaving NSW and Queensland as the only states where abortion law is still ultimately based on 19th century English law. The English law on which the provisions in relation to abortion were originally based, (Offences Against the Person Act), dates from 1861; similar provisions were removed from English law in 1967. 
Against this background, Dr Mehreen Faruqi (a member of NSW Parliament for the Greens NSW party) introduced a Bill to the NSW parliament to reform abortion law. The Bill contained three main provisions. Firstly, it removed abortion from the Crimes Act 1900, as had been done previously in the ACT. Secondly, it provided for protester exclusion zones near abortion clinics so that women attending clinics would be protected from harassment by anti‐abortion protesters. Lastly, it required medical practitioners holding conscientious objections to give women information about their options for managing unplanned pregnancy, including referrals to practitioners or clinics where abortion is available, if desired. The Bill was debated but defeated in May 2017 by 25 votes to 14, despite endorsements of support from medical practitioners, public health professionals, nurses, lawyers and other community groups. 
Previously, a community survey had been conducted in 2015 to inform the development of the Bill, and to ensure that the new legislation would reflect current community sentiment. The survey is significant as it is the first survey of NSW residents’ knowledge of abortion law in their state and the first to canvass community views on abortion law reform. Our aim in this paper is to report the methods and full results of the survey, and provide a detailed analysis of the results. Although previous surveys have measured support for legal access to abortion, information about the NSW community's knowledge of the law, as it stands currently in their state, and the community's views towards various options for abortion law reform were unknown prior to this survey. 
They go on to comment A total of 1,015 NSW residents completed the survey: 431 men and 584 women, across age ranges from 18 to 65+ years (Table 1). Due to the sampling methodology, we were unable to estimate the response rate. Instead, we compared the sample characteristics with those of the general adult population of NSW in Census data (Table 1). The majority of respondents were living in the Sydney metropolitan area, with 41% (unweighted percentage) living in regional cities or rural areas of NSW. About 60% were married or living with a partner. In these characteristics, the sample was similar to the NSW population as described in Census data. However, the sample was more highly educated than the overall NSW population. Forty per cent of participants reported identifying with a particular religious belief. 
Most respondents (73%) thought abortion should be decriminalised and regulated as a healthcare service, with 13% of respondents opposed to decriminalisation and 14% uncertain (Table 2). Support for decriminalisation was consistent across men and women and all age groups, with older citizens – especially older men – strongly supporting decriminalisation (see Supplementary File 2 – Supplementary Table). Support for decriminalisation was also consistent across all levels of educational attainment, with no significant differences by education (P=0.565). There was weak evidence that support for decriminalisation may be higher among regional and rural residents (77%) than among Sydney residents (71% support, P=0.068), see Table 3) 
Most respondents (78%) thought there should be a legal responsibility for medical practitioners, regardless of their personal views, to provide referrals and objective information on options for unplanned pregnancy (Table 2). Views were divided as to whether medical practitioners should have the right to refuse an abortion if they hold a conscientious objection (50% thought they should have this right, and 36% thought they should not, with 13% undecided). 
There was a strong majority view (89% agreed or strongly agreed) that women seeking abortion should be protected from harassment or any form of threatening behaviour. Consistent with this, 80% supported the establishment of protester exclusion zones around abortion clinics (Table 2). 
In general, knowledge of the legal status of abortion, support for decriminalisation and support for protecting women were significantly higher among regional and rural respondents (Table 3). For example, 93% of regional and rural residents (vs. 87% Sydney residents) agreed that women seeking abortion should be protected (P=0.0021), and 86% (vs. 79% in Sydney, P=0.018) supported exclusion zones around abortion clinics. Support for these measures did not vary by level of educational attainment (data not shown). 
Overall, 47% of respondents reported that they knew someone who had had an abortion, 56% of women and 38% of men. More regional/rural residents reported knowing someone who had had an abortion (53% regional/rural vs. 46% Sydney residents, P=0.030). Consistent with previous surveys, 58% of respondents thought women should be able to obtain an abortion readily and 29% that abortion should be allowed in some circumstances, and few respondents (5.6%) thought abortion should not be allowed in any circumstances.
They note
We found three‐quarters of respondents in this survey were unaware that abortion is currently listed as a criminal offence in NSW legislation under the NSW Crimes Act, an Act that has been in force in NSW since 1900. Once informed, there was strong support for decriminalisation, with approximately three‐quarters of respondents stating that abortion should be decriminalised and regulated as a healthcare service. Majority support for decriminalisation was consistent across men and women and all age groups and was supported by more regional/rural residents than Sydney residents. There was a strong majority view (89%) that women seeking abortion should be protected from harassment or any form of threatening behaviour. Consistent with this, 80% supported the establishment of protester exclusion zones around abortion clinics. Almost half the respondents (47%) reported they knew someone who had had an abortion. Of note, more regional and rural residents knew someone who had had an abortion, thought abortion should be decriminalised and thought women seeking abortion should be protected from harassment. Abortion clinics in some rural centres, notably Albury on the border of NSW and Victoria, are subject to strong protester activity. This presents an impediment to access and engenders feelings of stigma and intimidation among women attending the facilities. These barriers may explain why there was stronger support for decriminalisation in regional and rural respondents in NSW.  .... 
NSW and Queensland remain the only Australian states that still retain criminal offences for abortion dating from the 19th century. In Queensland, decriminalisation and law reform is under active consideration; whereas, in NSW there are no current plans towards decriminalisation. It is unclear why the NSW parliament is so out of step with community opinion and with legal changes in other Australian jurisdictions. One reason may be the existence of strong, socially conservative factions in each of the two major political parties in the NSW parliament, with the result that NSW abortion law reform has lacked an effective champion. This, together with the influence of socially conservative minor parties, appears to have prevented legislative change longer in NSW than in other Australian jurisdictions. In Queensland, there has also been little political support for abortion law reform in the past. However, the issue is currently being considered by the Queensland Law Reform Commission, and it is possible that any recommendations made by the Law Reform Commission will form the basis of legislation to decriminalise abortion in Queensland. 
For NSW women, accessing abortion is likely to remain challenging, especially for those in regional and rural areas. Despite hope that PBS subsidisation of medical abortion would make abortion much more accessible, uptake of medical abortion is still relatively low and the majority of women choose surgical abortion. Surgical abortion, however, remains mainly limited to large metropolitan centres where abortion is provided through a number of clinics that operate as fee‐for‐service clinics, as most public hospitals do not provide abortion in NSW. This situation results in the capacity to pay limiting access for some women, especially rural residents. In a recent study of Australian women having an abortion, 25% of women reported travelling more than one hour to have it and an additional 11% reported having to stay overnight. Median out‐of‐pocket costs were $470, even with the Medicare rebate. Costs were higher for abortions performed after 13 weeks, and for women who had to travel more than four hours. A total of 34% of women said they found it difficult/very difficult to pay for the abortion. Women who experienced difficulties paying for the abortion were more likely to present for later abortion, suggesting that access remains a barrier to timely abortion provision. 
Finally, unlike other women in Australia, NSW women remain unable to make their own decision about whether or not to have an abortion and remain reliant on doctors to make this judgement for them, raising questions about the adequacy of women's autonomy and reproductive rights.
'Anti-Abortion Protest and the Effectiveness of Victoria’s Safe Access Zones: An Analysis' by Ronli Sifris and Tania Penovic in (2018) 44(2) Monash University Law Review 317 comments
 This article is concerned with conduct which is aimed at averting women from terminating a problem pregnancy and takes place around clinics that provide abortion services. Such conduct is widely referred to by the seemingly benign term of ‘protest’ but in fact encompasses a range of harmful activities targeted at individuals seeking access to premises at which abortions are provided. We examine the impact of this conduct and the operation of laws which seek to address it. Legislation providing for safe access zones around clinics which provide abortion services has been introduced in five Australian jurisdictions. After outlining the safe access zone legislation enacted in Australia, we examine the operation of the Victorian legislation with reference to qualitative empirical research that we have undertaken. Drawing on the observations of the health professionals we have interviewed, we consider the context in which the Victorian legislation was introduced, including the experience of protest outside the Fertility Control Clinic (‘FCC’) in East Melbourne. The impact of anti-abortion protest outside clinics is then considered in conjunction with the objectives of Victoria’s safe access zone legislation and an examination of whether these objectives are being met. The final portion of our article examines objections to safe access zones. Those who oppose safe access zones have characterised them as an infringement of their rights. The right to free speech is the most frequently cited basis for their resistance to these provisions. We therefore consider whether the legislation is vulnerable to challenge on constitutional or human rights grounds. We analyse whether the legislation infringes the freedom of political communication implied in the Australian Constitution and conclude by examining the compatibility of safe access zones with the protesters’ rights under international human rights law.
‘Anti-Abortion Clinic Activism, Civil Inattention and the Problem of Gendered Harassment’ by Pam Lowe and Graeme Hayes in 53(2) 2019 Sociology 330-346 comments
In the UK, there is evidence of a recent increase in anti-abortion activism outside clinics. In response, abortion service providers have called for the introduction of ‘buffer’ zones to protect women from ‘harassment’ while accessing abortion services. Drawing on two datasets – extensive ethnographic fieldwork, and a content analysis of clinic client comment forms – we deploy Goffman’s concept of ‘civil inattention’ to further our understanding of the material practice of anti-abortion clinic activism. We find that although anti-abortion activists understand their own actions to be supportive, practices of religious observance outside clinics inescapably draw attention to the site and to the act of accessing healthcare, inherently challenging normative expectations of privacy and confidentiality. Our analysis suggests that anti-abortion activism outside clinics consequently violates social rules governing encounters with strangers in specific places and reinforces gendered hierarchies. As such, they are often experienced as acts of gendered harassment. 
In mainland Britain, abortion clinics have recently become highly visible sites for the making of public claims over the terms of the provision of reproductive rights, as a series of anti-abortion groups have begun to stage actions directly outside clinics. In the North American context, where anti-abortion actions outside clinics have been recurrent since the mid-1980s, there is now considerable research on the claims-making tactics of anti-abortion groups. Perhaps most prominently, scholars have focused on the different framings of anti-abortion discourse, including moves in the US from ‘foetal personhood’ frames (e.g. Petchesky, 1987) towards a ‘woman’s health’ frame (e.g. Saurette and Gordon, 2015). The instrumental use of foetal imagery by anti-abortion groups has often provided a point of departure (Jasper, 1997; Rohlinger and Klein, 2012). Equally, scholars have analysed processes of recruitment and organisational growth in the US anti-abortion movement (Haugeberg, 2017; Munson, 2008), and the development of litigation strategies and free speech advocacy by conservative activists in clinic disputes (Lewis, 2017; Wilson, 2013). 
Yet we know relatively little about the material and situational practices of anti-abortion clinic activism, or – from a micro-sociological perspective – how these specific practices shape the experiences of women seeking to terminate a pregnancy. Here, we explore the relationship between the staging of anti-abortion activism outside clinics and the experiences of women accessing abortion services. We do so in mainland UK,1 where academic discussion of anti-abortion activism is noticeably thin, where there has been an increase in anti-abortion activism and where abortion service providers and rights campaigners have consequently called for the introduction of ‘buffer’, or exclusion, zones around clinics, in order to combat what they see as the harassment of clinic clients by these groups. Our focus is on ‘public witness’ forms of anti-abortion activism, acts of presence and of looking. Developing Goffman’s (1963) understanding of the social rules of public conduct, we argue that as anti-abortion activism at clinics is structured around the potential production of ‘face engagements’ in public space, it has significant implications for the definition and reproduction of the social norms which underpin the availability of these engagements, and thus for the delimitation and operation of gendered hierarchies of power. 
We propose two key advances in the understanding of anti-abortion activism. First, through our ethnographic observation of anti-abortion activism and analysis of comment forms completed by abortion clinic clients, we bring into tension two original datasets, enabling us to capture the dominant practice of activism outside abortion clinics in Britain. Most significantly, our data enable us to capture the relationship between these practices and the experiences of women forced to negotiate them. Second, in response to our data, we argue that clinic activism is experienced by women as intrusive through the condition of its presence, precisely because it subjects them to a critical unwanted scrutiny similar to other unwanted street encounters. Combining a Goffmanian approach with attention to the power relations that structure the use of public spaces thus enables us to draw out the inherently stigmatising structure of anti-abortion activism outside clinics, even where these actions are apparently designed to be non-aggressive. 
In what follows, we first set out the British context of abortion, and of anti-abortion activism, before discussing questions of stigmatisation and, drawing on Goffman and Gardner in particular, civil inattention and gender. We then elaborate our research design and methods, before presenting and analysing our data from observational fieldwork and clinic client comment forms. We conclude by situating abortion clinic activism within broader understandings of gendered harassment and civil inattention.