Summary and comment, Marge Berer, Reproductive Health Matters


This bill manages to allow abortion if a woman’s life is at risk while at the same time protecting the life of the fetus, as required in the Irish Constitution, and at the same time, meeting the conditions laid down by the European Court to legislate clearly on matters arising from previous court cases.


The bill allows abortiononly if there is a real and substantial risk to the life of the mother”, for example arising from a physical illness. It says that it is “not necessary for medical practitioners to be of the opinion that the risk to the woman’s life is inevitable or immediate, as this approach insufficiently vindicates the pregnant woman’s right to life”. However, it repeats often that there must be a real and substantial risk to the life of the mother.


It also says: “In circumstances where the unborn may be potentially viable outside the womb, doctors must make all efforts to sustain its life after delivery. However, that requirement does not go so far as to oblige a medical practitioner to disregard a real and substantial risk to the life of the woman on the basis that it will result in the death of the unborn.”


This appears to take particular account of what happened to Savita Halappanavar, as does the name of the bill.


It creates separate conditions for what to do if the woman is threatening suicide, including requiring at least three medical opinions as to whether to allow an abortion on this ground.


It makes it clear that legal abortion will be very rare. It allows a woman to appeal a decision against her but makes it extremely difficult to do so.


It allows for conscientious objection by individuals but NOT by institutions, which is important, and requires anyone objecting to find another medical professional to refer the woman to.


The bureacracy for medical professional control of the decision to allow an abortion is prodigious and possibly even unworkable in practice if a woman’s life is at risk. It potentially requires many medical professionals to be involved to agree an abortion is legal, far more than in any other country. The numbers required to agree to an abortion in case of a threat of suicide appear to say it is hard to believe any woman would actually commit suicide and so she must be examined by many to prove it. It requires any abortion to take place in an obstetric hospital unless it is a medical emergency, which also has specific conditions attached.


It makes it very clear that there is no restriction on travelling to another country for an abortion where it is legal. It almost invites women to continue doing so rather than go through this process.


Last, and not least, it says that anyone found providing or having an illegal abortion will be subject to punishment of up to 14 years in prison. This is very serious. In my opinion, it is perhaps the worst aspect of this bill from Irish women’s point of view.


I believe this bill is extremely successful at doing exactly what the European Court required, to clarify the law when a pregnant woman’s life is at risk, and not a step further. For all the easy criticism we can make of every word of it, it is a gift to the politicians who must have felt (no matter what their personal views) that their political lives were not worth having this fight. They can now say “We did exactly what we were told to do by the European Court” and no more. It will be impossible to oppose it – in those terms – from any point of view. The person/people who drafted it deserve a gold star for compliance with the political necessity involved.

In the worst way possible, a woman refused a life-saving abortion in Ireland has proved ‘pro-life’ advocates wrong

Jill Filipovic for Feministe, part of the Guardian Comment Network, Wednesday 14 November 2012 10.19 GMT

“This is a Catholic country,” was what Irish doctors told Savita Halappanavar after she learned she was miscarrying her pregnancy and asked for an abortion to avoid further complications. She spent three days in agonising pain, eventually shaking, vomiting and passing out. She again asked for an abortion and was refused, because the foetus still had a heartbeat.

Then she died.

She died of septicaemia and E Coli. She died after three and a half days of excruciating pain. She died after repeatedly begging for an end to the pregnancy that was poisoning her. Her death would have been avoided if she had been given an abortion when she asked for it – when it was clear she was miscarrying, and that non-intervention would put her at risk. But the foetus, which had no chance of survival, still had a heartbeat. Its right to life quite literally trumped hers.

US politicians and “pro-life” advocates like Joe Walsh will tell you that there are no circumstances under which women need abortions to avoid death or injury. The Republican platform doesn’t include an exception for medically necessary abortion. And the Republican party is trying to put laws similar to those in Ireland on the books in the United States – laws that would allow emergency room doctors to refuse to perform abortions, even in cases where the pregnant woman’s life or health depends on terminating the pregnancy. The GOP isn’t exactly the most science-friendly or fact-reliant crowd in the world, but to them, women like Savita either don’t exist or just don’t matter. As Jodie at RH Reality Check writes:

“These are the lives of your sister, your mother, your daughter, your aunt, your friends, and your colleagues. These are the lives at stake. These are the very people that the fanatical anti-choice and religious right see as ‘not people’.

They are all Savita Halappanavar.

We are all Savita Halappanavar.

But we do not have to die at the hands of misogynists.

In honour of Savita Halappanavar; in honour of the nearly 22 million women worldwide each year who endure unsafe abortion; in honour of the 47,000 women per year worldwide who die from complications of unsafe abortion and the estimated 10 times that number who suffer long-term health consequences; in honour of the millions of women who do not have access to contraception, who have no control over whether and with whom they have sex or whether or with whom they have children, we can fight back. In honour of the young girls married young and the women forced to bear children long past the point they are able to care for more … for all these women, we must continue to act, to liberalise abortion laws, ensure every woman has access, remove the stigma, and trust women, like Savita, who know when it is time to end even the most wanted pregnancy.”

Just two months ago, a consortium of Irish doctors got together to declare abortion medically unnecessary. They claimed that abortion is never needed to save a pregnant woman’s life, and stated: “We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”

I’m pretty sure Savita Halappanavar would disagree. I’m pretty sure she didn’t get optimal care.



Protest the death of Savita Halappanavar in Ireland




To: Taoiseach Enda Kenny (Irish Prime Minister)

cc: Tánaiste Eamon Gilmore (Irish Deputy Prime Minister and Minister of Foreign Affairs)




Copy also to the Irish Embassy in your country. Find contact details here:



Re: Death of Savita Halappanavar in Galway


Honourable Taoiseach,


We are writing to you to express our concern about the recent death of Savita Halappanavar, who was repeatedly denied an abortion in Galway. This tragic case demonstrates once again that the prohibition of abortion in Ireland is not just undermining the autonomy of the women across the country, it is leading to unacceptable suffering and even death.


Savita Halappanavar made repeated requests for an abortion after presenting at University Hospital Galway on 21 October while miscarrying during the 17th week of her pregnancy. Her requests were refused, and she died one week later after several days in agonising pain and distress.


The situation of Savita Halappanavar provides the clearest possible evidence that laws that permit abortion only to save the life of a woman, such as the Irish law, are clinically unworkable and ethically unacceptable. There are numerous clinical situations in which a serious risk posed to a pregnant woman’s health may become a risk to her life, and delaying emergency action only increases that risk. There is only one way to know if a woman’s life is at risk: wait until she has died. Medical practitioners must be empowered by law to intervene on the grounds of risk to life and health, rather than wait for a situation to deteriorate.


You will be aware that the European Court of Human Rights, as well as a number of United Nations human rights bodies, have called upon the Irish government to bring its abortion law in line with international human rights standards. Had these calls been heeded before now, the death of Savita Halappanavar would have been prevented.


With the death of Savita Halappanavar, Ireland joins the ranks of countries worldwide where abortion is denied to women and leads to their deaths.


We call on your government to take urgent and decisive steps to reform the legislation that led to the death of Savita Halappanavar. Until the Irish legal system is reformed the lives, health and autonomy of women across Ireland are in jeopardy.


Yours faithfully,

Faiza Ilyas | Metropolitan > Karachi |

KARACHI, Jan 14: Although abortion is legal in Pakistan and a consensus exists among Islamic scholars on its permissibility in certain conditions, a majority of medical professionals look upon it as an un-Islamic act and refuse treatment to women, compelling them to seek the help of untrained healthcare providers and risk their lives.

According to estimates, about 890,000 induced abortions are carried out every year in the country and the procedure — contrary to the general perception that it is sought by unmarried women — is wanted by married women, with four to five children, who consider abortion an ‘easier family planning tool’ rather than using contraceptives.

These were some of the points highlighted at a seminar, The politics of abortion, organised by the Society of Obstetricians and Gynecologists of Pakistan (SOGP) at the PMA House on Saturday.

Giving a presentation on abortion and maternal health in Pakistan, Dr Shershah Syed, a senior gynaecologist, said most victims of the ailing social mindset were poor women because the rich could pay huge amounts to get the procedure done by trained professionals.

“The politics of abortion is that to keep silent and not to create awareness of the subject,” he said.

Giving some statistics, he said 30,000 women died every year in Pakistan because of pregnancy-associated complications that put the maternal mortality rate to about 276 per 100,000 live births.

Complications of miscarriages/ abortions, he said, accounted for 10 to 12 per cent of maternal deaths while one out of six pregnancies was terminated by induced abortion through a risky method.

“Due to a lack of health services and access to modern family planning methods, a large number of abortion-related complications worsen the maternal health situation in our country. Besides, cases of abortion are mismanaged by untrained healthcare providers,” he said, adding that about 36.81pc of abortions were conducted by unskilled traditional birth attendants.

Reproductive and sexual health issues, including early marriages, unplanned pregnancies and sexually transmitted diseases, he said, increased the burden on women’s health.

Referring to a report in a foreign publication, he said about 75,000 women who tried to abort pregnancies by inserting different objects into their bodies died every year worldwide. Most of them, he said, belonged to South Asian and African countries.

Painting a picture of what’s happening in the United States, Dr Huma Farid, clinical fellow in obstetrics, gynaecology and reproductive biology, Brigham Women’s Hospital in Boston, Massachusetts, said the abortion issue had been politicised in America and it was no longer viewed as a health subject.

“The US is perceived as a liberal country, but what is happening there on the abortion issue could have dangerous repercussions in the coming years,” she said, while explaining that though abortion was legal in the US, a number of states under the strong influence of conservative Christians had started passing anti-abortion laws.

“The risk of death from a legal abortion performed by a licensed provider is 0.4 per 100,000 cases while the risk increases to 17pc in cases of illegal abortion,” she said.

The US, she said, had a high rate of unplanned pregnancies (49pc); of those unplanned pregnancies, 42pc ended in abortion; 19pc of abortions were among teenagers; 67pc of women who sought abortions were unmarried and almost half of American women had terminated at least one pregnancy.

She also traced the history of abortion and pointed out that in the early 1600s the procedure was legal. Two centuries later, the states started passing anti-abortion laws and by 1900 abortion was illegal in every state in the US.

“Since abortions were illegal, the procedure was performed in hiding (about 200,000 to 1.2 million cases annually) and in a highly unsafe environment and represented 18pc of maternal deaths in 1930,” she said.

The case, she said, finally went to the US Supreme Court, which ruled in 1973 that the right of personal privacy included the abortion decision.

Citing a survey, Dr Nighat Shah, representing the SOGP, said that 80pc of doctors wanted stricter laws on abortion instead of favouring relaxation of rules. She also stressed that abortion was purely a health issue and must not be confused with religion and culture.

Imtiaz Kamal, president of the Midwifery Association of Pakistan, said Pakistan laws permitted that abortion could be done to save a life and to carry out necessary treatment.

Islamic scholars, she said, permitted the procedure to be done within 120 days of pregnancy.

“Professional values are more important than personal beliefs. Healthcare providers must refer the patient seeking abortion to the right place if they are not willing to carry out the procedure,” she said.

Ann Furedi, chief executive of BPAS, reviews Sara Dubow’s book Ourselves Unborn: A History of the Fetus in Modern America.

Ourselves Unborn: A History of the Fetus in Modern America
Sara Dubow, Oxford University Press, 2011, 320 pp.

Recent discussions about the permissibility of later abortions have raised interesting questions about how we regard the fetus. How much value do we accord to life that has been conceived but not born? Has the way we assess this changed? Does our expanding knowledge of the science of fetal development mean that it should?

For decades, opponents of abortion have called on us to “confront the reality of abortion,” asking us to admit that the embryo is “human and alive” and that abortion “stops a beating heart.” They have accused the prochoice movement of devaluing the fetus, of denying that it is different than any other “blob of tissue” or of likening it to an unwanted growth, a “cancer” or a “parasite.” Their assumption, on the level of rhetoric or conviction, has been that prochoice politics is built on ignorance of what the fetus truly is. Today their challenge to us is this: as modern science tells us more about human development, as 4D scans show us the true face of the fetus, how can we allow its ending through late-term abortion?

Indirectly, implicitly, this book addresses that question.

Ourselves Unborn: A History of the Fetus in Modern America is not an argument about abortion, nor a vehicle for the beliefs of the prochoice movement. Sara Dubow, a historian at Williams College in Massachusetts, has written a detailed and scholarly study of the way value has been attributed to fetal life over the last century. “A fetus in 1870 is not the same as a fetus in 1930, which is not the same as a fetus in 1970, which is not the same as a fetus in 2010,” Dubow says. The change, she explains, is not driven by knowledge about the fetus, but by the emotional and political investment people have in it. Through their approach to the status, development and significance of the fetus, “people— individually and collectively—expressed their assumptions about personhood, family, motherhood and national identity.” How we understand and relate to the fetus is driven by social values and political circumstances far more than by biology or theology.

The book dismisses the idea that the advances in our knowledge about the developing fetus should shape our attitude to fetal status in respect to abortion. It shows that the fascination with fetal feeling, experience and appearance, which seems newly stimulated by today’s scientific discovery, has been a part of the medical, cultural, social and political discourse for more than a century. The form that this discussion takes and the conclusions that are drawn from it have been driven by cultural values and not by accumulated knowledge or new discovery. Throughout modernity, support for women’s choice about the future of her pregnancy was never built on ignorance of fetal life. Instead, it was based on the understanding of the fetus partnered with the concept of what pregnancy, giving birth and raising a child means for a woman.

Today’s commentators assume that, regarding fetal life, our trajectory has been to accumulate evidence that there is little difference between the unborn and the born. Dubow’s first chapter demonstrates how untrue this is. The progression of scientific thinking in relation to the fetus, from Aristotle until the mid-nineteenth century, was not so much a journey to discover how alike babies and fetuses are, bringing us closer to a view that the fetus is deserving of more respect. Rather, she illustrates that the voyage has been one to discover the differences between embryo, fetus and baby. A famous late-fifteenth century drawing by Leonardo da Vinci is generally regarded as the first accurate presentation of the fetus in utero (in “fetal position” ). While feminists have criticized the accuracy of da Vinci’s representation of the uterine context (which appears opened like a Fabergé egg), there can be little criticism of his rendering of the fetus. It is astonishingly similar to the photographs we see today in modern scans and medical textbooks—we are touched by how much it looks like a born “baby.” But in 1487, many would have been surprised by how un-like a man it was. Before then, the fetus was typically illustrated by various kinds of imagined homunculi—little humans—or cherubic infants. (A rich collection of illustrations is included in Karen Newman’s essay, Fetal Positions: Individualism, Science and Visuality, published in 1996 as part of Stanford University Press’s “Writing Science” series.)

Twenty-first century science’s knowledge of the fetus has not exposed the reality of fetal life, nor has it made public support for later abortions untenable. As Dubow reminds us, the Swedish photographer Lennart Nilsson first started to gain recognition for his photographic images of the fetus in the early 1950s.

Nilsson’s iconic series of fetal photographs, which first appeared in the 1965 Life magazine article “The Drama of Life before Birth,” have become the classical reference for feminist discussion of fetal imagery. They employ all manner of deliberate technical presentation and descriptive techniques to evoke “fetal personhood.” And yet, despite the photographer’s intent to dramatize life before birth, just two years later in Britain, and nine years later in the US, abortion was legalized.

In truth, the public has been exposed to, and fascinated by, accurate representations of the fetus for well over a century. Dubow cites the displays of anatomically correct wax models of human embryos, the centerpiece of an 1893 Chicago exposition that attracted crowds of visitors. Forty years later, the fetus was still a public draw, motivating exhibitors to go further to meet the audience for realistic representation. In 1933, some 20 million visitors paid 10 cents each to see a “graduated set of human embryos and fetuses” preserved in formaldehyde “to illustrate the development of an unborn baby from the first month to the eighth.” At this time they were seen as scientific curiosities—educational specimens. Times change, however, and Dubow recounts that, when a similar exhibition was mounted in 1977, the organizer was arrested and charged with the illegal transportation of human remains. Dubow discusses in some detail the changes that had occurred in the intervening decades—how the preserved fetus had turned from a scientific specimen to an emblem of the American family. My point is more straightforward: for more than a century people have known that in later pregnancy fetuses look like babies, and yet they have continued to make legal, moral and public policy decisions related to abortion regardless.

Just as there has been a long-standing interest in what the fetus looks like, so there has been similar interest in what fetuses feel and know. Dubow writes of research at the Samuel S. Fels Research Institute for the Study of Prenatal and Postnatal Environment in the late 1940s, which attempted to address social, psychological and physiological aspects of fetal behavior. She documents studies of “prenatal life” reported in the popular press of the time, such as a magazine article suggesting the new questions being researched: “What happens to a baby before he is born? Is he sometimes uncomfortable? Does he feel motions? Can he hear? Can he think? Is he capable of learning?” Dubow suggests that “prenatal psychology” got a stamp of approval as early as the 1940s, though without any implication of a protected status or fetal life.

The controversies regarding second trimester abortion in the 1970s illustrate most clearly how politics and advocacy are not framed by scientific or medical perception—it is politics that drives perception.

On April 11, 1974, Boston City Hospital physician Kenneth Edelin was indicted for manslaughter following a second trimester abortion. Although the Supreme Court Decision in Roe v. Wade had provided a relatively liberal framework for abortion, this case was complicated by tensions around race, class, ethnicity and concerns about the unchecked authority of doctors and scientists. In a hysterical environment excited by allegations that elective abortions were producing a supply of fetuses for research purposes, some of which were supposedly “kept alive” for experiments, Edelin was accused of causing the death of a fetus. He was said to have deprived a 24-week-old fetus of air after he had carried out an abortion by hysterotomy— by making an incision in the uterus. Edelin denied he had asphyxiated the fetus after delivery, but he was unashamed about his actions as an abortion doctor, which were not intended to result in a live birth. Under cross-examination he confirmed his belief that he owed no duty to the fetus. He was not concerned whether the fetus was live or dead at the start of the procedure since his only concern was for “the mother,” and even if he had thought that the fetus was alive after delivery he would not have called a pediatrician because “this being an abortion before viability,” he thought that an attending pediatrician would have been “number one, contrary to the patient’s wishes, and number two, contrary to good medical practice.”

Edelin was convicted following a sham of a trial, which Dubow describes in detail. The account is fascinating, but even more astonishing were the media reports, which gave unequivocal backing to the abortion doctor. The Boston Globe described Edelin as “a victim of judicial inadequacy that no society should tolerate.” The Washington Post wrote that the Edelin conviction brought “‘disgrace and shame’ to the State of Massachusetts and the entire judicial system … and warned that the impact of the decision ‘on the practice of medicine and on medical research in Boston, and elsewhere, is likely to be enormous.’” The New York Times called the decision “unbelievable” and feared that “it will now become more difficult than ever for women to obtain abortions when they are in the second trimester after conception.”

The case caused the American College of Obstetricians and Gynecologists (ACOG) to issue a statement reaffirming their support for “unhindered access by women to abortion services,” and warned that the profession, “must guard against local jurisdictions or vocal minorities imposing their ethical positions for medical care on family planning and abortion on patients and doctors who do not hold those positions.” The Planned Parenthood Federation of America worried that the decision “will make doctors fearful of performing abortions.” The National Abortion Rights Action League (NARAL) was concerned about the affect on “women with no financial means or alternative options.”

Edelin’s conviction carried with it a maximum sentence of 20 years, but he was sentenced to one year of probation, suspended until the anticipated appeal. In 1976, a unanimous ruling by the Supreme Judicial Court of Massachusetts overturned the conviction.

We can ask—if Edelin were to come to trial today, what chance would there be that the media, ACOG, Planned Parenthood and abortion lobbyists like NARAL would stand together in unequivocal, unapologetic support for a second trimester abortion doctor found guilty of manslaughter?

Sadly, I think we have to concede that many would say—even if convinced of the righteousness of the doctor’s actions—that public support would be unwinnable. Today, late abortion is something even some who call themselves “prochoice” will no longer defend. Their retreat is not because they have learned more about the fetus, but because they have failed to learn what they should about women’s lives.

Dubow’s work shows that, from the late nineteenth century to the early twenty-first century, “the fetus has been a vehicle through which people have wrestled with assumptions about science and religion, anxieties about demography and democracy, beliefs about feminism and motherhood, and ideas about conservativism and liberalism.” This will be as true for the future as it has been for the past. Ourselves Unborn: A History of the Fetus in Modern America tells a story beginning a century ago, when the fetus was framed in a historical context during which, “embryology became a science, obstetrics became a profession, abortion became a crime, birth control became a movement, eugenics became a cause and prenatal care became a policy.” The challenge we face today is to understand the context in which our appreciation of the fetus is currently framed, and our task is to shape that context and not passively accept it.

In 1996, Edelin, who went on to become a chairman of Planned Parenthood, addressed the matter of whether the loss of a fetus in abortion was always a tragedy. He wrote: “Many women choose abortion because of the tragedies in their lives and in the circumstances surrounding their pregnancies. For these women, abortion is not a tragedy; instead it liberates them from tragic circumstances. Women must never be left out of the abortion debate, or the debate about fetal research, medical progress or moral politics.” He was right. Dubow provides the evidence: it is not fetal science that teaches us what we know to be right. Instead, through the years we interpret and understand that science in the context of what appears right from our own and society’s perspective.

Ann Furedi is chief executive of BPAS, and author of Unplanned Pregnancy: Your Choices.

This review is published in Conscience magazine, Volume XXXII, No 2, 2011. Reprinted with kind permission on Abortion Review:

by Marianne Mollmann, Amnesty International

October 20, 2011 – 9:30am

Restrictions on abortions just don’t work in that they don’t result in the desired outcome.  This is the predictable, yet bold, conclusion of a reportto be presented at the United Nations on Monday, October 24th by Anand Grover, a UN-appointed independent expert on health.  The report, which is part of an annual report-back from various human rights experts to the United Nations’ General Assembly, consolidates years of legal analysis and empirical evidence from other experts and concludes that abortion restrictions are unworkable and damaging to women’s health. Instead, the report advocates access to full, accurate, and complete sex education and information about contraception, as well as to all forms of modern contraception, because these services and state support for women’s equality actually do work to reduce the need for abortions.

Abortion restrictions are generally justified by reference to a desire to lower the number of terminations, be it by limiting access to abortion for all women, as in ChileEl Salvador, and Nicaragua, or just for the “undeserving,” as in most of the rest of the Americas including the United States. Some explicitly prefer pregnant women to die rather than having access to a life-saving abortion, but most refer to some sort of makeshift hierarchy of morals.

“Most people, of course, should have access free of charge,” a high school friend from Denmark told me the other day. “But women who just keep having abortions: there really should be some sort of punishment for them.”

I have heard this sentiment echoed so many times.  “Seriously, I believe in access to abortion,” a young Mexican friend told me. “But really women need to show a minimum of responsibility.” This friend had, in the course of the same conversation, told me he recently had a condom break during intercourse.  When asked if he believed the woman in that case, if she were to become pregnant, had shown the requisite minimum of responsibility he was confused and horrified.  Of course she should have access to an abortion.  At least they had tried.

These considerations about who, if anyone, deserves access to abortion are often at the core of public debate on the issue.  All but the most radical anti-choice activists would say that pregnant rape victims should have access, as well as those whose lives or health are threatened by the pregnancy.  This distinction between the vulnerable madonnas and the physically healthy sluts is, in fact, the bright line in determining public funding for abortion services in the United States today.

The truth of the matter is that abortion restrictions in law and policy have little if anything to do with how women and girls deal with their pregnancies.  Of the hundreds of women I have spoken to about their abortions, none mentioned the law as a deciding factor in whether or not to continue an unwanted or unhealthy pregnancy. Sure, the criminalization of abortion might be an impediment to getting a safe and timely abortion, but never a real barrier to getting one at all.

In fact, the only two questions policy-makers can helpfully ask themselves about their approach to abortion are 1) is it workable; and 2) does it actually work.

Most policies that allow only partial access to abortion for the “deserving” women are not all that workable. You need a process for determining the validity of rape claims, for example, and a solid definition of just how unhealthy a pregnancy needs to be to be unhealthy enough for the woman to be entitled to care.  In Ireland, where abortion is only theoretically legal for women who will die as a result of their pregnancy, a doctor asked me in visible distress: “How terminal does she have to be?  Can I help her if she has a 51 percent chance of dying, or does it have to be more?”

The notion proposed by my Danish friend—that irresponsible women who just have one abortion after another need to be punished—is equally unworkable.  How do you determine responsibility? And how many abortions are too many?  And what would be an appropriate punishment?  Carrying the pregnancy to term?  For many, the key moral question in the abortion debate is whether women who want their pregnancies terminated actually care.  But any policy based on a value-judgement on that count raises more ethical questions than it solves.  It is not workable.

By Joyce Arthur

October 20, 2011
Anti-choice activists in Canada argue that abortion should be defunded and that women should pay out-of-pocket for abortion care. But that is a right-wing ideological position that ignores evidence and human rights. Defunding abortion would be unconstitutional, discriminatory, and harmful to women. The following points explain why. (Each point is expanded upon here with detailed arguments, evidence and citations.)

1.   Women’s lives and health are at stake. Funding abortion is necessary to guarantee women’s right to life and security of the person under the Charter of Rights and Freedoms. The main reason the Supreme Court threw out the old abortion law in 1988 was because it arbitrarily increased the risk to women’s health and lives through unnecessary delays and obstructed access. Not funding abortion would have the same effect and the same constitutional problems as the old abortion law, and would put politics and ideology ahead of women’s lives and health.

2.   Women’s liberty and conscience rights under the Charter require abortion to be funded. The government must not interfere with the deeply personal decision to bear a child or not, which is integral to women’s autonomy and privacy. Otherwise, the government would be co-opting women’s right to choose by funding childbirth but not abortion, and paternalizing women with an official stance of moral disapproval of abortion.

3.   Since only women need abortions, funding abortion is necessary to ensure women’s legal right to be free from discrimination. Restrictive policies and laws that apply to only one gender violate human rights codes that provide protection on the basis of sex. Further, women’s equality rights under the Charter cannot be realized without access to safe, legal, fully funded abortion—otherwise, women would be subordinated to their childbearing role in a way that men are not.

4.   Abortion funding is crucial to ensure fairness and equity, without discrimination on the basis of income. We must not compel low-income women and other disadvantaged women to continue an unwanted pregnancy due to lack of funding, or to delay care while they try to raise money. Any delay in abortion care raises the medical risks, especially when it extends into the second trimester. Delays are also a punitive burden that unnecessarily prolong stress and discomfort for women. Best medical practice should ensure that abortion takes place as early as possible in pregnancy, and this requires full funding. 

5.   Funding abortion is very cost-effective while unwanted pregnancies are costly. The medical costs of childbirth are at least three times higher than the medical costs of abortion, and the social costs of forced motherhood and unwanted children are prohibitive. Further, the overall cost of abortion care to the taxpayer is a pittance relative to healthcare costs as a whole.

6.   Funding abortion serves to integrate abortion care into the healthcare system in general, and ensure the comprehensiveness of reproductive healthcare programs, which is essential. If abortions were not funded, it would ghettoize abortion care, as well as the women who need it and the healthcare professionals who deliver it. This would likely increase stigma, lead to other restrictions, further marginalize abortion care over time, and increase anti-choice harassment and violence. All of this occurred in the United States after abortion was defunded for poor women by the 1973 Hyde Amendment.

7.   Funding abortion is the right thing to do, despite some peoples’ belief that abortion takes a human life. There is no social consensus on the moral status of the fetus, and our laws do not bestow legal personhood until birth. Regardless, most Canadians believe that the woman’s rights are paramount in all or most circumstances, because she is the one taking on the health risks of pregnancy, bearing a child is a major decision with significant lifelong consequences, and a woman should be able to direct her own life and pursue her own aspirations apart from motherhood.

8.   Legal abortion is very safe for women, and generally beneficial. The alleged medical and psychological “dangers” of abortion to women as described by anti-choice activists are either totally false or grossly overstated. Such arguments cannot support the defunding of abortion anyway, since pregnancy and childbirth are actually far more medically risky, and many other funded medical treatments carry substantial risk. Access to legal, safe, fully funded abortion is also beneficial for women and families because it allows them to continue with their lives and plan wanted children later when they are ready to care for them.

9. Opinion polls showing that a majority of voters do not want to pay for abortion are misleading and not pertinent. Voter opinion on this issue has been shaped by anti-choice misinformation, as well as lingering prejudice about women who have abortions. Regardless, voters have no authority to dictate what medical treatments to fund, as this is the role of provinces and medical groups. Women’s basic rights and freedoms must not be subject to a majority vote.

10. Abortion must be funded because it is not an elective procedure, any more than childbirth is. Pregnancy outcomes are inescapable, meaning that a pregnant woman cannot simply cancel the outcome—once she is pregnant, she must decide to either give birth or have an abortion. To protect her health and rights, both outcomes need to be recognized as medically necessary and fully funded, on an equal basis.

11. Anti-choice activists often say that “pregnancy is not a disease” and therefore abortion should not be funded. But the same arguments can be made for childbirth, since there are no medical reasons for a woman to get pregnant and have a baby. More importantly, health is much more than the absence of disease – it’s about achieving a state of overall health and wellness. Women with unwanted pregnancies are not in a healthy place, so their abortion care should be funded.


WASHINGTON — After an emotional floor debate, the House of Representatives on Thursday passed theso-called Protect Life Act, which prohibits women from buying health insurance plans that cover abortion under the Affordable Care Act and makes it legal for hospitals to deny abortions to pregnant women with life-threatening conditions.
House Majority Leader Eric Cantor (R-Va.), a proponent of the bill, told voters last week that its purpose is “to ensure that no taxpayer dollars flow to health care plans that cover abortion and no health care worker has to participate in abortions against their will.”
In fact, the Affordable Care Act already keeps public dollars separate from the private insurance payments that cover abortion. A federal judge ruled in August that the anti-abortion group Susan B. Anthony List had to stop making the claim on its website that “Obamacare” subsidizes abortions because the assertion is false.
“The express language of the [Affordable Care Act] does not provide for taxpayer-funded abortion,” the opinion states. “That is a fact, and it is clear on its face.”
H.R. 358, introduced by Rep. Joe Pitts (R-Pa.), goes beyond the issue of taxpayer dollars to place actual limits on the way a woman spends her own money. The bill would prevent a woman from buying a private insurance plan that includes abortion coverage through a state health care exchange, even though most insurance plans currently cover abortion.
An even more controversial aspect of the bill would allow hospitals that are morally opposed to abortion, such as Catholic institutions, to do nothing for a woman who requires an emergency abortion procedure to save her life. Current law requires that hospitals give patients in life-threatening situations whatever care they need, regardless of the patient’s financial situation, but the Protect Life Act would make a hospital’s obligation to provide care in medical emergencies secondary to its refusal to provide abortions.
“Congress has passed refusal laws before, but it’s never blatantly tried to override emergency care protections,” said Sarah Lipton-Lubet, policy counsel at the American Civil Liberties Union. “We’ve heard proponents of this bill say that women don’t need emergency abortion care, but that is really just willful blindness to the facts.”
According to the American Journal of Public Health, Catholic hospitals already have a years-long history of ignoring the emergency care law to avoid performing abortions. In late 2009, an Arizona bishop excommunicated a nun who authorized an abortion procedure for a woman who otherwise might have died of pulmonary hypertension at a Catholic hospital in Phoenix.
Rep. Jackie Speier (D-Calif.) said she personally faced a situation in which an abortion was medically necessary.
“I was pregnant, I was miscarrying, I was bleeding,” she said on the House floor Thursday. “If I had to go from one hospital to the next trying to find one emergency room that would take me in, who knows if I would even be here today. What my colleagues on the other side of the aisle are trying to do is misogynist.”
Despite a strong showing in the House, the bill is unlikely to pass in the Democrat-controlled Senate, and the White House said on Wednesday that President Barack Obama will veto the legislation if it ever reaches his desk.
“The Administration strongly opposes H.R. 358 because … the legislation intrudes on women’s reproductive freedom and access to health care and unnecessarily restricts the private insurance choices that women and their families have today,” the White House said in a statement.

Concern about termination services is rising, with fewer doctors willing to perform the procedure, DoH says

Denis Campbell, health correspondent, Monday 18 July 2011 23.30 BST
A survey of medical students has found that almost half believe doctors should be allowed to refuse to perform any procedure to which they object. Photograph: Christopher Furlong/Getty Images

Pregnant women could find it harder in future to obtain an abortion because of the growing number of doctors who are opposed to carrying out terminations.

A survey of medical students has found that almost half believe doctors should be allowed to refuse to perform any procedure to which they object on moral, cultural or religious grounds, such as prescribing contraception or treating someone who is drunk or high on drugs.

Abortion provoked the strongest feelings among the 733 medical students surveyed, according to the study in the Journal of Medical Ethics. “The survey revealed that almost a third of students would not perform an abortion for a congenitally malformed foetus after 24 weeks, a quarter would not perform an abortion for failed contraception before 24 weeks and a fifth would not perform an abortion on a minor who was the victim of rape,” said researcher Dr Sophie Strickland.

“In light of increasing demand for abortions, these results may have implications for women’s access to abortion services in the future,” she added.

Concern about termination services is rising, with fewer doctors willing to perform the procedure, according to the Department of Health. The Royal College of Obstetricians and Gynaecologists has voiced concern about the “slow but growing problem of trainees opting out of training in the termination of pregnancy and is therefore concerned about the abortion service of the future”.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, said: “Abortion is taught increasingly infrequently in medical school, and students may not be required to engage much with the reasons why a woman may find herself with an unwanted pregnancy and the distress this may cause. All of us involved in women’s reproductive healthcare need to ensure that young doctors understand why women need abortions, and that this is a profession to be proud of.”

Some 45.2% of those surveyed believed doctors should have the right to refuse to treat someone when doing so clashed with their personal beliefs, but 40.6% disagreed. “Once qualified as doctors, if all these respondents acted on their conscience and refused to perform certain procedures, it may become impossible for conscientious objectors to be accommodated in medicine,” said Strickland.

Backing for a doctor’s right to refuse to perform any procedure was highest among Muslim medical students, at 76.2%. Some 54.5% of Jewish students also thought doctors should have the right to refuse, as did 51.2% of Protestants and 46.3% of Catholics.

Guidance drawn up by the General Medical Council (GMC), which regulates doctors, advises doctors to refer a patient to a colleague if they object to a certain procedure or treatment.

“However, we also make clear that doctors have an overriding duty to provide care for patients who are in need of medical treatment, whatever the cause of that medical need. It is not acceptable to opt out of treating a particular patient or group of patients because of personal beliefs or views about them, for example if they misuse drugs or alcohol,” said Dr Peter Rubin, the GMC’s chair.

The British Medical Association said that while doctors and medical students can refuse to participate in treatments they are uncomfortable with, patients must not be harmed or affected by their decision. They must also give patients enough information so they can seek treatment elsewhere within the NHS, according to a spokesman for the doctors’ union’s medical ethics committee.

The Department of Health said: “Patients’ clinical needs always come first, and practising doctors understand this. It is unlawful to discriminate on the grounds of religion or belief and the law does not entitle people to apply such beliefs in a way which impinges upon other people, even if they claim that their religion or belief requires them to act in this way.

“All patients have a right to a comprehensive and fair NHS. The NHS constitution, white paper and the Equality Act provide the legal framework and principles that underpin the way the NHS should provide its services and support its staff.”

Why Poland’s Proposed Abortion Ban is a Get-Rich-Quick Scheme for the Medical Establishment and a Death Sentence for Women

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by Katarzyna Pabijanek

July 11, 2011 – 11:08am


July 7, 2011. ( A proposal that would ban all abortions in Poland has been sent by Parliament to committee for consideration. Under current law, abortion is legal if there are serious fetal anomalies or in cases of endangerment to the life or health of the mother. In reality, legal abortion even under these circumstances is inaccessible. There is, however, a huge black market in abortion in Poland and the medical establishment earns nearly $100 million annually off the books providing unsafe abortion.

On June 30th, the Polish Parliament debated a bill that would totally ban abortion in Poland, even if a woman’s life were in danger. The left-wing party put forward a proposal to reject the bill during the first reading but the other political parties demanded the bill be referred to committee for consideration, and their proposal won by a vote of 261 to 155.. The committee will present a report on the bill to Parliament by early September. The draft bill, named “On the protection of human life from the moment of conception” – was initially submitted to Parliament in April 2011. The draft was prepared by the Committee of Legislative Initiative led by Mariusz Dzierzawski, a fanatic opponent of abortion, known as an organizer of the macabre anti-abortion exhibitions held in the Polish cities.

Poland’s abortion law is one of the most restrictive in Europe and even more restrictive in practice than on paper. Although the law allows termination of pregnancy under three conditions – including for therapeutic reasons and when it results from a criminal act – legal abortion is actually not accessible even for women whose conditions fall under the exceptions. According to the annual report on implementation of the current abortion law (“Law on family planning, protection of the human fetus and conditions for legal abortion”) there are approximately 500 (out of ten million women of reproductive age) legal pregnancy terminations a year.

The legal principles are applied with great rigidity and there is widespread abuse of conscience clauses among doctors and entire institutions intended to deny women legal abortion.   According to Polish law, physicians can refuse to perform abortion or dispense contraceptives on the grounds of conscientious objection. The conscientious objection clause and the way it is exercised in Poland have become a significant barrier to accessing services to which women are entitled by law.  It also happens quite often in Poland that conscientious objection is ”practiced” by the entire hospital, not by individual doctors, which opposes the individuality-based concept of the conscience clause. The recent anti-choice initiative call on the pharmacists to refuse to sell the contraceptives in pharmacies, and was inspired by the Council of Europe’s recent unfortunate resolution “The right to conscientious objection clause in the legal care”.

One case that upset much of the general public concerned a visually-impaired Polish woman, who was denied an abortion on health grounds, even though medical diagnoses confirmed that continuing her pregnancy could further severely damage her vision, thereby constituting a risk to her health.

Meanwhile the criminalization of abortion in Poland has led to the development of a vast illegal private sector with no controls on price, quality of care or accountability. Clandestine abortions generate up to $95 million a year for Polish doctors as women turn to the illegal private sector to terminate pregnancies. Since abortion became illegal in the late 1980s the number of abortions carried out in hospitals has fallen by 99 percent. The private trade in abortions is, however, flourishing, with abortion providers advertising openly in newspapers. The biggest losers are the least privileged: in 2009 the cost of a surgical abortion in Poland was greater than the average monthly income of a Polish citizen. Low-income groups are less able to protest against discrimination due to lack of political influence. Better-off women can pay for abortions generating millions in unregistered, tax-free income for doctors. Some women seek safe, legal abortions abroad in countries such as the UK, the Netherlands, Czech Republic and Germany.

The newest law proposal is being debated by the Parliament, and the report is to be presented in early September. The leftist Democratic Left Alliance Party presented another bill calling for liberalization of abortion. However, the progressive bill will not be discussed by the Parliament during its current term. Parliamentary elections are scheduled for October and it is becoming obvious that abortion will be the main coin used to gain voters. Pro-choice groups are currently forming an initiative to push for a liberal bill introducing refundable legal abortion till the 12th week of pregnancy, funding for contraceptives and sexual education in schools.

Poland is currently presiding over the council of the European Union, and the failure to reject this very restrictive bill on the very first day of the Presidency of the EU Council is a worrying signal to the international community. Polish groups have initiated a campaign calling on supporters to send a letter to the Prime Minister of Poland.

The letter is available at ASTRA’s website [21] and copied below.  We encourage you to send your letter opposing this law to Prime Minister Donald Tusk, [22].  We also ask that you send a cc: [23].

Sample letter:

Your Excellency, I write to express my concern that the draft text for the new bill on abortion: “The law on changing the Law on family planning, protection of the human fetus and conditions for legal abortion” – to be discussed by the Parliament’s Committee by the 1st of September – contains provisions on that will result in violations of women’s sexual and reproductive rights and health. The international human rights standard is to liberalize abortion laws to make it safe and accessible to women and thereby lessen maternal mortality related to unsafe abortion. The language used in the draft of the new bill regarding the right to life does not correspond to that used in international and European human rights instruments – to which Poland is also party – as it unconditionally prohibits abortion, thereby leading not to lessening the number of women inducing abortion but only makes it dangerous for women who will undergo clandestine and unsafe abortion. Passing the bill will increase maternal mortality, abortion-related injuries and deaths are likely to be especially high among poor women, who can’t afford to travel abroad. As a result, many of them might try self-induced abortions. It is unacceptable that in the 21st Century, a European country includes in its legislation a provision which directly endangers women’s lives. I trust that you will do your best to ensure that Poland considers reviewing its legislation regarding abortion in a forward-looking legislation, taking the lead in promoting women’s sexual and reproductive rights. Sincerely yours,