We need to talk about abortion more.

In one sense, people talk about abortion all the time. In many countries, debate rages about a woman’s right to choose versus the rights of the foetus. Right now in the UK, the 50th anniversary of the Abortion Act 1967 is prompting debate about reform, while the creation of ‘buffer zones’ around abortion clinics, and Scotland’s decision to allow women to take abortion-inducing medication at home are making headlines.

But in another way, we don’t talk about abortion. Nearly 200,000 abortions are performed in the UK every year, and one in three women will have an abortion in her lifetime. Yet very few women speak about their experience. This is partly because choosing to end a pregnancy can be a conflicted and intensely personal decision. It is also because having an abortion carries a substantial stigma.

We need to remove this stigma so that women can talk openly about their choice, helping them to process and seek support if they need it, without fear of judgment. Women internalise this stigma as shame, and suffer as a result.

But there is another important reason why we need to be able to talk about abortion, which is that without understanding why women terminate, we cannot have an informed, and hopefully respectful, empathetic, realistic discussion about whether and how we should reform the law.

Fifty years ago, the Abortion Act gave women access to safe, legal abortions. Today, the law prevents very few women from terminating their pregnancies, so why think about reform?

One reason is that arguably, the damaging stigma around abortion is partly sustained by the way the law frames abortion. In 2017, performing or procuring an abortion remains a crime in the UK. The Act merely provided defences to this crime. There is no ‘right’ to have an abortion in the UK. Rather, for an abortion to be lawful, the woman must offer one of the reasons outlined in the Act – risk of foetal anomaly, or risk to the woman’s life or her mental or physical health (or that of her existing children)

Part of our conversation must be about whether the consensual ending of a pregnancy should still be considered criminal. We might think that some or all abortions should be crimes. Or we might think that a woman’s decision to avoid an unwanted pregnancy is not something that belongs in the same category as rape, assault or murder.

We are all free to form our own views on this, but in doing so we need to understand what it means to call something ‘criminal’, to deem an act so wrong that it is the state’s business to punish those who perform it. It makes a complex, personal decision one that the community, via the state, can judge, leaving thousands of women to defend their decision to those whom it does not affect.

Another reason we should think about reform is that a woman’s choice alone is not sufficient to render an abortion lawful; two doctors must vouch that these risks really exist. In addition, a woman who takes medication to induce miscarriage must take the pills at the dispensing clinic, often subjecting her to the distress of beginning to miscarry as she travels home. While permitting abortion, the law’s failure to trust women and their choices, shames and infantilises women as it does so.

We should think about how the way we frame abortion, and the legal steps it involves, affect women. We need to reform with women’s stories in mind, and we need to craft a law that lets each person follow their conscience and respects their choices and their dignity.

Dr Imogen Goold is an Associate Professor in Law at the University of Oxford. She writes about a wide range of issues in medical law and ethics.

The My Body My Life exhibition will be open at The Old Fire Station, Oxford from 7th-11th November 2017, 11am-6pm