Wednesday, 3 July 2013

On Reproductive Rights and Irish Abortion Law - EWTS Session One

Notes and thoughts on session 1 of the EWTS conference, which was about Reproductive Rights and Abortion Law in Ireland. Speakers were Ailbhe Smyth, Anthea McTiernan, Ophelia Benson, Ross Kelly and Clare Daly.
Trigger warning - contains discussions about abortion.

Ailbhe Smyth is involved with many pro-choice and LGBT* groups and is a spokesperson for Action on X.  

Until 1992, contraception was unavailable in Ireland, at least officially. There were black markets selling condoms, and people used to bring suitcases home with them when they went on holidays to the UK. We need to remember that the struggle for abortion lies on a foundation of battling for basic human rights. Divorce was only legalised in 1996, and male homosexuality wasn’t decriminalised until 1992.

We need to ask why abortion seems to be the big resistance issue. Very few polls on the topic ask the right question, with many choosing to use highfalutin language in an effort to confuse the public. One poll which dared to use simple, direct language showed that over 80% of the population believe that abortion should be permitted in Ireland when there is a risk to the woman*’s life or health, in cases of rape or incest, and in cases of fatal fetal abnormalities. 40% believe abortion should be permitted where a woman* deems it to be in her best interest. While this highlights the fact that we are, for the most part, a pro-choice country, a shocking 11% said they do not agree with abortion to save a woman*’s life.

The 8th Amendment, which prevents legislation for abortion unless there is a real and substantial risk to the life of the woman*, uses frustratingly incorrect terminology, indicating the impact religious dogma had on the amendment. Instead of ‘woman’ and ‘fetus’, ‘mother’ and ‘unborn’ are used. This seems to be the only instance in which a woman* is legally a mother before giving birth or adopting a child. Yet, to the best of my knowledge, someone who is 12 weeks pregnant cannot claim children’s allowance for her ‘unborn’ child.

On the inclusion of the right to information and the right to travel, Smyth points out that we live in a democracy – why did we have to fight for these basic rights? Even the right to information is complicated – when discussing abortion services, one must only discuss leaving the country for a termination (as self-inducing in Ireland remains illegal) and discuss the options of parenting and adoption with equal regard.

The abortion debate is only progressing due to avoidable deaths as a result of our draconian laws. The deaths of Shelia Rogers, Michelle Harte and Savita Halapanavar raised the public consciousness of the anti-women abortion laws in place. But there are doubtless many others who were in similar situations, as well as the 4,000+ women* who travel and the 1,000+ who self-administer the abortion pill in Ireland every year. We need to trust women*, repeal the 8th and legislate for what women* in Ireland need.

Anthea McTiernan is a board member of the Irish Family Planning Association. Her speech was printed by the Irish Times here if you want to read it in full (you should - it's fab).

Women (in fact, we all) have spectacular bodies, and not just the ones whose body type is commodified in mainstream media, with reproductive abilities which, in an ideal world, would only be employed when/if we wanted children. Yet we live in a country living which belongs in the past, with laws and regulations, the sole purpose of which is to control, restrict and kill women*. Savita’s father made the seemingly obvious point that religion has nothing to do with medicine. Yet in Ireland, it has everything to do with medicine. Savita’s request for a termination was denied, it was ‘a Catholic thing’. Indeed, while other religious denominations expressed their concerns about the 8th Amendment in 1983, it was the Catholic Church which pushed for it.

There is no, one, religious view on abortion or when life begins. There’s no definitive answer because different cultures and people have different views. The Church of Ireland, along with Presbyterian and Methodist churches, welcome the X-case legislation, as to the Jewish community which view all abortion cases individually. In Islam, the soul is believed to develop between 40 and 100 days after conception, so abortion is allowed before this point, as well as in cases of fatal fetal abnormalities. Due to the lack of consensus, and the lack of ultimate truth, why is the Catholic Church allowed to dominate the debate with their doctrine? We should not allow a single doctrine to determine our laws.

Currently, the right to life pregnant women* have in this country is only worth as much as a fertilised ovum. The legislation, and the rhetoric souronding it coming from the anti-abortion side, paints women* as sly and sneaky, people who cannot be trusted to make important medical decisions for themselves. Suicidal women* who are unable to deal with a pregnancy are forced to go through a panel of three doctors (two psychiatrists and one OB) to ‘prove’ that she is suicidal. The OB is not trained in mental illness, and so I cannot for the life of me understand why one would be needed to judge whether or not a woman* might kill herself because her pregnancy is too much. If their vote is not unanimous, the woman* will be forced through the process again with a different set of doctors. It is said that women* will abuse this process, ‘claiming’ to be suicidal in order to have a termination in Ireland. I would be surprised if someone who was suicidal would subject themselves to this ordeal rather than travel or self-administer.

As I write this, x-case legislation is being debated in the Dáil, 7,789 days after the Supreme Court ruling. I am 21 years old, and this ruling was issued just less than 2 weeks before I was born. One has to wonder what kind of country waits 21 years to legislate to save women*’s lives. If the Irish government respected women*, this legislation would have celebrated its 21st birthday with me in March. 

Ophelia Benson is a feminist author and blogger on

The US is in a similar situation to us in Ireland. The same thing that happened to Savita could very easily happen to a woman* in the US, and go unprosecuted due to religious influences and political cowardice. 

Benson tells us about a woman in Phoenix, Arizona who was a mother in her 20s. She had severe pulmonary hypertension, which was made worse by her pregnancy. She needed a termination because her life was increasingly at risk as a result of her pregnancy. Because she presented in a Catholic hospital, her case went before an ethics committee. Thankfully, they agreed that she should have a termination, and she survived. One of the members of the ethics panel was a nun, and she was in agreement with the committee's decision to allow a termination. This greatly pissed off the bishop for the area (how dare she have put the life of the woman and her three, already born children ahead of the potential life of her fetus, amirite?), and he made every effort to get the hospital to agree, in writing, that they wouldn't do the same thing again. That they wouldn't save another woman*'s life, that they would sit back and let the next woman* in this kind of situation die unnecessarily. The hospital, thankfully, wasn't too keen on this deal, and said no. This, I can only presume, pissed the bishop off even more seeing as he believed he called the shots regarding the hospital and they way they treat patients. Instead of being a grown-up about it and realising that the hospital was making the best decision for their patients, he stripped the hospital of it's Catholic standing. All this means, however, is that mass cannot be said in patient's rooms anymore, and apart from the bishop, nobody really cared. 

In many other, usually Catholic, hospitals, direct abortions are not allowed. Doctors must look for a loophole in order to carry out terminations, such as finding a uterine tumor and performing a hysterectomy. This is something that's also done over here - loopholes are used to 'distinguish' between abortions (which are bad) and 'necessary medical interventions which sadly, but unintentionally, result in the loss of a pregnancy' (which are graaaand). The treatment of ectopic pregnancies is one example of a loophole abortion according to many anti-abortion groups. What they fail to realise is that when treating an ectopic pregnancy, a surgeon will purposefully try to remove the zygote and cause as little damage as possible to the fallopian tube. There have been stories of anti-choice doctors waiting until the tube is incredibly damaged, so that they have to remove the entire tube rather than targeting the zygote directly. 

It is absolutely terrifying when women* can only get (potentially life-saving) healthcare through loopholes in laws or religious doctrine.

Ross Kelly is a member of Doctor's for Choice, and the potential poster boy for the pro-choice campaign (think feminist Ryan Gosling - we're working on our meme-making skills)

Legislation for X is effectively a box-ticking exercise - it's the bare minimum of legislation which will probably not do anything to save women*'s lives or reduce the number travelling/self-administering. There's no responsibility, but it means they can go back to the European Commission of Human Rights and say 'aren't we great, we did it'. 

As a doctor, you want to do everything you can for your patient, and you want to know with certainty that you can intervene in complex situations without facing massive legal repercussions (doctors who carry out an abortion illegally can be striped of their licence and face up to life imprisonment). The death of Savita spurred many questions about when, and whether, you can intervene in that kind of situation. Doctors do their best to give the best care they can to patients with respect to their wishes. Just as a Jehovah's Witness could deny blood products, someone personally opposed to abortion could deny a termination. However, Savita requested a termination, but due to the presence of a fetal heartbeat during her miscarriage, the doctors had to sit back and do nothing, regardless of whether or not they wanted to help (which remains unclear). 

The proposed legislation brings clarity to these emergency situations. When it's obvious there is a threat to the pregnant person's life, only one doctor's opinion is needed to terminate the pregnancy, when it is less clear, or the threat is less immediate, two doctors are required. But when the risk to life is through suicide, legislators clearly fall short. The requirement of a panel of doctors in the first place shows a lack of trust of the woman* in question, and the inclusion of an OB shows a lack of understanding of mental health issues. We also need to examine what is deemed an acceptable risk to life. For some, even a 10% risk is too much, for others, the risk could be higher before it's an issue. It all comes down to personal circumstances. 

Abortion is not a treatment for suicide. I'm not sure anyone has actually claimed it is. There is no 'treatment' for suicide - all that can be done is to try to manage and alleviate the feelings and pressures which are causing someone to feel like there is no way out. For some people, a pregnancy, particularly an unplanned/crisis pregnancy, could be the straw that broke the camels back regarding their mental health. It is a huge thing, and can severely affect your hormone levels, potentially worsening feelings of despair. In these particular and unique situations, an abortion may help the situation, and make things just a bit easier and reduce or remove suicidal feelings. Like all mental health issues and treatments, it's complex and needs to be dealt with on an individual basis. Quitting your job doesn't cure suicide, but if your job is what's making you feel suicidal, in that particular case quitting your job may 'cure' your suicide, or at least make feelings more manageable. It's the same for abortion. There's no way to properly research whether or not abortion reduces suicidal ideation - that would require a focus group of suicidal women who would be left without the treatment they need which would be a massive abuse of human rights. What we need to do is trust women. It's really that simple. 

Kelly goes on to say that the right to travel isn't massively helpful either. with all medical procedures, follow up care is vital. Many women* can't access the few clinics (like the Well Woman clinics) which offer post-abortion care and check ups, either due to fear of the stigma attached with having travelled for a termination, or being unable to access these clinics. Anti-abortion groups claim that they 'love them both' (meaning women and babies), yet the restrictions on abortion and related services due to their campaigning and scaremongering put women* in dangerous situations. Women who self-administer at home in Ireland are often afraid to go to the ER if they feel like something might be wrong, for fear of being prosecuted. The safest way to ensure women* have safe experiences is to let them go through their own doctors and have the correct pre- and post- abortion (both medical and surgical abortion) counselling and check-ups here, along with being able to access abortion services here. 

Kelly finishes by saying that many anti-choice religious organisations talk about faith - if they really had faith that their followers wouldn't have abortions, what's the worry? But it's not about faith, it's about controlling other women*. 

Clare Daly is an Independent TD, representing the United Left Alliance. Earlier this year she attempted to get emergency legislation for the X-case passed. 

We need free, safe and legal abortion in Ireland, regardless of situation. 
This is part of the struggle for reproductive rights which includes the right to have children and bring them up away from poverty and discrimination. 

Before the right to information and travel was clarified in 1992, magazines from the UK in Easons used to have pages ripped out if there were adverts for abortion clinics, and international phonebooks had the numbers of family planning clinics blacked out with marker. 

Despite the Supreme Court decision in 1992 that the treat to life didn't have to be immediate, our government, who are only legislating due to ECHR pressure, are ignoring this. The emergency legislation Daly proposed at the end of November last year, which would allow abortion in cases where the woman*'s life is at risk, and in cases of risk by suicide, would require the opinion of a consultant psychiatrist or a clinical psychologist. There was also a conscientious objection clause. This proposed bill was voted against, with many who voted against it saying that it didn't go far enough. These same TDs have voted for the current legislation, which is considerably more restrictive. 

Savita's death was a wake up call for the people of Ireland - it took many people off the fence as they realised the reality of the Irish abortion situation. Abortion happens in Ireland and to Irish people, and it is beyond naive to suggest that Ireland is 'abortion free'. We have similar abortion rates as other countries, we just sweep it under the rug and ignore it, just as we did with the Magdalene Laundries and the countless women who were subjected to symphysiotomies so that they could continue having children. This legislation is symbolically huge, but also has huge shortcomings. TFMR (terminations for medical reasons, usually fatal fetal abnormalities) are excluded from the bill, despite the potential that they are covered under the 8th Amendment, and women who self-administer, and anyone who assists them, can face an undisclosed fine and/or up to 14 years imprisonment.

Forced pregnancy is a war crime, and yet in Ireland, it is commonplace. For those who cannot travel for a termination, either because the cost involved, family situations or uncertainty regarding migrant status, these women legally are forced to continue their pregnancy, or chose to break the law. 

Points made in summation piece and Q&A session

-The ECHR couldn't find a plausible reason as to why there had been a failure to legislate for X for 21 years. The only reason is the lack of separation of church and state. 
-We need to defend and support the right to life of the bigger life. Whether or not a fetus has an inherent right to life, or a soul, or whatever, it is *certain* that the pregnant person does, and their life is, or at least should be, more valued. But we also need to understand the concept of personhood. A fetus does not have personhood rights, the pregnant person does. 
-The McKenna judgement which calls for media to be unbiased on political issues, and as such giving both sides equal coverage/time, may not be valid for the abortion debate, but it's used anyway. As such, we have to be tolerant of intolerance and intolerant people who spew lies rater than logic and facts when discussing abortion. 
-Education is the most important factor to consider when making reproductive healthcare accessible. It's important to change people's minds and present them with comprehensive, fact-based information on pregnancy and abortion. 

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