What the Death of Savita Halappanavar and Canada’s Attitude to Abortion Have to Teach Us

http://www.xojane.co.uk/issues/what-the-death-of-savita-halappanavar-and-canadas-attitude-to-abortion-have-to-teach-us

Savita Halappanavar’s life ended because medics put the life of her unborn child – who they knew would die anyway – before hers, and because those medics were prevented by law from performing a procedure that would have saved her.

 

This week I’ve been thinking a lot about the tragic death of Savita Halappanavar, the 31 year old dentist who passed away in a Galway hospital last month, after being refused an abortion that could have saved her life. By the time this goes live, I’m sure the controversy will have reached Frankenstorm proportions.

Halappanavar was admitted to hospital miscarrying at 17 weeks. However, abortion is illegal in Ireland, and because the foetal heartbeat was still beating, medics refused to perform the medical abortion she needed and begged for. She miscarried days later, but not before she’d contracted the septicemia that would go on to kill her.

Anti-choice campaigners may rabbit on about the provision under law that states that abortion can be provided when there’s a direct threat to a woman’s life, or claim that the medics looking after Halappanavar should have induced labour in order to save her life.

The reality, as we’ve now seen, is that abortions are just not performed. And as for their suggestion that medics should have induced the birth of her unborn, but dying foetus? It would have been both cruel and totally unnecessary when the foetal heartbeat could have been stopped as the first step of the abortion Halappanavar repeatedly asked for.

The fact is, her baby, sadly, was not going to survive no matter what course of action her doctors took. So why not opt for the one that would have saved her?

Last week, I was contacted by Joyce Arthur, who is the Executive Director of the Abortion Rights Coalition of Canada (ARCC). Arthur emailed members of the British media wanting to talk about Nadine Dorries’ recent attempts to reduce the time limits on abortions in Britain.

She explained that abortion had been fully decriminalised in Canada in 1988 because it was felt that the application of either civil or criminal laws to medicine was inappropriate.

Abortions are seen as a matter for women and their doctors, not law-makers and politicians, and the overall impact has been positive – abortion rates had fallen. Arthur also felt that Dorries, and her strategies, were ‘misguided.’

Happy to talk to anyone who describes Nadine Dorries as ‘misguided,’ I contacted her for an interview.

Who are the Abortion Rights Coalition of Canada, and what do you do?

The Abortion Rights Coalition of Canada is a national advocacy group for abortion rights so we do lobbying and education. We act on various issues, working with MPs, to protect the abortion rights that we have and also try and improve access to abortion in different ways.

What abortion services are freely available in Canada? Are they available on the Canadian National Health Service for free?

We do have universal healthcare [an equivalent to the NHS] so it is fully covered. In 1969, abortion was decriminalised to allow women to go before a therapeutic approval committee of three doctors to get approval before an abortion.

Abortions were available at some hospitals but it turned out that the committees were very arbitrary in how they made decisions so that law was completely struck down by our Supreme Court in 1988.

After that, access improved. Before 1988 abortions were funded [by the health service] and that continued. We had a fight over the next ten years of getting private abortion clinics, which had previously been illegal, funded.

In your email to me you said, “Parliamentary debate led by MP Nadine Dorries on reducing the time limit for abortion is misguided since criminal or civil law is inappropriate in medicine.”

Can you explain to us how the laws surrounding abortion in Canada works?

We don’t actually have any laws. Basically, abortion care is delivered just like any other healthcare. We don’t use civil or criminal law in healthcare normally. Healthcare is delivered by the medical profession and they have their internal policies, they have a code of ethics for doctors around informed consent, all the normal stuff like that.

Really what it comes down to is a decision between a woman and her doctor, and the doctor has discretion over what’s appropriate for each patient and what their own limits are, and so on and so forth. They decide whether they want to perform abortions, to what gestational length and all that kind of thing.

The Canadian Medical Association passed a policy around the time of the Morgenthaller decision in 1988. Briefly, the policy is on induced abortion. It says:

“Abortion on request is recommended up to twenty weeks, and after that under exceptional circumstances.”

It doesn’t really go into [what these “exceptional circumstances” might be]. It just leaves it up to the Doctor’s discretion.

In practice what happens is that very, very few Doctors in Canada perform abortions after twenty weeks. It’s obviously a more complex procedure – it’s more skilled, so not many doctors are trained in it to begin with, meaning it’s only available at a few centres.

In almost all cases, what usually happens, especially later on in pregnancy, an abortion is sought because of lethal foetal abnormalities, where the foetus can’t survive the birth. Other cases most often involve serious health or life endangerment problems for women.

And sometimes a late abortion might be performed in especially socially compelling circumstances, which would be at the discretion of a doctor. For example, if a very young girl was in denial about her pregnancy, or a sexual assault or a domestic abuse survivor sought an abortion. In situations like that though it’s on a case-by-case basis according to the Doctor.

How has the full decriminalisation of abortion affected women in Canada?
The overall effect was that abortion was kind of incorporated into a regular part of healthcare, and even though we also had stand-alone clinics doing abortions, hospitals still were doing the bulk of abortions at the beginning.

They still do almost half so I think having that hospital-based service is important for integrating abortion care into regular healthcare instead of having it so isolated the way it is in the United States, for example.

I think it’s also shown that it’s working – we’ve gone for 25 years without law and nothing bad has happened – women are not presenting for 9 month abortions so they can fit into their prom dress, and so on.

—-

Back to Ireland. Performing or procuring an abortion in Ireland is a criminal act, with persons found guilty of either risking life imprisonment.

Savita Halappanavar’s life ended because medics put the life of her unborn child – who they knew would die anyway – before the life of the woman in front them. Because those medics were prevented by law from performing a procedure that would have saved her, and because the politicians who have the power to legislate so that no woman ever has to go through this again have refused to.

On Wednesday, hundreds of people gathered in protest outside the Dail (Dublin’s equivalent to the House of Commons), to express outrage at this tragedy and, once again, demand the government decriminalize abortion in this country.

Surely this time, now that Ireland and its abortion laws are under international scrutiny, something has got to give.

I’m tweeting angrily about Savita, Dorries and the state of reproductive rights in Ireland @AlisandeF

To make donations to ARCC or show your support, check out their website, or follow them on Twitter @abortionrights. 

 

USA: The Right Wing Has Made It Next to Impossible for Many Women to Get Abortions

from  http://www.alternet.org

For many women, getting access to abortion has become extraordinarily difficult. Conservatives’ plan is to make it impossible.

They say it’s too easy.

According to 48 percent of American voters, it’s “too easy” to have an abortion in this country.

Too easy?

Every year, legislatures introduce hundreds of bills to restrict abortion. Every year, dozens pass. This year has been no exception. The Center for Reproductive Rights published a report on the nearly 50 new laws that have already been passed this year: biased counseling, forced ultrasounds, bans on insurance coverage, parental notification… And it’s only September.

Louisiana was among the many states to pass new laws restricting abortion. One of them gave the state’s Department of Health the authority to shut down any abortion clinic — permanently — for health and safety concerns.

And it had its first success: it shut down the Hope Medical Group for Women in Shreveport. According to the Department of Health:

The Legislature gave us this authority because they recognized we must have the ability to stop unsafe practices that place these already vulnerable women in danger.

But closing abortion clinics doesn’t protect vulnerable women. And under Louisiana’s new law, once a clinic is shut down by the health department, its owners and managers are prohibited from ever operating another clinic, ensuring one less provider for the women of Louisiana and making it that much harder for them to obtain an abortion in that state.

The State of Louisiana just accomplished what the terrorists who attempted to bomb that same clinic in 2005 failed to do, shutting down the clinic.

Too easy?

Consider the challenges a woman in Missouri now faces. There is now only one provider in the entire state, so unless she’s lucky enough to live in St. Louis, she will have to travel, perhaps 100 miles or more, to even reach an abortion provider. That is the case for one in five patients at the clinic in St. Louis.

If she’s a minor, she’ll first need her parents’ consent. Maybe she knows her parents will say no. Maybe she’s afraid she’ll be punished if they find out she wants to have an abortion. Maybe she’ll be kicked out or beaten. Maybe she’ll even be killed. These things happen.

She can go to the court and hope that a judge gives her permission. But judges don’t always say yes. Maybe she’ll get one of those judges who thinks that at 17, she’s too young and immature to make the decision about whether to terminate her pregnancy. Not too young to have a baby, of course, but too young to have an abortion.

That’s the end of the line for her.

If she gets the consent of her parents, or the court, she has to travel to St. Louis. Maybe she has a car. Maybe she takes a bus. Maybe a friend gives her a ride. If she’s lucky.

At the clinic, she is told about the physical and psychological risks of abortion. It doesn’t matter that there really aren’t any. The procedure is perfectly safe. But that’s not the point. The point is to scare her, to make her think she is putting her life in danger.

She is given a brochure that tells her about “the probable anatomical and physiological characteristics of the unborn child.” She will have to look at color photographs and descriptions of a fetus, from conception to full term.

The brochure also says: “The life of each human being begins at conception. Abortion will terminate the life of a separate, unique, living human being.”

That’s not a medical opinion; that’s a religious belief. The state is not supposed to be in the business of promoting religious beliefs, but that’s the law in Missouri now.

If she is 22 weeks into her pregnancy, she will also be told that the fetus “may” feel pain, and she will have to decide whether she would like anesthesia for the fetus. It doesn’t matter that it’s not true. What matters is that she believes she is causing pain to her unborn child.

She will have to decide whether to have an ultrasound so she can see a picture of her fetus, and whether to listen to its heartbeat. It doesn’t matter that there probably is no heartbeat yet. What matters is that she thinks about her fetus — her baby — and what it looks and sounds like, and the pain she will inflict on it.

And then she will have to wait at least 24 hours. A whole day. She has to go think about her decision. The government has a vested interest in making sure she really thinks about what she’s doing, about the ultrasound and the heartbeat and the risks and the pain. Sure, it’s legal for her to have an abortion, but first, she has to feel bad about it. Shamed.

And where does she go for 24 hours? Does this teenage girl have the means to stay in a hotel? Does she go all the way back home and hope to return the next day? Maybe she just goes home and never comes back.

Too easy?

Those are the obstacles women face in Missouri. And Oklahoma. And Louisiana. And Nebraska.

In Nebraska, the legislature passed, and the governor signed, a “patient screening” bill. The bill requires doctors to read every single peer-reviewed study on the risks of abortion and to advise their patients of all of the reported risks — even the debunked ones.

Planned Parenthood immediately sued and obtained an injunction to prevent the law from going into effect. The state’s attorney general concluded that it would be too costly for the state to fight the injunction. So women and their doctors are safe from that law. For now. But many legislatures find their laws overturned; it doesn’t stop them from re-introducing the laws, again and again and again.

And the women of Nebraska are still subject to many of the same restrictions as the women of Missouri — parental notification, ultrasounds, waiting periods, false information. And because 97 percent of Nebraska’s counties have no abortion providers, traveling to an abortion provider in another part of the state imposes a significant burden.

Too easy?

The State of Oklahoma made it legal for doctors to withhold information from their patients if they think that information may influence a woman’s decision to have an abortion. So if her ultrasound shows the fetus has birth defects, the doctor may choose not to disclose that information to the patient if she might be inclined to have an abortion. And she has no right to sue the doctor for failing to provide her with that information. This, in the same state that, at the same time, passed a law requiring women to have a vaginal ultrasound before having an abortion — all the in the name of “informed consent.”

Too easy?

How hard should it be? How many more lies should women be told? How much longer should they have to wait? How much further should they have to travel? How much more should they have to pay? How much harder does it need to be?

Already, we have fewer and fewer doctors who even know how to perform abortions. Only 13 percent of counties even have one abortion provider. The cost of hundreds of dollars is burdensome to low-income women; for minors, who already face the greatest obstacles, it can be prohibitive.

All of that — and abortion is “too easy”? As if those obstacles weren’t enough, there is also the state-mandated shame.

We condemn other societies that publicly shame women. Sometimes we invade them, and we claim to liberate their women. We brag about it. It’s what gives us the right to say we are better. It’s how we justify acts of war. We’re making their lives better. Easier.

But in this country, conservatives engage in its own form of public shaming and punishment. They stand outside health clinics and terrorize women. Sometimes they set clinics on fire. Sometimes they set bombs. Sometimes they assassinate doctors. And those who hold elected office are constantly inventing new, burdensome restrictions and new methods of emotional manipulation and shame.

Look at this picture of your baby. Listen to its heartbeat. Look at this picture of a fetus at eight months. Your baby would look like that. Do you really want to end its life? Do you really want to cause it pain? Would you at least like to ease its pain a little before you kill it? Go home and think about it first. Think about your baby. Here, take this picture with you.

Too easy?

If it were any easier, American women wouldn’t be able to have abortions at all. But then, that’s the point, isn’t it?

By Kaili Joy Gray

 

The example of Switzerland – liberal laws important but not sufficient

Switzerland is a good example of how liberal abortion legislation is important, but not sufficient to guarantee access to abortion to all women.

In 1942, Switzerland was one of the first countries in Western Europe to legalize abortion for health reasons. Two doctors had to agree that the pregnancy held a great risk of severely and lastingly damageing the health of the woman. Soon doctors began interpreting the law very differently, some including broad mental health reasons for legal abortion, others accepting only vital indications. Practice differed also greatly between cantons (counties). „Abortion tourism“ was flourishing from conservative cantons and from other countries to liberal cantons like Geneva or Zurich.

Over the decades abortion practice was liberalized in ever more cantons, an evolution speeded up by political campaigns and lobbying from 1971 onwards.

In 2002 finally, the Swiss Union for Decriminalizing Abortion (Schweizerische Vereinigung für Straflosigkeit des Schwangerschaftsabbruchs / Union suisse pour décriminaliser l’avortement SVSS/USPDA), founded in 1973, succeeded in getting abortion on request within the first 12 weeks of pregnancy (Fristenregelung / régime du délai) adopted in a referendum, by gorgeous 72,2% of the votes. Simultaneously, a constitutional amendment for a total abortion ban, proposed by the anti-abortionists, was defeated by 81,7%.