Tag Archives: abortion

Wading in, wading out?

The first time I ever heard anything about abortion was also the first time I watched Dirty Dancing.  I was ten, maybe. My best friend’s older sister was baby-sitting for us, and had plugged it into the VCR. She allowed us to stay, in our pyjamas, wide-eyed.

After the infamous the guy had a dirty knife and a folding table line, I asked what was happening.  I don’t remember what I was told, but I do remember being horrified at poor Penny’s suffering.

Dirty Dancing was set in 1963, a decade before the historic decision of the U.S. Supreme Court to legalise abortion through the famous “Roe v. Wade” case.  The film itself was released in 1987, only fourteen years after.  But even by then it was hard to imagine quite what the past had felt like; abortion had already become an accepted right for most American women, as the film’s screenwriter and co-producer Eleanor Bergstein explains in a recent interview:

When I made the movie in 1987, about 1963, I put in the illegal abortion and everyone said, ‘Why? There was Roe v. Wade ― what are you doing this for?’ I said, ‘Well, I don’t know that we will always have Roe v. Wade.’

Roe v. Wade revolved around the US Constitution’s 14th amendment (the right to individual liberty).  The case is back in the headlines now, as a landmark decision under threat from President Trump’s appointment of Brett Kavanaugh to the Supreme Court (nomination subject to US Senate approval, as this article explains).

Many women’s health and rights organisations have decried Kavanaugh’s nomination, arguing that his previous track record as a federal Judge implies a possible reversal of Roe v. Wade with a swing of the Supreme Court to the right (see the #SaveRoe campaign). There is already evidence of states increasing restrictions to the federal policy, with 214 limitations on the right to abortion voted between 2011-2014 (more than for all three previous decades).

In just the last 4 years, states have enacted 231 abortion restrictions

Analysis by the Center for Reproductive Rights predicts 22 states in America would use a Supreme Court reversal to enact their own abortion laws. So if Roe v. Wade is struck down, what would that mean for American women?  Was “the Penny situation” typical, and would it still be, in 2018?

There are obviously no official statistics about how many American women underwent illegal abortions before 1973.  Some argue that Roe v. Wade did not change much: in five states (Washington, New York, Alaska, Hawaii and California) abortion was already legal.  Others obtained terminations quietly from sympathetic doctors.

The same would probably occur today, with women travelling interstate or abroad, or procuring drugs such as mifepristone and misoprostol to avoid some of the most awful home-alone methods of yesterday. But regardless: self-administration of any medical or non-medical procedure is not without risks, and seeking a legal abortion elsewhere would still require time off work, and a budget for the operation, travel or accommodation.

This point is particularly relevant. Of the 926,000 abortions performed in the US in 2014, half were for women of low income, according to an article by the BBC.  Illegalising abortion would create a double burden of discrimination in terms of need and access, but could also threaten disproportionate criminality for poor women, as described by Michelle Oberman writing in the New York Times:

In Chile, the small number of abortion prosecutions annually typically target doctors. El Salvador prosecutes women. Government officials there have toured the country’s hospitals to inform doctors of their duty to report women suspected of having induced their miscarriages. Not only does this policy violate near-universal norms of patient confidentiality, but because doctors have no reliable way to tell a natural miscarriage from an abortion, reports are made on the basis of suspicion. Whom do doctors tend to suspect most readily? Poor women.

It is difficult to have an exact figure for illegal abortions, but it is estimated that 25million terminations (of a total of 56million annually worldwide) are unsafe, defined as lacking either trained medical staff to conduct the termination, or the use of unsafe/incorrect methods.  And again, since accessing drugs online such as misoprostol still requires knowledge, money, and supply, it is not surprising that the majority of unsafe terminations happen in developing countries (where there is also the greatest unmet need for contraception, and where the laws tend to be the most restrictive).

Disparities in safety of abortions across countries with varying legal restrictions

So banning abortion does not stop it from happening; it simply makes it more dangerous. Unsafe terminations result in around 22,800 deaths annually (likely a conservative estimate), and some 6.9m ‘complications’, detailed below by the IPPF (and which cost an estimated $553m a year to treat according to the WHO).

So what are the risks? Immediately: severe bleeding, uterine perforation, tearing of the cervix, severe damage to the genitals and abdomen, internal infection of the abdomen and blood poisoning.

In the medium to long-term possible repercussions of unsafe abortion include reproductive tract infections (RTI – a 20 to 30% chance), pelvic inflammatory disease (PID), chronic pain and infertility (20 to 40%). Then there’s the risk of ectopic pregnancy, miscarriage or premature delivery in subsequent pregnancies.

But the picture is not stagnant. Whether for these ethical, economic, or human rights reasons, 27 countries have relaxed laws on abortion since 2000. This is also in line with international treaties signed by the majority of the world’s countries which establish rights to dignity, health, equal treatment, and health – all fundamentally linked to contraception and abortion.

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However, legislation, though a pre-condition, is insufficient alone.  Rights can only become reality when women have freedom to enact them.  Laws are always at the behest of public opinion, or a politician’s pen: Poland has progressively and aggressively narrowed grounds for abortion in recent years.

Where does that leave us? With a fairly linear conclusion, it seems to me. There will never be a happy compromise between the viscerally-opposed pro-life and pro-choice camps.  And abortion will always be the most visible and controversial element of a broader taboo surrounding women’s sexual and reproductive health; rights which appear as a challenge to sacred tenets such as the family, the community, religion, virility, or fertility.

Well, so be it.  Those rights are inherent to existing first and foremost as a human being, and not just as a mother, wife, or child-bearing instrument. An abortion is already a very difficult and intimate decision. It shouldn’t also be a source of persecution, prosecution, injury, or death.  Save (Jane) Roe, indeed.

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All creatures great and small

 

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grub’s up

My five-(“and a half! and a half!”) year-old daughter will tell you: the only living thing it’s ok to squash is the mosquito.

(however, now that she is into wildlife documentaries, questions are starting to be asked about whether one can also squish a black widow spider in cold blood, in the interests of self-preservation).

Mosquitoes – the insect incarnation of La Poste – deserve whatever bloody end they get (and indeed, if it is bloody, then it is even more well-deserved, since that’s your blood on the wall).

Urgh. Mosquitos. They serve no positive purpose, unless you have a sado-masochistic penchant for that nails-down-blackboard whine, issuing seemingly from inside your eardrum, startling you from your sleep; or for the ensuing, desperate game of “where is it? where is it?” as you turn the light on and blink, red-eyed, at the expanse of wall around you.

Yes: the mosquito; the ultimate bad one-night stand.

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That kind of Night Nurse

But not only do they leave you sleep-deprived and somewhat uglier, with those maddeningly itchy bites: they also delight in injecting you with some of the world’s deadliest diseases.  Through malaria, dengue, yellow fever or the superbly-named chikungunya, mosquitoes kill 725,000 human beings a year (definitely more than that black widow spider).

And – just when you thought it was safe to come out from under the bed net – now there’s another one for the list.

I first heard of Zika a few months ago.  I admit I initially thought it was a new fitness craze: next-level Zumba. But no. Zika is a virus.  And not some new-fad-virus, thank you very much:  Zika is actually a sextogenerian, first identified in 1947 in Uganda.

Despite its comic-strip baddie name, Zika is actually fairly harmless.  You get a temperature, a red rash, some aches and pains. Symptoms fade within a few days.  Aside from the few occasions where Zika has been associated with the rare Guillain-Barré syndrome, it isn’t anything to worry unduly about.

Unless, that is, you happen to be pregnant.

Because Zika is tentatively linked to a neonatal malformation known as microcephaly, or babies born with unusually small heads.  This rare condition affects one birth in a thousand, but since autumn last year Latin America – and particularly Brazil – has seen a surge of cases in parallel to the Zika epidemic.

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Zika

Although experts are still wary about making a conclusive link between Zika and microcephaly, the peak in suspected cases has lead to governments and the World Health Organisation proactively recommending measures to prevent being bitten, such as removing water sources where mosquitoes commonly breed; sleeping under bednets, or donning long sleeved/full-leg clothing (joyful, in hot countries).

Oh, and not getting pregnant in the first place.

Simple, right?

Or not, since avoiding pregnancy requires one of two things: abstinence (never overly popular) or contraception.

The latter, on the face of it, is easier. Brazil scores fairly well on overall access to contraception (measured by the % of women with “unmet need“).  But there is a difference in contraceptive access between socioeconomic classes or urban/rural locations. Couple that with a peak of Zika infections in the less-wealthy north-east of Brazil (with a hotspot in the slums of Recife) and you have a situation disproportionately affecting women from poorer backgrounds: uninformed about the risks of falling pregnant, or
unable to avoid pregnancy through poor or unreliable birth control methods.

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who you gunna call?

So as rousing as Brazilian President Dilma Rousseff’s
declaration of war on mosquitoes was (including limited edition t-shirt),  what about ensuring women have the access they need to contraception?

Hear hear! said the Pope.

Yes, yes, the Pope. I kid you not: reversing the Vatican’s position on contraception in between a Zumba lesson and midnight mass.  Is the Catholic church finally moving with the times?

Alas, not quite.  Because what Pope Francis actually said was:

Abortion is not the lesser of two evils. It is a crime (…) an absolute evil. On the ‘lesser evil,’ avoiding pregnancy, we are speaking in terms of the conflict between the fifth and sixth commandment. (…) avoiding pregnancy is not an absolute evil (…) I would also urge doctors to do their utmost to find vaccines against these two mosquitoes that carry this disease. This needs to be worked on.

So no: no dramatic departure from teachings of old (the Pope is indeed a catholic). Au contraire, not falling pregnant every time your body is biologically capable of it is still evil, apparently, just a tad less evil, than abortion.

Not that Catholics appear to pay much attention. A 2014 survey showed that 78% of Catholics worldwide support the use of modern contraception, and even 65% are in favour of abortion in some cases.

So you may legitimately ask: if Catholic wo/men do not take the humanae vitae literally, what does it matter what the Pope says or doesn’t say?

Well, it does matter. For two reasons:

  1. such rhetoric entirely misses the point of – and therefore diverts attention from – access to reliable and low-cost birth control. Without which the question of whether you should or should not be using it is moot; and
  2. labelling women who try to prevent or put an end to unwanted pregnancy as “evil” (as opposed to addressing unmet need – especially for poor women) – is, frankly, criminal.

Criminal, yes: and yet those who are considered the criminals are the women themselves. Abortion is restricted or illegal in many Latin America countries, including in Brazil, hotspot of the Zika epidemic.  If you abort (apart from to save the mother’s life; in the case of anencephaly (absence of a portion of the brain or skull); or as a result of rape) you risk up to 3 years’ imprisonment.

Oh – and your life.

In Brazil, there are an estimated 850,000 illegal abortions per year, resulting in around 200,000 women requiring treatment for, let’s say, injecting corrosive substances into the uterus in a desperate attempt to abort alone.

And with the Zika virus, these numbers are on the rise. Which is why the resistance to strict abortion laws is increasingly criticised, and not only from traditional quarters.  Jon O’Brien, head of Catholics for Choice, says that

progressive Catholic theologians argue that abortion can be justified under a range of situations (…) traditional Catholic teaching about conscience gives women the the final moral authority over the abortion decision

Moral authority or not: the fact of the matter is this. If a woman falls pregnant, and the pregnancy is unwanted, she may well take matters (and her life) into her own hands. This is especially true faced with the possibility of a baby born with microcephaly.

Ignoring that reality, and badging abortion as an “absolute evil”, is therefore not only immoral, but pointless.  If the Pope really is as progressive as he would have us believe, then it is time he moved the Catholic church away from wielding women’s sexual and reproductive health and rights as a moral pulpit, and used his considerable influence to make every pregnancy wanted, and every childbirth safe.

Simply: the word evil has no place in this debate. Unless, of course, we’re back to talking about the mosquito.

I think the jury might still be out on the black widow spider, though.