“My body, Your business?” Decisions about a woman’s body in the 21st century

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“My body, my business” screamed the banners as thousands of women left their workplace and homes and took to the streets in 60 cities and towns across Poland in October this year. The country came to a halt by a nationwide protest against further tightening of the country’s already restrictive laws on abortion. Without half their workforce, government offices, universities and schools across Poland had to stay closed.

 

“We are not incubators to regulate.” “We want doctors not missionaries.” “No women, no country.” Some of the other slogans and shouts heard across the country reflected the feelings of woman in Poland, which already has some of the toughest laws on abortion in Europe. The existing hard law (in force since 1993) bans abortion except for cases of rape, severe congenital defects or threat to the mother’s health.

 

The proposed new law, against which the protestors came out, would have banned all abortions except those to save the mother’s life, with the penalty for terminating a pregnancy illegally extending from two years in prison to five for women seeking abortions and doctors who perform them.

 

Three days after nationwide protests, the parliament overwhelmingly rejected plans for a near-total ban on abortions, marking a setback for the conservative government. Members of the ruling Law and Justice Party (PiS), which supported the proposed new abortion law, think they can still bring about a complete ban on abortions. Jarosław Kaczyński, the party leader and a devout Catholic, told parliament that: “PiS will continue to back the protection of life and it will continue to take action in this respect, but it will be considered action.” Beata Szydło, the Polish prime minister, had supported the proposed measure, although she stressed it was her “private opinion.” Poland’s foreign minister, Witold Waszczykowski, seemed unconcerned about the ‘Black Monday’ protests, as he told one radio station, “Let them have fun. They should go ahead if they think there are no bigger problems in Poland.”

 

Magdalena Korzekwa-Kaliszuk, director of Pro-Life campaigns in Poland still believes that, “our generation can stop abortion. Poland’s case can spread to other countries in the European Union so they can (also) stop abortions.”

 

 

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Poland is not the only country. A closer look at abortion laws around the globe shows that the legal framework in 68 countries currently prohibits abortion entirely or permits it only to save a woman’s life and 2 in 5 (40%) people in the world live in countries with highly restrictive laws governing abortion.

 

However, other than restrictive laws, another problem plagues the issue of abortion. Even in countries where the law may permit abortions, women often do not have access to proper contraception or safe abortion services.

 

A combination of restrictive laws and lack of access to contraceptive or abortion services leads to 22 million women undergoing unsafe abortions worldwide each year; and 47,000 women dying from abortion-related complications. Thus, approximately 130 women die each day or more than 5 women every hour just because they could not access a medically safe abortion procedure which is not that complicated or expensive from a technology or cost point of view.

 

Take the case of Ireland where abortion is only available to those women who are in immediate danger of dying if they do not get the procedure. Women who have illegal abortions face 14 years in prison, making it one of the toughest laws on abortion in Europe.

 

Ireland’s ban on abortion got global attention in 2012 when Savita Halappanavar, a dentist who was seventeen weeks pregnant, died a preventable death after being denied abortion under the country’s law.  Within hours of admission to the hospital for severe back pain, Savita was informed that she was miscarrying. However, under the national law she was denied abortion as the fetal heartbeat was still present. After three days of excruciating pain the fetus’s heartbeat stopped and it was removed, but soon after, Savita died of septic shock.

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Despite Ireland’s 2013 Protection of Life during Pregnancy Act, which now allows for abortions in Irish hospitals in limited circumstances, in 2014 an 18-year old rape victim was denied access to abortion; and she had to undergo a Caesarian section to give birth at 25 weeks. Irish women who have the money, travel to Britain and get an abortion done. However, in the case of many women in Ireland, as the short film below shows, crossing the seas is not an option as they cannot afford £400-£2000 for private healthcare and cost of stay. Ordering emergency contraceptive pills off the internet or using other dangerous methods of self-inducing abortion becomes the only option for many women in Ireland, putting their lives at grave risk.

 

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In June 2016, the UN’s human rights committee called on the Irish government to reform its restrictive abortion legislation, after ruling that it subjected a woman to cruel, inhuman and degrading treatment and violated her human rights. Despite this international call for reform, the struggle against persecution of women in the name of policy still continues in Ireland.

 

Will Ireland wait for its own case of Gerri Santorro, a 28-year-old American woman, who died in a motel room in 1964 while trying to induce an abortion, before it reforms its restrictive laws? The painful photograph of Gerri’s dead body found in the motel room became the symbol of American pro-choice movement in the sixties and seventies and still continues to be an issue for Presidential debates in 2016.

 

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On the same continent, further south, a stronghold of the catholic church, the small country of El Salvador has one of the most draconian laws deeming abortion illegal in all circumstances. Abortion – or miscarriages treated as suspected abortions – can be regarded as murder in El Salvador, which can carry a 40-year sentence.

 

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Maria Teresa Rivera (in image above) was sent to jail for 40 years for the crime of suffering a miscarriage. In 2011, Maria Teresa, a factory worker who lived with her son and mother-in-law, suffered a miscarriage. Her husband had left her several years ago. She was detained at the hospital and taken before the court, and in just fifteen minutes, a judge sentenced her to 40 years in prison. An international effort by campaigners around the world resulted in this conviction being overturned in May 2016 after Maria Teresa had spent 5 years in an overcrowded jail with no visits from her family.

 

In December 2015, an article published in The Guardian newspaper carried a film with extracts from letters written by women who were serving time behind El Salvador’s jails for murder and attempted murder as a result of their miscarriage and abortion.  Most women serving these sentences are single, poor, largely uneducated, have no access to legal counsel, and sometimes not allowed to sit in their own hearing. Women in El Salvador who do manage to get an abortion done, are those who can afford to catch the two-hour flight and visit a private clinic in Miami.

 

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In the United States, presidential nominee Donald Trump recently commented in an interview that women who have abortions should be punished. Trump’s statement comes 43 years after the historic Roe v. Wade case that legalized abortion for women across the US. Trump’s vice-presidential candidate Mike Pence has gone beyond his leading man’s comments and vowed to reverse Roe v. Wade; defund Planned Parenthood; and redirect those dollars to women’s health care that does not provide abortion services. While Trump may be backtracking or moderating his views on abortion closer to the elections, these comments really throw light on the highly debated situation of reproductive rights in one of the world’s most overhyped democracies and one of the most developed economies.

 

 

Prior to the landmark Roe v. Wade judgement in 1973, abortion was illegal in all cases in 30 states, legal in certain circumstances (rape, incest, danger to health) in 16 states, and only totally legal in four (Alaska, Hawaii, New York, and Washington). The 1992 Academy nominated short film ‘When Abortion was illegal – untold stories’, gives us first person accounts of the physical, emotional and legal consequences of having or providing an abortion when it was a criminal act in the US.

 

 

In 1969, Norma McCorvey, pregnant with her third child, wanted to obtain a legal abortion but was denied one, and was referred to attorneys Linda Coffee and Sarah Weddington.  In 1970, Coffee and Weddington filed suit in the United States District Court for the Northern District of Texas on behalf of McCorvey (under the alias Jane Roe). The defendant in the case was Dallas County District Attorney Henry Wade, who represented the State of Texas. Roe v. Wade reached the Supreme Court on appeal in 1970 and three years later, the Supreme Court issued its decision with a 7-to-2 majority vote in favor of Roe.

 

Since 1973 however, there have been several attempts where pro-life groups and institutions, employers and legislators have tried to restrict reproductive rights granted by Roe v. Wade. The graph below prepared by Guttmacher Institute shows the number of restrictions on abortion passed by the state in the last three decades in the US despite the public’s overwhelming support for women’s access to safe, legal abortion.

 

The figure below lists the specific approaches to restrictions on abortion access in the US since Roe v. Wade.

 

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The sheer number of new contraception-related restrictions enacted in the US in 2015 alone — a total of 57  — coupled with the anti-abortion plans of Trump and running mate Mike Pence, make it clear that there will be continued assault on the reproductive rights of women in the US. This foces us to ask how far have American women really come since Roe v. Wade, and whether the US is going back in time with respect to woman’s rights over their bodies?

 

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In India, the second largest country in the world, with a population of more than 1.2 billion people, a woman dies every two hours because of an unsafe abortion. This is the same country that started the world’s first family planning program in 1952 and also legalized abortion in 1971 under the Medical Termination of Pregnancy (MTP) Act (which may have been driven by the need to control population rather than advance women’s reproductive rights).

 

Despite the existence of such landmark policies and programs for family planning, 42% of Indian women still do no use any contraceptive methods, an overwhelming 70% of female contraceptive users opt for sterilization, and the number of unsafe abortions outnumber legal and safe abortions in the country.

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The problem arises because in India only one in ten couples report use of any contraceptive method by the male partner and male sterilization rates in India are less than 1 in 100 of all methods. This puts the onus of birth control entirely on the woman. As per social and cultural norms, couples are expected to give birth soon after marriage to prove their fertility, which means that couples rarely use any contraceptives to delay the birth of the first child. A married woman is under societal pressure to give birth to a son. National surveys show that 4 out of 5 married women and married men want to have at least one son. Therefore, the couple keep trying to have children until the woman gives birth to a male child. This gives further license to the male partner not to use any contraceptive method. When the desired number and type of children are born or the desired family size is attained, the woman undergoes permanent sterilization.

 

Three in five married women report not having a say in decision-making in their households, with husbands or other family members deciding family size and use of birth control, thereby limiting women’s autonomy with respect to reproduction and their own bodies.

 

Access to information and availability of the different methods of birth control are extremely limited for many Indian women, especially those living in rural parts of the country. The Indian government incentivizes female sterilization and promotes this method heavily through its community health workers who are given targets to meet. Financial incentives for female sterilization act as a form of coercion especially in the case of marginalized women who are poor, illiterate and belong to lower caste groups.

 

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Under such restrictive circumstances, most married women in the country have sterilization as the only option for birth control. World over, India has the highest rates of female sterilization. There re two issues here: one is the poor quality of health services. Many women get sterilized in inadequately staffed and stocked clinics or camps with poor hygiene, sometimes operated by untrained personnel, in many cases hurriedly without the use of basic disinfectants and medication. The second issue is an untimely pregnancy. In case the woman gets pregnant at a time when she cannot afford to have a baby for psychological, personal or financial reasons, then the only option for her is to have an abortion. Many women in India try medical abortion where they buy pills that medically induce abortion and the sale of such pills is quite high.

 

Under the Medical Termination of Pregnancy (MTP) Act, women can get an abortion within 12 weeks of pregnancy, provided a registered medical practitioner diagnoses danger to the woman’s physical and mental health. An abortion between 12 and 20 weeks of pregnancy requires permission from two medical practitioners. For married women, the Act allows abortion in the case of contraceptive failure and if the fetus will be born with severe abnormalities. Unmarried women have the right to terminate pregnancy in the case of rape, fetal abnormalities and grave danger to physical and mental health due to pregnancy. However, the Act does not clarify a woman’s right to terminate pregnancy beyond 20 weeks and many such cases have reached the Supreme Court with mixed judgements. The Act also does not cover marital rape as a reason for terminating pregnancy.

 

In the case of married women seeking abortion, limited or lack of decision-making power especially among those who reside in rural areas and are illiterate, makes it difficult to choose an abortion, leave alone finding proper access to abortion services and registered practitioners. While the government has increased the number of MTP clinics for legal abortion, many of these places have been found to be short staffed and ill-equipped for safe procedures, hence married women who do decide to get an abortion and have resources, prefer to go to private health clinics. Married women who cannot afford to travel to a clinic or pay user fees, ends up using the help of traditional midwives or quacks, sometimes even self-inducing abortions at home.

 

Single women face the dilemma of shame due to pregnancy before marriage and stigma from family and community members. Single women therefore choose confidentiality over shame and quality of health service. Several accounts of unmarried women in India seeking abortions describe how they are forced to use backstreet private clinics or resort to self-induced abortions by using emergency contraceptive pills and other dangerous methods, often ending up in infections and mental trauma. With the existing Pre-Conception and Pre-Natal Diagnostic Techniques Act that bans and criminalizes sex determination, private doctors are scared to conduct abortions even though it is a legal procedure, as they fear arrest and imprisonment under the Act.

 

Will a woman ever own her own body?

  

These country cases on the state of reproductive rights of women clearly show that decisions about a woman’s body are by everyone else, except the woman herself. They raise various questions.

 

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Civil society groups under the pro-life banner have been leading assaults on contraception-related national and state legislations for decades. While every individual or group of persons has the right to their own values and beliefs, enforcing these on others without their agreement is unfair and unjust. Patriarchal societies have been dictating terms for women for centuries on all matters including their reproductive decisions.

 

In Poland, despite a deeply conservative catholic mindset and the recent election of the right-wing Law and Justice Party (PiS), a poll revealed that only 14% of people approved the proposed (new) restrictive law on abortion, raising the question then of who makes the decisions about a woman’s body and how she must use it. Even in a democracy, can a conservative government go ahead and pass legislation when the vast majority of people do not approve of it?

 

It seems they can, if they initiate a referendum and acquire a certain number of votes.

 

In Poland, the proposal for a newer, draconian version of abortion laws came from an anti-abortion civil society citizens’ initiative led by a group called ‘Stop Abortion,’ supported by the church and members of the conservative ruling party (PiS), which has a majority in parliament. They gathered about 450,000 signatures many of which were from the Polish diaspora living in USA, Canada and Africa.

 

Is it okay for a group of people, who may not even be living in the same country to decide the biological fate of Poland’s resident 19 million women? Is a referendum or internet poll enough to drive legislation on what power a woman has over her own body?

 

The state, which is expected to protect all citizens from repressive societal norms and practices, often becomes the oppressor itself. State legislations either ban abortion and criminalize or restrict the procedure so heavily that it becomes almost impossible for a woman to take the legal route and have a safe abortion or maintain good reproductive health.

 

In El Salvador, Mirna Ramirez, a 48-year old mother, ended up serving 12 years in prison because of a premature birth was considered an abortion. Mirna has been free from prison for a year now, but she is still scared.

 

Is it okay for the state to criminalize a woman who needs an abortion, and put her behind bars for decades on the charges of murder or attempted murder?

 

In many countries, while the legal right for abortion has been put in place the moral right still remains to be won.

 

In India, most often it is women with some sort of agency in the form of education, employment, financial resources and psycho-social support, who are able to make informed decisions about contraception and retain autonomy over their bodies. The woman without human or social capital, meagre resources and social support are rarely able to control their reproductive choices. The lack of stewardship and regulation by the government health system, patriarchal attitudes across institutions, obstinate cultural norms and gender inequality still make it difficult if not impossible for most women in India to control their reproductive fate.

 

Is it okay for a husband or other family members to dictate terms around reproductive choices of the woman? Is it okay for cultures and societies to condemn women with guilt and shame for accessing contraception?

 

Private sector organizations including insurance companies decide if they want to provide or deny coverage for contraceptive services, failing to understand that these are not wants but rights and critical needs for the health and wellbeing of their female employees.

 

In 2014, the U.S. Supreme Court ruled that privately run companies may object on religious grounds to a provision of the Affordable Care Act that would have compelled them to provide birth control free of charge as part of coverage plans. This decision has hit women employed by private corporations with objections to contraception. These private organizations deny any health cover for abortions.

 

Is it okay for private employers to deny women coverage for contraceptive services on religious grounds even when the state has mandated them to do so? Is it okay for the state legislators or governments to make personal and life-changing decisions for women?   

Despite the grim situation for women’s reproductive rights in many parts of the world, there are a few cases where a woman can practice her reproductive rights.

 

Netherlands and Norway offer legal and safe abortion services on demand and provide financial coverage for the same; illegal abortions in these countries are almost non-existent.

 

Nepal, is another example where abortion was banned in all circumstances and women were prosecuted for ending their pregnancies. Owing to high number of deaths due to illegal and unsafe abortion, the Nepalese government legalized the procedure in 2002. Since then the government has worked to integrate abortion into the rest of women’s health services, providing an example of how to ensure safe access to the procedure.

 

However, what is most needed to ensure that women have control over their bodies in the 21st century is a deep introspection of how women are viewed in society.

 

Are women merely incubators that need to be regulated?

 

Is motherhood the sole goal of a woman’s existence?

 

Time and again women have been pressured to get married and have children, or they would be seen as incomplete or a burden or in the case of Chinese women, they would be labelled as ‘Sheng Nu’ or the ‘leftover woman’ (video below).

 

 

When the world starts viewing and treating women as humans with multiple roles and responsibilities other than motherhood, changes in attitudes and practices will follow.

 

We need to discuss reproductive health and gender equality with young children. Adolescents and young men and women need to have access to information and understand reproductive health issues. Women need to have the self-efficacy to make decisions and access contraceptive services. Governments need to revisit their legal frameworks around contraception and provide evidence-informed, quality services.

 

Reproductive rights are not just limited to access to information and contraceptive or reproductive health services, but they also include a woman’s right to choose – if and when she wants to have a child and how many children she wants to have. When women are able to control their reproductive fate, they can choose the lives they want to live. To get married or not. To have children or not. They can choose to pursue a career or stay at home and raise a family or do both.

 

It is time to challenge these long-held beliefs and norms that the female gender exists solely for procreation and care of others; that only a marriage or a child can complete a woman; that family, husband and society can easily control the right of a woman to have a child or not have one. Hopefully sometime in the distant future the scream of the women in Poland will become the norm: My body is my business. A woman’s body is her own business. The question is: When?

 

 

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