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Background: Routine ultrasound scanning to determine gestational age and pregnancy location has long been part of pre-abortion assessment in Britain, despite not being legally required or recommended in national clinical guidelines. To support implementation of fully telemedical abortion care (implemented in Britain in April 2020), the Royal College of Obstetricians and Gynaecologists (RCOG) issued clinical guidance for an 'as-indicated' approach to pre-abortion ultrasound, removing the need for a clinic visit. We aimed to understand patient experiences of ultrasound in abortion care by conducting a qualitative study with individuals who had abortions with and without an ultrasound scan. Methods: Between November 2021 and July 2022, we recruited patients who had a medical abortion at home without a pre-procedure ultrasound at 69 days' gestation or less at British Pregnancy Advisory Service (BPAS), and also had at least one other abortion with an ultrasound from any provider in Britain. We conducted interviews using a semi-structured interview guide to explore our participants' experiences and conducted reflexive thematic analysis. Results: We recruited 24 participants and included 19 interviews in our analysis. We developed three themes from our data. These were 'Ultrasound scans and their relationship with autonomy and decision-making', 'Intrusive and out of place: the ultrasound as an inappropriate technology' and 'Towards preference-centred, quality care'. Conclusions: Further research and user-testing of strategies to improve the scan experience should be undertaken. Patient testimonies on the negative impact of ultrasound scans in abortion care should reassure providers that omitting them according to patient preference is a positive step towards providing patient-centred care.

(from the Executive Summary): Reproductive coercion and abuse (RCA) occurs when power and control is exercised over the autonomous pregnancy decision-making of another. Interpersonal RCA occurs between individuals, when someone seeks to reduce another’s individual autonomy over reproductive decision-making through coercive or controlling behaviour, deception, manipulation, threats, violence, or other forms of abuse. This includes regulating everyday behaviour in relation to the prevention or promotion of pregnancy, and/or access to reproductive healthcare services. RCA can also be institutionalised through laws, regulation, policy or practices when control is exerted on a non-clinical basis. Institutional RCA involves targeting groups or individuals to accept specific reproductive healthcare interventions, withholding them, or making access to other services dependant on their use. This research aimed to investigate policy and practice in abortion, contraception, and maternity care across the UK, undertaking qualitative research with healthcare professionals and experts in interpersonal violence, and it focuses on the safeguarding needs of those at risk of pregnancy.

In the UK, the vast majority of people accept abortion, whether or not they are religious. Holding an absolutist anti-abortion view is out of line with the general population. The overwhelming majority of anti-abortion activists are motivated by conservative Christian religious beliefs, not necessarily shared by others in their faith communities. Their minority position, and ageing population, poses issues for the continuance of the anti-abortion movement, creating a need for specific anti-abortion religious socialisation that is unavailable elsewhere. Drawing on data from a longitudinal ethnographic study of anti-abortion activism, this article highlights the ways in which anti-abortion activists seek to develop anti-abortion values among primary-aged children. It illustrates their conflict between the need to develop a strong anti-abortion identity and involving children in potentially controversial discussions on abortion. We use the framework of lived religion to argue that, while much attention has been given to the concerns about children in minority religions, this has resulted in a lack of attention to the diversity of practices within mainstream religious communities, and how controversial forms of socialisation are managed.

The United Nations view access to abortion as a fundamental human right. Yet increasingly in the UK, religiously-motivated activists undertake public displays opposing abortion, often outside abortion clinics, and precipitated through international campaigns like 40 Days for Life (Lowe and Page forthcoming). Activists see their actions as an essential intervention; some explicitly frame this as a form of help. But examining this from the perspective of how bodies are gendered and regulated in the public sphere raises questions regarding whether this is a form of harassment, and therefore gendered violence. This article is based on a UK ethnography. Using Kelly’s (1988) continuum of violence thesis, we examine whether this activism constitutes gendered violence, examining two different activities – prayer and graphic images. Despite these activities being distinct and contrasting, we argue that both should be understood as part of a continuum of violence, causing harm to those seeking abortion services.

There is a long history of regarding marginalised groups as unfit to parent and of eugenic policies targeting those with ‘undesirable’ bodily conditions or behaviours. This is part of a broader pattern of stratified reproduction – structural conditions that enable or discourage certain groups from reproducing – that often brings about and exacerbates injustices. This paper critically assesses the US and UK social and medical literature on applying pressure to marginalised groups, or those who have behaved ‘irresponsibly’, to use long-acting reversible contraception (LARC). Targeting young people for LARC fails to recognise that social inequality is the context for teenage pregnancy, not the result of it. Provider pressure on women of colour to use LARC is linked to institutional racism, whilst policy for those with physical and intellectual disabilities is shaped by disability discrimination. Other groups to be targeted include so-called ‘welfare mothers’, substance users, those who have had children put into care and offenders. Particularly controversial are cases in which LARC has been ordered by courts. LARC policy incorporating these kind of discriminatory practices needs to stop; future policy should focus on person-centred care that bolsters reproductive justice.