by Terry Bellamak
It is difficult not to become so accustomed to the dysfunctional status quo around reproductive health care that we lose sight of how messed up it really is.
It is not sensible or reasonable that pregnant patients need certifying consultants to sign off on abortions, women need prescriptions to access oral contraception that has been proven extremely safe over 40 years, women who want permanent sterilisation are denied because they have not borne children, students are told not to have sex because women are like licked lollipops.
What would the world look like if reproductive health care were treated as regular health care, women were treated as adults, and every person was universally acknowledged as owning their own body?
- Oral contraceptives would be sitting on pharmacy shelves, available without a prescription, and reasonably priced or subsidised.
- The morning-after pill would be sitting on pharmacy shelves and available without a prescription, and reasonably priced or subsidised.
- All long-acting reversible contraceptives (I.e. IUDs and implants) would be available to everyone who wanted it, fully subsidised.
- Sterilisation would be available to every adult who wanted it, without any other approval required.
- There would be no waiting periods, no time limits, no signoffs, no need to give reasons, and no time-wasting scramble to get an abortion.
- Ultrasounds would only be given if they were medically necessary.
- Health practitioners who tried to tell patients abortion would give them breast cancer and mental illness would be laughed at and then sacked for incompetence.
- Any doctor or nurse practitioner would be able to prescribe pills for a medical abortion, and after giving them instructions, hand the pills to the patient for them to take at home when they are ready.
- Doctors and nurse practitioners would be trained to perform surgical abortions in regular health-care settings like clinics and doctors’ offices, not just hospitals.
- Late term abortions would not require the signoff of any authority, like a medical ethics committee or a certifying consultant, once doctor and patient decided it was necessary.
- Students would receive fact-based, age-appropriate education about relationships, consent, sex, contraception, and abortion throughout their school years.
- Health practitioners who refused to provide treatment or medicines that were a normal part of their specialty on the basis of their conscience would be disciplined by their licencing body.
- Health practitioner licencing bodies would condemn and punish discrimination against women patients who need reproductive health care like contraception and abortion.
This list sounds like science fiction. But if it were reality, the health system would save money, people’s lives would be made easier, women would find it easier to succeed economically, and our country would be richer and happier.
When rights get in the way of justice and equality
This is the tenth in the blog series by Morgan Healey, immediate past President of ALRANZ, who has recently returned to the US. It aims to bring to life the uniquely absurd state of reproductive rights and justice in the US.
Americans love their rights. We celebrate them. In fact, we talk incessantly about how we have the ‘right’ to do ________ [fill in the blank]. Rights also provide a good excuse to get away with outrageous behavior. Perhaps no more so than when we use a rights-based discourse to harm or deny certain groups equality and justice.
For example, we have the right to “keep and bear arms” (2nd Amendment, Bill of Rights). This has been interpreted as the right to own a gun. If you are white person this seems to also include the right to point said gun at a person of colour and pull the trigger. Murder? Yeah, nah. It was self-defense.
We have the right to religious freedom (or more specifically that “Congress shall pass no law respecting an establishment of religion, or prohibiting the free exercise thereof, ” 1st Amendment, Bill of Rights). This is a good one because it allows us to deny people basic health care by refusing care and/or treatment. The ole ‘conscientious objection’ ploy, which was originally used to describe pacifists’ refusal to be enlisted in war and has now been co-opted by the antis to assert their beliefs over the health of their patients.
The beauty of this right is that it can be exercising at the individual level, enabling a medical professional’s ‘conscience’ to trump a person’s ability to access healthcare, or at the system level, by being a religious institution or employer that does not believe in providing sexual and reproductive health care. [MergerWatch and the American Civil Liberties Union (ACLU) just released a report that highlights the issue of the growing number of Catholic hospitals in the US. Then there are the two Supreme Court cases relating to religious employers refusing to provide their workers health insurance that covers contraception and/or abortion.]
And thanks to a Kansas jury, we now have the right to threaten abortion providers under the guise of a right to free speech. Antis won big, all in the name of ‘rights’.
Ostensibly the Kansas jury drew a distinction between the meaning of said threat: Angel Dillard never meant to threaten physical violence. Instead she meant to emotionally and spiritually wound Dr. Mila Means (I could not make this shite up if I tried)… When someone threatens that if you continue with your work you might find a bomb under your car, is the aim to maim your spiritual wellbeing alone? Um, no. It is meant to intimidate and strike fear into that person, enough to hopefully alter their actions. In this case to scare Dr. Means so much that she would give up her plans to start providing abortions in Wichita.
When banning abortion is a cover for discrimination: The selective abortion issue
This is the ninth in the blog series by Morgan Healey, immediate past President of ALRANZ, who has recently returned to the US. It aims to bring to life the uniquely absurd state of reproductive rights and justice in the US.
A bill was recently introduced in the US Congress that would impose criminal penalties on any provider that performed an abortion because the pregnant person did not want to give birth to or raise a child of a particular sex or race. In other words, the law would outlaw sex and race selective abortions. This is not a new concept. This particular legislation has been debated before and there are already eight sex selective abortion bans and one race selective abortion ban enacted at the state level (See Guttmacher’s State Policies in Brief).
The Prenatal Nondiscrimination Act 2016(HR 4924), commonly referred to as PRENDA, unsurprisingly does the exact opposite of what is says on the tin. That’s right. Don’t let the title fool you. Hidden under a thinly veiled guise of disingenuity is a bill designed to discriminate, to infantilise, and to police the bodies of non-white people in the US. (Read Rewire’s coverage of the Congressional testimony here.)
What is the likely outcome when medical professionals, fearing that they might be criminally penalized for performing a simple medical procedure, one they were specially trained to perform, are presented with a non-white, pregnant person seeking an abortion? I will go out on a limb here and say the person will be refused care, while simultaneously discriminating against based on their skin colour.
Right to Life NZ has published a blog post railing against the NZ Cancer Society for refusing to amplify RTL’s spurious claim that abortion causes breast cancer, in a post entitled “The Inconvenient Truth – Abortion Breast Cancer Link”.
The truth is a great deal more inconvenient for RTL than it is for the following organisations whose research has repeatedly emphasised there is no link between abortion and breast cancer: the National Cancer Institute (USA), the American Cancer Society, the Canadian Cancer Society, the German Cancer Research Centre, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynaecologists, and the World Health Organisation.
The theory RTL refers to, about differentiation of breast tissue cells, is a theory first proposed in the 1980s, and still lacking supporting evidence.
The only researchers still touting this thoroughly rubbished theory are avowed anti-choicers.
Right to Life seemingly wonders why it cannot impose on the NZ Cancer Society to amplify its unsupported claims about abortion causing breast cancer. The reason is simple: the Cancer Society uses evidence-based research in the study and treatment of cancer, not hysterical propaganda.
The reality at the heart of Trump’s abortion punishment statement
This is the eighth in the blog series by Morgan Healey, immediate past President of ALRANZ, who has recently returned to the US. It aims to bring to life the uniquely absurd state of reproductive rights and justice in the US.
Firstly don’t let the title of this dispatch fool you. I dislike Donald Trump and think that most of his words are drivel. He is a bombastic, bully. But he has proven successful at tapping into the heart of American white nationalism/supremacy. In some ways, he holds a mirror up to us all (and I will include myself in this, as a white privileged American), reflecting back often disavowed ‘truths’ about this country. His racial and gendered diatribes are manifest of a country built off the backs of slave labour, colonized at the expense and blood of the indigenous nations/peoples, and based on misogynist gender binaries, which despite ostensibly gender-neutral language, continues to promote cisgender (particularly non-white) women as second-class citizens and erased the realities of those who do not conform to gender dichotomies.
Insert public safety warning here: As Americans, we would be wise to neither ignore nor underestimate the popularity of Trump’s hatred and fearmongering.
In his ‘telling it like it is’ rhetoric, which apparently was too truthful as he has subsequently stepped back from his abortion comments much like he did when he accepted the endorsement of David Duke of the KKK, the discourse that Trump uses to sell himself as a candidate personifies the repugnance of our racist, classist, and discriminatory past and present. So when he said that abortion should be illegal and women should be punished, he did more than align himself with the antis, bluntly stating what they have always believed (read Jill Filipovic’s article on this here). He brought to the fore (at least for me) a much deeper thread that runs through social laws and mores governing abortion – the constitution and production of gender binaries and the idea that women’s sexual activity outside heteronormative, procreative situations is abhorrent and must be regulated (and yes, these constructions assume a cisgendered body, leaving non-heterosexual and non-gender conforming people well outside the pale and marginalized). This is the root of abortion stigma; the belief that people with anatomical features that allow for reproduction should do nothing more than that. In other words, womanhood equals motherhood period. Socially such beliefs still translate into laws designed to control and prescribe certain gendered bodies: eliding sex with gender, and assuming an essentialist or biologically determined understanding of what it means to be a ‘woman’.
Cross-posted from The Hand Mirror.
By Alison McCulloch
Back in the 1960s, when the Pill became available in Aotearoa New Zealand, the New Zealand Branch of the British Medical Association (the precursor to today’s NZMA) decided it would be unethical for doctors to let unmarried women get their hands on it. Doing so, it was argued, would be akin to doctors giving extra-marital relationships a stamp of approval, and the NZMA wasn’t about to do that.
If you thought doctors keeping us from the Pill for our own good was a thing of the past, think again. Sure, it’s no longer under the guise of protecting our moral purity – (most) doctors have (mostly) given up on that argument. Now, it’s all about protecting our health.
As recently as 1996, both the Royal College of General Practitioners and the NZMA opposed the reclassification of the Emergency Contraceptive Pill. “We have concerns that in a pharmacy the patient may be disadvantaged from receiving the greater advice that would occur in a general practice consultation,” the college’s chairman, Professor Gregor Coster, was quoted as saying in an article in the British Medical Journal.
Fast forward to 2016, and a new front in this seemingly endless struggle is focused on efforts to get the Pill, aka oral contraception, liberated from doctors’ prescription pads and made available over the counter. The most recent round began in 2014, when Pharmacybrands Ltd (now Green Cross Health, which represents 300 community pharmacies and has an equity interest in 80) and Pharma Projects Ltd, now Natalie Gauld Ltd., made an application to Medsafe’s Medicines Classifications Committee to reclassify the Pill so it could be sold in pharmacies without prescription, though only by specially trained pharmacists, following the model that’s now used for the Emergency Contraceptive Pill.
That application was turned down in the face of stiff opposition from general practitioners and the NZMA: the latter said they didn’t think prescription only access was a barrier to the Pill and wanted to make sure doctors continued to provide “the advice and counselling about its use and about sexual health in general”, while the College of GPs, apparently felt “as if they are being excluded from an important part of primary health care”. (Never mind that the actual users of this “important part of primary health care” were – and continue to be – excluded.)
This is the seventh in the blog series by Morgan Healey, immediate past President of ALRANZ, who has recently returned to the US. It (usually) aims to bring to life the uniquely absurd state of reproductive rights and justice in the US. But this time, it’s about the also absurd situation in Ireland.
We shall return to our normally scheduled programming, where I unload on reproductive rights and justice in the US, next time.
Instead, this dispatch will focus on my other, other life – the one where I studied women in politics and abortion rights in Ireland (the Republic of Ireland). Specifically, I want to discuss the recent General Election and the impact that could have on the campaign to repeal the 8th Amendment (that pernicious law that pretty much outlaws all abortion except where there is a risk to the life of the mother (as distinct from her health), including a threat of suicide). Read Sinead Corcoran’s article for a short history lesson on the 8th Amendment.
I have been unable to help myself. I have been consumed reading articles on the outcome of the 2016 General Election. With the pressure on to repeal the 8th Amendment, the election, which took place on 26 February 2016, could play a substantive role in determining the success of the campaign (or not) for the next five years (that timescale assumes that whatever coalition government is formed goes the full term allowed by the Constitution, which seems unlikely particularly in light of rumors of a ‘grand coalition’ between the two intra-nationalist parties, Fine Gael and Fianna Fáil).
The results highlight a different Ireland than the one I left in 2008. The Ireland I left had condensed the number of political parties, with Labour trying to refocus as the predominant ‘left’ party, alongside Sinn Féin, who was regaining a foothold in the South, and the Greens slowly making ground (they were part of the Fianna Fáil led Government in 2007). Independents made up no more than a handful of elected TDs (short for Teachtaí Dála, Irish for Member of Parliament). At this time, there was also little or no conversation about abortion law reform, let alone all out repeal.
by Terry Bellamak, ALRANZ President
In a recent post on RTL’s website Ken Orr accuses ALRANZ, by name, of “conducting a campaign of 40 days harassment of those praying in these vigils. There has been verbal abuse, theft of signs and prayer material.”
For Wellington at least, this is pure fantasy.
I have been at several counter protests this year outside the hospital in Wellington, and been in close contact with the organisers of others. We have not seen anything like the kind of confrontation Ken writes about. In fact, I have been surprised and pleased at the degree of amity between the two groups of protesters.
The day we took treats and gifts to the Te Mahoe abortion services clinic both groups were quite large. They did not interfere with one another in any way. At one point a random angry anti-choicer verbally abused us, but he had nothing to do with the other protesters. When we broke for the day my friend Sam approached the anti-choice protesters to thank them for coming out and exercising their right of free speech. As I walked away we all smiled and waved and said goodbye.
Another day, a random person who said he was angry about religion verbally abused the anti-choice protesters. He was not with us, and I doubt he had any feelings one way or another on the subject of abortion; he was just angry. The pro-choice protesters tried to get him to leave, and checked in with the anti-choice protesters to make sure they were OK.
None of this peaceful, supportive behaviour should surprise anyone. It’s the Kiwi way.
So why is Ken stirring up drama with accusations of harassment?
Is he trying to import the acrimony of the abortion debate in the States into Aotearoa?
Does Ken dream of a New Zealand where right-wingers can pass laws restricting access to abortion at will, as they do in Texas?
Is he worried that if his followers come to realise pro-choice folks are not demons, and have good points about preventing harm to women and other pregnant people from illegal, unsafe abortion and not forcing pregnant people to endure childbirth against their will, they will soften their stance to something more like, “I wouldn’t have an abortion, but everyone should decide for themselves” as other religious people have done?
Does Ken dream of a New Zealand where people who support abortion and other reproductive rights are sometimes murdered by “pro-life” activists? ON EDIT: You know, I don’t think Ken dreams of a New Zealand quite so much like the States as that, because that would make Ken a monster. Ken is not a monster. He’s just a guy who feels compelled to compel others to live by his religious code.
Such dreams sound like nightmares for Aotearoa.
Last year, abortion provider Dr. Simon Snook launched a telemedicine service 0800-ABORTION, aimed at easing the referral path for women seeking abortions in New Zealand. Alison McCulloch of ALRANZ spoke with Dr. Snook about setting up the service, and how it’s been going since the launch last August.
Q. When did you start thinking about setting up 0800 ABORTION?
A. It’s been an idea for the past few years really because it’s an idea that formed out of an ongoing discussion with patients as you realise the potential failings of the current system. Women were finding it difficult to access abortion services, so you start to formulate ways that you might overcome that. So the idea’s sort of grown. But in terms of sitting down and really putting together how that might be done, it was probably six months or so prior to when we first launched the pilot in August of last year. So beginning of 2015 we really got active thinking about it.
Q. What obstacles did you have to overcome in setting it up?
A. We needed to make sure that what we were planning to do was both legal within the CSA Act and also correct within Medical Council guidelines for telehealth. That’s an area that’s expanding, and the Medical Council guidelines are quite strict on what you can and can’t do without having a patient directly in front of you. So there was quite a bit of research that went into that and discussion. We met with the Abortion Supervisory Committee on a couple of occasions to make sure that they were aware of what we were planning and that they were comfortable that it was within the Act. So that was one side of things. Another side was purely logistical and technical in terms of how we were going to conduct note taking, referral, getting swabs and ultrasounds done. Covering the whole country, there’s quite a lot of background you have to do to know where to refer people for ultrasounds wherever they might be, for example. So there’s quite a bit of background in that process stuff. And the third arm really was to make sure that the people that we had to talk on the phone would be skilled enough and know what they were talking about to give out the best quality advice and information. So those were the three arms of the obstacles we had to overcome.
Q. Can you explain how it works to someone who doesn’t know anything about the system in New Zealand or your service? Continue reading