Abortion surveillance: How women’s bodies are being monitored

Surveillance data and technology are being exploited to stoke fear and prevent abortions in countries including the United States, China, Hungary and Poland.

Period tracking apps, car licence plate data and pregnancy registers are the latest tools activists warn are being harnessed to stop women using legal or geographic loopholes for terminations. All four countries have reversed abortion rights over the past two years.

“The surveillance of pregnancy and abortions using technology and data is increasing,” warned Beth Schlachter, director of Advocacy with the International Planned Parenthood Federation (IPFF).

In the United States, the Supreme Court overturned its Roe v Wade ruling in June, which eliminated the constitutional right to an abortion after almost 50 years. Most abortions are now banned in at least 14 states.

Period tracking apps have come under scrutiny after a number of platforms shared user data with third parties, experts say. In states where abortion is a crime, prosecutors can request information collected by these apps when building a case against someone.

“If they are trying to prosecute a woman for getting an illegal abortion, they can subpoena any app on their device, including period trackers,” said Sara Spector, a Texas-based criminal defence attorney, and ex-prosecutor.

It comes after a recent case in Nebraska saw police obtain a 17-year-olds private Facebook messages, through a search warrant, to charge the teen and her mother with violating the state’s ban on abortions after 20 weeks of pregnancy.

Alarm systems were again raised this week about new licence plate technology, called Flock, being installed across the US. The company says its purpose is to “eliminate crime”.  Activists worry the growing network of licence plate readers could be weaponised to allow police to monitor abortion clinics and the vehicles seen around it.

In Poland, a near-total abortion ban introduced in January 2021 has restricted abortions to cases of rape, incest or if the life of the mother is threatened. Polish women have instead sought termination pills online or travelled abroad for their operations.

Its government has since introduced a database to track pregnancies – and experts warn it is being used by the government to crack down on terminations and reinforce to women that they are being watched.

“Every pregnancy is registered anyway, but the [new] register is a threat – to stop women going abroad, to stop them taking pills. It is only to make women much more frightened,” said Krystyna Kacpura, the executive director of the Federation for Women and Family Planning in Poland.

Irene Donadio, a spokesperson for the IPPF, added that there was a “wave of panic” when the new government introduced the database to track pregnancies.

“Obviously, as a woman, you do feel terrified when you know that they are tracking pregnancies in a country, where every few years there are fundamentalist groups that put the bill in the parliament to send women to jail,” she said. “You would be very scared.”

Meanwhile in China – where birth rates are plunging and causing officials to worry about staffing its production lines –  the government has also started to clamp down on abortions it deems “not medically necessary”.

It is unclear how such a policy will be monitored yet, but human rights groups said it’s likely that the state will use its already extensive surveillance system.

“One fact that we know about China is that the government surveys people – it collects lots of information about people. If they want the information [on who has had or seeking an abortion], they can have the information,” Yaqiu Wang, a senior researcher on China at Human Rights Watch, told The Telegraph.

Ms Wang said China has mastered an “informal” culture of fear and stigmatisation as its core tactic for reducing abortions.

“People are discouraged from abortions – it’s not about the policies, it’s about the propaganda and the atmosphere of discouraging abortions,” she said. “There is informal discouragement, informal obstacles. The doctors will discourage you. The local authorities are using propaganda, saying you should have more children to help the country.”

Creating anti-abortion sentiment in different pockets of society has been a key tactic in Hungary, too. Hungary’s far-right prime minister, Viktor Orban, has pushed his “traditional family values” agenda since he was elected 12 years ago – and earlier this month he modified the abortion law, announcing that women must listen to the “foetal heartbeat” before a termination.

Noá Nógrádi from Patent, a Hungarian women’s rights organisation, said the government has engaged in “several, less overt steps gradually curtailing women’s reproductive rights,” such as billboard campaigns and “increasingly manipulative content” during state-provided compulsory counselling sessions.

Ms Nógrádi added that, when it comes to monitoring pregnancies and abortions, there is a “rather strict system within the state infrastructure that requires pregnant women to contact the state nurse services upon learning about their pregnancy and check in regularly”. Meanwhile, women are reporting that it is harder to book the mandated counselling sessions within the legally set time-limits for the procedure, she said.

Creating fear at a local level is a strategy used to curtail terminations in some Latin American countries too, said Marge Berer, coordinator of the International Campaign for Women's Right to Safe Abortion. She warned that it is not uncommon for women who seek emergency medical care – because of complications of an unsafe abortion – to be reported to the police.

“They are even handcuffed to the bed until discharged, when they are taken to a holding cell to be charged. Such cases are not uncommon in Peru and a number of Central American countries where all abortions are illegal,” Ms Berer said.

Voices against choices

Anti-choice groups are becoming more active, too, emboldened by the policy changes in countries including the US.

The day after Roe v Wade, conservative lawmakers in Puerto Rico introduced a bill punishing “the crime of abortion” with 99 years in prison. The bill was withdrawn the same day, but it signals how anti-choice groups are starting to piggyback on other countries political decisions. Meanwhile, ahead of Italy’s recent election – which saw a shift to the far-right – gigantic billboards sprung up denouncing terminations, similar to those seen in Hungary.

In Poland, as Ukrainian refugees crossed over the border to flee the war, women who had been raped by Russian soldiers were met with gruesome posters from such anti-choice groups.

“They did their best at stopping Ukrainian women from getting abortions from rape. They were standing close to the border with bloody posters that read ‘This is your child. Abortion kills more people than war’,” said Ms Kacpura.

Such information was incorrect, as abortions are allowed in the circumstance of rape. “They didn’t tell women they would not be punished [for having an abortion],” Ms Kacpura added.

Such groups are not confined to countries where abortion access has recently been restricted.

In the UK – where abortions are permitted with consent from two doctors, but have not been decriminalised – anti-choice groups have increased their presence outside clinics. Employees told the Telegraph that there are sometimes dozens of protestors calling for women to not go through with their terminations.

There are also  concerns about the stance on abortion of some Conservative MPs, with the new health secretary, Thérèse Coffey, previously stating that she “would prefer women didn’t have abortions”.

Meanwhile, in Uganda, where abortion is only legal in limited circumstances, anti-choice groups are taking the political route.

“Human Life international, a local Ugandan group, have really grown in their prominence and their voice over recent months,” said Sarah Shaw, head of advocacy at MSI Reproductive Choices, which provides contraception and safe abortion services.

“They’ve now got an office outside parliament, so they’re constantly in parliament, lobbying parliamentarians and decision makers that are participating in consultations.”

Where abortion rights have improved

Over the past 50 years, the global trend has been the liberalisation of abortion laws, and many countries have taken steps to improve access.

In India, a ruling last week said that all women – including those not married – had equal rights to an abortion. Abortions have been legal in India since 1971, but over the years, authorities have made strict rules for who can terminate a pregnancy and until what stage.

Thailand also said last week that it will legalise abortion up to 20 weeks, relaxing pregnant people’s access to the previously restricted medical procedure. Terminations remained illegal in the kingdom – except under incidents of rape or threat to the mother's life – until February last year when it was lifted for women up to 12 weeks pregnant.

Colombia decriminalised abortion in a historic move earlier this year, in response to “Green Wave” feminist activism in Latin America.

According to the World Health Organization (WHO), legalising abortion does not lead to an increase in procedures – but does make them much safer.

Each year, around seventy-three million abortions take place worldwide, the UN health agency says. This translates to about 39 abortions per one thousand women globally, a rate that has stayed roughly the same since 1990.

“Women will have abortions whether they are safe or not, they risk their lives every day of the year to have abortions because that is what they see as necessary in order to be able to go on with their lives,” said Ms Berer.

The WHO estimates that approximately 5-13 percent of maternal deaths worldwide are due to complications from unsafe abortions, the vast majority of which occur in developing countries.

Three pregnant women have died in Polish hospitals after being denied an abortion since the court's decision, according to Abortion Support Network, a UK-based organisation that helps people in Poland obtain abortion care. The infant mortality rate also increased by nine per cent in 2021, reversing a long-term decline, while doctors have noted a rise in miscarriages and stillbirths.

“Abortion has become a very heated debate in a lot of countries. The narratives are changing, the rules of the game are changing. The level of funding is much higher,” said Ms Donadio.

“Those who seek to enforce their anti-abortion views on women's lives and decisions are murderers in fact or in intent,” said Ms Berer. “They should be the ones who are locked up as a danger to the community.”

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