THURSDAY, MAY 26, 2011 14:02 ET

Abortion saved my life

I almost died in an emergency room because the doctor on call refused to perform a necessary procedure

A version of this piece originally appeared on Mikki Kendall’s blog.

There’s this lawmaker out of Kansas, Rep. Peter DeGraaf, who has a lot to say about abortion. He’s currently best known for saying that women should plan ahead in case of rape and not expect their regular insurance to cover an abortion after an assault. And I could spend a lot of time discussing the flaws in his logic, or even hashing out when life begins, but what I’m really concerned about is the idea that anyone besides a pregnant woman should have a say in what she does with her body after finding out she’s pregnant.

I’m a mom, and I love my sons more than anything. And it is because I love them that I had an abortion at 20 weeks. It was my fifth pregnancy (I’d had two earlier miscarriages), and, as it turned out, my last. There was trouble from the beginning; I didn’t experience any of the normal indicators of pregnancy, so I was already ten weeks along when I found out. I hadn’t so much as missed a period; in fact, I was seeing an OB/GYN because of the increased heaviness in my cycle. When we found out, I talked it over with my husband and we debated an abortion before deciding we’d try to make it work. My doctor told me that my pregnancy was very high risk and that she wasn’t sure of a good outcome. Per her instructions, I took it very easy because I wanted to give the baby the best possible chance. But I kept having intermittent bleeding and I knew there was a good chance I wouldn’t be able to carry to term.

I was taking an afternoon nap when the hemorrhaging started while my toddler napped in his room when I woke up to find blood gushing upward from my body. Though I didn’t know it at the time, I was experiencing a placental abruption, a complication my doctor had told me was a possibility. My husband was at work, so I had to do my best to take care of me and my toddler on my own. I managed to get to the phone and make arrangements for both of my children before going to a Chicago hospital.

Everyone knew the pregnancy wasn’t viable, that it couldn’t be viable given the amount of blood I was losing, but it still took hours for anyone at the hospital to do anything. The doctor on call didn’t do abortions. At all. Ever. In fact, no one on call that night did. Meanwhile, an ignorant batch of medical students had gathered to study me — one actually showed me the ultrasound of our dying child while asking me if it was a planned pregnancy. Several wanted to examine me while I lay there bleeding and in pain. No one gave me anything for the pain or even respected my request to close the door even though I was on the labor and delivery floor listening to other women have healthy babies as the baby I had been trying to save died in my womb.

A very kind nurse risked her job to call a doctor from the Reproductive Health Clinic who was not on call, and asked her to come in to save my life. Fortunately she was home, and got there relatively quickly. By the time she arrived, I was in bad shape. The blood loss had rendered me nearly incoherent, but she still moved me to a different wing and got me the painkillers no one else had during the screaming hours I’d spent in the hospital. After she checked my lab tests, she told us I would need two bags of blood before she could perform the procedure. Her team (a cadre of wonderful students who should all go on to run their own clinics) took turns checking on me and my husband. They all kept assuring me that soon it would be over, and I would feel much better. My husband had to sign the consent for surgery (I was clearly not competent enough to make decisions), and they took me away along with a third bag of blood to be administered during the procedure.

Later I found out that the doctor had taken my husband aside as they brought me into surgery. She promised him she would do her best to save me, but she warned him there was a distinct possibility that she would fail. The doctor who didn’t do abortions was supposed to have contacted her (or someone else who would perform the procedure) immediately. He didn’t. Neither did his students. Supposedly there was a communication breakdown and they thought she had been notified, but I doubt it. I don’t know if his objections were religious or not; all I know is that when a bleeding woman was brought to him for treatment he refused to do the only thing that could stop the bleeding. Because he didn’t do abortions. Ever.

My two kids at home almost lost their mother because someone decided that my life was worth less than that of a fetus that was going to die anyway. My husband had told them exactly what my regular doctor said, and the ER doctor had already warned us what would have to happen. Yet none of this mattered when confronted by the idea that no one needs an abortion. You shouldn’t need to know the details of why a woman aborts to trust her to make the best decision for herself. I don’t regret my abortion, but I would also never use my situation to suggest that the only time another woman should have the procedure is when her life is at stake. After my family found out I’d had an abortion, I got a phone call from a cousin who felt the need to tell me I was wrong to have interfered with God’s plan. And in that moment I understood exactly what kind of people judge a woman’s reproductive choices.

The Human Life International Poland and the Human Life’s Friends Club on 17th of February called for signing a petition concerning the right of the Polish pharmacists to refuse to sell the contraceptives in pharmacies. The HLI Poland has created a special website where a support for the right of pharmacists to refuse to sell the contraceptives, called by HLI Poland “miscarriage pills”, can be expressed. This wording illustrates best how scarce is the knowledge about contraception in Poland , even among health professionals. Polish Federation for Women and Family Planning hot line operators report the lack of information and knowledge regarding difference between contraceptives, emergency contraception drugs and abortifacients. According to current regulations, pharmacies are obliged to sell all the drugs registered in the national drug registry. The anti-choice initiative is based on the resolution “The right to conscientious objection clause in the legal care” adopted by the Council of Europe last year and claims that pharmacists, as health care professionals, also have a right to use a conscientious objection.

Source: Federation for Women and Family Planning at www.federa.org.pl

 

EP President considers MEP question concerning women rights to abortion inadmissible. Using in an arbitrary manner the rules of procedure of European Parliament, the President Buzek deemed inadmissible the question of SYRIZA (GUE/NGL) Member of Parliament Mr. N. Chountis, referring to the resolution of the Council of Europe on abortion. At 7th of October 2010 the Parliamentary Assembly of Council of Europe adopted a resolution titled “the right to conscientious objection in lawful medical care” (1763/2010). In this resolution is mentioned “No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human fetus or embryo, for any reason.” The MEP questioned about what is the Commissions position in relation to the mentioned resolution and he asked which measures will the Commission take in order to prevent the prevalence of extreme conservative views on the pretext of freedom of conscience are trying to restrict the women rights. The question was deemed inadmissible by the Polish Christian Democrat President of the European Parliament, Mr Buzek. This incident adds to our concerns with the deteriorating situation for SRHR in the European Parliament. ASTRA Network believes that Mr Buzek’s behaviour represents dangerous signal regarding SRHR across the EU.

Source: GUE

More:http://newsportal.european-left.org/nc/english/newshome/news_archive/news_archive/zurueck/news-archive-3/artikel/ep-president-considers-mep-question-concerning-women-rights-to-abortion-inadmissible-1/

 

The rationale behind the draft of the resolution was to regulate the use of conscientious objection by reproductive healthcare providers. The resolution did not pass as proposed and its provisions were severely diluted by a number of harmful anti-abortion amendments. As a result, instead of offering a set of comprehensive guidelines from a regional or international body on how governments must balance a woman’s right to reproductive health and autonomy with an individual’s right to conscientious objection, the adopted resolution: (1) fails to oblige health care institutions to provide legal health services to the public; (2) enables both doctors and institutions to refuse emergency care without being held liable; (3) is based on the false assumption that the practice of conscientious objection is adequately regulated in the vast majority of Council of Europe member states.

 

“25 organizations-members of ASTRA Network supported by Action Canada for Population and Development (Canada), Association for Women’s Rights in Development, Catholics for Choice (USA), Center for Reproductive Rights, Family Planning Association (Ireland), French Family Planning Movement (France), International Women’s Health Coalition, IPAS, Sensoa (Belgium), Swedish Association for Sexuality Education (Sweden) expressed deep concern with the result of voting on the resolution “Women’s access to lawful medical care: the problem of unregulated use of conscientious objection” that took place during the 35th sitting of the Parliamentary Assembly of the Council of Europe in a letter sent to the President of the Parliamentary Assembly of the Council of Europe, Mr Mevlüt Çavusoğlu.

read the full letter here:

 

Click to access astraletter.pdf

October 7, 2010

New York, NY – Today, the Parliamentary Assembly of the Council of Europe (PACE) undercut a resolution intended to regulate the use of conscientious objection by reproductive healthcare providers. The resolution did not pass as proposed and its provisions were severely diluted by a number of harmful anti-abortion amendments.

 

“It is truly a dismal day in Europe when the lives and health of women take a back seat to political agendas and ideological imperatives,” said Christina Zampas, regional manager and senior legal adviser for Europe at the Center for Reproductive Rights. “Today’s disappointing vote shows the growing political power of the anti-choice movement among both governments and civil society, as well as a lack of political commitment to women’s reproductive health by ostensibly pro-choice politicians.”

The resolution would have offered the first set of comprehensive guidelines from a regional or international body on how governments must balance a woman’s right to reproductive health and autonomy with an individual’s right to conscientious objection. In many member states of the Council of Europe, the practice of conscientious objection in the medical field is largely unregulated. As a result, healthcare providers deny women access to lawful reproductive health services based on moral or religious objections–severely impacting their health and lives. The PACE resolution as originally proposed recommended that governments develop comprehensive regulations and guarantee the right to conscientious objection only to individuals, not to public health facilities. They also recommended that public facilities provide patients with information on all of their medical options and treatment in cases of emergency regardless of an individual practitioner’s objections.

“When a healthcare worker objects to providing legal reproductive services because of his or her conscience, it is imperative to a woman’s health and life that the government make sure that she can still get the services she needs and is legally entitled,” said Zampas, whose  expertise helped draft a report presented to PACE on the unregulated use of conscientious objection.

In a number of European countries, including Italy, Poland, Hungary, and Croatia, there are laws requiring doctors to inform patients of any conscientious objection to a procedure and refer the patients to another provider, but there is no oversight mechanism.  For example, the Center is currently working closely with the Polish Federation for Women and Family Planning and the Warsaw University Law Clinic on a lawsuit against Poland in the European Court of Human Rights for the death of a woman who was refused treatment for colon disease because doctors feared it would harm the fetus. Edyta* was two months pregnant when she was diagnosed with the painful colon disease which was aggravated by her pregnancy. When she sought medical care in her Polish hometown and other cities, however, doctor after doctor refused to treat her illness because she was pregnant. They repeatedly expressed concern about the fetus, but none of them formally raised a moral or religious objection so they did not have to refer Edyta to a doctor that would treat her. Edyta’s symptoms grew worse until she miscarried and eventually, died. The lawsuit aims to ensure that Poland maintains enough healthcare workers who are willing to provide all legal health services and that patients get timely referrals. The suit also asks the court to prohibit hospitals and other institutions from invoking conscientious objection or using it to deny patients information or emergency care.

 

FOR MORE INFORMATION:


Dionne Scott, dscott@reprorights.org, (917) 733-4357

Bojana Stoparic, bstoparic@reprorights.org, (917) 637-3683

 

Importance of the PACE draft resolution on “Women’s access to lawful medical care: the problem

of unregulated use of conscientious objection”


The Parliamentary Assembly of the Council of Europe will discuss and vote on the resolution on

Women’s access to lawful medical care: the problem of unregulated use of conscientious objection”

(Doc. 12347, 20 July 2010) on 7 October 2010 during the 2010 Ordinary Session in Strasbourg.

The draft report and resolution (attached to this summary) was prepared by Ms Christine McCafferty

(United Kingdom, SOC) and adopted by the Social, Health and Family Affairs Committee on 22 June

2010.


Why is the draft resolution significant?

International law recognizes the importance of conscientious objection to the exercise of an

individual’s right to freedom of thought, conscience and religion.1 However, international standards

also recognize this must be balanced against an individual’s rights including right to life, health,

privacy and non-discrimination.2 And that states have a duty to ensure that exercise of such refusals

does not harm the health and rights of patients. If adopted, this resolution will be in accordance with

international human rights standards, which include rights relevant to health care providers and users

in the context of conscientious objection, as set forth in the International Covenant on Civil and

Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights

(ICESCR) and the Convention on the Elimination of All Forms of Discrimination Against Women

(CEDAW). This resolution will provide guidance to states on how the right to freedom of thought,

conscience and religion can appropriately be balanced with the right to access lawful medical

services. It has potential to ensure that interests and rights of both healthcare providers and

individuals seeking legal medical services are respected, protected and fulfilled.

In many member states of the Council of Europe, the practice of conscientious objection in the

medical field is largely unregulated. In a number of countries, women are denied access to lawful

reproductive health services, where conscientious objection most often arises, severely effecting their

health and lives. The unregulated practice disproportionately affects low income and rural women.

Two cases pending before the European Court of Human Rights against Poland illustrate the impact the

unregulated practice has on women’s lives. One in which a woman was repeatedly denied a genetic

prenatal examination she was legally entitled to receive3 and the other case concerns a woman with a

wanted pregnancy who was refused diagnostic care and treatment by doctors, in part, because of they

claimed it would harm her foetus. Tragically, she miscarried and then died due to the lack of care.4

In Austria healthcare professionals frequently conscientiously object to performing abortion and there are

no specific legal guidelines regarding this practice.5 In Bratislava, Slovakia’s capital, a recent news

report notes that only one out of five public hospitals provides abortion.6 Moreover, hostile and

judgemental treatment from some health personnel in the remaining hospital towards a woman

undergoing abortion on request has been reported.7 It is not unusual that practitioners who provide this

medical service face contempt and judgemental behaviour from their colleagues who object to performing

abortions.

Where comprehensive and clear regulations exist, many member states lack oversight and

monitoring mechanisms to ensure that healthcare providers act in accordance with these regulations

and that patients can exercise their right to access lawful health services (e.g. Poland or Italy).



According to data provided by Italy’s Ministry of Health, nearly 70% of gynaecologists and 50.4% of

anaesthetists in Italy refuse to perform or participate in abortions. In the southern parts of the country, the

numbers are even higher.8


What has the European Court of Human Rights said about this issue?

The European Court of Human Rights, in the only decision to date that addresses the issue in a

reproductive health care context, held that two French pharmacists, who refused to deliver medically

prescribed contraceptives, were imposing their beliefs on the public. The Court declared the application

inadmissible and explained that ‘religious beliefs can be manifested in many ways outside the

professional sphere’ and that the right to freedom of religion, as a matter of individual conscience, does

not always guarantee the right to behave in public in a manner governed by that belief. The Court

concluded “as long as the sale of contraceptives is legal and occurs on medical prescription nowhere

other than in a pharmacy, the applicants cannot give precedence to their religious beliefs and impose

them on others as justification for their refusal to sell such products.”9 This is the only case thus far

where the Court has ever addressed conscientious objection in access to health care.


What does the draft report and resolution recommend to member states?

To develop comprehensive and clear regulations that define and regulate conscientious objection

with regard to health and medical services, including reproductive health services, which:

a. guarantee the right to conscientious objection only to individual healthcare providers directly

involved in the performance of the procedure in question, and not to public/state institutions such

as public hospitals and clinics as a whole;

In France, a Constitutional Council decision recognized that conscientious objection applies to

individuals, not institutions.10 In Germany, the Federal Administrative Court indicated that public hospitals

must provide abortions, enabling women to realize their entitlement to abortion under the law.11

b. oblige the healthcare provider to:

provide information to patients about all treatment options available (regardless of whether

such information may induce the patient to pursue treatment to which the healthcare provider

objects),

inform the patient in a timely manner of any conscientious objection to a procedure, and to

refer patients to another healthcare provider in that case,

ensure that the patient receives appropriate treatment from the healthcare provider to whom he

or she has been referred;

For example, in Poland a woman with wanted pregnancy died as a result of being denied necessary

medical treatment on the grounds that doctors conscientiously objected to this treatment for fear it would

harm the foetus.12

c. oblige the healthcare provider to provide the desired treatment to which the patient is legally

entitled despite his or her conscientious objection in cases of emergency (notably danger to the

patient’s health or life), or when referral to another healthcare provider is not possible (in

particular when there is no equivalent practitioner within reasonable distance).

Only eleven Council of Europe member states expressly prohibit the invocation of conscientious objection

in the case of emergency or risk of death as well as danger to the patient’s health.13

To provide oversight and monitoring, including an effective appeals mechanism if a patient is denied

access to services they are legally entitled to receive so as to ensure that everyone has access to an

effective and timely remedy, and to guarantee the effective implementation and enforcement of these

regulations within member states’ respective health services.

The aim of this recommendation is not an adversarial proceeding, but to ensure effective access

to lawful health care. In Tysic v. Poland, a case which did not concern denial of abortion due to

conscientious objection, but lack of an effective means of appeal in case of lawful therapeutic

abortion, the European Court of Human Rights recognized the importance of a timely remedy due

to legal and biological time restrictions on abortion and pregnancy, and emphasized that “[o]nce

the legislature decides to allow abortion, it must not structure its legal framework in a way which

would limit real possibilities to obtain it.”14

In Poland, Croatia and Hungary, laws require physicians to inform patients of any conscientious

objection to a procedure and refer such patients to other doctors, but they do not have an oversight

mechanism to ensure that this happens, leaving many patients without a referral.15 In addition, in

Poland, it has been reported that some doctors who refuse to perform lawful abortions in public hospitals

will offer patients to perform abortions privately, for excessive money.16



1

See Human Rights Committee, General Comment No. 22: The Right to Freedom of Thought, Conscience and Religion, UN Doc.

HR1/GEN/1/Rev. 1 (1993) (the right to conscientious objection can be derived from the right to freedom of thought, conscience and

religion); European Union Network of Independent Experts on Fundamental Rights, Opinion No. 4-2005: The right to conscientious

objection and the conclusion by EU Member States of concordats with the Holy See (2005).

2

See EU Network of Independent Experts on Fundamental Rights, id. See also Art. 9(2) of the European Convention on Human

Rights that reads: “Freedom to manifest one’s religion or beliefs shall be subject only to such limitations as are prescribed by law

and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for

the protection of the rights and freedoms of others.”; Human Rights Committee (CCPR), General Comment 22: The right to freedom

of thought, conscience and religion, CCPR/C/21/Rev.1/Add.4; Committee on Economic, Social and Cultural Rights (CESCR),

General Comment 14: The right to the highest attainable standard of health, E/C.12/2000/4.

3

RR v. Poland, ECtHR, Appl. no. 27617/04, the case is pending.

4

Z. v. Poland, ECtHR, Appl. no. 46132/08, the case is pending.

5

PACE – Social, Health and Family Affairs Committee, “Women’s access to lawful medical care: the problem of unregulated use of

conscientious objection”, Explanatory memorandum by Ms McCafferty, rapporteur, Doc. 12347, 20 July 2010 [hereinafter

Explanatory memorandum by Ms McCafferty, rapporteur”], para. 46, citing to International Planned Parenthood Federation

European Network, Abortion Legislation in Europe.

6

Potrat? Nerobíme! Chote inam, hovoria lekári Slovenkám” (“Abortion? We do not perform! Go somewhere else, the doctors say

to Slovak women”), 30 July 2010, available at: http://tvnoviny.sk/zeny/top-tema/potrat-nerobime-chodte-inam-hovoria-lekari-

slovenkam.html (last visit: 27 August 2010).

7

Id.

8

Explanatory memorandum by Ms McCafferty, rapporteur, supra note 5, para. 45, citing to Republic of Italy, Ministry of Health,

Report of the Ministry of Health on the Performance of the Law Containing Rules for the Social Care of Maternity and Voluntary

Interruption of Pregnancy: 2007-2008.

9

Pichon and Sajous v. France, ECtHR, Appl. no. 49853/99 (admissibility decision).

10

Explanatory memorandum by Ms McCafferty, rapporteur, supra note 5, para. 26.

11

Explanatory memorandum by Ms McCafferty, rapporteur, id. para. 27.

12

Z. v Poland, supra note 4.



Explanatory memorandum by Ms McCafferty, rapporteur, supra note 5, para. 40.

14

Tysic v. Poland (2007), ECtHR, Appl. no. 5410/03, ¶ 116.

15

Explanatory memorandum by Ms McCafferty, rapporteur, supra note 5, para. 33.

16

Reproductive Rights in Poland, the effects of the anti-abortion law, Federation for Woman and Family Planning, edited by Wanda

Nowicka (2008).

European Parliament Platform for Secularism in Politics held a Platform´s meeting last Wednesday 15 September on the subject of “Conscientious Objection in Medicine”.


The aim of the Platform is to initiate debate on secularism in politics. The Platform reaches out to a wide group of people, including practitioners, experts and the civil society.

Please find below the links to the videotaped contributions.

F – 67075 Strasbourg Cedex | e-mail: assembly@coe.int | Tel: + 33 3 88 41 2000 | Fax: +33 3 88 41 27 33

Doc. 12347

20 July 2010

Women’s access to lawful medical care: the problem of

unregulated use of conscientious objection

Report1

Social, Health and Family Affairs Committee

Rapporteur: Ms Christine McCAFFERTY, United Kingdom, Socialist Group


Summary

The practice of conscientious objection arises in the field of health care when healthcare providers refuse to

provide certain health services based on religious, moral or philosophical objections. While recognising the

right of an individual to conscientiously object to performing a certain medical procedure, the Social, Health

and Family Affairs Committee is deeply concerned about the increasing and largely unregulated occurrence

of this practice, especially in the field of reproductive health care, in many Council of Europe member states.

There is a need to balance the right of conscientious objection of an individual not to perform a certain

medical procedure with the responsibility of the profession and the right of each patient to access lawful

medical care in a timely manner.

The Parliamentary Assembly should thus invite member states to develop comprehensive and clear

regulations that define and regulate conscientious objection with regard to health and medical services,

including reproductive health services, as well as to provide oversight and monitoring, including an effective

complaint mechanism, of the practice of conscientious objection.

The Assembly should also recommend that the Committee of Ministers instruct the competent Steering

Committees and/or other competent Council of Europe bodies to assist member states in the development of

such regulations and the setting up of such oversight and monitoring mechanisms.

(more…)

During its 3rd plenary session in Strasbourg that was held from 21-24 June 2010, the Parliamentary Assembly of the Council of Europe’s Committee of Social Affairs and Health adopted the report without any additional amendments. This is the first and important vote before the report will go to the Plenary in October to be adopted by all 47 Council of Europe Members States Parliamentarians.

The report and the draft Resolution will be the first documents on the level of the Council of Europe to address and regulate the practice of conscientious objection-the right of health services providers, including doctors, nurses and other medical personnel to refuse to provide certain health services based on religious, moral or philosophical grounds. The main purposeof the report is to ensure that the practice of conscientious objection which often arises in provision of reproductive health services does not prevent women from accessing lawful medical care in a timely manner. In the report the Rapporteur Hon. Christine McCafferty (Socialist, UK) expresses her concern about the increasing and largely unregulated occurrence of the practice of conscientious objection, especially in the field of reproductive health. If adopted, the Resolution will call on Member States to develop comprehensive and clear regulations that define and regulate conscientious objection with regard to health and medical services including reproductive health as well as to provide oversight and monitoring.