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Tag: abortion coercion (Page 1 of 2)

Abortion coercion admitted

Relevant section of hearing available here

On 12th September Dr Carol Portman, one of Queensland’s only later term abortion providers spoke at a Committee Hearing for the Termination of Pregnancy Bill.  When asked if she had ever experienced a woman attending for termination who may be experiencing her coercion, her response revealed all that typifies abortion discourse.  A discourse that upholds the concept of ‘abortion rights’ above all else, even a woman’s right to be free from coercion, to be entitled to the highest standards of ethical medical care and the right to say ‘no’.  

Portman says:

“Sometimes even in the best of circumstances we understand that a person is to a degree being coerced but feel they still need to go ahead.. because it’s their only choice, because otherwise this person will leave them, and their 4 kids (for example).    it’s very hard to know what to do in those circumstances so you go ahead with what their choice is even though to a degree they are being coerced.

Note that not one of the politicians in this hearing committee questioned this doctor about why she would perform an abortion on a knowingly coerced woman.

Let’s try this approach this in other settings:

  • A woman attends to undergo a breast enlargement saying her boyfriend is going to leave her if she doesn’t have it so she feels like she has to.
  • A woman requests a tubal ligation saying her husband is going to leave her if she doesn’t have it done, even though she isn’t really sure.
  • A woman says she is having sex every night with her husband or one of his friends, even though she doesn’t really want to, but feels she has to because he will leave her otherwise.

In each case the woman says this is her ‘choice’ while also talking about ‘not really wanting to’.

I wonder how many doctors would proceed with a cosmetic surgery procedure or a tubal ligation when a woman is clearly expressing doubt or clearly expressing that her partner is pressuring her and she is consenting under coercion?

How many people would accept that a woman having unwanted sex with any person because she is fearful of abandonment or threats of violence is okay?

For more than a decade we have been talking about both direct and indirect forms of coercion toward abortion, and abortion advocates and providers have denied coercion exists or simply stated that if they identified that a woman was coerced an abortion wouldn’t be performed.

It's not that big a leap from 'my husband will leave me or hit me' to 'I don't have enough money' or 'I will lose my job' or 'my school will kick me out'.   Yet these types of situations would make up the bulk of those experienced by women seeking abortion and we still dress them up as 'choice'. 

I have dozens of cases in front of me of women who experienced coercion to abort, both overt and subtle, from partners, mothers, employers and inside abortion clinics by doctors.   Such coercion can be direct threats, threats to withdraw support or lose jobs.  They include women who are pressured to abort after being told they aren’t possibly capable to providing for this baby and still support other children.  They are also women who cried in front of the abortion provider saying they were unsure or they didn’t want to do it.

At least now if nothing else comes out of the Queensland hearings, these women’s stories are validated by Portman’s revelation.   

  • Abortion providers do abortions on women they know are not fully consenting.
  • They do not care about the exercise of the woman’s right to freely choose.
  • Abortion ‘rights’ are not about women’s rights to autonomy, freedom or control of her own life.
  • They do not abide by the most basic tenet of informed consent; that is that a person must be free from coercion and able to exercise his/her own will.

How much more evidence is needed by our politicians and the public that abortion is not serving the needs of women when even abortion providers admit to completely ignoring coercion? In the same hearing, the Director of Marie Stopes, Philip Goldstone states that his organisation is currently working to develop tools to assess for coercion.  I have to wonder for what purpose, when it appears to make no difference whether consent is free or coerced anyway.  

We must do better than this for women.  Every state should be revisiting their abortion law in light of this confirmed information that coercion both exists, and is ignored by those who should be held to a higher ethical standard.

Briefing paper on Abortion Coercion

Abortion Coercion

Briefing Paper: Reproductive Coercion: Coercion to Terminate a Pregnancy  July 2018

Printable version

Marie Stopes, one of Australia’s biggest abortion providers recently released a draft White Paper entitled Hidden Forces: Shining a Light on Reproductive Coercion.   As expected from an organisation heavily invested in marketing and delivering abortion services the paper has a very strong emphasis on coercion related to continuation of pregnancies with coercion to terminate barely warranting a mention.

In a culture where abortion advocacy is the dominant force the majority of published literature on reproductive coercion is biased toward coercion related to contraceptive sabotage and pregnancy continuation.   It is no surprise therefore that the literature drawn on in the references to the White Paper rarely addresses coercion to terminate.  For the most part coercion to terminate is no longer differentiated from coercion to continue a pregnancy, both being lumped together under the tidy label of ‘pregnancy outcome control’.

The White Paper spends a lot of time within its 50+ pages lamenting a lack of clear definition of coercion.  I suspect this will remain a long-term problem as abortion advocacy organisations seek definitions that meet their ideological objectives of keeping abortion positively framed.  Acknowledging abortion coercion becomes hugely problematic for such groups, especially when coercion in these circumstances must also include many of the reasons that the majority of women seek abortion.

Most abortions occur in the setting of women lacking necessary resources to continue a pregnancy, whether these are practical, economic, relational or supportive.  When this is combined with subtle or overt coercion by other people, and by a dominant discourse that offers abortion as a solution for these social inequities, it seems very obvious that coercion toward abortion must be significant.

With leading abortion advocates and providers denying the existence of the dozens of women who change their minds every year after commencing medical abortions, we have a baseline for how such ideologues view the existence or prevalence of coercion to terminate.   ‘These women simply don’t exist’.

While ignoring the prevalence of coercion toward termination, the White Paper makes a giant leap when it labels the Federal Government’s 2006 pregnancy support counselling scheme a form of reproductive coercion because it doesn’t allow abortion provider counsellors to access the Medicare rebate for counselling.  They suggest that abortion providers, who only receive payment if a woman proceeds to abortion, demonstrate no bias in decision making counselling and should therefore have access to the payment.  Such counsel should form part of any medical or surgical informed consent process without the requirement for added funding to do so.

It is also interesting to see the way in which abortion advocates perceive threat from  the very few, mostly unfunded and volunteer driven pregnancy support services which offer support for women who would choose to continue a pregnancy.  In spite of the fact that not all of these services have a religious basis, and many of them are volunteer staffed by qualified professionals, they are deemed to be incapable of providing accurate information without bias.  In fact they further suggest, in the absence of any evidence, that such services can inflict psychological harm on women.

There is a very interesting statement made in the midst of this section, in relation to pregnancy support counselling services:   ‘In no other sector can such unregulated practises occur without legal ramifications.”   I would argue that in no other sector of health care can women demand a medical or surgical procedure for no reason other than that they want one, and doctors be forced to provide access to it either directly or indirectly.   Of course the preference within this White Paper is that no doctor ever be allowed a conscientious objection to abortion because this is also a form of reproductive coercion.    Apparently women are autonomous, intelligent decision makers who don’t need help or support in deciding whether abortion is right for them, but if they happen to come across a doctor who doesn’t provide them with an immediate referral, they may be forced to ‘continue a pregnancy against her wishes or seek abortion at a higher gestation’. 

While Marie Stopes is being encouraged to take this process of investigation into reproductive coercion forward, it is prudent to note their own record of ignoring any pressures toward abortion from their 2008 survey entitled Real Choices.    In their questions on why women resolved their unintended pregnancies in particular ways, parenting, adoption, abortion, their response options reveal exactly what they are looking for. With multiple options to choose ‘feeling pressured into’ for questions on resolving an unintended pregnancy by parenting or adoption, not one option was provided for a woman to say she was pressured to abort.  This alone typifies abortion advocates’ interest in abortion coercion and the reasons why it is vital that we now highlight the very real and very prevalent experiences of women pressured to terminate.   For this reason, this paper deals only with reproductive coercion related to pressure to terminate.

Coercion is more than just overt pressure

The majority (>95%) of terminations in Australia occur for psychosocial reasons including not having enough resources, whether financial or material, not feeling able to cope with a baby due to age or lack of support, fears about the impact of pregnancy and parenting on other life choices, as well as consideration for the needs of other people a woman cares for.

Abortion advocates cite such reasons, among others, as supporting the need for abortion, yet in reality abortion offers surgical or medical solutions to social and relational problems, meaning women are forced to decide between their social/economic wellbeing and the continuation of a pregnancy.   The power of this subtle form of coercion becomes even more insidious for post-abortive women who experience regret, suffering or mental health problems following abortion as the discourse convinces them they made a real choice to terminate and therefore carry full responsibility.   Post-termination counselling offered by abortion advocacy organisations are generally geared toward ensuring the right to abortion is upheld and therefore reframing the woman’s experience toward understanding that she made an autonomous and free choice, regardless of her internal experience.

The dominant discourse is strongly abortion advocating, upholding abstracted rights as an ideal.  Aspects of the discourse that contribute to its manipulative and coercive nature include alarmist statements, disinformation and the censorship of dissenting voices, regardless of the veracity of facts the latter present.  The pervasive effects of the dominant discourse contribute to an environment where continuing a pregnancy is framed as a burden and parenting is experienced as an unsupported journey.

Alarmist, incorrect statements that abortion is anywhere from 14 – 100 times safer than childbirth feed into fears many women may have about birth, and are more like soundbites for abortion marketing.   The same is true of alarmism inherent in statements that women will die without abortion access and that abortion access is the only way in which women can achieve ‘true’ equality.

Coercion exists in the absence of information

Pregnancy termination is a surgical or medical procedure, and therefore governed by guidelines for all other surgical or medical procedures.  If abortion provision was practised according to guidelines for other health care it would not be necessary to address whether women are screened for coercive factors, as this should be considered a standard aspect of informed consent practise.  Such practise includes that women have a full understanding of the risks and benefits of each option, that they understand and can access the full range of options, and that they are freely consenting. The fact that women are citing coercion as a factor in terminations they have undertaken is a sign that effective and expected screening and informed consent for pregnancy termination is falling short of that expected.    Given the highly contentious nature of abortion, it would not seem unreasonable to hold such processes to a higher standard than those for other procedures, yet the opposite appears to be true in practise.

Post-abortive women who have sought counsel or advice through our service often describe very limited and inadequate processes of consent including:

  • Group sessions, whereby they were given information and the opportunity to ask any questions only in a group context,
  • Only seeing the doctor when they had already been prepped and ready for surgical termination,
  • Being asked ‘is this what you want?’ as the only checking in with their wishes,
  • Being ‘counselled’ in the presence of a pressuring partner, and
  • Being given misinformation about the effects of mifepristone and their ability to withdraw consent and discontinue a medical abortion procedure.

Coercion exists in the walk-in – walk-out nature of abortion provision

Most private abortion clinics operate on a walk in walk out model, whereby a woman phones to make an appointment and is scheduled for termination during the same appointment where she may also receive information and/or counselling.   Abortion advocates argue vehemently against alternatives such as ensuring at least two appointments with an opportunity between them to fully consider options, citing the added burden on women of two visits.   This is in spite of the fact that there are no other invasive surgical procedures such as termination that can be accessed on the day of request using such a model.

Coercion exists in labelling doctors who object to abortion as untrustworthy

When laws exist that state that a doctor who does not agree with abortion, whether for religious, ethical or medical reasons, cannot be trusted to provide accurate information about abortion, abortion discourse becomes the sole domain of those more concerned with ‘rights’ than with women themselves.  When AMA guidelines advise doctors with a conscientious objection to end consultations with women considering pregnancy options, but then suggest that abortion providers may still decline abortion based on a woman’s individual circumstances, the only conclusion is that one group of doctors is untrustworthy.[1]

Censorship within abortion discourse not only affects those who disagree with abortion, but also those who support abortion access, but still feel pressured to withhold information, use certain words, or in some way encourage abortion due to fears of impeding rights.[2]  Such internalised censorship means that women have few sources of information about the potential of adverse impacts on their physical or mental health or their relationships.  It also means they may view with suspicion any information, no matter how accurate, regarding adverse impacts of abortion.

Coercion exists in the absence of alternatives information

Abortion advocates frequently disparage supportive services established to provide women with material aid, emotional support and decision-making counsel, purely on the grounds of ideology.  Where centres exist that offer to meet the identified needs of women, such as material aid, financial resourcing, emotional support, such information should be provided to women in order to provide them with alternative options.   Yet, not only do these referrals not happen, but abortion advocates work to discredit and undermine the essential work undertaken by them to support women.

Key Recommendations

  1. It is essential that coercion to terminate be seen as a phenomena in its own right, not packaged and hidden in euphemisms such as ‘pregnancy outcome control’. The consequences of coercion to terminate are hugely significant on the lives of women and add considerably to the burden of mental health and other emotional issues that they experience.
  2. Research on, and education about, coercion to terminate should be a priority at a time when the discourse is rapidly working to further reduce access to necessary supports for women, through legislation and ongoing censorship.

Access to independent (not provided by abortion providers) information about, and access to supportive services for women to continue a pregnancy needs to be strengthened and such services need to be more effectively resourced.

[1] Australian Medical Association: Conscientious Objection Policy document: June/July 2013

[2] Martin, LA., Hassinger JA., Debbink M. and Harris, LH. (2017). Dangertalk: Voices of abortion providers. Social Science Medicine, July (184). Pp. 75-83

‘Choice’ coerced

We have seen an increase in the numbers of women coming forward to talk about their negative experiences of being pregnant and being pushed toward abortion.   Some of these women continued their pregnancies, others succumbed to pressure, aborted and now live with terrible grief, one or 2 are still in the midst of great turmoil and pressure.   All beg the question, what kind of society have we created where the coercive nature of choice has become so commonplace that we barely recognise it anymore.

When the nature of abortion coercion has become so insidious, and the practise so commonplace that it is no longer recognised, women are in serious trouble.

Today a young married woman, excited about being pregnant, can present to her doctor for her first prenatal appointment and be asked about whether she ‘wants’ the pregnancy as a matter of routine.  This can even occur where the doctor knows the couple were trying to conceive.

‘I couldn’t believe it.  My husband and I were so excited about being pregnant that we did 2 tests just so we could see it again.  Then the doctor asks if we want it?  We switched doctors.’

A university aged woman will be told that she can’t possibly complete her education without abortion and that the ‘minor procedure’ will give her back her life.

‘I went to the office to find out the supports I could get throughout my pregnancy and into the next year with a new baby.  The woman sent me to the uni counsellor who immediately handed me a card for a local abortion clinic saying ‘this is where we send everyone, they will take care of you’.   When I said I didn’t want an abortion, she told me it was a quick and simple solution to my ‘problem’ and that without it I would probably have to leave uni.’

Well-intended parents, perhaps placing their own unmet life-goals and expectations onto the next generation, will threaten withdrawal of emotional, financial and practical support if their daughters don’t comply with demands to abort.

‘My boyfriend and I did lots of research about how we could manage a new baby and I could stay at university to finish my degree.  We had it all worked out before I told my parents.  My parents said they were counting on me to be the first one in our family to go to university.  They said that now I’d be on my own and couldn’t count on anybody, even my boyfriend and his family who they said were pressuring me to have the baby.  I had to wonder how it was that my boyfriend was supposedly pressuring me when I hadn’t even considered anything but having my baby before my parents made me feel such a disappointment’.   

The most concerning aspect of these kinds of responses to a woman’s pregnancy is that they are typical examples, not extraordinary scenarios.

University students are routinely told that having a baby will ruin their opportunity for an education.  Many universities still fail to offer flexible study options or suitable child care so that young women have genuine choice. Where child care centres do exist on campus, serving the needs of staff and students, limited places and long waiting lists are common.  At the same time universities allow abortion providers to offer generous student discounts for abortions through advertising in university diaries.

Doctors behave as though abortion is the default response to every pregnancy, making every woman ‘choose’ instead of just congratulating her.

Abortion advocates judge people who work to highlight the real needs of pregnant women as woman-hating radicals, condemning them for not providing practical support, and then undermine and act with hostility toward those who are offering supportive services.

In Gippsland in Victoria, a pregnancy and parenting resource centre offers free services to all women and their partners during pregnancy and early parenting.  They produce a family services guide which is widely distributed, provide breastfeeding and nappy change facilities at local events, help local eateries to become more family friendly, as well as providing material, financial and practical assistance to any woman referred or requesting it.    Yet twice since they established their services they have been actively undermined by council employees who have refused to allow local establishments to fundraise for them, and more recently have removed the family services guide from local maternal and child health services.   They have done this citing ideological concern, even though there has been no evidence of any ideological agendas except for the actions of the council employees themselves.   This has occurred in an environment where community members and health professionals, including maternal and child health staff have expressed nothing but the highest praise for the work of the organisation.

When threatened or actual withdrawal of financial, material and emotional support from a pregnant woman is seen as ‘normal’, and genuine offers of support are seen as ideological, where do women turn when their much wanted children begin to become a ‘choice’?

Threats of, and actual withdrawal of support is an insidious and cruel act which preys on women’s fears at one of the most vulnerable times in their lives.  The lack of supportive services for women and the removal of services when they are provided is an ideological act of the most insidious kind for women.

With evidence of harm from abortion growing as more and more research is undertaken, abortion advocates continue to cry foul when such evidence is presented to women.  Surely if abortion advocates are truly concerned with choice, they must insist that these choices are fully informed.  If they are truly concerned about women, they must insist that women have every supportive service they need so that they can choose to continue a pregnancy.  Otherwise they are simply marketers for an abortion industry that has already done a great job of ensuring that their services are ‘sold’ at every outlet, including our universities.

[This article as also published at On Line Opinion: 'Choice' coerced]

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