Colin Francome, Abortion in the USA and the UK, Aldershot and Burlington, 2004, 180 pages, 0-7546-3015-3

Reviewed by Dr Gayle Davis

There has been a general global trend of liberalization in the laws restricting abortion over the past four decades. Abortion has been legal in Britain since 1967, through David Steel’s Abortion Act, and in America since 1973, through the Supreme Court decision in the case of Roe v. Wade. The sexual politics and legislative developments surrounding abortion have, in recent years, attracted increasing attention from historians, sociologists and political scientists. Following the 2004 film about the back-street abortionist, Vera Drake, and recent political developments on both sides of the Atlantic attempting to limit access to abortion, this book is especially timely in reminding us of both the efforts women have gone to in order to avoid unwanted pregnancies, and the gains we have accrued from the legalization of abortion.

Over the last three decades, Professor Colin Francome has extensively researched aspects of abortion from a sociological perspective. Abortion in the USA and the UK chronicles the different routes taken by both countries to legalize abortion, addressing historical, socio-political and legal aspects of this most emotive and contentious element of women’s reproductive health. This comparative political history of the fight for and against liberalization examines the contribution of various groups to the debate over fertility control, set within its historical context of the major social changes and economic prosperity which the 1960s and 70s ushered in, followed by the economic and political backlash of the 1980s.Francome looks at the experiences of both countries before, during and after the legalization of abortion although, oddly, in reverse chronological order. After a useful introduction which surveys the major perspectives and the general social forces involved, he discusses the experience of legal abortion, principally relating those agencies which perform abortion, describing how the procedure is performed, and reviewing statistics. He then turns to the events leading to, and factors involved in, legalization in both countries. The author finally discusses the period when abortion was illegal and argues that, despite the risks to health and the costs involved, abortions were nevertheless prevalent, and the illegal abortionist a valued member of the community.

The book has largely separate chapters on the UK and USA, although in fact it is rather more comparative than that structure would suggest. We learn, thus, that America has a much more liberal abortion law than Britain and a higher abortion rate, perhaps since it allows abortion on request whereas British law requires medical permission, even in the early months of pregnancy. There is also a higher political profile for the issue in the USA, including a significantly higher degree of abortion-related violence, which Francome argues stems from the fact that such permissive legislation is ‘out of step’ with attitudes in much of (Conservative) America (p.167). Also different has been the attitude of the medical profession, more supportive in the USA, and the role of the women’s movement, much more active and militant in America. Similarities between the countries include the gradual liberalization of broader sexual attitudes, and a related growth in the availability of contraception. This comparative element is particularly instructive in providing a fresh perspective to the historiography of abortion.

However, I do have a few reservations about the book. While it provides a most useful broad sweep of this subject from the early nineteenth century right up to the present, it often lacks finer detail. For example, while the lay reader will appreciate the most useful potted history of events leading to legalization, historians will find the material to be rather flimsy in places, often lacking appropriate footnotes, elaboration of detail, or a clear evidence base. The stories of individual women and their experiences are not always well integrated into the narrative flow (see, for example, pp.50-1). The argument is also disjointed in places, not helped by the backward chronology. Indeed, chapter 7 on the politics of legal abortion ends with a section on ‘the future’, followed by two chapters on ‘when abortion was illegal’. Finally, the conclusion of individual chapters is either watery, unrelated to the paragraphs before, or non-existent; and there is no overall conclusion to the book either – simply a few pages of discussion on ‘future developments’. It would have been nice to see the ends more neatly tied up for the reader, and useful for Francome’s overall findings to be stressed clearly.

Nonetheless, this is an interesting and wide-ranging book, a most useful introduction to the history of abortion politics on both sides of the Atlantic. Just don’t expect an objective account. Right at the outset, the foreword sets the tone, written by Frances Kissling, director of one of the first clinics to provide abortion services in the state of New York. Francome then takes the pro-choice stance that abortions ‘cannot be legislated out of existence’ and ends the book with the sentence that women need to be given ‘the freedom to choose and to provide the education that enables them to make informed decisions’ (p.170). He is obviously alarmed by possible future restrictions to abortion provision in the USA, presenting a strong case for the gains which have accrued from legalization, and making a case for the law to become more liberal in the UK, where women are still dependent upon the opinion of two doctors.

Dr Gayle Davis

Centre for the History of Medicine

University of Glasgow