Unsafe abortions - The silent pandemic

published: Sunday | February 17, 2008
Heather Little-White, Ph.D., Contributor
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As advocacy for increased access to safe, legal abortion continues in Jamaica, arguments for or against it are usually well presented. Unplanned or unwanted pregnancies are a reality of life, so Sheronbelieves that abortion should be made legal so that it can be safe for those who need to have one done. Sheron, 38, a victim of unsafe backdoor abortion, tells her story.

"I remember visiting the country at age 20 to visit my ailing grandmother. My grandmother had to be hospitalised and most times I was alone in the house. One day my uncle came home from work early, to my surprise. He always had 'eyes for me' but I used to tell him how disgusted I was with his behaviour. Later that day as I was taking a shower, I heard the bathroom door open, it was my uncle, naked as the day he was born ... he pushed me against the shower, and forced himself on me, raping me despite my pleas to stop. I could not fight him off with my small frame as he was a tall, heavyset man.

"I felt dirty and ashamed. Days later, I eventually found the courage to tell my mother, who did not believe me and accused me of telling lies on her brother. I cried even more. Weeks passed, I missed my period and realised that I was pregnant, I decided that no way could I carry a child for my uncle ... when my mother discovered that was I pregnant, she was alarmed and offered to take me to a 'doctor' in town.

"I remember ascending a flight of stairs to a dusty room where I was asked to lay on a table behind a black curtain. Today the visit is still vivid in my mind. I was given a cup of warn drink and soon felt drowsy. Later, the middle-aged 'doctor' asked me to spread my legs, he pressed my stomach hard, asked me to take a deep breath and I could feel a cold instrument being inserted into my vagina, then a piercing pain, after about an hour or so I was released in pain and blood, the bleeding continued for three days despite the doctor's promise of a couple hours. I realised that I had an abortion which resulted in infections and my inability to conceive later in life and the psychological effect is like a nightmare."

Sheron's story concurs with similar stories from an estimated 20 million women around the world who have unsafe abortions annually (Allan Guttmacher Institute, 1999). However, some victims of unsafe abortion do not live to tell the tale. Anti-abortionists argue that women should not find themselves in the position where they end with unplanned or unwanted pregnancies, even though these may occur for a number of reasons.

Like Sheron, pregnancy could result from incest or rape or from failure to use contraceptive, pressure from a partner not to use contraceptive, contraceptive failure and changes in circumstances that make a pregnancy unwanted, such as abandonment, relationship problems with husband or partner, risks to maternal health and financial difficulties. Women may also want to pursue educational or career goals and will want to postpone childbearing. The number of unplanned pregnancies illustrates the unmet needs of family planning.

Unsanitary conditions

The World Health Organisation (WHO) defines an unsafe abortion as a procedure to terminate an unintended pregnancy by untrained persons who are styled as 'doctors', and usually in unsanitary conditions that do not conform to medical standards. In the United States, a slang term for unsafe abortions is back alley abortions, characterised by the use of a coat hanger. The magnitude of unsafe abortions in the United States led to Roe vs Wade Supreme Court decision 1973 to legalise abortion in America.

In developing countries, unsafe abortion places women at risk because abortion is highly restricted by law, or where it is legally permitted safe abortion is not easily accessible. According to WHO, an estimated 20 million unsafe abortions are performed each year with 95 per cent in developing countries. Simply put, unsafe abortions are performed at a rate of eight per hour.

Bitter concoctions

Unsafe abortion use self-induced methods which are crude, dangerous and even fatal. These include taking teas and herbal remedies, such as boiled avocado or basil leaves, wine boiled with cinnamon and raisins, boiled celery water with aspirin and bitter concoctions; ingesting alcohol and toxic solutions such as turpentine, detergent solutions, bleach and acid; pushing objects into the uterus, such as a stick, wire, coat hanger, knitting needle, ballpoint pen, bicycle spoke, rubber tubing; air blown in the vagina by a syringe and physical damage such as an abdominal or back massage, lifting heavy weight or falling or jumping from the top of stairs or roof when there is no other way to end an unwanted pregnancy. Pharmaceuticals administered include uterine stimulants, such as misoprostol or oxytocin, and quinine or chloroquine used for treating malaria.

On the contrary, safe abortions are performed by trained professionals in sterile conditions using safe methods like pharmaceuticals, suction curettage and induced labour. When performed in sanitary conditions, legal abortions are one of the safest procedures in contemporary medicine. However, the cost of safe abortions is usually prohibitive, which causes poor women to delay getting an abortion until later into the pregnancy when the risk is greater. Regardless of the legal status of abortion, the data show that poor women are at greater risk for undergoing unsafe abortions using primitive, unsafe methods for self-induced abortions.

Bleeding

Morbidity complications resulting from unsafe abortions include incomplete abortion, infection (sepsis), haemorrhage and trauma to the cervix, vagina and uterus and injury to internal organs, such as puncturing or tearing of the uterus. Long- term damage includes chronic pain, pelvic inflammatory disease (PID) and infertility. Death is also a consequence of unsafe, illegal abortions. Globally, WHO estimates that 68,000 women die each year from unsafe abortions. Teenagers comprise a significant proportion of victims of unsafe abortion because they tend to wait to seek abortion later than do older women and are at greater risk of complication.

Abortions conducted in unsafe conditions put the lives of many women at risk and present a grave public health problem to governments. Consensus from the IV World Conference of Women in Beijing 1995, posited that the majority of deaths, injuries and abortion-related health problems could have been prevented with improved access to health services, including safe and effective methods of birth control and gynaecological care.

Public health issue

At the 1994 International Conference on Population and Development (ICPD), nations around the world agreed that societies must ensure high-quality, compassionate treatment for complications resulting from unsafe abortions; provide access to family planning; reform restrictive laws that limit the availability of safe services and trained professionals and ensure safe abortion services. Public health record indicates that safe, legal accessible abortion improves health. The ICPD conference resolved that governments should work to eliminate unsafe abortions by an integrated, comprehensive approach involving health workers, policymakers and advocates.

Name changed for privacy

Abortion is here to stay

Sam Rowlands
Published 15 February 2008
New Statesman
Debating the abortion rate is futile - we need to focus on providing information and contraception

Recourse to abortion is a feature of all societies and is as old as humanity. Women have abortions regardless of the legal situation in their country. It’s clearly much safer for a woman to have an abortion in proper medical surroundings than as a clandestine procedure performed by untrained personnel. Younger generations need to be told and older generations reminded of the results of backstreet abortion: death and permanent injury from sepsis, mechanical trauma and chemical burns.

Globally there are about 42 million abortions annually, of which nearly a half are unsafe. 68,000 deaths occur annually from unsafe abortion, almost exclusively in the developing world.

It’s true that in the past, in countries like the former Soviet Union, because of almost complete lack of access to contraceptives women used abortion as a primary means of fertility control. This is not so nowadays in the West. But women clearly use abortion as an adjunct to contraception in the event of non-use, incorrect use, inconsistent use or failure of contraception. The most commonly used methods, the pill and condoms, have substantial failure rates in everyday use. This is why there is a current push from the National Institute for Health & Clinical Excellence for wider adoption of long-acting reversible methods (injections, implants and intrauterine devices).

Emergency contraception (pills or intrauterine devices administered after unprotected sex) have the potential to make inroads into the abortion rate. So far though, its use is not widespread enough to make any detectable difference.

An estimated 108 million married women in developing countries have an unmet need for contraception. So, there is potential here for reducing abortions in these countries. Availability of contraception in Eastern Europe has improved and abortion rates have fallen, but rates remains much higher than in the rest of Europe with more abortions than births.

Countries such as Belgium, Germany, the Netherlands and Switzerland have low abortion rates. High use of contraception and universal sex education almost certainly play an important part there. The specifics of their abortion laws and how they operate in practice will be relevant too. Abortion rates are determined by a complex range of factors including family size intentions, confidence in the safety of contraceptives, amount of sexual activity in adolescents and where the country concerned is in its demographic transition.

There has been a continuing decline of the abortion rate in the United States since it peaked in 1981, although it remains well above that of Western Europe. Increased use of contraception has contributed to this decline. Much of the decline took place in eight states in which efforts have been made to deliver good sex education, not the Bush administration’s abstinence-only approach. One suspects some of the decline is due to restrictive state laws causing delays or preventing some women altogether from having an abortion. These restrictions unfortunately have a disproportionate effect on the poor. And such a decline is not a unique trend - it may be part of a global decline which has been measured between 1995 and 2003.

In Britain the abortion rate has increased year on year since legalisation in 1968, but after 1998 this increase has been slower. There are signs that women’s desire to control their fertility is now being met by service availability.

Abortion is here to stay. There is little point debating whether our abortion rate is too high. What we should be concentrating on is making sure that women requesting abortion are supplied with evidence-guided information on which to base their decision. They should all be offered medical abortion: in this respect England and Wales are lagging behind Scotland. All women should be offered screening for infection. And all women should be offered contraception, including long-acting methods. Further research is needed on factors that detract from consistent use of contraception and from this possible effective interventions can be developed.

Dr Sam Rowlands is a freelance specialist in contraception and reproductive health and a Visiting Senior Lecturer at the University of Warwick.

What is The New York Times' problem with abortion?

In These 'Times'
The newspaper of record's squeamishness about abortion.

By Debbie Nathan
The New Republic
Published: Thursday, February 14, 2008

What is The New York Times' problem with abortion? The editorial page consistently supports sex education, birth control, and the right to legally end unwanted pregnancy. The rest of the Times, however, often seems uncomfortable with concrete applications of these principles. Not a season goes by that a news item or magazine feature doesn't imply that women who get abortions are acting with egotism, unhealthiness, and cruelty.

The most recent instance of this is Annie Murphy Paul's "The First Ache," in last Sunday's Magazine. "When does the experience of pain begin?" the subtitle asks. "Anti-abortion activists aren't the only ones to argue that it may be in the womb."

Paul's article, which runs over 5,000 words, begins with a doctor in Arkansas claiming that fetuses as immature as 20 weeks after gestation suffer agonies when prodded and cut during, say, prenatal surgery. And--the point of the piece--when they're aborted.

But then other doctors start discussing the Arkansas physician's claim, and their opinions are all over the map. One insists that fetuses feel no pain until at least 29 weeks. Another pushes the pain date all the way forward to 18 weeks. Someone else says that even born babies can't feel pain until they're one year old. Clearly, there's no consensus on the issue. But the lack of agreement is lost amid the article's looming intimation that women who end their pregnancies are hurting their fetuses. Paul never specifies that the vast majority of abortions--more than 96 percent--are performed before 18 weeks' gestation, the earliest date being claimed for the beginning of fetal pain. Nor does she mention that American women are getting abortions earlier and earlier in their pregnancies: The rate occurring in the first eight weeks has increased sharply in recent years, with many now done in the sixth week of pregnancy or earlier. Without these statistics, the article's main effect is to make female readers feel guilty and confused about abortion.

Paul's is not the only problem piece to run in the Sunday Magazine. Another, by Slate senior editor Emily Bazelon, appeared last January and looked at "post-abortion syndrome" (PAS). A takeoff on PTSD (post-traumatic stress disorder), PAS is not recognized by the psychiatric or psychotherapy establishment because there's no scientific evidence it exists. But moral conservatives out to overturn Roe v. Wade have popularized the purported malady among women who've had abortions. And last year, the Supreme Court cited affidavits submitted by people claiming they've suffered from PAS. The court said the risk to women of contracting the risk of "severe depression and loss of esteem" was one reason to ban "dilation and extraction"--better known as "partial birth" abortion. If for no other reason than this politicking, PAS is well worth exploring.

Problem is, Bazelon skips lightly over politics, focusing instead on fuzzy profiles of self-described PAS sufferers. One is Rhonda Arias, an evangelical minister who runs PAS-support groups in Texas women's prisons. Bazelon follows Arias as she holds forth in one facility, reading from the New Testament, playing gospel music, and handing dolls to inmates who weep as they mourn their aborted offspring. Then Arias asks these prisoners to send her testimonies about their PAS to her so she can submit them to places like the Supreme Court.

To be fair, Bazelon spends a long time discussing the piled-up scientific evidence showing that PAS doesn't exist, with many interviews from respected researchers illustrating the consensus that it's just a right-wing talking-point. Still, Bazelon writes that Arias's audience members "drink in [her] preaching," and about how Arias "ministers from the heart" with her face "alight." We read that Arias conducted a study with data culled from prisoner reports of psychological trauma from abortion (which she later sent to the Supreme Court). But Bazelon does not remind us that prison inmates are considered a terrible source of data for psychology studies. They are a captive population at great risk of saying whatever they think people in authority--including researchers--want to hear. Nor are we told that one facility where Arias does her PAS data collection has been cited by inmates as lacking access to work and substance abuse programs. Another prison houses all nine women on Texas's death row and is among the state's ten most violent prisons. No wonder inmates might exchange PAS testimonials for hugs and music.

And Bazelon only glances over the Justice Foundation, a Texas group that funded the collection of those PAS affidavits for delivery to the Supreme Court. The article calls the foundation "a conservative law center," but doesn't say that it was founded by, and gets its money from, James Leininger, a Christian right winger and one of the richest people in Texas. Leininger has used the Justice Foundation and other groups, also funded by him, to pack the Texas school board with members who oppose sex education and favor censoring textbooks. He has bankrolled political campaigns in which candidates who don't toe his line have been smeared with charges that they promote illegal drug use and homosexuality to school children. And he is staunchly anti-choice: Using the Justice Foundation, he almost single-handedly has enabled the gathering of PAS affidavits to erode Roe v. Wade. Rhonda Arias would be a nobody without this man's fortune and political designs. He's as important as she is--if not more so--to understand the PAS push.


Magazine articles aren't the Times's only problem. News stories also sometimes issue strange and conflicting messages about abortion. Last spring, for instance, a long piece appeared on the front page: "Today's Face of Abortion in China is a Young, Unmarried Woman," by Jim Yardley with Lin Yang contributing. The article's point seemed to be that, back when China coerced married women to have only one child, it wasn't their fault they had to get abortions--but now, single young women are obtaining them voluntarily. And this is bad.

Why bad? The article reeks with veiled references to selfishness and irresponsibility. The first paragraph says, "it was her second abortion in 18 months." Indeed, most patients sitting at a clinic with this woman have already had an abortion; one is on her sixth! And how did they find the clinic? The article notes that private abortion clinics proliferate in China now, and newspapers there run "sensational" ads promising "Painless Abortions." (The reporters seem unaware that ethnic papers in New York City, such as El Diario, are stuffed with identical ads, and that most abortions in this country are done at private facilities.)

Again, numbers are used out of context. The Times cites the number of abortions per year in China, and the number in this country: 7.1 million there, 1.29 million here--an alarming differential until you recall that China's population is over four times that of the US. The article never mentions this basic data.

A headline was the problem in another front page story, which ran on January 31. The article reported that Shanghai Hualian, a big pharmaceuticals manufacturer in China, made a contaminated leukemia drug that sickened patients in that country. The same firm produces all the RU-486 distributed in the U.S. (the drug is used to induce non-surgical abortions). But the FDA said the company's RU-486 factory had passed many inspections and is safe. The Times reported this at length. So why was the articled titled "Tainted Drugs Linked to Maker of Abortion Pill"?

To be sure, Times stories are not always pursed-lipped about abortion. Spring 2006 saw a national scare about a deadly bacterial infection associated with RU-486 abortions. In a follow-up article in May, reporter Gardiner Harris pointed out that infection with the same bacteria might be a risk for pregnant women who intend to have their babies. Harris even quoted two New York woman who'd had multiple abortions, some done surgically and some with RU-486. They discussed the pros and cons of each procedure, and one woman allowed publication of her name: Anne Hawkins. The whole thing was refreshingly matter of fact and devoid of cryptic moralizing. But the article was buried near the back of the A section.

Then there was the disturbing flap at the Magazine two years ago, after a cover piece about illegal abortion in Latin America reported on a woman in El Salvador who supposedly was criminally convicted for aborting her 18-week fetus. Post publication, it turned out the woman was actually judged guilty of murdering her newborn, full-term baby. The reporter had never bothered to read the court records, and the Magazine's fact checkers hadn't either. In its eagerness to champion abortion rights in a country that has none, the paper had gotten sloppy. And on its own national turf, where long-established rights are being chipped at, sloppiness runs in the other direction.

So, what's going on at the Times? Maybe only what's happening in the whole culture. Liberals and even feminists have bought into the reasoning that abortion is basically immoral, and if women could just be educated and dosed with birth control, we wouldn't have to terminate any pregnancies. Bill Clinton's famous formulation, that abortion should be "safe, legal, and rare," has become conventional wisdom.

It's the line on the Times editorial page. In other sections, awkward reality intrudes, making reporters and editors skittish. Women--particularly young and poor women--don't take their contraceptives, and when they get pregnant many wait to go to the abortion clinic. Then they get pregnant again. Their behavior seems mysterious and threatening. They become scapegoats, not just for the Right, but for older and more educated liberals, too. That's the demographic who work at the Times, and a good percentage of its readership. But the Gray Lady is powerful way beyond New York liberal circles. And by making anti-woman moral judgments and obsessing over "problems" with no good evidence they exist, she's abusing her nation and the world.

Debbie Nathan is a New York City-based journalist. Her latest book, Pornography (Groundwood Press), explains the subject to teenagers and young adults.

Men's Abortion Rights: What Will They Think of Next?

By Sherrie L. Porter, Communication Intern

January 18, 2008

The religious right has fought hard to chip away at women's rights and personal freedoms for decades. Over the years, we have faced a range of attempts – some successful - to take away a woman's control over her body. Men's abortions rights, the newest disturbing trend in the battle to undermine Roe v Wade, claims that men are "victims" of abortion.

The idea of male victims stems from the concept of "post-abortion syndrome" -- a nonscientific term coined in the 1980s by abortion opponents who claim that women experience psychological trauma after terminating a pregnancy. While there are no long-term, credible research studies, proponents of this creatively named "condition" claim it leads to depression in women, as well as alcoholism and drug addiction.

In a recent Los Angeles Times piece, "Changing Abortion's Pronoun," writer Stephanie Simon sees the political calculation behind the curtain: "Abortion is one of the most common surgeries in the country, with more than 1 million performed a year; while some who chose the procedure surely come to regret it, doctors say they see no epidemic of trauma in either men or women."

Despite the lack of evidence for post-abortion syndrome in either gender, anti-abortion advocates suggest "lost fatherhood" can lead to domestic violence and an addiction to sex. Both claims seem to suggest a rationale for men behaving badly. Men, they suggest, experience symptoms of post-abortion syndrome equally if not more powerfully than women. Male victims throughout the country are sharing stories of "their abortions." In November, anti-abortion activists met in San Francisco for what they boasted was "the first ever conference on the effects of abortion on men."

In the movement for men's abortion rights, Ohio legislators are attempting to make headway. Ohio house bill 287, seeks to give a man the legal right to decide whether or not the woman he impregnates should get an abortion and would make it mandatory for all women to have the written consent of "the father of the fetus" before she can go forward with the procedure. Under the same legislation, rape and incest victims would need a police report to "prove" they need an abortion. As for a woman who does not know (or doesn't want to reveal) who the man is, she would be unable to elect the procedure. Anyone, including doctors, who violate the bill would be guilty of "abortion fraud" and charged with a misdemeanor.

"If a woman wishes to include a man in her decision about whether or not to continue a pregnancy, she may do so. But the state cannot mandate that she do so," said NOW President Kim Gandy. "Requiring a 'permission slip' for abortion would mock the right guaranteed in Roe v. Wade."

Ohio HB 287 was introduced by Republican State Rep. John Adams in July 2007 and now sits at the desk of the House Health Committee. While it is unlikely that the bill will set sail--due to a variety of reasons, not the least of which is that it is not Constitutional--NOW activists are working across the country to fight the continual assaults on women's reproductive autonomy.

"What the extremists really want is an end to all abortion and birth control, severely restricting the personal, medical decisions of every woman in the U.S.," said NOW Action Vice President Melody Drnach. "While we will fight this legislation and every other attempt to deny our reproductive rights, we will not take our eyes off of the very real and dangerous fight that these extremists are waging against women."

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Abortion Rights Groups Say Legal Fights Loom

by Lisa Vives

NEW YORK - The 35th anniversary of Roe v. Wade — the U.S. Supreme Court ruling that gave women the right to abortion — is being observed this week amid concerns over threats to erode or eliminate a woman’s reproductive rights.

Republicans on the campaign trail have almost universally condemned Roe v. Wade and President George w. Bush this week voiced support for abortion opponents attending a Washington ‘right to life’ protest and rally, inviting about 200 of them for coffee and doughnuts at the White House.

Protests by anti- and pro-abortion activists took place this week across the country marking the high court ruling. Politicians used the occasion to rally their supporters. Republican candidate Mike Huckabee, an ordained Baptist minister, called Roe v. Wade ‘a great American tragedy that has led to the loss of millions of innocent lives.’

Members of the Democratic Party, including the leading contenders for the presidential nomination, Senators Hillary Clinton and Barack Obama, spoke out strongly in favour of women’s right to terminate an unwanted pregnancy.

‘We have a huge fight (to preserve a woman’s right to choose),’ said Rhonda Copelon, a law professor and director of the International Women’s Human Rights Clinic of the City University of New York School of Law, ‘but I think this is the time to fight it.’

‘In the last 35 years, anti-choice groups have grown more vicious, lashing out against the landmark Supreme Court decision as part of their ongoing campaign to eviscerate it,’ says Kim Gandy, president of the National Organisation of Women (NOW).

‘We have endured more than three decades of challenges and roadblocks from a well-funded opposition, and our rights are more tenuous than ever — so now, more than ever, we have to fight to keep Roe alive,’ said Gandy.

Legislation limiting woman’s rights has met with some success. In 2006, South Dakota lawmakers made it a felony for doctors to perform any abortion except to save the life of a pregnant woman, but the law was reversed by voters later that year.

Last April, the Supreme Court upheld an abortion procedure ban without any exception to protect the woman’s health.

‘The Court’s majority opinion leaves women out of this equation and allows the state’s supposed interest in ‘promoting fetal life’ to trump women’s rights to control the direction of our lives,’ noted Annie Tummino of the activist group Women’s Liberation Birth Control Project. ‘Two Justices, Thomas and Scalia, even went so far as to say that ‘the Court’s abortion jurisprudence, including Casey and Roe, has no basis in the Constitution’.’

‘What’s more, doctors who choose to uphold our rights can now be prosecuted,’ she said.

In Missouri, a proposed ballot measure, if adopted, would ban abortion in almost all circumstances and could spur a legal challenge before the Supreme Court.

Between four and eight ballot measures imposing new restrictions on abortion rights could face voters in upcoming state polls.

A new report by the Guttmacher Institute, a NYC-based research organisation studying reproductive health, has found that medically-induced abortions are dropping to historic lows. In 2005, they found, the abortion rate dipped to 19.4 per 1,000 women, its lowest level since 1974.

Many factors could explain this, says Rachel Jones, an author of the report, and ‘we just aren’t able to get at the reasons behind the decline.’

While traditional abortion providers are fewer in number, there has been a rise in the number of new clinics that offer only ‘early medication abortion services,’ or RU486, a medication that terminates a pregnancy in the first trimester by blocking the effects of progesterone.

Since the drug was introduced in the United States in September 2000, more than 840,000 women have taken it, and the Guttmacher study estimates that it is now used in 14 percent of all abortions, up from 6 percent in 2001.

Clinics that offer only RU486 — not surgical abortions — are growing in popularity. Also showing an increase is the use of a ‘morning after’ contraceptive pill, known as Plan B, available for women 18 and older.

About 150,000 of the 1.2 million abortions in the United States in 2006 were done with medication, the Guttmacher Institute has estimated.

‘Mifepristone (RU-486) is clearly starting to become an important part of the abortion provision in the United States,’ said Lawrence Finer, who studies the drug at Guttmacher. ‘I think we’ll continue to see increases.’

Of the roughly 1.2 million U.S. women who have abortions each year, half are 25 or older. Only about 17 percent are teens. About 60 percent have given birth to at least one child prior to getting an abortion.

A disproportionately-high number of women having abortions are African American or Latino. New figures from the Centres for Disease Control show they account for 35 percent of the abortions.

Meanwhile, the Planned Parenthood Federation of America Inc. has announced plans to spend 10 million dollars in a major effort to elect pro-abortion-rights candidates to Congress and the White House in November.

‘We’ve seen in this presidential election, unfortunately, in the Republican primaries a real rush to the far edges … folks really trying to move us in a direction antithetical to where the American people are,’ said Cecile Richards, president of Planned Parenthood’s political arm.

The campaign would wait for the results of the presidential primary elections before deciding which states get its most intense efforts, she said.

© 2008 Inter Press Service

Post your abortion story on NPR's blog!

In honor of the anniversary of Roe vs. Wade, NPR posted the following blog:

Click here to post your own abortion story on NPR's blog.

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One More Taboo...

In the Sex and the City episode "Coulda, Woulda, Shoulda," Carrie Bradshaw tackled one of the subjects most familiar and least handled in popular culture -- Abortion. In it, Carrie admits that she got an abortion herself after a drunk one night stand over a decade ago. This, for the show that regularly did competely unprintable things with say, wheatgrass, doesn't seem to be taboo, right? Except, abortion is one of those things that women rarely talk about after they've had them -- whatever the reason. It doesn't matter if you're pro-choice or pro-life or in-between -- many women don't talk about past abortions -- even with their dearest friends or family. So today, we're going to do it -- and we're asking you to tell your stories -- whatever they are. If you had an abortion, tell us about it, and how you felt at the time. And why, if this is your experience, you do or do not talk about it now.

Barrie Hardymon

Are U.S. Policies Killing Women?

By Michele Kort, Ms. Magazine
Posted on January 22, 2008

Even as we commemorate the landmark 35th anniversary of Roe v. Wade this year, U.S. reproductive-health policies are having an inordinately negative effect outside of our borders. They're causing women to die or be maimed. Harsh words, but true.

For the past 24 years, except during the Clinton presidency, U.S. administrations have maintained a global gag rule against providing counseling or referrals for abortions at U.S.-funded clinics in developing nations. It's a rule that only thwarts safe abortions, while reducing the already limited availability of other family-planning services. The global gag rule has also led to a pullback in overseas delivery of contraceptives, according to recent testimony by Rep. Nita M. Lowey (D-N.Y.) before the House Foreign Affairs Committee: "U.S. shipments of contraceptives have ceased to 20 developing nations in Africa, Asia and the Middle East. In some areas, the largest distribution centers for contraceptives have experienced decreased access for over 50 percent of the women they serve."

Women's health and rights activists in the U.S. have spent the past two decades fighting against such actions, and advocating on behalf of global reproductive health issues. But progress has come slowly.

While maternal mortality has been declining at 1 percent annually, it needs to decline by 5.5 percent a year in order to be three-quarters reduced by 2015 (one of the United Nation's Millenium Development Goals). Sounds like a lot -- but it would require just about $6.1 billion more in annual funding -- the price of three weeks of the Iraq war -- to achieve that goal. Without that commitment, more than 500,000 women will still die annually from childbirth and its complications, with an estimated 70,000 of those deaths due to unsafe abortions.

Take, for example, the situation of women in Kenya, where abortion remains illegal unless the pregnant woman's life is in danger (a loophole some compassionate doctors interpret liberally, as they know that desperate women will risk their lives to abort anyway). An estimated 250,000 to 320,000 abortions are carried out in the country each year, with unsafe procedures causing a shocking toll: Globally,
13 percent of maternal deaths result from abortion-related complications, but in Kenya it's as high as 40 percent.

In public hospitals such as Kenyatta National in Nairobi, about 20,000 Kenyan women are treated each year for abortion-related complications. Nearly two-thirds of the beds in the notorious gynecological section -- Ward 1D -- are occupied by those patients, who suffer everything from excessive bleeding to injured organs to sepsis. Those sufferers include women such as Wangui (not her real name), who drank a boiled concoction made from trees and took several doses of an anti-malaria drug in order to abort because her impoverished household couldn't support a fifth child. She ended up in Ward 1D because she required an urgent blood transfusion to save her life.

Women's-rights groups in Kenya have been pushing for a new national law on reproductive rights, as well as supporting a continental protocol on the rights of African women and a patients' bill of rights. But they're not helped in their efforts to improve reproductive health care by the global gag rule, which has forced a number of clinics to turn down U.S. funds rather than stop discussing abortion. Three clinics of the Family Planning Association of Kenya (an affiliate of the International Planned Parenthood Federation) and two clinics of Marie Stopes International (the U.K.-based reproductive-health NGO) have been closed for loss of funds, according to a 2004 report from the Center for Reproductive Health Research and Policy in San Francisco.

Maternity care in general is problematic in Kenya's public hospitals. The 2007 report "Failure to Deliver," produced by the Federation of Women Lawyers-Kenya (FIDA Kenya) and the Center for Reproductive Rights in New York, pointed out that public health facilities often suffer from lack of supplies and congestion. Claris Ogangah-Onyango, legal counsel for FIDA Kenya, points out the obvious: When the majority of beds in maternity hospitals are occupied by women with post-abortion complications, there is not enough space and care for other women.

"The government is mostly concerned with post-abortion care," she says, "and most of the funding goes to that. But they're not doing anything to stop [unsafe] abortions."

"What has really affected our work in Kenya is that we have very few women in our parliament [just 18 of 222 members]," says Ogandah-Onyango. "When we take our issues to the government, they are blocked. FIDA and other women's organizations have approached the candidates for the next parliament to sign a document that they will support gender-friendly bills. Putting more women in government would make a big difference."

And what can women in the U.S. do to help their Kenyan sisters?

"Lobby for change in the policies that govern reproductive health,"
she says. U.S. women can also support the efforts of groups such as FIDA Kenya, which is now part of the Reproductive Health and Rights Alliance in Kenya.

Sisterhood is a global mission. Economics and politics and even social conscience aside, we know that only by empowering all women can we ensure the future of the world.

For the full article, see the Winter 2008 issue of Ms. magazine, now available on newsstands and by subscription from www.msmagazine.com.

The Coat Hanger Project featured in The Burning Times' Prochoice Carnival!

Click here for a link to the Pro-choice Carnival

This is what was written up about my project:

The Coat Hanger Project is a documentary film currently being made and due for release in 2009. It is being directed by Angie Young, a committed pro-choice activist.

The focus of the film is the abortion provision in the United States, and the pro-choice campaign fighting to keep women’s access to abortion safe, legal, and harrassment free. The film also aims to provide a strong critique of the tactics of anti-abortion campaigners, who try to restrict and even ban women’s access to abortion. The website for the film says of these anti-choice campaigners,

“They channeled your discomfort with the reality of life and death to convince you that the brave, courageous individuals who do the work of providing abortions are immoral and deserving of jail time and hatred for helping women. They changed the way we spoke about abortion by inventing loaded, inaccurate terms like “partial birth abortion” and “fetal pain” and “post abortion syndrome” - none of which are concepts that previously existed outside of antichoice vernacular - but nevertheless have stupefied and scared even the most radical of us.”

In 2006, the state of South Dakota very narrowly avoided having a total ban on abortion imposed on its women, including in rape and incest cases. The concerted actions of pro-choice campaigners were instrumental in preventing the ban from going ahead. This shows that a woman’s right to abortion can never be taken for granted.

“Denying women access to abortion forces them to either carry a fetus to term that they do not want, or take their chances ending the pregnancy themselves or with the help of an underground provider who may or may not know what they are doing. It is beyond injustice, beyond horriflying, to put this burden on women. The Coat Hanger Project aims to provide a radical, fierce, unflinchingly prochoice perspective and show the world that we can stand strong as advocates for women’s reproductive freedom.”

The films website has a wealth of information about the film, and the beliefs behind the making of it. There are also video clips you can watch of counter-protests (a reaction to anti-abortion protests) outside Planned Parenthood clinics, and some tips on starting your own pro-choice counter-protest. The site also tells you how you can help and get involved.

The film is a tremendously exciting and valuable project, and I hope you will check out the website to find out more about it. Among other things, the film “features interviews with Vicki Saporta (President and CEO of the National Abortion Federation), Heather Booth (founding member of Jane, the underground feminist abortion service, 1969-73), Dr. Bonnie Morris (Author and Dean of Women’s Studies, Georgetown University), as well as artists, activists, and other notable voices on the movement.”

The Coat Hanger Project also has a blog, featuring abortion information and resources, and pro-choice related news and current events.

If you are on Myspace, you should add The Coat Hanger Project to your friends and help to spread the word about this important and exciting project. Have a look at the website, the blog, or the Myspace page to find out more about it!

Keep abortion safe, legal and accessible. No apologies. No exceptions.

A Change of Heart: From Pro-Life to Pro-Choice

By Anna Clark, RH Reality Check
Posted on January 9, 2008, Printed on January 9, 2008
Click here for article

What if I told you that I used to call myself pro-life?

What if I said that I once believed abortion was murder, or that I suspected women used the procedure to bypass the consequences of sex?

If I told you, would I lose your respect? Would you be suspicious when I say that today I'm committed to the right to reproductive health, access, and choice?

If so, you wouldn't be the first.

I'm a person who changed her mind. And no, it didn't happen with cymbal-crashing drama -- no unexpected pregnancy of my own or anyone I'm close to (that I know of). It didn't happen with abrupt college-age fervor; though I entered the University of Michigan as a progressive, I held onto my belief that abortion was wrong (though I got quieter about it).

Here's what did happen:

Growing up in Michigan, I advocated social systems as a response to unwanted pregnancies. Sure, there were plenty of reasons why someone wouldn't have the ability or desire to parent. But don't punish the future child, I argued.

Adoption seemed an ideal compromise. With some systematic improvements, then, I thought, abortion is rendered moot and the world will be just.

Fast forward: In college, I was part of the Prison Creative Arts Project. PCAP planned an event on reproductive rights and incarcerated women. It wanted the campus pro-choice group to sponsor it.

I argued for having both the pro-choice and the anti-abortion groups sponsor the forum. A more diverse audience! We won't preach to that interminable choir! Besides, not all inmates are pro-choice. No, of course, we don't want this to be a debate. Let's have a nuanced conversation.

In this leftist group, alluding to anti-abortion views was no less startling and shameful than if I'd proceeded to urinate on another PCAPer. The others made meaningful eye contact to each other and moved on. The event was sponsored by the pro-choice group.

Stay with me for one more fast forward.

In my twenties, in Boston, I was part of a feminist book club when I still hedged around identifying as pro-choice. Such a claim felt akin to articulating God: putting spirituality into words seemed to inevitably misrepresent it.

To assert the label "pro-choice" felt like I was taking somebody else's language to describe a most personal feeling about my own body and, yes, about my spirituality. To call it my own felt phony, cheap, and careless.

In my heart, however, the change had happened. I supported the right to choose, but I balked at throwing myself into the cartoonish divisions of the public "conversation" about abortion. So I said nothing. Silence seemed the only alternative to submitting my beliefs to sloganeering.

What changed?

I don't remember the day. But that day didn't come until after I'd met people -- surprise! -- who'd chosen abortion. It came after my school friends became parents; after I began having sex and selecting birth control; after I experienced and witnessed sexual harassment.

In short, it happened after pro-choice rhetoric took a human shape. I saw those I loved. I saw myself.

Today, I have the passion of a convert for reproductive rights. I remain equally passionate in my resistance to the machine that bypasses all ambiguity about abortion.

I didn't "switch sides;" I'm against the notion of "sides" in the first place.

I spent years in ambivalence, despite an inward belief in reproductive rights. While acknowledging my cowardice, I would've allied myself with the cause sooner had choice advocates talked with me, rather than dismiss me as an anti-choicer not worth the breath. I would've spoken sooner had I not felt that I must forsake anti-choice family and friends to do so.

My story echoes others -- those of parents, students, clinic workers; religious and non-religious individuals; those who changed their minds, those who changed their reasons, and those who changed nothing. Not only are a great many people unable to split themselves between the enemy camps of "pro-life" and "pro-choice," but there is widespread revulsion at how abortion is talked about.

Depending on whose statistics you use, 37-43% of American women have an abortion. Why don't more people connect their private and public ethic?

"I hear: 'Don't get me wrong, I'm pro-choice, I always have been, I just never thought I'd be here,'" said Claire Keyes, director of Pittsburgh's Allegheny Reproductive Health Center. "And others who come in, who have been anti-abortion their whole life, they say: 'Now I don't know how I can live with myself; not because of having abortion, but because I feel like a hypocrite.'"

Dr. Megan Gilliam practices pediatric and adolescent gynecology at a University of Chicago hospital; among other responsibilities, she provides abortions. When asked about patients that identify as "pro-life," she said, "Oh, it happens all the time."

"People obtain services for their reason," Gilliam said. "We luckily don't have protesters, but they tell me about how they protest (a clinic) one day, come in the next, and are back out protesting a few days later."

This dissonance is also apparent in Raleigh, North Carolina, where Emily Batchelder once managed a clinic that provides abortions.

"I can't tell you how many times I checked in a patient who said, 'Now I don't believe in this kind of thing, but...'" Batchelder said. "No one wants to have an abortion, but it's all those 'ands' and 'buts' that make abortion services a necessary part of the reproductive health dialogue."

This fluidity between pro- and anti-choice beliefs also affects doctors.

Medical students may cite ethical difference and opt-out of aspects of their rotations. Dr. Gilliam said that in any trainee group, one or two pick their way through family planning. They might refuse to assist an abortion, Gilliam said, but they will offer counsel.

Many, particularly younger residents, change their mind about abortion.

"Where does conversion happen?" Gilliam asks. "They encounter us in so many settings. You admire someone as a physician, and biases begin to chip away."

"Conversion happens with the human connections," she emphasized. "People are able to live with a lot of grey. It's people with no experience whatsoever who can live with black and white."

Is there enough acknowledgment of the grey in the pro-choice movement? I do not mean that we should dilute strong positions against mandatory delays, for example, but we certainly could use more nuance in our interactions with one another and with those with whom we currently disagree. While many will nod knowingly at Gilliam's pronouncement that "the dichotomy is a political tool," our movement feeds into it.

So many of us feel like we don't fit -- to the point that even some who exercise their right to an abortion don't consider the movement to be their own.

Why do we support choice, after all? We cite constitutional rights (at least a little while longer); but as Claire Keyes points out, patients don't talk in those terms. "They don't come in to exercise their constitutional rights," Keyes said. "They may feel grief, but they feel this is the right choice for them."

We valorize "choice;" but Dr. Gilliam says that such language doesn't resonate with those who see themselves in communities -- part of a church, school, neighborhood, or family. "They don't approach life on such individualistic terms," Gilliam said.

We speak of the right to control one's body. But ownership language causes some progressives to bristle. One of them, Harvard sophomore Jessica Ranucci, recalls the world's sordid history of people who take it upon themselves to define who is and isn't human. She wonders how she can use the same language to justify abortion. "How is that different from the slaveholder?" she asks. The politicized language of abortion leads us to address each other as one thing, or another. This is symptomatic of the discomfort when, as in my case, divisions blur.

Which is unfortunate for the future of reproductive justice, because those human connections that Gilliam says are vital to conversion -- that were vital to my conversion -- simply do not exist when we fight "the other side."

Says Matthew Spektor, a 41-year-old in Los Angeles and lifelong pro-choicer: "I sometimes think my liberal education and cultural background drilled the pro-choice ethic into me so absolutely that it's been difficult even to understand that pro-lifers aren't all religious crazies," Spektor said.

Enemy caricatures mask the greatest strength of pro-choice philosophy: inclusiveness.

"If you asked me five years ago about abortion, I would have told you that I was 100 percent pro-life and there was no way around that," said Jeremy Shermak, a 28-year-old from Illinois. "But somehow during that moment and today, I realized that you can be pro-life while at the same time be pro-choice."

Pro-choice society, like democractic society, is predicated on space for those who disagree. When we play sides, we forget there are no enemies in the vision we pursue. Our inclusiveness of those who choose not to have abortions, and even those who judge abortion to be morally wrong, is our movement's power. When we approach anti-choicers as friends, not only do we act on the heart of our beliefs, but we create space for anti-choicers to become our allies.

I urge reproductive health advocates to remember the ones who will change their minds. We must build spaces where those of us who move slowly into the pro-choice movement are recognized as true partners, rather than tagalongs.

Our beliefs are not created by what -- or who -- we are against. They exist because of what we are for: comprehensive reproductive health for all, and the ability to decide for ourselves if we will or will not have an abortion.

As individuals and as a movement, we must act from that truth.

© 2008 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/73169/

The First Pro-Choice Carnival

This is from an awesome pro-choice blog titled "Abortion is a Woman's Right" . The goal of the pro-choice carnival is to highlight excellent pro-choice writing & thinking. Spread the word!

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This is an excerpt from the Pro-choice carnival website:

Welcome to the first edition of the Pro-Choice Carnival. I hope it will be the first of many. This Carnival aims to highlight some of the best writing on the theme of a woman’s right to choose, and will be published every other month. Contributions can be new or old, long or short, written by women or men, feminists or non-feminists, just as long as the writing comes from a firm belief that access to safe, legal abortion is every woman’s basic human right. Links to all editions of the Carnival will be posted on the Carnival homepage.

Although abortion is legal in most countries of the world today, that legality is constantly under threat from people, organisations, religions, and systems of government who seek to minimise or eradicate abortion. We must therefore be vigilant and never become complacent.

On with the Carnival, then, I hope you enjoy it, and will help to spread the word about it on your own blogs!