Two Tales of Choice: Reproductive Rights and State Control in the UK

Trigger Warning:

This article contains discussion of abortion, reproductive trauma, unsafe procedures, and medical distress. Some content may be upsetting or triggering for readers.

Spoiler Alert:

The piece includes spoilers from Women Without Kids by Ruby Warrington, Happening by Annie Ernaux, and the TV series Private Practice.

A

nyone who knows me knows I love medical dramas—or more accurately, series set in medical environments. I’m fully aware that shows like Grey’s Anatomy are far from medically accurate, but that’s never been the point for me. These shows often do something more important: they humanise ethical questions, especially when it comes to reproductive rights.

Lately, I’ve been rewatching Private Practice, the Grey’s Anatomy spin-off centered on Addison Montgomery, an OB-GYN surgeon. The show often tackles abortion—not abstractly, but intimately, including Addison’s own story. Despite being successful and secure, she once chose to have an abortion. Not because she didn’t want children, but because she didn’t want one with the wrong man.

One episode in particular stood out. At the same time, I was reading Annie Ernaux’s memoir Happening, a raw and devastating account of her illegal abortion in 1963 France. The overlap between fiction and reality—between what was dramatised in Private Practice and what Ernaux endured—was chilling.

In the episode, a woman arrives at the clinic unwell. She had sought an early abortion, but fear of clinic protestors pushed her into the hands of an unqualified doctor. When Addison performs an ultrasound, she discovers the abortion was incomplete. The woman is still pregnant—and now requires a late-term abortion.

Addison is shaken but resolute. Despite her own fertility struggles, she does not impose judgment. She prioritizes care. She reminds her team, and the audience, of a vital truth: “Why can’t she do what she wants without judgment?” Later, she says:

“It’s not enough to have opinions, because in a nation of over 300 million people, there are only 1,700 abortion providers. And I am one of them.”

It’s a line that lands even harder today, knowing what followed. Within a decade of that episode airing, Roe v. Wade would be overturned in the U.S.

While watching Private Practice, I was also immersed in real-life cases like Nicole Packer’s in the UK—charged after experiencing a 26-week miscarriage alone at home during lockdown, following an abortion that was legally initiated. Or the continued opposition faced by Poland’s newly established abortion center, where protestors gather to label women “murderers” outside clinic doors.

In a future piece, I’ll explore this further—including the UK’s recent Supreme Court ruling, the political weaponisation of “gender-critical” feminism, and the well-documented financial links between aristocratic families and anti-gender movements across Europe. As Sian Norris shows in Bodies Under Siege, this is not just about reproductive health. It’s about state power, class, control, and fear.

Right now, I can’t remain silent.

Reading these stories—fictional, autobiographical, judicial—I keep returning to one thought: opinions are not enough. The fight for reproductive rights is not a hypothetical debate. It is a daily, embodied struggle. And in this struggle, silence is complicity.

So no, it’s not enough to argue about when life begins. Because when someone dies from a back-alley abortion, the real question is: who are we trying to protect?

As I see it:
Abortion should happen as early as possible, and as late as necessary.

A Tale of Two Choices: Probes, Blue Lines, and Donna Summer

“The following persons shall be liable to both a fine and a term of imprisonment:

– Physicians performing abortive practices

– Physicians, midwives, pharmacists, and others guilty of suggesting or encouraging such practices

– Women who have aborted, whether by their own hands or with the help of others

– Those guilty of instigating abortion and spreading propaganda advocating contraception.”

The French Law 1963

This was the reality of abortion laws in France at the time. Today, Annie Ernaux is celebrated as one of the most notable writers of the 20th century and a Nobel Prize winner. But in 1963, she was just a young literature student at the University of Rouen in Normandy. Coming from a working-class background with little financial support, she found herself facing an unplanned pregnancy—an experience she documented in her memoir Happening.

At just 77 pages, I read the memoir in one sitting, completely absorbed by the relatability of Ernaux’s background and her raw, honest words. She equated her pregnancy to a form of social failure, shaped by her working-class roots. In one passage, she writes:

“My degree in literature had waived the inescapable fatality of the working class—the legacy of poverty. Sex caught up with me, and I saw the thing growing inside as the stigma of social failure.”

Discovering Ernaux’s writing has been one of the greatest privileges of my literary experience. But enough of my admiration—let’s get to the point.

Ernaux recounts her harrowing journey in attempting to terminate her pregnancy. Desperate, she visits a doctor, pleading for her period to return. He smiles and prescribes her medication—only later does she realise it was intended to prevent miscarriage rather than induce menstruation.

Her words capture the profound hopelessness she felt upon leaving his office:

“Girls like me were a waste of time for doctors. With no money and no connections… we were a constant reminder of the law that could send them to prison and close their practice for good.”

Out of options, she turns to the unthinkable—perhaps using knitting needles in a desperate attempt to end the pregnancy. The pain is excruciating, and yet she fails.

Eventually, someone agrees to help. Climbing the stairs to the apartment, fear grips her—she’s entrusting her life to a stranger. But the alternative is worse: shame, lost education, and the erasure of choice.

Back-alley abortions are grotesque because they are. Ernaux remembers the kitchen, where surgical tools boil in a saucepan. That stark, sterile smell lingers in her memory. She doesn’t call it trauma, but the way she recalls every detail says enough.

When the pain strikes—the woman between her legs, the blinding agony—she writes, “I killed my own mother inside.” It’s pain beyond words, silenced by the cold command: “Stop screaming, girl.” But how could she not?

The first procedure fails. She returns to that same apartment for a second attempt. This time, she’s no longer afraid. The probe doesn’t hurt.

Later, on a train back to university, she reads about Kosovan refugees risking everything to cross borders. She sees a parallel: “Smugglers today are hunted just like abortionists once were. But no one questions the laws that make them necessary.”

This is the truth anti-abortion laws ignore: criminalisation doesn’t end abortion—it only makes it more dangerous. Globally, 25 million people undergo unsafe abortions each year. And when the law polices bodies instead of protecting them, it creates harm (WHO 2017)

In Poland, women are dying of sepsis in hospitals, denied care under strict bans. In Texas, maternal mortality has jumped 60% since Roe was overturned. Providers delay help until patients are near death. Some don’t survive.

Ernaux’s abortion did succeed, technically—but she nearly died from a haemorrhage. A surgeon later told her: “I am no plumber.” That sentence stuck with her. It drew a brutal line—between those who hold power and those who suffer under it.

By contrast, Ruby Warrington’s abortion at age 23 was safe, legal, and uneventful. A simple clinic visit, a pill, a peaceful nap. The next day, she went dancing to “I Feel Love.” No shame. No pain. Just choice.

The gulf between their stories is vast. Reading them, I ask: what about people like me? What happens when that choice vanishes?

With Trump at the helm of a shifting global political landscape, JD Vance has called for a complete prohibition of abortion—even going so far as to criticise the UK’s legal protections for abortion access. Among his targets are buffer zones—the 150-meter protective areas around abortion clinics designed to shield patients from harassment. These zones prevent women from being subjected to graphic anti-abortion leaflets, hostile vigils, and protesters shouting “baby killer” as they seek medical care (Sherman 2025, Topping 2025)

Vance has also spread misinformation, falsely claiming that the Scottish government sends leaflets to homes near abortion clinics, warning residents that they cannot pray in their own houses—allegedly violating safe zone laws. This claim, rebuffed entirely by Scottish officials, appears to be an attempt to stoke anti-abortion rhetoric in the UK (Topping 2025).

Thankfully, nearly 90% of Britons support choice (MSI Reproductive Choices, 2023). However, the surge in Reform UK’s popularity during the recent local elections raises concerns. The party’s leader, Nigel Farage, a close ally of Trump and Vance, has advocated for parliamentary debate on rolling back the 24-week abortion time limit—potentially leading to further restrictions (Quinn 2024).

Louise McCudden, Head of External Affairs at MSI Reproductive Choices, responded to this push for debate by arguing that instead of wasting parliamentary time discussing an issue that should remain solely in the hands of those capable of pregnancy, lawmakers should focus on reforming the outdated Victorian-era abortion law, which continues to leave women vulnerable to prosecution simply for making decisions about their own bodies. A topic which I will explore in the next section (Quinn 2024).

The Enduring Legacy of the Offences Against the Person Act of 1861

The UK is widely regarded as a pro-choice country today, but that was not always the case. Throughout the 19th and 20th centuries, a series of laws were introduced to restrict access to abortion. However, as history has shown, criminalisation did not stop women from seeking abortions—many resorted to dangerous, back-alley procedures that left them with severe health complications or resulted in death.

During this period, newspapers advertised so-called “menstrual blockage” remedies—a euphemism for abortifacients that many women recognised as such (Abortion Rights- Timeline) . However, most of these substances were not only ineffective but also highly toxic. Some of the cheaper, lead-based options poisoned and even blinded those desperate enough to use them (Abortion Rights- Timeline).

Today, abortion is legal in the UK under the Abortion Act 1967, a private bill introduced by Liberal MP David Steel. The legislation permits abortion up to 24 weeks of pregnancy, with stricter regulations for later-term procedures. It also requires two doctors to certify that an abortion is in the patient’s best interests.

The Offences Against the Person Act 1861, a Victorian-era law, remains embedded in the UK’s legal framework, continuing to impact abortion access in England, Scotland, and Wales.

Under this act, self-administering an abortion or assisting one outside legal exemptions can lead to life imprisonment. This means anyone terminating a pregnancy at home—such as by purchasing pills online—could face criminal charges with severe consequences (Abortion Rights – Timeline, Bosley 2017, Creasy 2025).

Although UK abortion laws have evolved, the 1861 Act remains in force, reinforcing restrictions beyond legal exemptions. The Abortion Act 1967 introduced protections, permitting abortion up to 24 weeks, yet those who terminate a pregnancy outside these limits still risk prosecution (Abortion Rights- Timeline, Bosley 2017, Creasy 2025).

Until 2019, Northern Ireland had the UK’s strictest abortion laws, only decriminalizing the procedure after decades of advocacy. While abortion is now legal there, the 1861 law continues to apply across England, Scotland, and Wales, leaving many vulnerable to prosecution despite the protections introduced by the Abortion Act (Creasy 2025)

Legal Cases That Highlight Ongoing Criminalisation

Several recent cases underscore the continued legal risks surrounding abortion in the UK.

– Sophie Harvey, 19, was investigated by Gloucestershire Police, who requested hair testing for abortion drugs. She was accused of administering “poison” to cause a miscarriage—despite claiming the foetus was stillborn and delivered naturally. She had sought a legal abortion but, at 28 weeks pregnant, turned to ordering pills online. The foetus was delivered before the pills arrived, yet her actions still breached both the 1861 and 1961 laws (Tortoise 2024)

– A 15-year-old girl suffered a late-term miscarriage and was met with police officers at her hospital bedside. She had sought abortion advice—which she had every right to do—but was beyond the 24-week legal limit. Her laptop and phone were seized in an investigation, yet it was ultimately concluded that her miscarriage was natural (Das 2022)

– Nicola Packer’s case, previously mentioned, is another stark example of how abortion laws continue to criminalise those seeking reproductive care (BBC 2025)

Calls for Reform and Parliamentary Debate on Abortion Law

Despite its continued presence in UK law, the 1861 Act reflects a deeply outdated era—a time when women were denied reproductive autonomy and not even permitted to vote. Its lingering existence has fuelled growing calls for full decriminalisation, with campaigners arguing that abortion should be treated solely as healthcare, not as a criminal offense.

Next month, Parliament will debate the future of the 1861 law, with two key amendments to the Crime and Policing Bill aiming to protect abortion rights in England and Wales:

– NC1, a cross-party amendment tabled by Tonia Antoniazzi MP, seeks to end the criminalisation of vulnerable women. It would remove women and their pregnancies from the 1861 Act, eliminating the legal basis for their prosecution (Cosmpolitan 2025, UK Parliament 2025)

Stella Creasy, Labour MP for Walthamstow, has proposed an amendment known as NC17, which aims to reinforce existing abortion protections by:

• Restricting ministers’ ability to roll back abortion rights through delegated powers, preventing future governments from quietly eroding protections without parliamentary scrutiny.
• Preserving current abortion time limits and buffer zones, ensuring continued access to safe services.
• Enshrining safe, legal abortion as a human right, safeguarded by the Secretary of State.

Both amendments signal efforts to modernise UK abortion laws and move beyond punitive frameworks that have disproportionately harmed women.

Beyond legal battles, the current abortion landscape raises concerns about surveillance. The National Police Chiefs’ Council recently issued guidance on child death investigations, suggesting that women’s digital data—including period tracker apps—could be monitored (MSI- Reproductive Choices 2025). This heightens fears of increased surveillance on those seeking reproductive care. Many now consider returning to traditional calendar methods rather than risk their private health data being scrutinised, including myself.

These cases expose the impossibility of securing reproductive freedom within a carceral system. Most women investigated had sought abortions but were a week or two beyond the legal limit. Neither of the proposed amendments challenges the 24-week restriction, despite the fact that the original Abortion Act 1967 allowed abortion up to 28 weeks before it was reduced in 1990 . The criminalisation of reproductive healthcare is not surprising—it reflects the consequences of a system that polices women’s autonomy under laws that can be easily altered or restricted (Abortion Rights- Timeline, Bosley 2017, Creasy 2025).

A Future Defined by Policing and Gender-Based Control?

With the rise of the far-right—alongside gender-critical feminists who successfully pushed for a Supreme Court ruling that defines women solely by their “biological imperatives”—the future of reproductive rights in the UK feels increasingly uncertain.

What’s to stop the police from demanding proof of “womanhood” through invasive, humiliating means? With the 1861 Offences Against the Person Act still in place, and with abortion restrictions tightening, what prevents authorities from criminalising women suspected of having “illegal” abortions?

The answer is: nothing—because it’s already happening. We must push back against the rise of biological determinism and a state apparatus that increasingly equates womanhood with reproductive function. The recent Supreme Court ruling doesn’t exist in isolation—it’s part of a broader system of control, where gender is defined in service of state interests, not personal identity or autonomy.

Under the guise of “safety,” we are seeing the steady expansion of policing powers—but who exactly are they keeping safe? I can’t help but draw a line between the 1861 Offences Against the Person Act, the current police guidelines tracking menstrual data, and this recent legal ruling.

Take the 2014 Practice Advice on Child Death Investigation—it didn’t even mention stillbirths. The 2024 update now includes eight full pages on the subject. Is this just a coincidence? Or are we witnessing a deliberate shift: a move toward greater state and police authority over how womanhood is defined, and how people with wombs are monitored, judged, and criminalised for their choices? (BMJ 2025)

It is a grotesque reality—one where a foetus that cannot survive outside the womb is often granted more legal protection than the person carrying it. And it’s bewildering to think that police involvement is part of this process at all. Yet, it is. They can open investigations, pursue prosecutions, and treat medical decisions as potential crimes.

This lack of flexibility in legal access to abortion inevitably pushes people toward unsafe, underground options.

Take, for example, the way late-term abortions are weaponised through language—described as “partial-birth abortions” to stigmatise and delegitimise women, while erasing the real, complex circumstances behind such decisions. The story I referenced earlier—the woman who wanted an early-term abortion—illustrates this clearly, and even though is fictional, I am sure there are cases like her. From what I am witnessing in Poland where first abortion clinic is everyday haunted by pro-lifers I cannot withstand how their passions for ‘life’ is so degrading.

 She was afraid to enter the clinic because of aggressive pro-life protestors. She turned to someone unqualified who claimed the abortion was successful. It wasn’t

We can argue about why she didn’t notice her lack of periods or other symptoms. We can scrutinise her choices. And some people will. But doing so erases complexity. It reinforces a binary system of blame, rooted in the belief that law and police should control the most personal aspects of someone’s body.

Consider this: after death, a person’s organs cannot be harvested without consent. The sanctity of that decision is upheld out of respect for bodily autonomy. So why doesn’t that same principle apply to someone who is alive and does not want to carry a pregnancy?

There’s a moment in Private Practice (2011) that captures this tension. A woman, scared to go through with a late-term abortion, is guilted by a pro-life doctor who tells her, “At this stage, your baby can hear you.” When Addison, the attending OB-GYN, assures her that the choice is still hers, the woman replies: “Maybe it shouldn’t be.” Addison responds: “It has to be.”

That line haunts me. It has to be.

But looking at today’s political climate, I can’t help but ask: Have we moved forward at all—or are we slowly moving backward?

Where do we go from here? The future of reproductive rights has long been precarious, its fragility often unspoken—yet tensions surface with cases like Nicole Packer and Sophie Harvey. These moments force us to ask: Who truly holds the power over this choice? When will two tales of choice—one permitted, one denied—become a single, standardised right?