Fiona Bloomer

Until 2019, abortion was illegal, with little exception, on both parts of the island of Ireland with the laws dating from the Offences Against the Person Act (1861) , a vestige of British colonial law. However, in each country, very different approaches changed the law. In the Republic of Ireland, the process involved a Citizens Assembly, a government committee and a referendum of all citizens. In Northern Ireland, as the Northern Ireland Assembly was suspended, the UK government, based in Westminster, introduced new legislation. This study explores how these different processes impacted on how abortion seekers feel about their capacity to access abortion care; being a citizen and how this relates to their sense of belonging in each country, what we are calling reproductive citizenship. We are interested in how legalising abortion on the island of Ireland matters for people's sense of citizenship. Specifically, we are asking how the local availability of abortion matters to abortion seekers sense of belonging and how this shapes their understanding of citizenship. This article sketches out our conceptual framework for Reproductive Citizenship, expanding upon Bryan Turner's initial formulation of reproductive citizenship to encompass abortion.

Liberal abortion laws are crucial to the freedom of reproductive decision-making. However, even in countries like Iceland, which have high levels of gender equality and liberal abortion policies, women often feel constrained by socio-political rhetoric and traditional attitudes about motherhood. This paper examines the association between reproductive choice and potential regret in motherhood. Through in-depth interviews with 35 individuals in Iceland who can bear children, we investigate the tension between the decision not to have an abortion and feelings of regret about motherhood. Using thematic analysis, we explore three main themes relating to abortion attitudes: legitimacy and morality, the weight of responsibility, and the social and personal constraints to reproductive autonomy. The participants’ personal narratives reveal how socio-political discourses and attitudes surrounding abortion complicate the process of reproductive decision-making. The results suggest that the complexity arises when women struggle with the decision to end a pregnancy, feeling they have no real choice without a legitimate justification for having an abortion. These experiences can serve to minimize the negative discourse and social stigmas that are commonly associated with abortion in the public discourse. The findings can assist clinical, medical, and social welfare professionals by fostering a deeper understanding of the importance of reproductive autonomy and support in reproductive decision-making processes.

Incarcerated women are confined in institutions designed to punish. These sites often ignore the complex mental and physical health needs of people who are incarcerated. Despite the World Health Organization stressing the need for access to reproductive healthcare in carceral institutions, stigma surrounding abortion care and health inequalities create contextually specific issues for incarcerated people seeking to access these services. There is also a dearth of research conducted directly with incarcerated women, trans men and non-binary people to examine their experiences of abortion. A systematic review of international peer-reviewed and grey literature was completed to summarise existing evidence from research conducted on the experiences of needing abortion care whilst incarcerated. Various experiences were identified including: conditions of confinement shaping abortion decisions; bureaucratic obstacles to accessing abortion services; incarcerated women, carceral staff and carceral healthcare staff's lack of understanding of abortion rights and procedures; and a scarcity of support and empathy, including experiences of stigmatisation and lack of confidentiality. There exists a significant gap in research examining the experiences of incarcerated people who may need an abortion, emphasising the need for international collaboration and advocacy to address systemic issues that extend beyond local contexts.

Abortion was decriminalised in Northern Ireland in October 2019. Following decriminalisation, the new regulations set out legal provision for abortion up until 12 weeks, with conditions thereafter. This cross-sectional descriptive survey, conducted in late 2019 in Northern Ireland, gathered the views of health professionals on decriminalisation, and their willingness to provide abortion services. This article provides a thematic analysis of answers to narrative questions from the online survey, and identifies priority areas of engagement with healthcare professionals. We assess how healthcare professional roles and responsibilities, abortion procedures, the foetus, and women and pregnant people were discursively constructed by respondents who are willing or unwilling to provide abortion services in Northern Ireland. We identify a narrow understanding of 'harm', and gendered norms of women as irresponsible or duplicitous, as inhibitory factors to the normalisation of abortion services in Northern Ireland.

Objective To explore experiences of pain in the context of early medical abortion (EMA) in the UK and to guide best practice around anticipatory guidance on pain. Methods From late 2020 to early 2021, we recruited individuals from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and data were analysed thematically using NVivo 12 software. Results Focused coding and thematic analysis addressed accounts of pain, which were prominent in many interviews. We constructed the following subthemes: expected pain is manageable for some; the problem with unexpected pain; pain (co)produces fear; and problematising ‘period-like pain’. The key issue which our analysis draws out is that while EMA pain experience might vary, for some it may be much worse than anticipated. Moreover, the common trope of likening it to ‘period pain’ can be misleading and a source of additional uncertainty at a potentially already challenging time. Conclusions For some individuals, pain experienced in EMA will be severe and/or worse than expected. Insufficient preparation for pain can result in extremely negative experiences of EMA. Alongside development of improved analgesia, improvements should be made to anticipatory guidance on pain, particularly for those self-manging EMA at home. Framings of ‘period-like pain’ do not clarify expectations and should be avoided.

Medication abortion has been established globally as safe and effective. This modality has increased accessibility and the opportunity to centre individual autonomy at the heart of abortion care, by facilitating self-managed abortion. Previous research has shown how self-managed abortion is beneficial in myriad settings ranging from problematic to (relatively) unproblematic contexts of access. In this paper we explore the relationship between self-management and sources of support (including health professionals, family, and friends); as well as considering issues of reproductive control and autonomy. Drawing on qualitative, experience-centred interviews, we utilise the concept of social connectedness to examine how supported self-managed abortion was experienced in the United Kingdom during the COVID-19 pandemic. Overall, self-management was welcomed, with participants speaking positively about managing their own abortion at home. However, a sense of connectedness was crucial in helping participants deal with difficult experiences; and functioned to support individual autonomy in self-care. This paper is the first to examine factors of connection, support, and isolation, as experienced by those undergoing self-managed abortion in the UK in detail. Our research suggests a continued need to advocate for high quality support for self-managed abortion, as well as for choice of abortion method, to support patient-centered care.

We have noticed that hegemonic public and academic discourses often present the liberalization of abortion laws as the end of a struggle. Indeed, Northern Ireland may be showcased as a success stor...