Abstract
This essay argues that abortion, as a practice and a political cause, challenges traditional and hegemonic health frameworks and contributes to the development of a feminist approach to health. The essay focuses on experiences and activism for legal abortion in contemporary Argentina, drawing some examples from other contexts. First, it argues that abortion reveals the extent to which health and sickness are entangled with symbolic and localized processes, including marked stigma, which influence the lived experience of health care. The essay analyzes how feminist activism in Argentina gradually changed these processes. Second, it contends that abortion as a health practice contributes to the deconstruction of traditional dichotomies between prevention and intervention and health and sickness, as well as to modifying hierarchical decision-making mechanisms. In the Argentine case, ensuring abortion access in public health institutions, with the help of activist professionals, allowed for the broadening of biomedical frameworks and a move toward more holistic approaches. Third, the essay analyzes how increasing access to medication abortion challenged monopolistic and exclusionary processes in the production and institutionalization of legitimate knowledge about health.
Argentina achieved an anticipated legalization of abortion in 2020 after a long struggle whose origins date back to the return to democracy in the 1980s. There, as in other countries, the discursive repertoires used to demand legal abortion neither were nor are monolithic, and they have been continuously changing and converging.
The Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito (National Campaign for the Right to Legal, Safe, and Free Abortion; hereafter, the Campaign) is a collective of organizations and activists from across a broad political spectrum focused on the goal of obtaining legalization through political and parliamentary lobbying while also seeking to build a greater social consensus. The Campaign's launch in 2005 was a milestone in Argentina's abortion rights movement. Since its beginnings, the Campaign made clear that its primary position in public debate would be that the right to abortion is a human rights, public health, and social justice issue. Its first proposed law demanded the recognition of sexual and reproductive rights as “basic rights belonging to all people,” highlighting “the integrity, interdependence, and indivisibility of human rights.”1 Beyond its reference to the recognition and integrity of women's citizenship, this argument holds a local political significance because it responds to the history of human rights violations in the context of state terrorism in Argentina and to the resonance of this discourse in the country's political and activist history.2 Since its beginnings, the Campaign also emphasized that the criminalization of abortion entails unnecessary risks to people's health and lives. Its first proposed law maintained that complications from abortion were the primary cause of maternal mortality3 in the country. This public health focus allowed the Campaign not only to obtain increased support from people working in the medical field but also to progressively institutionalize public policies for access to safe abortion, as we will see.4
The Campaign also advocated for the legalization of abortion as a social justice issue. Because clandestine abortion disproportionately put at risk women and people who are poorer and who have less access to material and symbolic resources in a Latin American context of urgent social inequality, legalizing abortion would allow for the reduction of these disparities.5
With these three arguments as a foundation, the Campaign sought to highlight undeniable facts, invoking the legitimacy conferred by medical discourse (the main successful argument that had led to legalization in Uruguay),6 focusing effectively on women from underserved sectors (a discourse that had prevailed in countries like France during its legalization process),7 and noting the weight that the term human rights retains in a country like Argentina.8
The Campaign's foundational arguments remain largely influential among feminist movements for legal abortion, but these movements’ repertoires for demanding legalization and discourses in favor of abortion have been diversified and made more complex, both in Argentina and elsewhere in the region, as well as on an international level. The argument focused on public health in particular has been sharpened as new actors have joined the discussion and feminist movements have grown and acquired an unprecedented legitimacy.
In Uruguay, advocacy for legal abortion as a public health issue laid the groundwork for obtaining legalization in 2012—earlier than in other countries in the region. But the result was a law that was paternalist in its approach (due to the limited alternatives at that time). The Uruguayan law of Voluntary Termination of Pregnancy (IVE) diminishes the autonomy and decision-making ability of pregnant people, imposing requirements that can restrict access.9 In this way, it marks a shift in the state's supervisory authority, which moves from repressive surveillance to medical surveillance of women's health due to the strong influence of the biomedical approach.10 In the first decades after legalization, something similar occurred in countries like France: a medicalization of abortion with the extramedical objective of giving medical staff control over elements associated with (non)reproduction.11
In Argentina, on the other hand, the different forms that the debates took and the differences in the historical moment and timing allowed the country, unlike these others, to enact a law with a feminist perspective. Before legalization, abortion was permitted when the pregnancy resulted from rape or put the person's health or life at risk. After the IVE law was introduced in Argentina, women and other pregnant people were given access to abortion until the fourteenth week of pregnancy without any requirement beyond signing informed consent. After this gestational state, access to abortion is regulated by the Legal Termination of Pregnancy (ILE) for the reasons previously considered not punishable. Specific protective measures are also established for the rights of children, adolescents, and people with disabilities, as well as guidelines for technical quality and comprehensive care; conscientious objection and other potential unjustified delays are regulated as well.12 I consider the law to be characterized by a feminist approach to health because it centers on people's autonomy and decision-making capacity rather than on the health system or health professionals. However, I will not focus here on the law but rather on the processes and discursive frameworks that allowed it to be passed, through the tensions, disputes, and consensuses that developed within the broader movement that advocated for it.
I use the term feminist health for epistemological and political reasons. This concept allows me to condense many proposals and contributions that I have carried out alongside colleagues and allies who are activists, researchers, and educators working at the intersection of feminisms, sexualities, health, and human rights. Together with Sandra Fernández Vázquez and Florencia Maffeo, I propose thinking of feminist health as a theoretical and practical framework that takes into account the trajectories and experiences of different feminist and LGBT+ health movements to establish an alternative, critical, intersectional, and holistic health model based on the voices and experiences of people and social groups.13 This model is born from the activisms of identity-based groups—women, lesbians, gay men, and bisexual, intersex, and trans people, among others—who have been historically excluded from and systematically violated and pathologized by health institutions. We consider the abortion rights movements in Argentina and in other countries to have contributed to building a feminist model of health. I would like to return to some of these reflections but also to go beyond abortion as a political and historical demand to reflect on abortion as a health issue, on a social and symbolic level, and as a practice that can undermine the traditional power hierarchy in “doctor-patient” relations. Just as feminist theory has contributed to and is inseparable from the development of activist movements, the inverse also occurs: feminist movements, actions, and practices generate theory.
In particular, I contend that abortion rights movements and abortion as a social practice within a given sociohistorical context can contribute to and generate theory, especially to support the development of a feminist approach to health. This focus should be understood as both theoretical and practical, as a praxis, because it concerns changes in action, relational proposals, and interventions in and from institutions, agendas, organizations, and legislation, all inseparable from theoretical discourses and perspectives. I will focus primarily on Argentina, drawing on examples from other countries, keeping in mind that the Argentine case is an echo and a part of regional and transnational processes.
First, I propose that abortion highlights how health and sickness are intertwined with symbolic processes, imbued with social meanings, including forms of stigma, which vary in different time periods and contexts. In Argentina, networks providing abortion accompaniment have reappropriated and inverted this stigma, changing connotations that remain in dispute. Second, I maintain that abortion as a medical practice contributes to breaking the dichotomies of health and sickness and sickness and intervention and to challenging the traditional decision-making process that occurs between doctors and patients. In Argentina, activist professionals ensuring access to abortion in public health institutions have favored more just and egalitarian models of care in ways that go beyond the practice of IVE. Third, I analyze how movements for medication abortion have contributed to changing hierarchical and exclusionary processes in the construction of biomedical knowledge. For these reasons, I argue that abortion and the struggles surrounding it advance the construction of feminist and LGBT+ health on a theoretical and practical level.
1. Other Stories of Abortion
Experiences with abortion make clear that there is no division between health and its social meaning. Rather, all experiences of health and sickness are constituted and shaped by social representations. Nayla Vacarezza and July Chaneton analyze how abortion in the context of legal restriction in Argentina in the early twenty-first century was characterized by secrecy, not only because economic, social, and symbolic resources were necessary to obtain it but also because, even having them, the experience of abortion was marked by silence and illegality.14 Affecting the rules of the game, criminalization has biopolitical effects. Although the personal yet also sociocultural and historical experience of abortion is a form of escape, of resistance, and of overcoming criminalization's aim to dominate the individual, the rules succeed in establishing the conditions: a clandestine abortion is done in secret, in hiding, with potential feelings of guilt, self-blame, uncertainty, and anguish for having exposed one's own body to dangerous and unknown conditions.15
But the condemnation of abortion does not prevail only in cases of legal criminalization. French sociologist Luc Boltanski describes how, in contexts in which abortion is allowed within certain stages or for certain reasons, as in France, it is tolerated in practice but repressed in discourse, an act before which one must “close one's eyes.” It is not possible to legitimize nor eliminate it; therefore, it is “forbidden”: “It is forbidden in practice, and, if it is practiced, it is forbidden to be made public, to grant it a representation, or even to think of it.”16 When abortion remains in the sphere of secrecy and concealment, despite being a legal and to some extent legitimate practice, many still experience it as something morally reprehensible.
In a study carried out in France in the early twenty-first century, almost thirty years after legalization, two French researchers found that women who had undergone legal abortions felt a strong moral culpability and experienced it as something that had happened to them because they had failed to avoid pregnancy. The women's narratives referred to a “contraceptive norm” that no longer established the obligation to choose between continuing a pregnancy or exposing oneself to serious risks but rather the imperative to avoid an unplanned pregnancy at all costs and not have to resort to abortion. Abortion was therefore experienced as a failure, a shortcoming, and a product of one's own negligence. Within this framework, women alone appear to possess the final responsibility of avoiding an unplanned pregnancy at all costs, without taking into account the potential ambiguities, mistakes, and omissions, both on their part and on that of medical technologies, that occur in all realms of life, particularly in the realm of sexuality.17 On a social level, to decide to have an abortion was thus doubly reproachable: first, for breaking with the mandate of motherhood; second, for not being responsible enough to avoid a pregnancy they already knew they did not want.
The stigma of abortion is negatively attributed to those who decide to terminate a pregnancy because they challenge what is socially and culturally considered to be the “natural essence” of “being a woman.”18 Far from being a universal truth, this stigma is locally constructed and reproduced, acquiring specific connotations in each location and historical moment,19 and within each particular context or social group. Although feminist and LGBT+ movements have played a central role in the transformation of the stigma surrounding abortion, they are not entirely distanced from it, either.
In Argentina, the Campaign has advocated for “sexual education to decide, contraceptives to not abort, and abortion to not die” since 2005. This triple slogan sought to respond to arguments from conservative sectors that claimed to solve the problem by supporting strategies that they themselves obstructed (access to sexual education and contraceptives). As feminists, we aimed to express precisely that our cause was holistic and that we demanded a spectrum of rights. However, as the demand for legal, safe, and free abortion became integrated into the feminist agenda and the broader social and political sphere, some sectors of feminism questioned this slogan: we pointed out that suggesting that abortion was to be avoided at all costs and practiced only as a last resort could give rise to a new normativity. Furthermore, “legal abortion to not die” implied that the risk of death was the most important reason to legalize abortion, and it characterized abortion as a primarily clandestine practice.
Although the slogan lingered and took central stage in 2018 when debates about abortion became popularized in the country,20 alternative slogans had begun to circulate alongside alternative narratives years before, in the early 2010s. As Donna Haraway states,21 we need to tell ourselves different stories because they allow us to envision new scenarios and possible futures. In this case, narratives about abortion began to change as people's experiences changed in tandem with feminist activism for medication abortion and vice versa.
Since the commercialization of misoprostol, a pharmaceutical intended for at-home, self-managed abortion during instances in which individuals do not also have access to mifepristone, spaces and networks of abortion accompaniment were launched in countries such as Argentina, Chile, and Ecuador, among others.22 In Argentina, Lesbianas y Feministas por la Descriminalización del Aborto (Lesbians and Feminists for the Decriminalization of Abortion), created in 2009, was the pioneering organization, followed by Socorristas en Red (feministas que abortamos) (Network of Rescuers [Feminists Who Have Abortions]), a network of organizations that accompanied abortions in various parts of the country.23 The accompaniment is carried out by trained activists using official resources, aiming not only to offer reliable information to people getting abortions but also to support them throughout the process.24 Before legalization, accompaniment sought to anticipate the reality that we aimed to construct as activists, one in which abortion was just another form of health care not only because it was safe but also because it was performed within a framework of listening, support, and dialogue, free from value judgments. Activists aimed to transform a supposedly private issue into a political and collective one. At the same time, they sought to transform a generally medicalized practice into an experience of care, primarily shared and performed among women and lesbians.25
These initiatives operated on a symbolic level in at least two senses: on the one hand, through an explicit aim to reverse the stigma surrounding abortion, and on the other, changing the experience of abortion led to changes in what was known, said, and thought about the practice. The Socorristas en Red took the slogan “Feminists Who Have Abortions” to invert and reclaim the stigma historically placed on someone who has an abortion (the “abortera”), while Lesbians and Feminists for the Decriminalization of Abortion repurposed the discourse of lesbian pride to propose “taking abortion out of the closet.” These initiatives fostered a heretical discourse, in Bourdieu's sense of the term, that sought to denounce a tacit contract of adhesion to the established order and offer an alternative worldview.26
Furthermore, more dangerous and invasive methods of abortion were increasingly replaced by the use of medication, accompanied by networks of feminists and of committed health professionals.27 In turn, this produced a simultaneity of discourses and realities in which stigma, silencing, and fear still weighed heavily on the one hand, while on the other, it became easier to speak out to deconstruct stigma and foster a new consciousness.28 According to Julia Burton, abortion accompanied by feminists can bring individuals relief not only in the sense of freeing themselves from something that imprisons them and granting them a new opportunity to do what they had planned to do but also because it challenges the silence to which this experience had been confined and therefore allows individuals to situate themselves in a new enunciative place. The experience of abortion can be understood as a choice and a lived experience that generates happiness and joy because it allows for a reinstatement of one's own desire based on a reclamation and affirmation of the self in the face of strong social impositions.29
In tandem with these processes, abortion as a morally charged health practice allows us to visualize the extent to which all processes of health and sickness are inextricable from social connotations, in particular processes of (non)reproduction by women and other people with the capacity to become pregnant. In this manner, it calls our attention to how questions of health, assumed to be “natural” under the current hegemonic medical model,30 are not so in reality. These symbolic elements also come into play within health institutions and within the complex relationships between “doctors” and “patients.”
2. Subverting Obsolete Hierarchies
During twentieth-century capitalist modernity, the hegemonic medical model was instituted as the dominant form of medical care. This model was characterized by anthropologist Eduardo Menéndez as biologistic, ahistorical, and individualizing, among other attributes, as it did not take into account how subjective and social factors intervene in people's health.31 Moreover, it involves both a high degree of medicalization and unequal power dynamics between doctors and patients.32 Doctors apprehend these modes of socialization and relationality during their education and institutional training and then reproduce them in a manner they perceive as natural because they take for granted the hierarchies of their own field, which they internalize as habitus.33 Within the “authoritarian medical habitus,” low-income women patients are conceived of as objects of medical care and as “passive recipients of services”34 rather than as subjects with rights. This habitus is expressed paradigmatically within public gynecology and obstetrics health services in Latin America through violent treatment practices that range from neglecting to provide patients with information to abuse during gynecological treatment, birth, and, especially, abortion procedures.35
Although this panorama is far from uniform and has undergone changes, people in various countries in Latin America who seek medical assistance during the termination of a pregnancy, whether miscarriage or abortion, can still be the object of suspicion, blame, and punishment.36 Through a process that demarcates and differentiates “cooperative” patients from “problematic” ones, the latter can be interrogated, indoctrinated, mistreated, or even reported to the police by health workers.37 In Argentina, although current documented mistreatment does not match that of past decades,38 human rights violations have still been recorded even after legalization, such as delays and undue burdens on accessing abortion, patients being asked for additional requirements beyond what is necessary or being denied the procedure, and instances of violence while providing it.39
The persistence of barriers to accessing abortion occurs because abortion is a heavily socially stigmatized and morally condemned practice, and because, along with other (non)reproductive rights, it challenges professional, gender, and class-based hierarchies within health institutions. Doctors implement normalizing practices when their reading of the clinical picture does not match their guiding normative expectations, which they take for granted. Elective abortion, excluding when it is practiced for health reasons, is a procedure that does not seek to prevent an illness or to recover a lost state of health; rather, it responds to reasons that go beyond the doctor's orders and that center self-determination. In this sense, besides deconstructing strong social mandates associated with femininity and motherhood, it deconstructs the traditional dichotomies of “health and sickness” and “sickness and intervention,” and, above all, the traditional hierarchies that structure decision-making between doctors and patients. Providing an abortion in an institutional context is the arena for a particularly critical classificatory struggle, given the importance of what is at stake.40
Although circumstances in which the procedure is obstructed or is not carried out as mandated by law still occur, an increasing number of health institutions in Argentina are providing abortions within a framework of respect that promotes autonomy, provides holistic accompaniment, and ensures the best possible quality of services.41 These changes not only are a product of legalization but also were gained—not without conflict—thanks to the efforts of feminist movements and collectives of professionals, civil society organizations, and decision-makers.
In the 2010s, access to medication abortion was increased not just by feminist activists but also by health professionals and institutions. Spaces providing abortion counseling, during which professionals offered guidance and information before and after the procedure without intervening directly, became increasingly prevalent. This framework followed the “model of risk and harm reduction for abortion practiced in high-risk conditions,” which was institutionalized and became public policy in Uruguay and was then adopted by health-care teams in Argentina.42 Over time, this model showed its limitations, including that it could not ensure access to the necessary medication, which in turn exposed people to clandestine medications and methods.43 For this reason, this approach transitioned to ILE, in tandem with legislative and institutional changes.44 Before legalization, ILE referred to specific cases in which abortion was not criminalized: when the pregnancy was a product of rape or when it posed a risk to the woman's health or life. Due to the possibility of moving toward a law based on gestational stages, countries such as Argentina, Colombia, and Brazil rolled out a strategy based on “health grounds,” which sought to promote and implement a broad interpretation of the grounds for decriminalization in cases of risks to the person's health. In a holistic approach to health, if a patient's medical history established that a pregnancy put their physical, psychological, and/or social well-being at risk, health professionals could legally justify access to the procedure.45 In 2015, the Ministry of Health developed the first protocol for access to ILE, institutionalizing an approach that was already happening in practice. According to Fernández Vázquez, the ILE model was born as an “unstructured public policy” because it was health professionals who, beyond providing isolated procedures, were the ones who identified the problem and who formulated, decided upon, and implemented a public policy that was consolidated “from below.”46
Although this approach had limitations, such as the potential discretion of a sole professional with the power to facilitate or deny access, it allowed for improvements in the safety of abortion within a framework of restricted legality, as well as for the modification of models of care within health institutions. The model of access to ILE on health grounds led to the formation of teams of professionals with an interest in undergoing training, organizing, establishing guidelines, and offering holistic health care. Moreover, this holistic approach to health contributed to expanding the limits of a hegemonic medical model that reduces health to the biological—to a factor isolated from others—and that tends toward a hyperspecialization of attention and care.47
In transitioning from the model of counseling spaces for risk and harm reduction to the ILE model, professionals organized in various collectives and networks48 played a key role; among these, the Red de Profesionales de la Salud por el Derecho a Decidir (Network of Health Professionals for the Right to Choose), part of the Campaña Nacional por el Derecho al Aborto, stands out.49 Julia McReynolds-Pérez has referred to those within the public health system who use the apparatus and institutions of the state to expand access to safe abortion as “insider activists.”50
Two years after the enactment of the IVE-ILE law, health centers and public hospitals in different regions of the country ensure access to the conditions established by the law, which seeks to limit medical and bureaucratic discretion. In this sense, the legislative framework that regulates conditions of access to abortion proves key, given that certain rights, or the other extreme, certain conditions that must be met, could just as easily safeguard the person's autonomy as they could deepen the unequal power dynamic between doctors and patients.51 This is not about a liberal or individualized view of autonomy, widely questioned by feminist political theory, which assumes the subject to be rational and responsible.52 Feminist movements for the right to abortion have sought to reclaim interdependency and vulnerability as power, recognizing that the choice and practice of abortion are not individual processes, but rather ones that are entangled in subjective, social, political, and material histories and dimensions. In this sense, spaces of feminist accompaniment and health institutions are key to ensuring conditions that reduce the effects of these limitations and that encourage an intersubjective, collectively envisioned autonomy.
Many teams of health workers, influenced by the heated battles for legal abortion, provide care from a feminist perspective of holistic care.53 In this sense, abortion has driven a change that goes beyond the procedure itself. These professionals have organized, educated, and trained themselves and others, and they have built networks with others in the fields of health and public policy, as well as with civic and feminist organizations in areas such as gender-based violence, gender identity, and access to health care for LGBTI+ people, among many other issues.54 By changing certain underlying dynamics in the relationship between doctors and patients, ensuring access to abortion in Argentine public health institutions has contributed to the development of more just and egalitarian models of care in which professionals are not judges and executioners but rather are guarantors of access to rights.55
The points analyzed here, in relation to the transformation of the relationship between doctors and patients, take on particular characteristics and stakes when we focus, in particular, on the increasing access to medication abortion.
3. Alternative Forms of Knowledge Production
The hegemonic medical model, in which the authoritarian medical habitus is maintained and enacted,56 presupposes an exclusion and a delegitimization of forms of medical knowledge not accredited or certified by modern medicine. This is expressed in particular in the realm of reproductive health care, where forms of knowledge traditionally constructed and transmitted among women were historically expropriated and delegitimized by the monopoly of scientific knowledge.57 Women lost certain skills and knowledge pertaining to birth and abortion—heavily medicalized processes in which women can be especially deprived of the right to information about their own health. This unequal situation can reach an extreme during clandestine abortions in the form of potentially dangerous procedures in which the patient has neither information nor the possibility of control.
However, even in clandestine contexts, acts of resistance have taken place. Since the 1970s, in countries such as the United States, France, and Italy, a range of feminist groups have organized with the purpose of providing the tools and information necessary to carry out safe abortions.58 The Del-Em device, or the “Karman method”—a technique that has changed over time and is known today as MVA (Manual Vacuum Aspiration)—proved revolutionary because it allowed for safer abortions provided by trained nonprofessionals, albeit in secrecy. Helen Hester interprets these initiatives as xenofeminist practices because they involve a feminist reappropriation of technologies designed for other purposes that, in a clandestine context, profited at the expense of those who needed them. Xenofeminist practices are political interventions that aim to “restore bodily autonomy to people who felt disempowered in their interactions with the medical establishment and who were excluded from the decision-making process.”59
More recently, increasing access to medication abortion facilitated similar processes in the Latin American context, where abortion remained criminalized in many countries. The first uses of misoprostol for self-managed abortion in Latin America did not come from activist or professional initiatives but rather from the medication's off-label use by low-income women. As soon as it became available on the market in countries such as Brazil and Argentina, methods of clandestine abortion began to change, moving from more unsafe methods such as the use of catheters to a use of misoprostol that was initially experimental and spread by word of mouth.60
The regulation and approval of misoprostol as a medication to induce abortion was paradigmatic because it subverted traditional models of development and approval of medications. As Natacha Mateo notes,61 although misoprostol was approved for use in gynecology and obstetrics in the United States and other countries, this was not the case in Latin America. According to the anthropologist Lynn Morgan, this occurred because the US laboratory that marketed it (initially Searle & Co., later acquired by Pfizer) was protected by its approval for the treatment of gastric ulcers; the laboratory did not request license for uses in reproductive health care for fear of causing controversy in the Latin American context.62 At the same time, a lack of control over its distribution meant that the use of the medication was allowed in practice. In this way, it was low-income women, without information or assistance, who experienced the effects, dosages, efficacy, and risks in their own bodies. Initiatives from activists gradually began to systematize information about the safe uses of the medication, and professionals were forced to research the adequate dosage in response.63
During the first uses of misoprostol for abortion, knowledge was collectively created between people and groups within and outside of the field of health.64 Health professionals suggest that they learned of the use of misoprostol for abortion from the women who used it and from information circulated by feminists. This process, in which professionals are the ones learning, conducting research, and seeking training in venues outside of the medical field, deconstructs the traditional hierarchical model of legitimate and accredited medical knowledge.
In Argentina, the collective Lesbians and Feminists for the Decriminalization of Abortion began to offer abortion accompaniment by phone, during which they provided information about misoprostol—dosages, likely symptoms, warning signs, steps to take before and after—based on technical guidelines from the World Health Organization.65 This information was also circulated via the manual Everything You Need to Know about How to Self-Manage Abortion with Pills,66 which was launched in 2010 with five hundred thousand downloads online and twenty thousand print copies distributed for free.67 Besides helping to reimagine the stigma historically surrounding abortion and abortion access, the use of misoprostol for abortion gave feminists the opportunity to combine direct action, fostering of agency, and redistribution of knowledge.68
The Lesbians and Feminists Collective also compiled information about the phone calls it received, circulating it through journalistic reports. In this way, the collective demonstrated that sharing information about abortion among women and lesbians, within the legislative and normative framework of the time, was not only legal but feasible and effective.69 In a context in which local medical institutions did not encourage the use of misoprostol, or in which this only occurred in isolated and covert initiatives, this collective circulated its own statistics and proven recommendations that demonstrated that breaking with the monopoly of medical knowledge was necessary, even by the medical field's own terms: it was a tool that could diminish the high rates of maternal mortality and reduce the quantity and severity of complications from abortion.70 Moreover, this organization was a pioneer in showing that offering information did not give rise to legal risks for those who did so, as long as they did not intervene in the procedure; this allowed for such experiences to multiply and constituted a turning point.71
Various professional spaces increasingly invited feminists to train and develop projects together. Lesbians and Feminists carried out trainings with associations such as Doctors of the World and the Association of General Practitioners, among others, while Socorristas en Red developed a model of postabortion accompaniment and care in partnership with the gynecology services of a public hospital. The “TeA” initiative (in reference to “Te Acompañamos” [“We Accompany You”]) established a system in which people were first received and counseled by Socorristas en Red, then referred to the hospital to receive postabortion care.72
In Argentina as in other countries and internationally, various feminist experiences with providing accompaniment for medication abortion continued to professionalize their accompaniment resources and systematized their data. Socorristas en Red in Argentina, Women on Web internationally, and other local organizations providing abortion accompaniment outside of the formal health system produced evidence that they published in reputable medical journals on the safety and viability of home abortion with remote accompaniment and supervision by primarily, but not exclusively, nonprofessionals.73 The Socorristas’ model, although it requires greater research in clinical terms, also proved to be a viable and safe alternative to accompany abortions remotely during the second trimester in legally restricted contexts.74
As occurred with other movements for health rights, such as those of people living with HIV or trans people,75 people seeking an abortion in a clandestine context went from being excluded from medical technologies and knowledge to being “expert patients”76 who produced, developed, and circulated a form of knowledge that not only offered solutions to their health needs but also allowed them to produce evidence that went far beyond the limits of the medical system itself and of the legislative framework in effect at the time. Misoprostol and the circulation of information about its uses for abortion allowed pregnant people to take the ability and power of managing and practicing nonmedicalized abortions into their own hands, restoring a power that they had historically been denied and granting them another kind of agency.
Final Considerations
Throughout this essay, I sought to reflect on certain aspects of the struggle for abortion in Argentina that contributed to and continue to contribute to the broadening of hegemonic approaches to health care, just as they rework and question the authoritarian medical habitus and hegemonic medical model. I contend that movements for legal abortion in Argentina generated both social, symbolic, legal, and institutional change and rich theoretical contributions. To ignore these contributions would be to lose key elements from a political, historical, and theoretical point of view.
In the first section, I focused on the stigma that surrounds abortion, even as this stigma takes on particular characteristics in each context. I elaborated on the role that feminist organizations in Argentina played in reframing the stigma that continues to be a source of tension. This stigma plays out in a specific manner in the field of health . As a health issue in which a person's desires are prioritized over medical choice or the medical gaze, abortion challenges the traditional roles and hierarchies between doctors and patients. In Argentina, the various experiences of activist professionals allowed for the broadening of approaches to health within public institutions through the adoption of a holistic approach centered on people's rights and autonomy. Finally, I analyzed how the availability of misoprostol in Argentina and the various initiatives to increase access to its safe usage allowed for these initiatives to return a power and a capacity for agency to pregnant people that they had historically been denied.
Based on this analysis, I maintain that abortion, considered from different perspectives and experiences, is a practice and a political claim that allows for the broadening of approaches to health and that contributes to consolidating a feminist approach. It consists of recovering an enunciative and epistemological capacity for agency from a collective and transformative place. The experiences I have analyzed can be considered alongside various sociohistorical initiatives in which people and social groups excluded from access to and knowledge about health seek to recover a power that has been denied to them, as occurred with people living with HIV, health care for trans people, gynecological care for lesbians and bisexual women, and in the processes of depathologization of fat people, people with mental illnesses, and people with disabilities. A feminist approach to health seeks precisely to promote an intersectional, holistic, and collective outlook and praxis, centered on a redistribution of knowledge and power in health and on a collectively envisioned autonomy.
Notes
Sutton and Borland, “Abortion and Human Rights.” After the last civico-military dictatorship (1976–83), human rights movements and discourses took on a marked relevance and acquired social and political legitimacy. Feminist movements in general, and struggles for legal abortion in particular, inscribe themselves in a genealogy that intersects with these movements and with the subsequent organization of social movements during the 1990s in response to neoliberal policies. The campaign is born from these fights, which it recognizes by taking a scarf as its symbol to pay tribute to the Mothers of the Plaza de Mayo (replacing the traditional white color with green). The Mothers demanded that their children, disappeared during the military regime, be returned to them alive, wearing white headscarves to express that they wanted to protest peacefully. Their appearance in the public sphere had a strong influence on the role of women in political struggles in Argentina and in Latin America. Sutton and Vacarezza, Abortion and Democracy.
Maternal mortality is an indicator used to measure maternal death due to causes related to pregnancy, birth, or the postpartum period.
Chaneton and Vacarezza, La intemperie y lo intempestivo; Szwarc and Fernández Vázquez, “‘Lo quería hacer rápido, lo quería hacer ya.’”
Boltanski, quoted in Pecheny, “‘Yo no soy progre,” 262.
The original term in English is “womanhood” (Kumar, Hessini, and Mitchell, “Conceptualising Abortion Stigma”).
Szwarc and Fernández Vázquez, “‘Lo quería hacer rápido, lo quería hacer ya.’”
To learn about some of the current experiences of Argentina and other countries in Latin America, see Socorristas en Red's website, https://socorristasenred.org/.
Grosso, Tripin, and Zurbriggen, “La gesta del aborto propio”; Santarelli and Anzorena, “Los socorrismos y las disputas de sentidos sobre el aborto voluntario.”
Ramos, Romero, and Aizenberg, “Women's Experiences with the Use of Medical Abortion”; Zurbriggen, Keefe-Oates, and Gerdts, “Accompaniment of Second-Trimester Abortions.”
Bourdieu, El sentido práctico; Erviti, Castro, and Sosa Sánchez, “Las luchas clasificatorias en torno al aborto.”
Castro, “Habitus profesional y ciudadanía”; Observatorio de salud, género y derechos humanos, Con todo al aire; Castro and Frías Martínez, Violencia obstétrica y ciencias sociales.
Erviti, Castro, and Collado, “Strategies Used by Low Income Mexican Women”; Observatorio de salud, género y derechos humanos, Con todo al aire.
Observatorio de salud, género y derechos humanos, Con todo al aire.
Szwarc, Maffeo, and Fernández Vázquez, “Aportes de los activismos feministas y LGBT+”; Tiseyra et al., “Barreras de acceso al aborto legal en el sistema público de salud.”
Red de equipos de salud sexual y reproductiva, “Experiencias de equipos de salud”; Cammarota et al., Consejerías en IVE/ILE.
Red de equipos de salud sexual y reproductiva, “Experiencias de equipos de salud.”
For more information about the Red de Profesionales (Network of Health Professionals), see the organization's website, http://redsaluddecidir.org/.
Red de equipos de salud sexual y reproductiva, “Experiencias de equipos de salud”; Alli, Burwiel, and Reynoso, Salud mental y géneros.
Hester, Xenofeminismo, 83. To Hester, xenofeminist projects are projects of feminist activism that respond to four principles: (1) circumvention of authority; (2) the repurposing of tools by taking ownership of devices with political purposes and separating them from the contexts in which they had been developed; (3) discourses on scalability that promote people's autonomy and that can be easily replicated; and (4) the potential for an intersectional application—in other words, projects that aim to change not only unequal gender relations but also those of other social categories. To understand this approach in greater depth, see Hester, Xenofeminismo.
Grosso, Tripin, and Zurbriggen, “La gesta del aborto propio”; Fernández Vázquez and Szwarc, “Aborto medicamentoso.”
Fernández Vázquez and Szwarc, “Aborto medicamentoso”; Mateo, “El misoprostol como droga abortiva.”
Organización Mundial de la Salud, Aborto sin riesgos.
Mines et al., “‘El aborto lesbiano que se hace con la mano.’”
Lesbianas y Feministas, Segundo informe sobre la atención de la línea; Lesbianas y Feministas, Las mujeres ya decidieron que el aborto es legal.
Grosso, Tripin, and Zurbriggen, “La gesta del aborto propio”; Fernández Vázquez and Szwarc, “Aborto medicamentoso.”
Moseson et al., “Self-Managed Medication Abortion Outcomes”; Aiken et al., “Safety and Effectiveness of Self-Managed Medication Abortion”; Shochet et al., “Self-Managed Abortion via the Internet.”
