Nursing's Relationship to Feminism: What Is Nursing's Response to the Global Backlash Against Women's Rights and Access to Abortion?

In this paper, I explore the ambivalent relationship between second-wave feminism and nursing in the context of attacks on and withdrawal of women's rights and access to abortion (LeBold and MacDonnell 2020). The literature discussed here shows how relevant and ethically suitable feminism is for nursing practice in women's health and abortion services. If there seems to be no one overall response from nursing to abortion, there are nevertheless strong, coherent, ethical and reasoned responses to the ‘global backlash against access to abortion’ (Hayes 2025) based on feminism, which should be more widely known in professional preparation programmes as well as in post-registration training. Access to reproductive health services, including abortion, improves societal health and the social and economic well-being of women and all people with a uterus (United Nations [U.N] 2014, 2020; Carson et al. 2022). Worldwide, 73 million induced abortions take place annually, with 29% of all pregnancies ending in induced abortion (World Health Organisation [WHO] 2024). While abortion laws vary among countries and over time, the easing of restrictions on abortion is seen as part of a broad social movement towards expanded rights for women (Berer 2017), albeit it remains a stigmatising experience (Maxwell et al. 2021). During the second half of the 20th century, abortion was made permissible within a legal framework that allowed abortion on specified grounds in 100 countries (https://www.globalcitizensolutions.com/the-abortion-laws-which-countries-allow-abortion/). The global North, central and eastern Asia have the most liberal laws on abortion, while Africa, Latin America, the Middle East, and southern Asia (Centre for Reproductive Rights 2024a) have more restrictive laws. Reasons for permitted abortion include the threat of life to the mother, to the child or socio-economic reasons. However, despite overall expansion on the legal grounds for abortion, policies remain restrictive in many countries (United Nations 2014). Since 2016, previously established rights and access to abortion have been withdrawn in many countries (Brysk 2025; LeBold and MacDonnell 2020). The approved amendment to the British government's crime and policing bill passed by the British Houses of Parliament on Tuesday 17th June 2025 will prevent women from being investigated, arrested, prosecuted or imprisoned for terminating their own pregnancies without changing the existing abortion legislation in England and Wales (Editorial, 15 May 2025, Guardian; Al-Othman 2025a, Guardian, 2). A rival amendment which sought to legalise abortion was not voted upon (https://voxpoliticalonline.com/2025/06/18/the-new-abortion-law-what-it-means-why-it-matters-and-why-some-missed-the-point/). These amendments follow the unsuccessful prosecution of Nicola Packer who was accused of “unlawfully administering to herself a poison or other noxious thing with the intent to procure a miscarriage” (https://www.bbc.co.uk/news/articles/c93y5gq09x7o); Al-Othman 2025a. Under the exemptions above, prosecutions by the police were rare prior to the COVID-19 pandemic, when online medication for early abortion was permitted under emergency legislation in the U.K. (https://lordslibrary.parliament.uk/coronavirus-and-abortion-law/). However, since the pandemic and the availability of online abortion medication in first-trimester pregnancy, 100 women have been criminally investigated, six have faced court and one has been sent to prison on suspicion of illegal abortion offences. It is increasingly the case that in England and Wales, women who suffer a pregnancy loss are treated as suspects and subjected to invasive investigations that inflict profound long-term harm. One of those prosecuted in 2025 was Nicola Packer, and her case makes salutary reading for nurses and midwives caring for women in similar situations. Packer was criminally prosecuted for illegally terminating her pregnancy in 2021. The case was heard in court in May 2025, and she was found innocent of these criminal charges. She described being arrested by police, ‘I was still in pain [from the abortion], I was extremely tired, I felt very weak and mentally, I just did not understand what was going on’ (Al-Othman 2025b, Guardian 19). Under guidance from the National Police Chiefs’ Council in 2025, officers were told that they can seize women's phones and search their messages, internet history and even health apps if they are suspected of ending a pregnancy outside of the law (Davis, 18 May 2025, The Observer p5). Packer describes not telling medical or nursing staff initially that she had taken abortion pills ‘because she was afraid it would affect the quality of care she received’. As she says, ‘They didn’t really help me, did they? I think I was right to be frightened’. Abortion has been politicised in battles over women's reproductive and sexual rights since first-wave feminism in the late 19th and early 20th centuries (Purcell 2015) see Table 1. The rolling back of legislation and permissions is described as ‘unprecedented threats’ to established women's rights (Feeley et al. 2020). Four governments have rolled back abortion legislation, in some instances banning it altogether: the United States, El Salvador, Nicaragua and Poland (Centre for Reproductive Rights 2024b). The ‘global back lash against abortion’ (Brysk 2025; Finer and Fine 2013; Hayes 2025) has seen an extraordinary withdrawal of women's rights and access to abortion (and other legal, reproductive and social rights) as ‘contradictory trends of 21st-century abortion rights are driven by disparate nationalist responses to globalisation’ (Brysk 2025). It has been observed that the sociological literature is richer than the nursing literature, which is concerned with practice rather than articulating any feminist nursing theory (Allan 1993, 1457). Chinn and Wheeler (1988) between nursing and second-wave feminism (Malka 2007; Sullivan 2002). As a result of the literature search and review undertaken for this paper, I argue that this relationship remains ambivalent even though the scholarship on feminist theory applied to nursing is far richer than it was in 1993. There are broadly four waves of feminist theory and action, which I will refer to in this paper (see Table 1 below). Feminism is not a homogenous theory or movement as the theories and political actions which emerged in second-wave feminism attest; different emphases continue to be placed by different feminists on the intersecting causes of women's oppression (Melchior 2004) and on social justice and equity (Melchior 2004). While a liberal feminist approach might argue for equality through a level playing field in education and social institutions (Melchior 2004), Marxist feminists would argue for the abolition of capitalism and private property, which they see as the root causes of inequality, including inequality between genders (Mitchell 1971). Socialist feminists would argue that the intersection of capitalism and patriarchy leads to women's oppression and that equality cannot be achieved until the end of economic and cultural oppression, which are overlapping structures that produce an individual's experience of oppression (Gordon 2016). [The] ‘centrality of whiteness at the expense of the equitable treatment of Black British people continues in all aspects of British healthcare for those employed and those using the service’ (Brathwaite 2018, 920). First-wave feminism in the 19th and early 20th centuries, which emerged globally in writings and actions among women of all social classes and ethnicities, coalesced around a number of health and social justice issues that resonate with nursing practice and scholarship today: the enfranchisement and property rights of women; abolition (of slavery); rejection of gender roles; a focus on women's health, particularly public health, poverty, poor wages and housing, the temperance movement, birth control, sexual health and safer childbearing (Malka 2007; Martz 2020; Fowler 2016; Martz 2020). In the 1960s, second-wave feminists critiqued the continuing and entrenched sex and gender roles caused by historic as well as new forms of patriarchy and their effects on women's health and social, economic and political position in society (Malka 2007). Of particular relevance to nursing, a women's health movement emerged in the 1970s as part of second-wave feminism (Nichols 2000; Roberts et al. 2016). This sought to increase awareness of women's health issues through knowledge of their own bodies outside patriarchal medical knowledge and professional structures such as medicine, nursing and midwifery: if we don’t learn about our own bodies, somebody else is going to be in charge of what happens to us. It's just that simple (Downer 2011). During second-wave feminism, equality feminism, in the 1960s–1970s, nursing was seen to embody an archetypal gendered profession that reinforced gendered feminine stereotypes (Ashley 1976, cited by Malka 2007, 98). As more women entered the workforce in the 1970s, other occupations offered less gendered choices for young women (Wright-Mendoza 2018). The gendered image of nursing remains deeply entrenched (Baduge et al. 2024). While nurses have resisted, they have often upheld gatekeeping and decision-making power reinforcing middle-class values, often undermining people's agency and knowledge (LeBold and MacDonnell 2020, 83) Some countries interpreted laws ambiguously (Mainey et al. 2020, 1516). Research in the U.K. conducted recently suggests that abortion by nurse practitioners would be acceptable to British women (Wellings et al. 2024). The authors conclude that the law in the U.K which requires abortions to be authorised and performed by doctors impedes best practice. Carson et al. 2023 argue that the aim of any feminist abortion education and care is to produce ‘Nurses who are willing to provide abortion care and lead advocacy efforts for equitable, accessible reproductive services face barriers to working to full scope’ (Carson et al. 2023, 58). However, nurses who work closely allied to and controlled by medicine within patriarchal healthcare systems, may be reluctant to challenge gatekeeping practices and discourses which frame abortion through the lens of patriarchal and professional interests, especially if they are lone practitioners (LeBold and MacDonnell 2020). This reluctance to challenge arises not only because nurses lack power in healthcare systems (Traynor 2017), but also because abortion is framed as a medical problem which empowers doctors as decision makers around access to abortion. LeBold and MacDonnell 2020 argue that framing abortion as a ‘medical necessity’ reinforces its essentially unacceptable nature in pronatalist and patriarchal societies rather than a social good. In the portrayal of abortion as a medical necessity, representations of alternative values related to abortion (e.g., viewing it as a human right, an economic or social good, a determinant of women's well-being) are absent from public discourse and even nursing and medical curricula (Carson 2018). Both Paynter et al. 2019 and Carson et al. 2022 point out that even where abortion is legal, positive representations of abortion in education, policy and healthcare systems are missing. Thankfully, there is evidence of nurses and midwives challenging patriarchy in many areas of women's healthcare where nurses and midwives have access to training and support from within the care context in women's health (Paynter et al. 2019). For example, where the practice milieu is supportive of innovative practice, they are able and willing to challenge patriarchal hierarchies and relationships with doctors (Allan and Barber 2005). Personal choice and reasoning are known to be part of why individual nurses take on new roles. Allan and Barber 2005 found that nurses taking on sperm aspiration in an infertility clinic searched for a moral story that validated their decisions to expand their practice, often in the face of resistance from doctors. (Carson et al. 2022) study showed that nurses challenged doctors’ control over women's reproductive care in relation to the introduction of medication abortion during the COVID-19 pandemic. In this case, the authors found that a health equity model provided justification for nurses in taking on new roles in abortion. Although feminist theories were used to underpin some nursing and midwifery curricula in the 1990s–2000s (Diekelmann 2001; Ironside 2001, 2005; Welch 2011), Paynter et al. 2019 found an absence of feminist discourse around abortion in nursing education and training. She cites Haney 2011 to argue that a failure to educate students about nursing roles in abortion services is based on the invisibility of nursing roles in a stigmatised service, on the lingering effects of religious beliefs which underpin the development of both nursing identity and professionalisation. But perhaps more importantly, a failure to educate nurses about abortion may be due to an orientation in nurse education and practice to doing and experiencing, Wall (2007) states that nurses’ exposure to social theory of any type can be limited during nursing education, they and their teachers are ‘likely to shy away from theory that is political’ (p. 42). Given Wall's argument, it is noteworthy that this hasn’t always been the case. In the U.K., the Royal College of Nursing (RCN) and the Royal Colleges of Midwives (RCM) successfully lobbied for the inclusion of a conscience clause in the 1967 Abortion Act (Fleming et al. 2024). And while the RCM and the Royal College of Obstetricians and Gynaecologists supported decriminalisation legislation in recent debates in the House of Commons, it wasn’t until December 2024 that the RCN spoke out in support of decriminalising abortion (Royal College of Nursing 2024; Royal College of Obstetricians and Gynaecology et al. 2025; Adam 2025). The Dobbs Court decision in 2022 in U.S.A. (Dobbs 2021 State Health Officer of the Mississippi Department of Health, et al. v. Jackson Women's Health Organisation) is perhaps the most (in)famous example of a right wing, conservative, religious government withdrawing women's rights and access to abortion (Brysk 2025). The Dobbs ruling held that the not provide a right to abortion, and it the to abortion to the people and their on laws and nurses may provide education, and about abortion and as by the care The that nurses may abortion as a reproductive health alternative if no other law in that the practice 2022). are to relevant sexual and reproductive health choices in an with their and support the decisions of their sexual health and reproductive choices 2022). The Dobbs ruling has under and nurse education as curricula under law rather than for example, nurse and nurse has to how their individual practice to law and if they to challenge such laws and 2024). There are of care in nursing that are by feminism in their to women both in nursing and as et al. 2019). These of care on rights for women that were in the As describes what a feminist practice of nursing might on the context of women's for the for women to have control over their bodies, health and that with other women the of their health would be for both women and However, the Dobbs v. Jackson Women's Health Organisation ruling in the and the withdrawal of abortion access in other countries globally (Brysk 2025) have had for how nurses care for In the U.K., the care Packer did not for feminist the care she did not to be within her life While she control not the of her the nurses did not to have offered her control against the she felt herself other nurses did not as in the patriarchal The Packer case for the relationship because any care that is provided has been by individual nurses in this case to be under As 2025 many and with suspicion in other similar that the law and such a societal there to be of the issues by the during the pandemic and for or for the of the prosecutions on women's access to abortion in the U.K. This case for nurses and and to the literature for this it is that some nurses have coherent, ethical and reasoned responses to the ‘global backlash against access to abortion’ (Malka these are limited in This is in the in which the of nurse or nurse has in countries the of medication abortion for first-trimester for nurse practitioners working in abortion care in other countries medication and with abortions has been challenging for some and will continue to be recent legislation (Brysk 2025). Given these legal restrictions on practice and social nurses can it a challenge to feminist care to women abortion in healthcare services which are not only by but by social and of education, social (Melchior 2004). 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