New worldwide research project will challenge law on self-managed abortions

Since the 1980’s, people have used medicines to terminate their pregnancies outside of formal healthcare settings. But in recent years, the practice of using at-home medications for self-abortion without the involvement of a clinician has become headline news.

Last year, a woman in the UK was jailed for taking a pill she ordered online beyond the legally-permitted 10-week gestational limit, while there are many other recent examples of women being similarly prosecuted around the world.

Dr Lucia Berro Pizzarossa has been awarded one of 15 British Academy International Fellowship Awards to examine this very issue at the University of Birmingham. Her three-year project will see her gathering first-hand evidence in Ecuador, Poland and Canada, as well as the UK, as she pursues this work in Birmingham Law School.

“My research will be a mix of interviews with doctors, policy-makers and activists doing community provision of abortions and legal analysis on how the law around self-abortions is constructed on the ground and how these practices are changing the ways we abortion,” says Dr Berro Pizzarossa, who aims to publish four articles and a book on her findings.

“The current law still imagines abortion is a service provided by a doctor in a clinic, but activists are ‘demedicalising’ and changing the way we see abortion,” she says. “Why is there a legal difference between doctors sending a pill in the post and an activist? The World Health Organisation says abortions with medicines are safe and don’t require medical supervision but the laws haven’t caught up.”

Indeed, the UK’s Court of Appeal has called the Abortion Act 1967 “cruel and antiquated”, and campaigners and legal experts are concerned at the increasing number of women being prosecuted over abortion. Such prosecutions are still rare but there is evidence that police investigations into such offences are on the rise.

Accusations of aiding and abetting an illegal procedure, using noxious substances, possession of medicines without authorisation, and even abuse of a corpse have all been made in various cases.

“All these laws don’t make sense or marry up systemically,” she says. “We need laws that are science, evidence and human rights-based.”

As an affiliated researcher with the Global Health and Rights Project at Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Dr Berro Pizzarossa will also be collaborating with a group of leading academics dedicated to advancing research on sexual and reproductive rights.

“I’m trying to understand how self-managed abortion fundamentally challenges paradigmatic approaches to abortion law and regulation,” she says. “We trust people to self-manage other health issues – why not this?”