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Population and Development Review
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The Transnational Politics
of Abortion
BARBARA B. CRANE
241
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242 TRANSNATIONAL POLITICS OF ABORTION
tiple sources, including doctors concerned with mortality and morbidity from
septic abortions; family planning professionals who believe abortion should
be available both for health reasons and as a backup to contraceptive fail-
ure; women seeking to increase access to abortion as a reproductive right;
and religious groups seeking to maintain or impose limits on what they
regard as a criminal act.
In addition to these domestic pressures, as in other areas of public policy
in developing countries, decisionmaking concerning abortion is strongly af-
fected by external influences. Some of these influences are the result of the
natural diffusion of ideas through education and, more immediately, through
mass media reports on abortion-policy developments in industrialized coun-
tries. But more and more, the activities of organized groups based in the
West, as well as the official foreign aid policies of the governments of the
United States and European countries, are also contributing to the
politicization of abortion in the developing world. Until the Clinton admin-
istration took office in January 1993, the US government officially opposed
abortion "as a method of family planning," and directed its funds for over-
seas private family planning agencies only to those not involved in per-
forming or "promoting" abortion (Blane and Friedman, 1990: 2). Other do-
nor governments and agencies, in contrast, have supported abortion-related
research, training, and technology.3 At the same time, nongovernmental
actors-associations affiliated with religions, family planning agencies,
women's rights groups, and medical organizations-with vastly divergent
perspectives are organizing actively with their counterparts in developing
countries to influence relevant global deliberations and national policies.4
The purpose of this chapter is to examine more closely the changing
global political environment of abortion. What is the history of global de-
liberations on abortion issues? What has been the impact of US govern-
ment policy? Who are the major actors currently seeking to influence na-
tional and international policies, and what are their objectives? What are
their strengths and weaknesses? The chapter concludes with an overview
of the conditions that are likely to affect the future prospects for expanding
access to abortion.
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BARBARA B. CRANE 243
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244 TRANSNATIONAL POLITICS OF ABORTION
delegates removed the adjective "illegal" from the original draft, which re-
directed the meaning of the statement to imply that legal abortions are as
much a potential source of suffering as illegal abortions. Based primarily
on the Mexico City recommendations, the Governing Council of the United
Nations Population Fund (UNFPA) affirmed as policy in 1985 that the fund
would not provide assistance for abortion services "as a method of family
planning"6 (UNFPA, 1990).
From 1985 to 1991, no significant change occurred in the way abor-
tion was treated in statements issued by intergovernmental forums-or even
by less formal gatherings involving intergovernmental organizations. An
international conference on safe motherhood in 1987 issued a call to ac-
tion that identified the problem of unsafe abortion but made no direct rec-
ommendation that safe abortion services be made more available (Dixon-
Mueller, 1990). In 1990, an expert meeting on the theme "from abortion
to contraception" was cosponsored by UNFPA, the World Health Organiza-
tion (WHO), and the International Planned Parenthood Federation (IPPF)
in Tbilisi, in the former Soviet Union. UNFPA discouraged dissemination of
the proceedings and the final declaration of the meeting, which called for
safe abortion services.7
The political climate had the effect of making not just UNFPA, but
other international organizations involved in family planning such as WHO,
the World Bank, and IPPF extremely cautious in their approach to abortion
questions. WHO, because of its medical orientation, was protected from some
of the pressure felt by other agencies and, through its Human Reproduc-
tion Research Programme, was able to support research during the 1980s
on new methods of inducing early abortion (WHO, 1978 and 1990).8 In
1989, WHO also issued a call for research proposals on "the determinants
and consequences of induced abortion." Yet WHO leaders avoided speak-
ing out on the question of access to abortion services.
The World Bank provided loans for constructing health facilities in
which abortions could be performed, but largely refrained from addressing
abortion policies in the wide-ranging "sector" reports in which it reviews
national health and demographic situations.
Because IPPF is a private voluntary organization, its secretary-gen-
eral, Dr. Halfdan Mahler, could confront antiabortion activism in public state-
ments more freely than could officials of other international agencies. Yet
IPPF's efforts to expand access to abortion were constrained until recently
by opposition from some of its national affiliates and by the heavy reliance
of the federation and its affiliates on donor-government funding.9 The or-
ganization was led from within to adopt in late 1992 the explicit goal of
increasing access to safe, legal abortion (IPPF, 1993). IPPF is now expected
to lay important groundwork for changes in norms and policies interna-
tionally and within countries where its affiliates are active. Additional ex-
pert meetings sponsored by UN agencies during 1992 in preparation for the
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BARBARA B. CRANE 245
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246 TRANSNATIONAL POLITICS OF ABORTION
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BARBARA B. CRANE 247
Antiabortion groups
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248 TRANSNATIONAL POLITICS OF ABORTION
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BARBARA B. CRANE 249
Prochoice groups
Population and family planning donor agencies Most of the major private
organizations involved in international family planning have been reluc-
tant to fill the gap left by USAID.21 For those organizations with demographic
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250 TRANSNATIONAL POLITICS OF ABORTION
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BARBARA B. CRANE 251
tiatives with private funds, although they were conscious of potential re-
percussions on their contracts with the US government.
After RU 486 began to be distributed in 1988, family planning special-
ists had hopes that it would transform the policy debate and would lessen
the need for expensive clinical services.27 These hopes have diminished as
it became apparent that close medical supervision is necessary for RU 486
to be used safely and effectively and that further research is required to
determine whether the drug would provide a safer and more accessible op-
tion than vacuum aspiration for women in developing countries (WHO,
1990). In developing countries, promoting abortion-related research has
been easier than finding support for expanding services. After losing its US
government funding, the international arm of the Planned Parenthood Fed-
eration of America decided to increase its role in abortion services, but found
that resources were difficult to obtain; private foundations are often reluc-
tant to fund services in general, particularly those involving abortion.28 While
some support for international abortion services in developing countries
can be obtained from private sources, significant expansion depends on fund-
ing from donor or developing country governments.
Even family planning agencies that are willing to conduct research
and to provide training and services have been reluctant to attempt to in-
fluence national abortion laws and regulations. Agencies disagree about how
much effort to devote to policy changes and what strategies to pursue. Some
believe that emphasis should remain on expanding services within the
boundaries of existing policies.29 This view is consistent with the belief that
focusing on services allows the agency to avoid direct confrontation with
policymakers and with organized opposition while it paves the way for fu-
ture policy change. Other agencies, such as IPAS, prefer to focus on admin-
istrative regulations and practices that can affect access to abortion; they
work for incremental and de facto policy change without creating opportu-
nity for divisive public debate.30 Still others, including Catholics for a Free
Choice (CFFC), avoid becoming involved in abortion services or adminis-
trative issues and seek instead to shape public discourse and thereby the
broader policy environment of abortion.3' Some prochoice groups in devel-
oping countries, including Brazil, also emphasize the need to change offi-
cial attitudes and policies, believing that without public funding, removing
restrictive laws or ending their enforcement would have limited impact on
poor women's access to abortion.32
The ambivalence of family planning agencies concerning abortion and
differences within and among them about how best to proceed have made
them slow in forming a strong and visible coalition to promote access to
abortion. The antagonisms persist, as well, between some family planning
groups and their potential coalition partners: women's rights advocates and
members of the medical community.
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252 TRANSNATIONAL POLITICS OF ABORTION
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BARBARA B. CRANE 253
tive services for women regardless of age or marital status, and abortion
services. Emphasis on this approach is often believed to provide a justifica-
tion that will be more widely acceptable politically for expanding abortion
access. To the extent that this approach ties abortion services to a particular
model of women's reproductive health care, however, and skirts the ques-
tion of what legal restrictions may be placed on abortion, it may not satisfy
those who feel access to safe abortion needs to be established in the public
mind as a woman's right.
Regardless of what approach they take, both local and transnational
women's groups are relatively weak. The women whose reproductive health
needs are greatest are also those most difficult to organize politically and
least likely to be able to lead and sustain effective efforts to influence policy.
The impact of women's health groups in supporting access to abortion is,
therefore, most likely to be felt if they can combine their efforts with those
of other organized prochoice groups. The challenge for women's groups
concerned with reproductive rights and health, however, is to find allies
who are willing to be as outspoken as they are.
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254 TRANSNATIONAL POLITICS OF ABORTION
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BARBARA B. CRANE 255
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256 TRANSNATIONAL POLITICS OF ABORTION
Notes
The author thanks the Ford Foundation and tiality of some individuals cited concerning
the Harvard School of Public Health for gen- this sensitive subject has been respected by
erously supporting most of the research on using their organizational affiliations rather
which this article is based. The assistance of than their names. Finally, the author is most
those individuals involved in abortion issues grateful for the helpful comments received on
who participated in interviews and shared rel- earlier versions of the article from Lincoln
evant documents is especially appreciated. Chen, Henry David, Ruth Dixon-Mueller,
Much of this article relies on the understand- Adrienne Germain, Charles Keely, Frances
ing they have given the author, even where Kissling, Michael Reich, Deborah Rogow, and
no specific citations are provided. Confiden- Joseph Speidel.
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BARBARA B. CRANE 257
2 Confirmation of this point comes from short of providing complete protection against
unwanted pregnancy, access to safe, modern
the author's interviews with knowledgeable
abortion techniques should also be offered
observers, unpublished trip reports and pro-
fessional conference presentations, and such wherever laws permit" (UNFPA et al., 1981: 35).
periodical publications as Abortion Research 8 During the 1970s, WHO convened ex-
Notes (David, 1984-92) and the newsletters pert groups on abortion and provided some
of the Women's Global Network for Repro- assistance for abortion training (WHO, 1978).
ductive Rights (1985-92). For further back-
9 Interview with Allan Rosenfield, Dean,
ground on Brazil, Nigeria, and the Philippines,
Columbia University School of Public Health,
see the chapter by Dixon-Mueller and
New York, November 1989.
Germain in this volume.
10 Interview with Joseph Speidel, former
3 Reports from informed observers in in-
USAID official and president of the Population
terviews with the author suggest, however,
Crisis Committee, Washington, DC, April
that the only bilateral donors involved in cau-
1991.
tiously supporting abortion-related activities
1 1 The New York Times, 9 March 1990.
are the governments of Finland, Great Brit-
ain, the Netherlands, and Sweden. No other
FPIA is administered by the Planned Parent-
hood Federation of America.
donor followed the US lead in withholding
funds from organizations involved in abortion 12 A study commissioned by USAID of
with private resources, although Canada and projects it supported in six ccruntries found
Germany have specified that their contribu- that most were not significantly affected by
tions to the International Planned Parenthood the policy; but in some of them, "project man-
Federation cannot be used for abortion agement have reacted to Mexico City policy
activities. requirements by approaching the abortion
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258 TRANSNATIONAL POLITICS OF ABORTION
question with an overcautiousness that ex- early abortion under limited circumstances,
tends to activities clearly permitted under the and some treat abortion as a personal moral
policy" (Blane and Friedman, 1990: vi). See decision that may be justified under many cir-
also Camp, 1987. cumstances (Maguire, 1986).
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BARBARA B. CRANE 259
and, according to family planning specialists, mental sessions signed a declaration calling for
do not provide a desirable model for devel- access to family planning, including abortion.
oping countries. Turkey, which in 1983 35 Some national and international orga-
adopted a new law to make abortion avail- nizations of antiabortion physicians exist, but
able on request in the first trimester, may pro- they tend to be overshadowed by other groups.
vide a further test of what happens when con-
36 The New York Times, 29 October 1988.
traception and abortion services are expanded
simultaneously (Leonard, 1989). 37 According to one observer, "The abor-
tion clinic in American society sets itself apart
27 Interview with Marie Bass, Reproduc-
from obstetrical delivery and care, and OB/
tive Health Technology Project, Washington,
GYN's have found numerous ways to keep
DC, December 1990.
abortion practice isolated from obstetric prac-
28 Interviews with staff members of tice" (Imber, 1986: 9).
Family Planning International Assistance,
38 Interviews with Barbara Radford, Ex-
January and November 1990.
ecutive Director, National Abortion Federa-
29 Interview with Jeannie Rosoff, Presi- tion, Washington, DC, December 1990 and
dent, Alan Guttmacher Institute, Washington, Warren Hern, Director, Boulder Abortion
DC, January 1991. Clinic, Washington, DC, March 1991.
30 Interview with Judith Senderowitz, 39 Interview with Allan Rosenfield,
IPAS board member, Washington, DC, Feb- Dean, Columbia University School of Public
ruary 1991. Health, New York, November 1989.
31 Interview with Frances Kissling, Presi- 40 Interview with Barbara Radford, Ex-
dent, Catholics for a Free Choice, Washing- ecutive Director, National Abortion Federa-
ton, DC, December 1990. CFFC, which is tion, Washington, DC, December 1990.
based in Washington, has been active in Latin
41 Interview with Jeannie Rosoff, Presi-
America and has an office in Uruguay.
dent, Alan Guttmacher Institute, Washington,
32 Interview with Carmen Barroso, DC, January 1991.
former President, Committee on Reproduc-
42 In comparative studies of Western coun-
tive Rights, Brazilian Ministry of Health, Bos-
tries, survey researchers have found that the rise
ton, November 1989.
of a distinct set of "postmaterialist" values is as-
33 A few women's groups opposed to sociated with much more permissive attitudes
abortion exist, although in general antiabor- concerning abortion (Inglehart, 1990).
tion women advance their cause as members
43 A thoughtful discussion of these issues
of organizations led primarily by men.
is contained in a presentation to the 1990 an-
34 Interview with Norma Swenson, Bos-
nual meeting of the National Abortion Federa-
ton Women's Health Book Collective, Boston, tion by Frances Kissling, President, Catholics
December 1989. A total of 167 women from
for a Free Choice (Kissling, 1990).
43 countries attending concurrent nongovern-
References
Ashworth, Georgina. 1982. "The United Nations Women's Conference and international link-
ages in the women's movement," in Pressure Groups in the Global System: The Transnational
Relations of Issue-Oriented Non-Governmental Organizations, ed. Peter Willetts. London:
Frances Pinter.
Benshoof, Janet. 1987. "The establishment clause and government-funded natural family
planning programs: Is the constitution dancing to a new rhythm?" Journal of Interna-
tional Law and Politics 20, 1: 1-33.
Blane, John, and Matthew Friedman. 1990. "Mexico City Policy Implementation Study," Popu-
lation Technical Assistance Project Occasional Paper No. 5, Washington, DC.
Boserup, Ester. 1970. Woman 's Role in Economic Development. London: Allen and Unwin.
This content downloaded from 131.104.97.86 on Tue, 22 Aug 2017 14:43:57 UTC
All use subject to http://about.jstor.org/terms
260 TRANSNATIONAL POLITICS OF ABORTION
This content downloaded from 131.104.97.86 on Tue, 22 Aug 2017 14:43:57 UTC
All use subject to http://about.jstor.org/terms
BARBARA 1. CRANE 261
Inglehart, Ronald. 1990. Culture Shift in Advanced Industrial Society. Princeton: Princeton Uni-
versity Press.
International Planned Parenthood Federation (IPPF). 1993. Planned Parenthood Challenges: Un-
safe Abortion. London: IPPF.
Jacobson, Harold K. 1984. Networks of Interdependence: International Organizations and the Globa
Political System. New York: Alfred A. Knopf.
Keohane, Robert O., and Joseph S. Nye, Jr. (eds.). 1971. Transnational Relations and World
Politics. Cambridge, MA: Harvard University Press.
Kissling, Frances. 1990. "Ending the abortion war: A modest proposal," in Reaching Out: Speaking
for Abortion in the '90s. Washington, DC: National Abortion Federation.
Laufe, Leonard. 1979. "Menstrual regulation-international perspectives," in Zatuchni et al.,
1979.
Lee, Luke T., and John M. Paxman. 1975. "Legal aspects of menstrual regulation: Some pre-
liminary observations," Journal of Family Law 14, 2: 181-221.
Leonard, Ann, et al. 1989. 'Turkey's liberalized abortion law: A policy response to illicit abor-
tion practices," paper presented to the Annual Meeting of the American Public Health
Association, Chicago, Illinois, October.
Luker, Kristin. 1984. Abortion and the Politics of Motherhood. Berkeley: University of California
Press.
Maguire, Marjorie R. 1986. "Pluralism on abortion in the theological community: The con-
troversy continues," Conscience 7, 1: 1-10.
Mastroianni, Luigi, Jr., et al. (eds.). 1990. Developing New Contraceptives: Obstacles and Opportu-
nities. Washington, DC: National Academy Press.
The New York Times. 1988. 29 October.
The New York Times. 1989. 26 March; 12 August.
The New York Times. 1990. 9 March; 8 November.
Oakley, Deborah. 1975. Memorandum to the World Federation of Public Health Organiza-
tions and attached "Observations on population politics at the International Confer-
ence on Women, Mexico City, June 1975." Ann Arbor: University of Michigan, unpub-
lished.
Paige, Connie. 1983. The Right to Lifers. New York: Summit Books.
Petchesky, Rosalind P. 1984. Abortion and Woman's Choice: The State, Sexuality and Reproductive
Freedom. New York: Longman.
Pope Paul VI. 1968. Humanae Vitae. Boston: Daughters of St. Paul.
Requena, M. 1970. "Abortion in Latin America," in Abortion in a Changing World, ed. R. E.
Hall. vol. I. New York: Columbia University Press, pp. 338-352.
Rosenfield, Allan, et al. (eds.). 1989. "Women's health in the Third World: The impact of
unwanted pregnancy," International Journal of Gynaecology and Obstetrics Supplement 3:
Schattschneider, E. E. 1960. The Semi-Sovereign People. New York: Holt, Rinehart and Win-
ston.
Symonds, Richard and Michael Carder. 1973. The United Nations and the Population Question,
1945-1970. New York: McGraw-Hill.
Trueman, Patrick. 1980. "A warning to Latin America," in The Dignity of Man and Creative
Love: Selected Papers from the Congress for the Family of the Americas, Guatemala, July 1980,
eds. Joseph Santamaria, Pedro Richards, and William Gibbons. New Haven: Knights of
Columbus.
United Nations. 1975. "World Population Plan of Action," Population and Development Review
1, 1: 163-181.
. 1984. "Recommendations for the further implementation of the World Population
Plan of Action," Population and Development Review 10, 4: 758-782.
United Nations Fund for Population Activities (UNFPA), the International Planned Parent-
hood Federation, and the Population Council. 1981. Family Planning in the 1980's: Chal-
lenges and Opportunities. New York: UNFPA.
This content downloaded from 131.104.97.86 on Tue, 22 Aug 2017 14:43:57 UTC
All use subject to http://about.jstor.org/terms
262 TRANSNATIONAL POLITICS OF ABORTION
. 1990. "Relevant facts about the United Nations Population Fund (UNFPA)." New
York: UNFPA.
United States. 1984. "US policy statement for the International Conference on Population,"
Population and Development Review 10, 3: 574-579.
Warwick, Donald. 1980. "Foreign aid for abortion," in Abortion Parley, ed. James T. Burtchaell.
Mission, KS: Andrews and McMeel.
. 1982. Bitter Pills: Population Policies and Their Implementation in Eight Developing Coun-
tries. Cambridge: Cambridge University Press.
Women's Global Network for Reproductive Rights (WGNRR). 1985-92. Newsletters.
Amsterdam.
World Health Organization (WHO). 1978. Induced Abortion: Report of a WHO Scientific Group.
WHO Technical Reports Series No. 623. Geneva: WHO.
. 1989. Newsletter on the WHO-HRP research initiative on the determinants and con-
sequences of induced abortion. Geneva: WHO.
. 1990. "WHO statement on RU486." Geneva: WHO Division of Public Information
and Public Relations.
. 1991. From Abortion to Contraception: Report of the Tbilisi Expert Meeting. Geneva: WHO.
Zatuchni, Gerald I., et al. (eds.). 1979. Pregnancy Termination: Procedures, Safety, and New Devel-
opments. Hagerstown, MD: Harper and Row.
This content downloaded from 131.104.97.86 on Tue, 22 Aug 2017 14:43:57 UTC
All use subject to http://about.jstor.org/terms