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Tag: NSW Abortion Bill 2019

NSW abortion decriminalisation

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This paper argues against the decriminalisation of abortion in New South Wales as currently being proposed.  Such moves are not only ideologically driven but are based on rampant disinformation which has no regard for the lived experiences of women impacted by abortion.   Within this paper I briefly address five specific issues based on my recently completed PhD research:

  • Disinformation regarding criminality of abortion
  • Community Attitudes
  • Conscientious Objection
  • Abortion ‘rights’
  • Adverse Impacts of Abortion

See also my Briefing Paper on Abortion Coercion.

Disinformation regarding criminality of abortion

The proponents of this Bill, along with the dominant media would have the general public believing that every woman faces major hurdles to access abortion, and walks around under criminal threat thereafter.  This is simply not true.  The only criminal prosecutions to take place have been where a doctor has been completely incompetent which only demonstrates the need for such safeguards for women.

Most women not only have no trouble accessing abortion, but are completely unaware that it is not completely legal with the threshold for performing abortion set so low that women can access it for any reason at all without threat of legal repercussion.  Even a short perusal of commentary in social media demonstrates how easy it is to access abortion and how little impact the legal status has,

There are Marie Stopes clinics that advertise them on their website. Not illegal at all!’

‘It's technically illegal, but they are straight forward to get, no referral needed for private clinics.’

‘No they aren't. They are perfectly legal not sure where you got your information from.’

‘They are not illegal.’

‘You can walk into ANY clinic that performs this procedure with an appointment and have the procedure done.’

‘Yes, its "technically illegal" however, you do not need a referral, you will not be arrested, you will not be charged with a crime.’

While some still advocate that abortion decriminalisation helps women ‘feel’ better about abortion, or gives them greater access, neither of these assertions hold up to any scrutiny.  In fact, abortion advocates have lamented that perhaps they got it wrong in Victoria, with Leslie Cannold, former President of Reproductive Choice Australia, stating, ‘little has changed on the (abortion) service provision front’ she goes on to state that, ‘Indeed, it may be that criminal sanctions on abortion don’t cause abortion shaming and stigma.’[1]

Some researchers have even admitted that abortion access may have reduced since decriminalisation in Victoria, ‘Since abortion law reform, access to public services has shrunk. It’s not getting better.’[2]

Community Attitudes

This Bill proposes to allow pregnancy termination without reason up to 22 weeks, and then up until birth for what ultimately will be any reason as well, as evidenced by the Victorian post 20 week abortion figures, where for a decade more than half of all late term abortions have been undertaken for psychosocial reasons, not health reasons.

It is interesting that both the media and abortion advocacy organisations often perpetuate the myth that the majority of people support abortion on demand for women, based on research that does not ask detailed questions, or on the findings of research that misrepresent the actual data.  The Victorian Law Reform Commission[3] identified five studies as having the greatest reliability, yet not one of these studies demonstrated majority community support for abortion past the first trimester.  In fact, the most interesting aspect of at least one of these studies is the level of ambivalence and dissonance displayed when people were asked about ‘abortion rights’ and also provided context for abortion.   In response to one question, 60% of respondents claimed to support a woman’s right to abortion on demand, but 51% opposed abortion for financial or social reasons, increasing to 82% opposition abortion after 20 weeks for non-medical reasons.

When asked about professional sanctions as opposed to criminal sanctions for medical practitioners the same dissonance can also be seen.  In an article published in 2010[4], abortion providers investigated the attitudes of Australians about abortion itself and about whether doctors should suffer professional sanctions for doing abortions.   This article suggests that the general public is far more conservative about pregnancy termination when questioned about professional sanctions in specific circumstances than we are generally led to believe.

Whilst 61% believe that abortion should be legal in the first trimester, this figure reduces significantly to 12% for the second trimester and only 6% for the third trimester.   This is hardly a call from the public for abortion on demand.  In terms of professional sanctions for doctors for performing abortions, the same study reveals even less support for abortion in most social circumstances.   The percentage of people supporting a lack of sanctions against doctors is significantly higher when asked about abortion for serious health and life threatening situations.   But when asked about social circumstances, the numbers change dramatically.

42% of people believe a doctor should face professional sanctions for performing an abortion on a woman when she states that she cannot afford to raise the child, with 28% being uncertain.  45% of people believe a doctor should face professional sanctions for performing an abortion on a woman when she states that she does not wish to have a child at that time, with a further 23% being uncertain.  Given that these circumstances encompass the majority of reasons why women have abortions, even in later trimesters, it would appear that the majority of the general public actually do not support abortion on demand for any reason, at any gestation, despite the misleading claims of abortion proponents.

Conscientious Objection laws

To legally enforce a requirement for any person to act against their moral beliefs and conscience is in itself morally reprehensible.   It is also another example of abortion being place in an entirely different category to that of ‘any other medical procedure’ that a woman might request.   Doctors are not legally required to refer a woman for an elective plastic surgery she requests, nor are they required to refer to another doctor who they know would make such a referral.   A doctor may refuse such a request on conscience grounds, on understanding evidence of harm, or of recognising certain risk factors that may predispose a woman to negative outcomes.

A law that states that a doctor is unable to act in the best interests of their patients, based on what they understand the evidence to be and on what they know to be true about the health of their patient or even based on what they know or believe to be true about pregnancy termination ending the life of a human being, is an interference in medical care and personal ideology that cannot be tolerated.

What the law tells women when it forces doctors to refer, is that a doctor who may question abortion for any reason is a doctor who can’t be trusted with your interests or wellbeing.    The very strong message it sends to medical practitioners (even those who may in some or many circumstances support abortion) is that they may risk prosecution for even suggesting abortion may not be the best or most appropriate course of action for their patients.  At what point can a woman trust that anyone will properly assess her for risk factors, screen her for coercion, or care in any way for her real needs?  Such a law essentially puts her on a conveyor belt straight to an abortion clinic, where doctors who know nothing about her circumstances, her health history or her real needs, will perform their business, providing abortions.

Abortion ‘rights’

Pregnancy termination is not just a medical matter and in fact for 95% of women accessing termination, it is a social, economic or relational matter and nothing to do with their health or the health of the foetus or the exercising of freedom and autonomy.   Abortion for the 95% is the best of what seems like bad options when women are forced to choose between full participation in their communities, professional worlds, or educational institutions, and their right to be full participants in these spheres AND bear children.

The argument that women have an inherent right to total control and autonomy of their bodies is not true.   No human being has this inherent right.   We have laws to protect people from drinking too much, from taking certain drugs, from self-harming, even when there is no question about the fact that it is only that person’s body being impacted.  We legislate all sorts of activities, both personal and social (such as piercings, tattoos, sunbeds, smoking and alcohol) in order to keep individuals safe and free from harm, even when that activity will only harm themselves and even when restriction from that activity interferes with one’s bodily freedom and autonomy.  To argue that abortion is the last bastion of freedom for women is just another deception that holds the interests of an ideology above the real freedoms or interests of individuals.

Adverse impact of abortion

Today we have thousands of women living mostly in silence with adverse effects from abortion, some to such a degree that their lives are irrevocably negatively changed.  There is substantial evidence in the literature that up to 20% of women experience serious and long term psychological harm from abortion, much of which I addressed in my PhD research and excerpt below.

Much of the research related to negative outcomes for women following abortion has focussed on the measurable mental health effects, including anxiety, depression, suicide, PTSD, and increased use of alcohol and illicit drugs (Coleman, 2011; Curley & Johnston, 2013; Dingle, Alati, Clavarino, Namman & Williams, 2008; Ferguson, Horwood & Boden, 2009). There now exists a substantial body of international evidence that abortion can lead to measurable mental health or behavioural impairment for a number of women (Coleman, 2011; Curley & Johnston, 2013; Dingle, Alati, Clavarino, Namman & Williams, 2008; Ferguson, Horwood & Boden, 2009). There are some well-accepted risk factors for the development of mental health problems following abortion including the following:

  • Pressure or coercion to abortion (Broen, Moum, Bodtker & Ekeberg, 2005; Coleman, Coyle & Rue, 2010; Kero, Hogberg & Lalos, 2004; Taft & Watson, 2008)
  • Conflicted, unsupportive relationship with the father (Allanson, 2007; Broen, Moum, Bodtker & Ekeberg, 2005; Coyle, 2010; Lauzon, Roger-Achim, Achim & Boyer, 2000)
  • Ambivalence about the decision or high degree of decisional distress (Broen Moum, Bodtker & Ekeberg, 2006; Coleman & Nelson, 1998;)
  • Prior mental health problems (Steinberg & Finer, 2011; Sit, 2007; Warren, Harvey & Henderson, 2010; Yilmaz, Kanat-Pektas, Kilic & Gulerman, 2010)
  • Personal values conflict with abortion (Congleton & Calhoun, 1993; Kero, Hogberg & Lalos 2004
  • The young age of the woman (Gissler, Berg, Bouvier-Colle & Buekens, 2005; Gissler, Hemminki & Lonnqvist, 1996; Major, Cozzarelli, Sciacchitano, Cooper, Testa & Mueller, 2000; Niinimaki, Suhonen, Mentula, Hemminkin, Heikinheimo & Gissler, 2011; Pedersen, 2008)
  • Psychological investment in the pregnancy and belief in the humanity of the foetus (Fielding &Schaff, 2004; Hill, Patterson & Maloy, 1994; Mufel, Speckhard & Sivuha, 2002)
  • Low self-esteem, low self-efficacy, emotional immaturity or instability (Cozzarelli, 1993; Faure & Loxton, 2003; Major, Cozzarelli, Sciacchitano, Cooper, Testa & Mueller, 2000)

Less measurable emotions including sadness, grief, anger, shame, embarrassment and abandonment can all feel debilitating and have all been described by post-abortive women in social media and accounts from post-abortion counselling (Burke & Reardon, 2002; Prommanart & Phatharayuttawat, 2004; Kersting, Reutemann, Ohrmann, Baez, Klockenbusch, Lanczik,& Arolt, 2004).  The researcher’s experience in hearing the stories of post-abortive women is that they often feel very isolated in their experiences, as the Dominant Discourse does not reflect or normalise negative experiences. Negative emotional experiences are often censored and dismissed as being irrelevant, fabricated, purely the result of social stigma or ignored. This censorship magnifies their sense that there may be something intrinsically ‘wrong’ with how they feel.[5]

It is ethically wrong to ignore this harm and add to the abandonment and betrayal of such women, whose real needs should have been assessed and addressed.  Abortion is the ‘simple’ solution for those living outside the sphere of the woman’s body, but it is only simple in the short term.  This simple common procedure takes minutes, but the effects can last a lifetime and the cost to our economy in lost productivity, and support of women who are harmed is yet to be measured.

I address a number of pertinent issues in a range of short YouTube videos:

It is not necessary for New South Wales to rush toward an act that other states of implemented just because it is the only state not to have done so.  In fact, NSW government have a unique opportunity to fully examine the evidence, assess why it is that many countries are restricting abortion in light of evidence, and truly make the more progressive decision.

[1] Cannold, L. (2012). http://rightnow.org.au/opinion-3/abortion-shaming-what-the-law-does-and-doesn’t-do/#disqus_thread

[2] Keogh, L., Newton, D., Bayly, C., McNamee, K., Hardiman, A., Webster, A. & Bismark, M. (2017). Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia. Journal of Family Planning and Reproductive Health Care; 43;18, 18-24

[3] VLRC. (2008). Victorian Law Reform Commission: Surveys of Attitudes. Available at: https://www.lawreform.vic.gov.au/content/4-surveys-attitudes

[4] De Crespigny, Wilkinson, Douglas, Textor and Savulescu. (2008) Australian attitudes to early and late abortion, Medical Journal of Australia 2010 193: pp9-12 (Appendix F)

[5] Garratt, D. (2019). Manipulative Dominant Discoursing: Alarmist Recruitment and Perspective Gatekeeping.  Unpublished PhD thesis

Feature photo © State of New South Wales through the Parliament of New South Wales

The difficulty of abortion

The discomfort of abortion discussion is articulated in many ways in this article by Pru Goward. Her concern, founded in medical advances in caring for very premature babies, and gestational limits around abortion, are on the surface, genuine and worthy of discussion.
 
What she fails to address, or maybe even to understand is that healthy babies, of physically healthy mothers are terminated at viable gestations on a regular basis in Australia. In Victoria around half of all post 20wk terminations are for psychosocial concerns and many of these are past gestations at which the babies could survive with minimal harm (if any), if given appropriate care.
 
In fact, it would be far less risky for the women to be delivered of a live baby than to undergo invasive procedures to ensure foetal death prior to delivery. Why aren't we discussing this?
 
Mostly because abortion advocates prefer to tell the public that such occurrences don't exist, in spite of the government reports which detail them.
Decriminalisation of abortion in NSW, the last Australian state to do so, will not be the end of the matter of abortion as it will continue to be uncomfortable for any but the most ardent abortion supporter and women will continue to suffer and have their suffering ignored.
When articles such as Goward's are presented in the mainstream media, it is important that we support the questions, allow the discomfort and continue to challenge the dominant discourse which is more concerned with perceived 'rights' then the reality of women's lives, or the reality of unborn human beings.

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