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20 February 2020

Backlash or Widening the Gap?: Women’s Reproductive Rights in the Twenty-First Century

Faculty of Law, University of Helsinki, 00014 Helsinki, Finland
The author would like to thank Professor Margaret Thornton and two anonymous reviewers whose comments have been invaluable in the process of revising this article.
This article belongs to the Special Issue Feminist Legal Theory in the 21st Century

Abstract

This article examines legal challenges to women’s reproductive rights in Ireland and the United States, arguing that backlash against reproductive rights is a consequence of the long unsettled position of women’s reproductive freedom in liberal democracies and the catalogue of rights. It examines the legal foundations of reproductive rights and their perceived conflicts with other values, such as religion, and focuses on the current legal challenges to women’s bodily autonomy regarding choice and motherhood. It demonstrates the many contexts in which women have not acquired full reproductive freedom, and explores the nature of the current backlash. It argues that the nature of the backlash is not simply a reclamation of what has been legally guaranteed, but instead a deepening of the preexisting divides within reproductive justice globally.

1. Introduction

The topic of women’s reproductive freedom entered feminist theory discourse in the 1960s (), though arguments for women’s reproductive freedom have been historically present in discussions on women’s liberation since the mid-1800s (). Since the adoption of the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) and the subsequent upholding of the importance of women’s rights in the Beijing Platform for Action (), women’s reproductive freedom has been intrinsically linked with the notion of human rights, which have since been thought to include women’s reproductive rights ().
Women’s reproductive rights have quickly become the cornerstone of a feminist approach to human rights law and have been unequivocally supported by the vast majority of feminist legal scholars in diverse contexts (; ; ; ). It is thus with great dismay that current feminist theory approaches the rapidly evolving legal changes to women’s reproductive freedoms. Current challenges to long-fought-for legal guarantees, such as those encapsulated in the Roe v Wade1 judgment concerning access to abortion, are seen as a backlash and a fundamental turn in the approach to women’s rights. Feminists struggle to classify current developments, which are seen as the return of traditional conservative narratives (), as well as an attack on women’s rights more generally ().
In this article I will examine historical and current legal challenges to women’s reproductive rights in Europe and the United States and argue that these developments are not in fact a surprise, but rather a consequence of the long unsettled position of women’s reproductive rights in Western liberal democracies. Following and reevaluating the findings of previous work on selected aspects of this problem (; ; ; ), I assert that women’s reproductive rights have never truly found a comfortable spot in the catalogue of women’s rights, and that what is seen as a backlash is an exploitation of the ambiguous approach to women’s reproductive freedom.
I will begin by examining the history of reproductive rights and their perceived conflicts with other values, such as religion, then focus on the current legal challenges to women’s ability to decide on whether they wish to become mothers. Finally, I will demonstrate how these challenges reflect the ambivalent commitment of liberal democracies to women’s reproductive freedom. My key argument will show that in many contexts, women have never fully acquired unfettered reproductive freedom. While the perception of backlash is not entirely unfounded, the true nature of this “backlash” is not a simple taking back of what has been legally guaranteed, but instead an exploitation of vulnerabilities in the current legal systems and a deepening of the gaps in the access to reproductive justice. The article will demonstrate that much remains to be accomplished insofar as women’s access to reproductive rights globally.

2. Influences on Women’s Reproductive Rights and the Notion of Backlash

Reproductive rights have long been a subject of debate. Feminist scholars have argued that without the right to reproductive choice, all other economic or social rights have only limited power to advance the wellbeing of women (). Others have seen the focus on reproduction and motherhood more generally as a social construct reinforcing a patriarchal conception of womanhood (). While many scholars anticipated gradual advancement of reproductive rights globally (), the twenty-first century instead brought about the state of the perceived “backlash”. As I will show below, liberal democracies have not, however, been overly welcoming to the idea of women’s reproductive rights in the first place. The “backlash” we are currently experiencing is thus in my understanding not as much a simple reversal of already achieved progress, but instead an exploitation of the uncertainties regarding the state of women’s reproductive rights in Western democracies. Legal challenges exploiting these uncertainties attempt to make access to reproductive justice more difficult, and additional legislative obstacles brought by “backlash” legislation and judicial decisions impact the most vulnerable women the most (). Such changes are particularly visible in countries with strongly mobilized religious populations that are experiencing, or have previously experienced, conservative political leadership.
The nexus between conservatism, traditional religious views and reproductive rights isn’t surprising as, since reproductive rights include prevention of, assistance with, or termination of pregnancy, many see it as overlapping with the protection of the fetus (a potential life). Such protection coincides with the core beliefs of many institutionalized religions, including both Catholicism and Evangelism. As I mentioned in my earlier work (), the focus on the role of God in the process of human creation in many beliefs is a ground for the inclusion of religiously motivated views in many discussions regarding women’s reproductive rights. When religious groups take on the position of ‘defenders’ of their religious values, they present themselves as legitimate entities with an interest in taking political action (), and their beliefs are transferred from their private religious spheres into public political forces (). The process of politicization of religion favors political homogeneity over the individual religious beliefs of members of various congregations (Ibid), which often allows politicized religious beliefs to become militant in their attempts to influence women’s reproductive freedoms. While I have argued that this politicization of religious group identities in diverse societies is more perceptible in societies where religious identity is more homogenous (), the twenty-first century has challenged this assumption and brought an unprecedented return of traditional religious arguments in political discourse in many Western societies. Instead of the expected pluralization of religious discourses, the twenty-first century has shown an increased prevalence of discourse on religious values, even in relatively multicultural societies like Australia, Canada or New Zealand (; ). This has happened not only in the context of women’s rights, but also in debates on same-sex marriage, which has been perceived by religious groups as a danger to traditional family norms, just as reproductive rights have (). To be sure, the simple juxtaposition of all religious and women’s rights () has been demonstrated as lacking nuance (; ) and the construction of a conflict between the two has been more frequent in relation to minority or new religions (; ). As Bano observed, while new or minority religions have been condemned for their religious conservatism, Western liberal theory often ignores Western cultural and religious influences, framing them as neutral rather than religious (). Pigeonholing conservatism as synonymous with only some religions, in particular Islam, turned out to be overly simplistic and the twenty-first century has challenged these assumptions by reanimating the troubled relationship between traditionally dominant religions and women’s reproductive rights (; ). Once nearly forgotten as ‘neutral,’ strong religious sentiment in Western democracies has been revived and has increasingly been combined with nationalism, reinvigorating the discourse on reproducing the nation with all its gendered and cultural order (). In this era of growing far right populism and nationalism, the return of politicized religious nationalisms and their impact on women’s reproductive freedom seems to be a consequence of the frequent appeal to tradition, national values, and the merging of nationalism with traditionalist religious values. As Friedland observes in his political analysis of religious nationalisms:
Religious nationalisms are animated by family drama; they all center their fierce energies on the family, its erotic energies, its gendered order. This is because the institutional logic of religion centers on the order of creation, locating humanness in the cosmos, replicating cosmology through ritual, a practical metaphysics that necessarily points before life and death.
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As Himmelstein adds, a common theme in the religious conservatism that opposes women’s reproductive autonomy is a general opposition to the perceived excesses of freedom and autonomy, as well as the liberation from traditional roles and norms (). Elomäki and Kantola note that impact of conservatism in many countries cannot be underestimated when it comes to promoting traditional views on gender and family and increasing anti-feminist discourses (). While we attribute the adjectives ‘religious’ or ‘conservative’ to approaches to women’s rights in those religions that have seemed culturally alien (; ), the impact of our own cultural and national approaches on reproductive freedom has often remained understudied. Yet feminist scholars in Ireland, the US, and other seemingly human rights-oriented places have pointed out that the situation has always been that of a struggle (e.g., ). Many liberal democracies have struggled with securing reproductive freedom goals as well as securing reproductive justice for those who are excluded on account of race () or economic status (; ). The nature of the current backlash is a widening of the chasms between ambitious reproductive justice goals and legal reality. In the following section, I will illustrate that the perception of a Western commitment to reproductive rights is historically misleading, given that the majority of binding human rights instruments steer clear of mentioning reproductive rights altogether. Furthermore, I will focus on the current perception of said backlash and demonstrate that the nature of this backlash is complex and leads primarily to the deepening of the existing gaps. The nature of the backlash thus does not necessarily reverse what has been legally set in stone, but further widens the gap between the goals and material reality by obstructing access to reproductive health services for those women who need it the most.

3. International and Domestic Approaches to Reproductive Rights: Historical Battle for the Right to Abortion in Ireland and the United States

While many have seen reproductive rights as gradually more entrenched in law and human rights law more specifically (; ), the legal standards in this arena have been at best vague and ambiguous. Historically, the strongest legal grounds for securing international reproductive freedom are included in the Convention on the Elimination of All Forms of Discrimination Against Women (), which explicitly includes provisions on reproductive rights. CEDAW challenges traditional family patterns by introducing the legal obligation to assure equality of men and women in all aspects of life, including family planning. In Article 16, CEDAW stipulates explicitly that women ought to have not only the possibility, but also equality, in deciding on the number and spacing of their children, and in Article 10 it guarantees access to the information, education and means to enable the exercise of these rights. Yet, despite the progressiveness of CEDAW, or perhaps because of it, it quickly became the human rights convention with the highest number of reservations (). This amount of reservations is ironically the consequence of none other than the inclusion of women’s reproductive rights. Due to these reservations, the gap between the strong conceptual commitment expressed in CEDAW and its implementation remains vast in many countries across the globe.
Other international declarations and legal standards keep references to reproductive rights sparse or aspirational. The frequently cited commitments to the idea of reproductive rights reaffirmed during the world summits in Cairo in 1994 and Beijing in 1995 remain aspirational but non-binding. The goal of ‘explicit recognition and reaffirmation of the right of all women to control all aspects of their health, in particular their own fertility, is basic to their empowerment’ () remains mostly unfulfilled, with the exception of several countries, mainly in Northern Europe, that have often been seen as positive models for other places (e.g., ).
Yet, even Europe, the seemingly progressive continent with regards to women’s rights, has avoided a strong commitment to reproductive rights in EU fundamental rights or human rights (). The European Union’s most detailed document on the matter, the now aged Van Lancker report from 2002 (), considering all relevant international documents and actions on reproductive rights. In its conclusion, it admits stark discrepancies in sexual and reproductive health and rights within the EU and acknowledges the gaps between these aspirations and reality. The necessity of further commitment to reproductive rights was reaffirmed by the European Union in the European Parliament’s resolution on the status of fundamental rights in the European Union in Resolution 2007 (2145). The resolution included a mention of reproductive rights and recommended withdrawing Member States’ reservations to CEDAW as well as assuring that women can fully enjoy reproductive rights, access to contraception, and avoid high-risk illegal abortions. As far as the main human rights law legislator in the European region, the Council of Europe (COE), is concerned, the situation has not been much better. The sparse documents on the topic include soft law sources such as Resolution 1399 () and Recommendation 1675 (), concerning reproductive rights and a Report () and Resolution 1607 () on decriminalizing abortion. Similar to the EU’s reports, the COE’s documents have noted the enormous disparity of standards between Member States in matters of reproductive health. The aspirations included in the soft law have often remained unfulfilled and the most recent sources have expressed a deep concern over the appearance of multiple regressive measures in this area () on the continent.
Due to rather sparse international and regional commitment, the gap between the aspirations of giving every woman a right to decide about the spacing and number of her children and the reality has remained vast globally, including in some Western democracies. The frequently compared context of the United States and Ireland (e.g., ) shows that historically, the full recognition of women’s autonomy has been particularly problematic when it comes to abortion access. Human rights standards have not contributed much when it comes to women’s autonomy to decide about becoming mothers in either of these countries. Despite Irish ratification of CEDAW and the European Convention on Human Rights (ECHR) and regardless of the lack of the ratification of CEDAW in the US, both Ireland and the US have followed historically similar paths when it comes to regulating abortion. Starting with the initial prohibition of abortion, these countries have only recently gone in very different directions in this regard, but historically they had both experienced the influence of politicized religious arguments in abortion debates. Throughout the twentieth century, the recognition of a woman’s right to abortion has been oscillating between decisions signaling greater recognition of women’s autonomy, and subsequent legislative and judicial backlash in response.
In Ireland the historical ban on abortion was entwined with the privileging of Catholicism prior to the amendment to the Constitution in 1973 (). With the privileging of Catholic natural law’s interpretation of rights in many matters concerning sexuality and private life, it is unsurprising that abortion has always been illegal in Ireland. This illegality became strongly legally entrenched with the passing of the Eighth Amendment to the Constitution in 1983, when the life of the unborn became a right defended by the state (). Similarly, the access to safe abortion has been seen as a continuous challenge to women’s reproductive rights in the United States. As Mohr observes, abortion before quickening, or before the first foetal movement, was not uncommon in the early 1800s and abortion post-quickening was regulated by common law and treated as a criminal offence (). The first wave of anti-abortion legislation between 1821 and 1841 began when Connecticut passed a bill outlawing abortion in 1821 (). While the law was a part of a broader legal framework, it was the first measure of this kind (). Eventually, during the first and second wave of anti-abortion laws, most states followed with similar measures, albeit embodied in different types of legislation (). After the establishment of the American Medical Association (AMA) in 1847, physicians affiliated with the AMA launched ‘an aggressive campaign against abortion on the eve of the Civil War’ () led by a prominent anti-abortion crusader, Dr Horatio Storer, who promoted his father’s view that life begins at conception (). Additional support for anti-abortion legislation came from anti-vice crusaders () who ‘turned to law as part of a battle against illicit sex. In the quest to protect American youth, these activists championed laws prohibiting devices, information and preparations designed to end pregnancy.’ (). However, it was the crucial endorsement of the anti-abortion stance by the AMA that led every state to eventually ban access to abortion by the 1880s ().
Gradually, women in both countries have challenged the strict abortion bans. In Ireland, the most contentious cases found their way to the highest court and eventually brought modifications to the strict interpretation of the constitutional provision introduced by the 8th amendment. Most significantly, the X case2 of 1992 has allowed for termination in rare cases of real, imminent and substantial risk to the life of the mother, including the risk of death by ‘self-destruction’, which could be avoided by terminating the pregnancy (). Further cases such as the C case3 also gradually removed some of the restrictions of travelling for an abortion ().
Meanwhile in the US, the early twentieth century witnessed the emergence of a family planning movement and population control movements, which kept evolving slowly from the 1920s through the 1960s (). The movements argued for improved access to contraception and abortion. With the influence of the sexual revolution in the 1960s, women’s feminist movements also gained ground to gradually demand improved access to contraception and eventually to abortion (). Despite different approaches to the issue expressed firstly by population control movements and later by feminist movements, they both had had an influence on the later crystallization of the fight over access to safe abortion in the early 1970s (; ). Naturally, the postulates of pro-choice movements did not remain without opposition from pro-life movements, which mobilized strongly around that time, despite having sprung up much earlier in response to the repeal of some states’ anti-abortion laws (). After two cases concerning access to contraception (Griswold v Connecticut4, Eisenstadt v Baird5), access to abortion became a major decision before the Supreme Court in Roe v Wade in 1973. In Roe v Wade, the Supreme Court weighed the interest of protecting the fetus against a woman’s right to privacy in her decision to undergo abortion. Reaffirming the decisions regarding the right to privacy established in both Eisenstadt and Griswold, the Supreme Court decided that the right to access abortion falls under the scope of said right (; ), establishing the core of the current legal framework regulating access to abortion.
Yet as Ziegler emphasized, it would be a mistake to see Roe v Wade as a simple ‘right to abortion’ (). While it has most commonly been understood as ‘anchored to a concept of personal autonomy derived from the due process guarantee’ (), the Supreme Court justices, in their decision, made only seeking access to abortion a part of the ‘right to privacy’. While most commonly Roe has been read as protecting women’s autonomy in the decision to undergo abortion, the decision has in fact emphasized the role of a physician in the process, and made it contingent on how far along the pregnancy was (; ). Greenhouse reminds us that, “Anyone reading the majority opinion in Roe v Wade (…) will be struck by the physician-centric framework that the Court establishes for the exercise of the right to abortion that it is declaring. The decision vindicates the right of the physician to administer medical treatment according to his professional judgment,” (). Gibson adds, analyzing Justice Blackmun’s extensive emphasis on medicine:
Considering that the Court’s decision in Roe v Wade connotes, to many, a turning point in the fight for women’s equality, one might expect the Court’s narrative of advancement to focus on new thinking about the rights and autonomy of women. However, Blackmun grounds the right to reproductive choice squarely within a narrative of medical progress, suggesting that women’s reproductive freedom hinges on contemporary medical knowledge and technology.
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Others highlighted that much remained to be done to secure realistic access of women to abortion (). While without a doubt a major achievement for women, even Roe did not fully encapsulate the autonomy of a woman to decide whether to continue a pregnancy. The physician-centered wording, while to many not problematic, was laden with potential for divergent interpretations. Already, Justice Ginsburg noted in her 1985 article when commenting on legal developments following Roe that:
If the Court had acknowledged a woman’s equality aspect, not simply a patient-physician autonomy constitutional dimension to the abortion issue, a majority perhaps might have seen the public assistance cases as instances in which, borrowing a phrase from Justice Stevens, the sovereign had violated its "duty to govern impartially”.
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The fight for recognizing the analogous right to privacy in terms of access to abortion has also continued in Ireland before the European Courts—both the European Court of Human Rights (ECtHR) and the European Court of Justice (ECJ)—in the hope of securing the right to abortion as a part of the right to privacy. Despite the challenges brought by the Grogan6 and Open Door7 cases, such recognition did not follow and the judgments merely recognized the right to spread information about abortion services as a free market principle and subsequently as a part of the right to freedom of expression (; ). In both instances though, the courts abstained from interfering with the state’s general regulation of abortion and did not consider whether access to abortion was a right in itself.
The fight for and against access to abortion has not settled in either of these countries, and has instead provided a catalyst for the mobilization of both pro-choice and pro-life movements. While pro-life movements did not appear as a result of Roe, the judgment provided an impulse for their consolidation nearly immediately after the decision was handed down (). From plans for constitutional reform to arguments of judicial activism, the pro-life movement has been steadily mounting challenges to the findings of Roe using both arguments of faith () and later broader arguments, such as abortion regret interwoven into the discourse of ‘pro-woman’ concerns (), which appeared in the case of Gonzales v Carhart8. At first though, challenges included Medicaid abortion funding restrictions, beginning with the Hyde Amendment in 1976. () traced the history and impact of Medicaid restrictions, reminding us that the law prevents the use of federal Medicaid funds to pay for most abortions and allows states to impose similar funding restrictions. After a long legal battle challenging the constitutionality of the amendment, in 1980 the Supreme Court ruled in Harris v McRae9 and Williams v Zbaraz10 that the restriction was constitutional. This resulted in the majority of states restricting the use of public funding for abortion, making the right to access often abstract for those who could not afford the procedure ().
Further challenges in the US also resulted in a serious modification of Roe introduced by the Planned Parenthood v Casey11 case. As Siegel and Greenhouse highlight (), it is in fact Casey, not Roe, that currently shapes abortion access for US women. Casey, decided in 1992, upholds the central reasoning of Roe in terms of protecting privacy in personal choices such as the decision to undergo abortion. At the same time, however, it adds a stronger emphasis on the interest of the government in regulating abortion () as well as several conditions seriously impacting the understanding of women’s rights:
It [Casey] adopted instead an “undue burden” standard that permitted the state to regulate abortion to protect unborn life from the beginning of pregnancy, so long as the state protected life by means that respected women’s authority to decide whether to give birth. In so holding the Court created opportunities for opponents of abortion to enact restrictions on abortion that Roe itself never sanctioned, restrictions that were designed to transform the public’s understandings of the morality and the constitutionality of the practice.
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This modification subsequently resulted in restrictions such as those introduced in the controversial HB2 Bill introduced by Texas in 2013, which rendered abortion practically inaccessible. Section 171.0031 of the Bill required a physician performing an abortion to have active admitting privileges at a hospital located no further than 30 miles away on the day of performing or inducing the abortion, as well as for the facility to meet regulatory standards for ambulatory surgical centers (). As Goodwin demonstrated, this has translated to the existence of such areas as Rio Grande, from where there is only one eligible clinic within a 230-mile radius. This of course meant that women who could not afford abortion or afford to travel further were most impacted by the restrictions.
The legal ambivalence in terms of securing the right to abortion was also re-emphasized when it comes to Ireland in the case A. B. and C. v Ireland12 before the ECtHR in 2010. Rather than securing the right to privacy or following the COE’s earlier recommendations encouraging Member States to decriminalize abortion, the Court ruled in favor of tradition and the morality of the Irish community (). While deciding whether Article 8 was compliant with the prevention of abortion for reasons of health and well-being, the ECtHR put strong emphasis on the role of the profound moral views of the majority of the Irish people” (A.B and C v Ireland 2010, p. 126) in limiting access to abortion. It found that limitations of access dictated by the protection of the moral views of the majority constituted a legitimate aim in a democratic society () and did not violate some of the applicants’ right to privacy entrenched in the Convention.
As shown in this section, full recognition of women’s reproductive rights, including access to abortion, has never been legally settled in either of these countries. This volatile situation has had a particular effect on poorer women, for whom access to public funding or even clinics have been key issues preventing them from accessing abortion. Ross and Solinger have compellingly illustrated that reproductive injustice has particularly touched poor women, who have often been treated as undeserving of public support for their reproductive rights and been excluded from considerations when discussing abortion access restrictions (). As Aiken notes, laws restricting Roe have had damaging and cumulative effects on those who lack financial and social resources (). Borchelt further illustrated that the need of raising money is a crucial problem in access to abortion for many:
Women struggling to make ends meet who are denied abortion coverage and are also forced to confront additional costs imposed by abortion restrictions are left with few options. They may have to postpone paying for other basic needs like food, rent, heating, and utilities to save the money for an abortion. In one study, more than one-third of women who had an abortion in the second trimester stated that they would have preferred to have the procedure earlier but could not because they needed to raise money. The greater the delay in obtaining an abortion, the more expensive the procedure becomes, catching poor women in a vicious cycle.
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The examples of Ireland and the United States show that even Western democracies that otherwise seem to be leaders on an international human rights stage have historically struggled with the recognition of women’s rights to make autonomous decisions regarding the ‘spacing and number of their children’. This has been particularly strongly visible in cases concerning access to abortion. Slow gains in abortion access have been fought-for for decades, while continuous challenges to these legal gains have created multiple legal barriers preventing women from accessing abortion. Despite the perceived commitment to rights, the examples of Ireland and the United States show that women’s access to reproductive rights has hardly been legally set in stone. Thus, the perception of a backlash as a simple abandonment of progress oversimplifies the years of struggles which women have been experiencing in those countries.

5. Conclusions

As illustrated, women’s reproductive freedoms have always been subject to their fragile position among the broader rights catalogue. Despite their inclusion in CEDAW, their legal position has always oscillated between soft law, temporary legal gains, and subsequent challenges and setbacks. While the perception of “backlash” is not entirely unfounded, this backlash should be understood in a nuanced way—namely as the strengthened ability of narratives of politicized religion and the reproduction of nationhood to impact access to reproductive rights negatively—rather than as a radical departure from legal standards set in stone. These narratives signify no improvement to women’s bodily autonomy and have been actively mounting legal challenges to reproductive freedoms for decades. The return of these narratives signifies the potential broadening of barriers in access to reproductive rights, which are most likely to affect poorer women and women from otherwise marginalized backgrounds. Women have struggled with reproductive rights constraints across the globe, with smaller or greater success, and have faced multiple challenges in that area, both before and after the adoption of reproductive rights in human rights law. While wealthier women will continue to access these services in a worst case scenario by continuing to contribute to reproductive tourism, poor and marginalized women will be left at the mercy of the only accessible abortion clinic, or the availability of a doctor who recognizes the freedom of reproductive choice. The backlash against women’s reproductive rights in the twenty-first century thus moves us further from the goal of achieving universal reproductive justice.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

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