Bruce amendment on "sex selective" abortion - write to your MP!

Fiona Bruce MP has introduced an amendment to the Serious Crime Bill, which aims to outlaw so called “sex selective abortion”. Bruce’s amendment, which has been signed by a long list of MPs including many who describe themselves as pro choice, is a worrying attempt by a seasoned anti abortion campaigner (Bruce is chair of the All Party Parliamentary Pro Life Group) to undermine the right to choose.

The amendment will be debated at the Serious Crime Bill's report stage on Monday 23 February.

Anti abortion campaigners are lobbying MPs intensively, so it is vital that MPs hear the pro choice movement’s arguments about why the amendment is unnecessary – and potentially incredibly damaging. At the end of this post, you will find a draft letter which you can use to email your MP – please do contact your MP, as every letter is vital.

The wording of the amendment is:

"Termination of pregnancy on the grounds of the sex of the unborn child 

"Nothing in section 1 of the Abortion Act 1967 is to be interpreted as allowing a pregnancy to be terminated on the grounds of the sex of the unborn child.”

A review by the Department of Health in 2013 into sex ratios at birth in the UK found “no group is statistically different from the range that we would expect to see naturally occurring”.

The amendment, if passed, will not even be effective, but could be the thin end of a wedge to undermine the 1967 Abortion Act. Laws already rightly protect pregnant women from reproductive coercion, as a form of domestic violence. 

The amendment will however introduce a duty upon doctors to consider something other than the health and wellbeing of the person who is pregnant: doctors will be tasked with policing the intentions of people seeking access to abortion. As intentions are impossible to prove, this will in practice lead to racial profiling, and differing levels of availability of the full range of reproductive options, based on perceived ethnicity.

Supporters of the amendment claim it will ‘send a message’, which it will – it will send the message that in certain circumstances, a foetus’s rights trump those of the person carrying it. Abortion laws don't need to change – what needs to change are ways of thinking that value a foetus of one sex over another.

Numerous pieces have been published in response to the Bruce amendment pointing out its deeply flawed nature, in the New Statesman, on the Conversation, in the Letters page of the Daily Telegraph, and in the Scotsman among others. Abortion Rights has written a letter to MPs which you can read here. For more background on how bans on “sex selective” abortion are an ineffective response, the Guttmacher Policy Review published an excellent piece in 2012. This very blog has two posts on the issue (from September 2013 and January 2014) which call into question the claims and evidence used by anti choice campaigners who are calling for a ban.

The Bruce amendment presents a real danger to the right to safe, legal abortion in the UK. Please act now to put forward the pro choice case, which will in the end strengthen women’s rights more than an amendment that pays lip service to feminism while undermining the right to bodily autonomy. 

Proposed letter to your MP

You can find your MP’s email address and contact details via this link: 
www.parliament.uk/mps-lords-and-offices/mps/

Feel free to use the below letter as a template, or to adapt it, or to write your own – we just need to make sure we contact as many MPs as possible.

Dear [MP name],

I am writing to you to express my strong opposition to the amendment to the Serious Crime Bill tabled by Fiona Bruce MP, “Termination of pregnancy on the grounds of the sex of the unborn child”.

Reproductive coercion, including forced abortion, is already illegal, as it is a severe and abhorrent form of domestic violence. Abortion clinic staff are trained to recognise the signs of someone being forced into having a termination they do not want, and follow procedures to ensure that women’s right to choose is respected. No new law criminalising women seeking abortion is required.

A review by the Department of Health in 2013 into sex ratios at birth in the UK found “no group is statistically different from the range that we would expect to see naturally occurring”. While there have been several highly upsetting first person accounts of women forced to abort due to the foetus’s sex, there is no evidence that this is a widespread practice in the UK, and no compelling argument that the Bruce amendment would have protected the women in question.

The amendment will do nothing to address the causes of boy-preference in some communities, and will lead to racial profiling of people from communities assumed to be 'at risk' of sex selection. It will give doctors the impossible task of policing the intentions of pregnant women, and remove the Abortion Act's requirement that the physical or mental health of the pregnant woman be the overriding concern of doctors authorising terminations.

I ask you to vote against this amendment and to make the case that your colleagues do the same.

Yours sincerely

[Name, address]

"How to get rid of a pregnancy"

Having seen people tweeting about the weird and wonderful ways readers reach their blogs, we decided to delve into our own statistics to see what people have been typing into Google to end up at this blog. 

Although of course plenty reached the EFC blog through links on other sites, or searches like 'abortion education in schools', one of the most common searches was the phrase 'how to get rid of a pregnancy'. Other popular searches included variations on 'pills to get rid of pregnancy'. Further investigation showed that quite a few people reached the EFC blog through a link on Ask.com which lead to this Mythbusting Monday post about medical abortion, explaining why the phrase 'abortion pill' can be misleading (Early Medical Abortion is actually a process involving two lots of medication, and two to three visits to a clinic, rather than just 'taking a pill').

It was sobering to realise that many people visiting this blog are not just looking for general information related to work or study but are likely themselves facing an unwanted pregnancy and unable to access the medical support they need to have an abortion. Sobering, but not all that surprising when you know that a decent proportion of visitors to this blog are from the USA and Ireland.

As you may know, although abortion is legal in the United States, access is severely restricted in some areas, meaning that those seeking abortion (especially poorer women) may look for 'cheaper' methods of ending a pregnancy, such as buying medication online. This graphic shows the varying levels of abortion access in the U.S - with mandatory waiting periods or insurance restrictions being enforced in many States, access to safe, legal abortion can be difficult.

Ireland, in turn, has one of the world's most restrictive abortion laws. Abortion is only available to save a pregnant person's life. Last year, almost 4000 women travelled from Ireland to England and Wales to have an abortion. Again, these women will have needed the financial means to pay for the procedure itself as well as transport and associated costs. Although the Abortion Support Network has been set up to help these women pay for the procedure, it can't support everyone. A recent article in Vice argued that more and more Irish women are turning to the internet to purchase abortion medication to administer themselves. The article points out that women taking this route are not recorded in the official statistics, although with hundreds of packages of such medication being seized every year, the number is clearly significant. 

Of course, ordering and using this medication is illegal in Ireland. But it seems that some are desperate enough to try to end a pregnancy even via methods which could put them in prison. And this is not just true of women in Ireland, or the U.S, but anywhere where abortion is illegal or restricted. And as the Guttmacher Institute makes clear, this method can be safer than traditional 'backstreet abortions' performed in unsanitary conditions: "In settings where abortion is illegal or highly restricted, it (abortion medication) has provided many women for the first time with a safe and discreet means for early termination of unwanted pregnancy." Safe Abortion Hotlines in places such as Chile, Poland and Kenya show that  where abortion is illegal or very severely restricted, there will still be women who find ways to end their pregnancies.

Unfortunately we were not surprised to see that some of these women had found their way to our site through searches for information on unwanted pregnancies which they cannot end in registered medical establishments, either due to legal, practical or economic constraints.

Henry Morgentaler and abortion in Canada

This week, Dr Henry Morgentaler died at the age of 90. Not many people here in the UK have heard his name but he is an extremely important figure in the abortion rights movement.

Born in Poland, Morgentaler’s Jewish family were sent to Auschwitz in 1944 – his mother and sister died there. Morgentaler survived both Auschwitz and Dachau and eventually settled in Canada where he graduated from the University of Montreal as a medical practitioner. When contraception was legalised in 1969 he began to specialise in ‘family planning’ and was one of the first Canadian doctors to provide IUDs and contraceptive pills to the unmarried.

On behalf of the Canadian Humanist group to which he belonged, Morgentaler spoke at a House of Commons meeting in 1967, stating his belief in the importance of safe, legal abortion for women. This appearance led to him being inundated with requests to perform abortions (at the time the procedure was illegal, except to save the woman’s life) which at first he refused, through fear of prosecution. However, through his medical practice he encountered a number of women who had suffered from botched illegal abortions and saw, first hand, the effect this lack of access had on their health and lives. In 1968 Morgentaler performed his first abortion at his private clinic, for the 18 year old daughter of a friend. He said:

 “I decided to break the law to provide a necessary medical service because women were dying at the hands of butchers and incompetent quacks, and there was no one there to help them...The law was barbarous, cruel and unjust. I had been in a concentration camp, and I knew what suffering was. If I can ease suffering, I feel perfectly justified in doing so.”

In 1969, the law changed to allow abortion, but only in hospitals, and where a woman’s request had been approved by a committee. However, the majority of hospitals did not have such a committee, and many did not meet, so women in these areas were still suffering from a lack of legal access to abortion. Morgentaler’s abortions remained illegal under this law, and he risked life imprisonment as well as physical attacks and death threats in order to challenge the law and provide safe, legal abortions to the women he saw in his clinics.

When Morgentaler was put on trial in the 1970s his lawyer argued the ‘defence of necessity’ – that as a doctor, Morgentaler’s responsibility was to safeguard the health and life of his patient, overriding legal restrictions which might conflict with this. Despite being acquitted by a jury, he was sentenced to 18 months in prison and underwent a number of trials and appeals to challenge the existing law. Eventually it was the public support for legal abortion, and for Morgentaler’s campaigning and actions which led to abortion becoming legal in 1988. Public juries repeatedly acquitted Morgentaler and polls found that a vast majority of Canadians believed abortion should be a decision made by a woman and her doctor. The Supreme Court ruling in 1988 essentially removed all criminal restrictions on abortion, leaving it to be governed by Canada's laws concerning medical practice (as with other medical procedures).

The Chief Justice in this case said at the time:

"Forcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus a violation of her security of the person."

Canada remains one of the few places in the world where there are no legal restrictions on abortion. Many worry that a lack of such restrictions will lead to an increase in abortions, but this is evidently not the case:

In Canada, the teenage birth and abortion rate is 27 per 1000 women between the ages of 15-19 versus 61.2 per 1000 women in the United States.

The abortion rate among all women of reproductive age (15-44) in Canada is 14.1 per 1000 versus 20 per 1000 in the United States. (Stats from Dr Jen Gunter).

What might the ‘Protection of Life During Pregnancy Bill’ mean for Irish women seeking abortion?

The Irish government has produced a bill which if passed, will, according to Prime Minister Enda Kenny, ‘clarify the circumstances’ in which medical practitioners can intervene to save a woman’s life by providing abortion. Kenny has stated that the new bill “would continue within the law to assert the restrictions on abortion that have applied in Ireland and which will apply in future”. In other words, it does not seek to change Irish law on abortion, which states that abortion is restricted only to cases where the pregnant woman’s life is in danger. Following the recent death of Savita Halappanavar in Galway there has been a demand for clarification on the circumstances in which doctors can legally provide life-saving treatment. Kenny claims that if the bill goes through it will “at last bring certainty to pregnant women and legal clarity to medical personnel who work within the system”.

So what does the bill actually say?

The bill is carefully worded so as not to present decision making around abortion as privileging the rights of the woman over the rights of the developing pregnancy. Suggested provisions are purely about saving a woman’s life in emergency situations and all efforts must be made to protect the ‘unborn child’ (as the pregnancy is referred to) wherever possible:

“Essentially the decision to be reached is not so much a balancing of the competing rights rather, it is a clinical assessment as to whether the mother's life, as opposed to her health, is threatened by a real and substantial risk that can only be averted by a termination of pregnancy.”

Some provision is made for those women who claim to be suicidal in the face of having to continue an unwanted pregnancy. It is proposed that in such cases, three doctors are to examine the woman and must reach a unanimous decision on the threat to her life. If the three doctors do not agree, the woman may appeal to another three consultants, meaning that her case could potentially be reviewed by six separate medical professionals.

What are people saying about the bill?

Members of the government claim that the bill would provide much needed clarity to enable doctors to work within the very restrictive Irish abortion law. However, there have been criticisms from both pro-choice and anti-abortion campaigners.

Some anti-abortion campaigners have evidenced concerns about the law being ‘relaxed’ with access to abortion expanded. Former Irish Prime Minister John Bruton said the idea that “a simple threat of suicide would make right something that would otherwise be wrong is a really dangerous principle”. And in a recent televised debate, a Fine Gael politician was asked if potentially fatal health risks are an 'acceptable risk' in pregnancy, or whether they are grounds for abortion in some cases. He responded: "But sure we’re all going to end up dead anyway." This begs the question of why he’s against abortion, and indeed whether he thinks medical care is redundant for all people whose lives may be in danger or just pregnant women.

Many pro-choice campaigners have taken issue with the ‘suicide clause’ in the bill. A spokesperson from the Centre for Reproductive Rights calls it ‘outrageous and paternalistic’ and goes on to criticise Irish abortion law more generally as being an “absolute violation of international human rights norms on women's right to health and dignity. It's totally off track with the rest of Europe."

In summation, the bill is not yet passed, and if it does go through both houses of Irish parliament, it will not make any changes to the law itself. Even with these amendments the thousands of Irish women who travel to the UK (and elsewhere) to access abortion would still need to do so. Arguably it might make provision for rare cases in which the woman's life is threatened but this will still sit within a legal framework which threatens to prosecute doctors whose actions are seen as being outside of these restrictions.

To follow the debate we suggest checking out the Irish ‘Doctors For Choice’ campaign which will provide regular updates.

The Protection of Life During Pregnancy Bill can be viewed in full here.

Protest the death of Savita Halappanavar

SOLIDARITY REQUEST: Protest the death of Savita Halappanavar in Ireland PLEASE SIGN AND SEND THE E-MAIL BELOW TO THE FOLLOWING: To: Taoiseach Enda Kenny (Irish Prime Minister) cc: Tánaiste Eamon Gilmore (Irish Deputy Prime Minister and Minister of Foreign Affairs) E-mails: taoiseach@taoiseach.gov.ie enda.kenny@oireachtas.ie eamon.gilmore@oir.ie Copy also to the Irish Embassy in your country. Find contact details here     Re: Death of Savita Halappanavar in Galway Honourable Taoiseach, We are writing to you to express our concern about the recent death of Savita Halappanavar, who was repeatedly denied an abortion in Galway. This tragic case demonstrates once again that the prohibition of abortion in Ireland is not just undermining the autonomy of the women across the country, it is leading to unacceptable suffering and even death. Savita Halappanavar made repeated requests for an abortion after presenting at University Hospital Galway on 21 October while miscarrying during the 17th week of her pregnancy. Her requests were refused, and she died one week later after several days in agonising pain and distress. The situation of Savita Halappanavar provides the clearest possible evidence that laws that permit abortion only to save the life of a woman, such as the Irish law, are clinically unworkable and ethically unacceptable. There are numerous clinical situations in which a serious risk posed to a pregnant woman's health may become a risk to her life, and delaying emergency action only increases that risk. There is only one way to know if a woman's life is at risk: wait until she has died. Medical practitioners must be empowered by law to intervene on the grounds of risk to life and health, rather than wait for a situation to deteriorate. You will be aware that the European Court of Human Rights, as well as a number of United Nations human rights bodies, have called upon the Irish government to bring its abortion law in line with international human rights standards. Had these calls been heeded before now, the death of Savita Halappanavar would have been prevented. With the death of Savita Halappanavar, Ireland joins the ranks of countries worldwide where abortion is denied to women and leads to their deaths. We call on your government to take urgent and decisive steps to reform the legislation that led to the death of Savita Halappanavar. Until the Irish legal system is reformed the lives, health and autonomy of women across Ireland are in jeopardy. Yours faithfully, [SIGNATURE]

Wonder Women and Other Women

As part of the Telegraph’s new ‘Wonder Women’ collective Cathy Newman has written a piece entitled ‘How the agony of my abortion made me see both sides’. In the article Newman shares her own experience of having ended a wanted pregnancy due to a diagnosis of severe fetal abnormality. She notes that she was lucky to find out about this abnormality relatively early, at 13 weeks, as many women would be having this scan at 20 weeks. She goes on to describe the difficulty of having to wait another week to access the procedure after having had this news:

‘Most women whose babies suffer from this condition wouldn't find out until the 20 week scan, if then. I was immediately offered an abortion, but quite apart from the emotional turmoil, it was extremely difficult to arrange. I was told I'd have to wait a fortnight, but eventually managed to fix the operation in a week - a week which seemed like a year as I dealt with the trauma of what was happening to me.’

We appreciate Newman sharing her personal experience, and acknowledging that there are complex situations and real people behind later term abortion, and that unavoidable delays can affect access and emotional wellbeing. However, there are a few points in the rest of the article we’d like to have seen more clarity on, this being such an important and emotive subject.

Firstly, the conclusions reached about later abortion are not entirely accurate. Newman claims that ‘if the law changes, women in similar situations might not have the choice I did’. The article’s ‘hook’ seems to be that Maria Miller, new Minister for Women and Equalities, voted in 2008 to reduce the abortion time limit to 20 weeks. In fact, if this part of the law changed it would presumably not affect somebody in a similar situation to Newman – that is somebody who had had a diagnosis of fetal abnormality, as this is a ground under which abortion can be accessed after the 24 week limit.

The more troubling statement which has been left unexplored, with no reference to scientific evidence, is that made by Miller herself regarding her reasons for supporting a reduced time limit. She claims to be:

‘driven by that very practical impact that late term abortion has on women...What we are trying to do here is not to put obstacles in people's way but to reflect the way medical science has moved on.’

There are two issues here. What is the ‘very practical impact’ that late term abortion has on women? Has this been measured against the ‘very practical impact’ which might arise from being forced to continue an unwanted or non-viable pregnancy to term? Secondly, Miller claims to be reflecting ‘the way medical science has moved on’. When Miller was voting on the 2008 Human Fertilisation and Embryology Act she would have heard that medical and scientific consensus remained in favour of maintaining a 24 week limit due to a lack of significant changes to viability before this point:

‘Having considered the evidence set out above, we reach the conclusion, shared by the RCOG and the BMA, that while survival rates at 24 weeks and over have improved they have not done so below that gestational point. Put another way, we have seen no good evidence to suggest that foetal viability has improved significantly since the abortion time limit was last set, and seen some good evidence to suggest that it has not.’

Miller’s insistence that it is ‘common sense’ which drives her desire to change the time limit should surely be questioned and backed up by relevant evidence. Rather Newman, (ironically Channel 4’s ‘factchecker’) allows this, as well as talk of ‘trauma’ to pass by, unexamined.

We know that only a tiny minority of women are accessing abortion after 20 weeks (1.5% in 2011) and as Newman acknowledges, this may be due to fetal health or delays to access (or an array of other issues, see this report from Marie Stopes for background on the reasons some women have later abortions). However, the article seems to support Newman’s own reasons for ending a pregnancy, but is shaky on the necessity of later abortion for ‘other women’. For example, women whose local hospital may not be 'one of the world's best in the field’. The quotes from Nadine Dorries in the piece are very telling – she claims that ‘prochoicers’ who support the current time limit are ‘ignoring the number of women who are traumatised and vulnerable during the abortion process’. Clearly, there are Wonder Women who can make logical, justifiable decisions about their pregnancy and there are Other Women who are vulnerable, whose choices need to be limited and who need to be ‘protected’ by politicians like Miller and Dorries.

Sarah Catt: when we've stopped pointing the finger let's ask ourselves how much we care

Sarah Catt faces an eight year jail sentence after taking abortion medication purchased over the internet to end her pregnancy at 39 weeks. I don’t know if she had any idea that she was putting her life and her liberty at risk when she did this. There is speculation as to both her motivation and her mental state, but the only fact of the matter is that for some reason the idea of giving birth to a living baby, which she almost certainly would have done within just a couple of weeks, was intolerable to her.

Speculation about whether she is a monster or just desperately ill and unhappy will, no doubt, be rife. Arguments will rage to and fro about whether she should have received such a long sentence. Others will ask whether the current time limit for abortion is right, whether there should be time limits at all or whether our focus should be on doing everything we can to make abortion as accessible as possible, as early as possible. Some people will say that this case demonstrates an argument for taking abortion out of the sphere of criminal law altogether, others that this proves we need legal limits on abortion provision because we simply cannot trust women not to go running around choosing late term abortions.

For me this case is so unusual that I’m not sure if it can helpfully inform debates about abortion law. They say that hard cases make bad law and this is probably a case in point.

If we can draw any lessons from this it might be about the support that we can provide to those women who consistently struggle to control their fertility, to choose and use an appropriate contraceptive method, and to manage relationships. There are many reasons why women who feel negative or at least ambivalent towards pregnancy still get pregnant repeatedly including complex personal circumstances. Easy as it is to blame individual women for making bad decisions (we rarely blame their partners) we also have to ask ourselves whether sometimes repeat unintended pregnancies do highlight a shortfall in services. Did Sarah ever seek or was she ever offered any support to think about her fertility, to clarify her own feelings about pregnancy and parenthood and to make informed choices about future relationships and contraceptive use?

Did she have the emotional and practical support she needed after she placed a child for adoption? Or did that process contribute to her belief that it was better to go through the potential pain and danger of labouring alone to have a stillbirth, than to give birth safely and retain the option of placing the baby for adoption? When she was turned down for abortion after 24 weeks did anyone offer her the opportunity to think about ‘what next?’ Did anyone offer to help her talk to her husband and think through the possible consequences (good and bad) of having this conversation in terms of her safety, their relationship and the future of their family?

When a healthy woman with a healthy pregnancy seeks abortion after the legal time limit, it is likely that her circumstances and her feelings about the pregnancy are pretty desperate. For good or ill, a woman in this situation cannot have an abortion after 23 weeks and 6 days. What do we offer these women to address the circumstances they find themselves in, in which continuing the pregnancy is intolerable? Are they made aware of the dangers both medical and legal of trying to induce an abortion themselves? Is there anything we can offer to make the next 16 weeks of pregnancy tolerable, safe and manageable for them...let alone the next 20 years of parenthood?

I don’t know what kind of support is available to the handful of desperate women who are turned away from abortion because they’re just too late. Later abortion is a divisive issue, but whatever anyone feels about it, we must all feel some duty of care towards women who want one, but can’t have one.

Myth Busting Monday: ‘Where abortion is legal, all women will be able to access safe, legal abortions'

This week The Guardian has published some interesting short articles on unsafe abortion in Zambia, written by Alice Klein, a young mother who has recently had an abortion herself.

Klein writes about the places women in Zambia can access illegal abortions for varying sums of money: an unhygienic Chinese clinic, drug stores selling misoprostol illegally, and ‘witch doctors’ offering herbal ‘medications’. There are also horrifying stories of women attempting to end pregnancies themselves; ‘inserting knitting needles and turkey basters into their vaginas, [to] drinking laundry bleach and jumping off stairs on to their stomachs’.

You’d be forgiven for taking from this that abortion is outlawed in Zambia, but another article reveals that this is not the case. In fact, Zambian ‘abortion law is one of the most liberal in sub-Saharan Africa and allows the procedure if the pregnancy risks the mother's physical or mental wellbeing’. However access to legal abortion is affected by a number of barriers: ‘it requires three doctors' signatures, almost impossible in a country with one doctor per 8,333 people (compared with one doctor per 435 people in the UK)’; also, in a country with an 80% poverty rate, costs of safe, clinical procedures can be prohibitive. The article also highlights the widespread stigma and religious objection to abortion in Zambia, which again, contributes to misinformation about available services, further reducing accessibility. One ‘healer’ offering illegal, herbal abortions advises the researcher to ‘avoid hospital abortions, saying metal clamps are used to open the vagina and scratchy cotton wool used to clean the womb. She repeated common myths, such as clinical abortions leave women infertile and unclean.’

Clearly, in Zambia, although abortion is effectively legal, this doesn’t mean it is accessible to all women who want to end their pregnancies. As a result, women undergoing illegal, unsafe abortions are risking their health, and in some cases, lives.

Of course, this is one example – there are many areas of the world where, although abortion is technically legal it is difficult (and generally for poorer, or younger women, virtually impossible) to access. Abortion has been legal in the U.S since 1973 but 88% of all U.S counties have no abortion provider (this rises to 97% in rural areas).

For more information on abortion worldwide, including the gaps between legality and accessibility, visit the Guttmacher Institute website.