The Ethics of State Involvement in Women’s Health

5 April 2010, 1646 EDT

I have been fortunate to be a part of a number of interesting conversations over the last few weeks, and am currently attending the conference linked above, hosted by the Levan Institute for Humanities and Ethics, the University of Southern California Global Health Institute, and the Center for International Studies at the University of Southern California. Conversations are centering around global norms and international agreements on women’s health, health aid, human trafficking, economic empowerment, violence and war, and medicine distribution. These conversations are extremely interesting to me, and just outside of my research agenda enough that I’m learning a lot without having preconceived notions of what I should be thinking on particular topics.

When I was invited to be a part of this conference, I decided to revive my interest in legal research and discrimination law, and pair that with my interest in gender in global politics. My presentation discussed the differential impacts of different grounds on which abortion is legalized in providing the expected women’s health benefits from legalization. A couple of themes in my paper have come up in other panels, and lead me to be more generally interested in researching the role of taboo in the protection of rights and the provision of goods and services to women. I’ll provide a skeleton of what I’m thinking about …


When abortion is illegal, illegal abortions take place frequently. The complication rate for illegal abortions is much higher than for legal abortion, where fully 1% of people who have illegal abortions die from complications and almost 5% have permanent health complications, while legal abortion is actually less likely to cause fatalities than childbirth. Worldwide, almost 80000 women die every year from complications from illegal abortions, and abortion-related deaths drop around 90% in the first five years of legality.
Fully half of abortions that take place every year are illegal and most of those take place places where abortion is illegal.

I couldn’t help but wonder if there is more to it. While legalizing abortions is necessary to decreasing the death rate from unsafe abortions, it is not sufficient. Particularly, I approached it by thinking about the grounds on which abortion is legalized.

Whether abortion is made legal by a court case (as in the United States) or by legislative process, a “grounds” on which abortion is legal almost always accompanies the jurisprudence or legislation. For example, in the United States, privacy is the grounds for abortion legality. Other places, involuntariness of the pregnancy, out-of-wedlock pregnancy, “maternal” health, and other grounds maintain the general taboo against abortion but make exceptions for certain circumstances understood as extreme. Other grounds for the legality of abortion eschew the taboo, characterizing abortion as generally acceptable behavior rather than acceptable only in extreme circumstances. These grounds include women’s rights and women’s labor arguments.

It is easy to say that the grounds don’t matter, abortion is legal or it is not. But practically, that’s not true at the most basic level because the grounds impact to whom abortions are available and when. Still, the grounds also affect availability in other ways …both in terms of the ease of obtaining abortions and the permissiveness (or lack thereof) of social norms and social culture surrounding the obtaining of abortions.

In theory, the “taboo-maintaining” grounds for legalizing abortion relegate women’s abortions specifically and their bodies generally to the private sphere of social and political life, a reification of the personal/political divide that feminists have always found both insidious and materially harmful to women. The division of the political and social world into ‘public’ and ‘private’ marginalizes those interests which are in private places, like inside the home, or inside their bodies. When issues fall on the “private” side of the public/private dichotomy, they are considered rights of individual bodies, which are often negative rights and even more often subject to situational enforcement.

On the other hand, grounds for the legality of abortion that remove it from the private sphere argue that it is a gender-based right, either in terms of equal protection of the laws or in terms of inequities in labor performed or the labor market. In countries where these are the grounds, the interconnections in women’s inequality between forced sex, economic deprivation, and reproduction are recognized as a matter of law.

In the early results of my study on these issues, controlling for poverty and the degree of abortion legality, the grounds on which abortion is legal are a significant predictor of the marginal effects of legality on women’s health as a result of abortion – abortions are safer places where the grounds lift the abortion taboo in addition to legalizing abortion. This is significant at the .001 level in a number of different coding variations.

The question of the “abortion taboo” has come up elsewhere today, and I have spent most of the morning thinking about the potentially fruitful relationship between feminist theorizing in IR/comparative politics and the study of (sexual and gendered) stigma and taboo in IR. What are the functional impacts of taboos? How are they gender-differential? And is a taboo a norm like we talk about in the literature on norms, norm diffusion, and norm entrepreneurs in IR? Or do we need some other framework through which to evaluate the idea of a stigma or taboo and its influence in global political and social relations?