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Category Archives: Reproduction

Pregnant Child Detained in Mental Institution For Asking For An Abortion

To access a life saving abortion in Ireland requires 3 medical professionals (two psychiatrists and one obstetrician) to agree that the woman is at risk of taking her own life. As the recent case of a young girl  shows it only takes one psychiatrist however to get sectioned for wanting an abortion in Ireland.

The girl was legally classed as a child and her identity has understandably been withheld so we know nothing more about her other than that she had an unwanted pregnancy and that when she sought an abortion from her healthcare professionals she was of the understanding that she was being taken to Dublin for the procedure. However unbeknownst to her the consultant psychiatrist had given evidence at a hearing to detain her under the Mental Health Act.

“The consultant psychiatrist was of the opinion that while the child was at risk of self harm and suicide as a result of the pregnancy, this could be managed by treatment and that termination of the pregnancy was not the solution for all of the child’s problems at that stage.”

How frightening it must have been for her to find herself in a mental hospital after travelling to Dublin expecting an abortion. We are told it was “days” later that another hearing was held that resulted in her discharge from the mental hospital. During this time her court-appointed guardian ad litem (GAL) had employed another consultant psychiatrist to access her and on the basis of their evidence the girl was released from the institution. She spent unnecessary “days” in a mental institution for the “crime” of nothing more than wanting an abortion.

I’ve heard numerous reports of suicidal people trying to access mental health units in Irish hospitals who have been sent away. In future I’ll suggest to those of them who are capable of getting pregnant to say they’re pregnant and want an abortion, as that seems to be a sure way to get sectioned.

This case raises a number of questions. How is it that it only took one psychiatrist to have the girl sectioned? Why was the PLDP act not enacted for this pregnant, suicidal child? How can the public be assured that the personal beliefs of medical professionals won’t interfere with them being able to access the healthcare they need? Did Government Ministers know of the case at the time?

Abortion Rights Campaign (ARC) spokesperson Linda Kavanagh said:

“Looking at the report, it’s hard not to think that the psychiatrist in this case essentially used the Mental Health Act as a tool to force a child into continuing an unwanted pregnancy because of their own personal beliefs. It is clear we need some process which ensures medical professionals with such conscientious objections cannot block timely health care in critical cases.”

This is the latest case in a long line of women and girls who have been failed by the state. Ms X was another suicidal child prevented from accessing an abortion in 1992 and Ms Y a teenage rape victim likewise led to believe she would be given an abortion and instead detained against her will. Ireland has a disgraceful history stretching back to the Magdalene Laundries of locking up pregnant women.

The Protection of Life During Pregnancy Act is supposed to “protect” women who are at risk of taking their own lives, not used as a tool to lock women who want abortions up.

The Irish Government are allowing this human rights abuse to happen on their watch, leaving a trail of abused and sometimes dead women, girls and children behind them.

Rally to Repeal is on Saturday 17th in Dublin. If you can’t go please contact your local T.Ds and ask them to urgently implement the findings of the Citizens Assembly.

You can sign an UPLIFT petition here:https://action.uplift.ie/campaigns/187

*I’d like to acknowledge the work of the Child Law Project. We would know nothing of this case if it wasn’t for their work. Since 2012 they have been able to report to the public on child care proceedings in the courts, they aim to report on 10% of cases.

I am not a nun, I am a midwife: maternity care in a “modern” Ireland

The author of this guest post wishes to remain anonymous.

I attended a protest at the Department of Health yesterday to highlight people’s outrage at the handing over of the new National Maternity Hospital site to the religious order of the Sisters of Charity. I went as a member of Midwives for Choice, and I expected to help hold the banner and maybe video our spokesperson speaking. As it happened she could not, fearful as she was of her job by speaking out against St Vincent’s Hospital Group. So it ended up that I had a microphone and a megaphone pointed in my direction. My reaction? I froze. My voice is an inside my head voice, for the most part; I can’t even speak up in small group conversations mostly. So for anyone who wanted to know why there were midwives behind a banner, here are my thoughts.

I’m already scared that I’m a nun. All the older nurses and midwives in our hospitals were trained by nuns and they tell of the iron fist, regimented care and much else. Sometimes with respect and awe, sometimes fear, sometimes relief that they are all but gone.

The church’s legacy is strong within our healthcare system. Many if not most hospitals in the state have some church connection (religious members on boards, etc). Yet the history of church-run institutions in this country reads like a horror story, from the Magdalene Laundries to the institutional schools. Say it slowly with me: the institutions of the Catholic Church are inherently misogynistic. Women’s bodies will always suffer under them. They are beyond redemption.

Finally, this is the generation where the church’s abuses are being exposed. We are sickened as a nation to our very core about the Tuam babies, symphysiotomies, Magdalene Laundries, the abuse of our children by priests and nuns. Finally we should have hope that our society will stand up and say no more, that we can extricate our institutions from the grasp of the religious. It will be a slow but worthwhile process. When we can get the church out of our government, our laws, our schools, our healthcare systems, our bodies, maybe finally we can have a humane secular society.

That’s what most of us were thinking, surely, in the wake of the Tuam babies case? Please save us from the church? Then what the hell is this move? It’s as Irish a decision as getting your kid baptised to have a family get-together… and maybe to get into the local school. Cop on, Ireland. Stop being so short-sighted, so disingenuous. If we know something is wrong – and by God we know the Sisters of Charity have done wrong – then let’s stand up against it.

As a midwife, my role in supporting women to make informed decisions around their care in pregnancy and childbirth is already curtailed by the patriarchal, over-medicalised, over-litigious, under-staffed, no-continuity, factory-model, fire-fighting maternity system in place here. But at least women in Ireland are starting to take back power, to demand evidence-based care and proper time to birth. Even if this is something that our systems literally cannot provide at present, at least there is an awareness that what we have now is not good enough.

It feels like a change, this last 10 years: women are coming together; midwives are coming together; there is a politicisation, a will to change, even if it can’t quite find traction within our systems yet. There is a recognition that the 8th Amendment is a barrier to proper maternity care; where the fetus and the woman have equal rights within our constitution, any perceived risk to the well-being of a fetus overrides even real and substantial risks to a woman’s health and well-being. Our National Consent Policy directly points to the 8th Amendment as being a reason why pregnant people do not have a legal right to informed consent and refusal of treatment. Women leaving this system will attest to being railroaded and sidelined within their own care (see Aims Ireland testimonials).

I work within the system as it is now. While, individually, I strive to do my very best for each woman I care for, I know that the system is letting them down. I know that women are leaving our maternity system traumatised and broken down. Childbirth itself is not an inherently traumatic event. It is what we do to women in the name of “safety”: ass-covering and over-intervention without proper thought, consideration, conversation and shared decision-making with the people whose bodies we care for.

This brings me back to my first point: I already fear that I’m a nun. When the Tuam babies story broke, as well as the horror and the disgust that we all felt, I had a sneaking fear lurking… Those nuns were midwives. What if I’m a nun? What if I were a nun in Tuam, entering the institution to try to do my best for the forgotten and ostracised single mothers. What if I was kind as I caught their babies and helped them to their mother’s breast. What if I was gentle as I cared for infants while their mothers worked, coming back to feed them on schedule. What if my heart hurt as I dried the tears of a mother whose baby was adopted out to America. What if I felt sick with fear as I saw too many little babies dying. What if I knew that they weren’t being buried so that the money for them would keep coming in. What if I turned a blind eye because I was just a little nun cog-in-the-wheel. Sometimes I fear that I’m just a little midwife cog-in-the-wheel.

So I have to go and hold banners. I have to add my face to pictures and my feet to marches. I have to overcome my fear of putting my job in jeopardy by being seen to be overly-political, overly-public, overly-outspoken. I have to find my voice as a midwife and encourage others to find theirs… even if I’m not quite ready for the microphone and the megaphone. I have to nod to pro-choice badge-wearers and pro-choice colleagues. I have to have small conversations in work and outside of it. I have to join Facebook groups, scribble my thoughts, cuddle my loved ones, help my pregnant friends, and I have to breathe and tell myself I am not a nun. I am a midwife. I am with-woman not with-institution, however hard that is in my everyday work. I will stay within the institution because free maternity care is a public right and should be available to all, not just those who can afford health insurance and private midwifery care.

Some day I dream of the true mind and body safety that comes with continuity of midwifery care for all women, and the true informed relational decision-making that can only happen when our maternity institutions are built back up to humane levels, free of the stranglehold of patriarchal and religious control – both constitutionally and structurally. We have a chance in Ireland to reject our broken past and to go forward with conscious intent to do the right thing. So Repeal the 8th Amendment. And take back the National Maternity Hospital from the Sisters of Charity.

All your wombs belong to us – The State, Ms. B and Forced C Sections

The High Court decision in HSE v B has been made public today (I’ll edit to add a link once it’s available). A month ago, a woman who wished to undergo a vaginal birth after three c-sections found herself in the High Court as the HSE attempted to have her compelled to undergo a fourth c-section against her consent. The HSE case was based on the notion that the Eighth Amendment rendered them more appropriate to decide what was best for her pregnancy than she was. This is a landmark decision, because for once, it’s a maternity rights case where the resulting decision hasn’t been completely terrible.

The judgment is long and make no mistake, there is no judicial feminism in here; the Court is at pains to point out throughout the judgment that they have no idea why this woman would possibly want a vaginal birth. But ultimately it goes on to state (at Paragraph 21):

“The court concludes that it is a step too far to order the forced caesarean section of a woman against her will even though not making that order increases the risk of injury and death to both Ms. B and her unborn child.”

Essentially this means that the Court recognises the right of the HSE to pursue a case against a heavily pregnant woman on the basis of the Eighth Amendment, but the idea of legally compelling a woman to undergo a caesarean including the sedation, anaesthetic, the surgery, the pain, the recovery….and all that goes with it, was a little bit too much even by an Irish High Court’s standards.

Maternity rights activists in AIMS have been pointing out for years that the Eighth Amendment is not just a tool of coercion for women who want to access abortion services, but that it is used just as regularly against women who are continuing their pregnancies. They report that women are regularly told the guards will come to get them if they don’t turn up for their scheduled inductions. Being threatened with the guards coming to your door when you’re in the full of your health and not in a vulnerable pregnant state is one thing, but threatening a woman on the brink of her due date is quite another – it is beyond bullying, it is obstetric violence. And as AIMS have pointed out, it usually ensures that women will go along with whatever is being forced upon them by the HSE. The prospect of being brought to court, like Ms. B was, is too much for most.

The ruling is not completely terrible in that it finds that the risk to the “unborn” is not so great that it warrants overriding Ms. B’s rights to have a c-section forcibly performed on her, however as is the practice with Irish judgments there is no sense of what might constitute a *risk* to the unborn that is sufficient that a woman may have some other form of medical intervention performed on her against her will. We are not out of the woods yet. As long as the Eighth Amendment remains in the Constitution, this will not be the last Court case on the matter.

While this was a case concerning a woman who fully intended to carry her pregnancy to term, it has important implications for the tiny number of women who may find themselves before panels of doctors in an attempt to access abortions under the Protection of Life During Pregnancy Act. In the Ms. Y case a young asylum seeker, pregnant as a result of rape was deemed by a number of doctors to be suicidal. However, the HSE also felt that the way in which to avert the risk of suicide would be to perform a cesarean section on her at 24 weeks gestation instead of the abortion she requested as soon as she found out she was pregnant at 8 weeks. When Ms. Y went on hunger and thirst strike, the HSE sought and received a court order to forcibly hydrate her. The threats of court were uttered in relation to the c-section, and Ms. Y gave birth against her wishes by c-section as a result. We now wonder whether the Ms. B judgment had been delivered earlier and Ms. Y’s counsel fought the HSE at the outset of a c-section being mentioned, would the outcome have been different? Ms. B is yet another judgment to add to the mounting stacks of obstetric violence entering the courts that don’t really give us clarity one way or the other.

What is clear though is how the Eighth Amendment does not just impact those seeking abortions, but on the broader spectrum of reproductive justice. The Eighth Amendment along with a warped mentality of maternity care that infantilises women leads medical practitioners to coerce women into interventions out of a fear that they will be found to have not protected the “right to life of the unborn.” Criminalising those accessing abortions, threatening women who want natural births with garda interventions or dragging women like Ms. Y and Ms. B into the courts is obstetric violence. It demonstrates that regardless of the circumstance or your wishes in pregnancy, the State via the HSE will treat you as a vessel with no competence to make your own choice. There is no autonomy within maternity “care” and doulas are viewed with at best suspicion and at worst, contempt. There is a separate system of medical consent for pregnant women that mean effectively forced c-sections happen every day. They don’t enter the courts, but when the decision to agree to a c-section you don’t really want is made because you can’t take the bullying from medical practitioners or because you believe they will take you to court, is it really not forced?

Any kind of surgery against your will would be unpleasant to say the least. I can’t imagine getting a tooth out without having given full consent. But a forced c-section is a whole other level of violence. It is misogynist and it is degrading, and it is the State sponsored infliction of terror on pregnant women. There is no way you can undergo surgery you have been coerced into and not feel a profound blow to your sense of bodily autonomy and integrity, and those conditions are ripe for birth trauma and postpartum post-traumatic stress disorder. Women are gaslit and told their ideas about what should happen during birth are simply “baby brain” and the parallels with domestic violence are striking; indeed many women first experience violence in a relationship when they become pregnant. This is gender based violence, and if anyone objects to that analysis, then please, show me the judgment where the HSE attempted to compel a non-pregnant person undergo major invasive surgery, then colluded with the courts to make sure it happened.

What exactly will it take to ensure women are afforded autonomy over their pregnancies? Obstetric violence and coercion of pregnant women is abuse, and it is a major public healthcare problem in Ireland. Having an unwanted vaginal exam performed on you without consent is a form of violence against women that is no less real than violence against women in the home. We need to start addressing it as such so that the structural and systemic aspect of it can be picked apart and broken and so that no more Ms. Y’s or Ms. B’s find themselves before the Courts. We need to repeal the Eighth Amendment.

@stephie08

Remembering Savita

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Savita Halappanavar died on this day 4 years ago in Galway University Hospital. She died in suffering and in pain, because she was pregnant, having been denied basic medical care she and her husband Praveen repeatedly requested.

She died because abortion is illegal in nearly all circumstances in Ireland and even now remains so; but she also died because she was a pregnant migrant woman and a woman of colour in Ireland. Migrant women are twice as likely to die in pregnancy in Ireland as women born in Ireland and the UK. Nora Hyland, Bimbo Onanuga, and Dhara Kivlehan are all names of migrant women who’ve died in or after pregnancy in recent years in Irish maternity hospitals who should be alive now with their children. Only a few months ago Malak Thawley died in an operating theatre of the NMH after basic surgical equipment “could not be found” to stop her bleeding to death.

Our maternity service is not a sufficiently safe place for migrant women, Traveller women, and women of colour; the denial of access to abortion in it only renders it more so, as demonstrated most recently and horrendously with the barbarities the Irish state perpetrated upon Ms Y.

I remember Savita and I remember the tears I cried for her on hearing how she was left to die unnecessarily. I remember Bimbo and how she was told she was exaggerating the pain which was a symptom of the uterine rupture she later died of, and how it took her partner and AIMS Ireland THREE YEARS of fighting to even get an inquest opened into her death. I remember Nora Hyland and how she died of a massive cardiac event after waiting over 40 minutes for a blood transfusion that never came, and with three times the recommended dose of Syntometrine in her body, a component of which is known to have adverse cardiac effects. I remember Dhara Kivlehan and how her doctor told her husband as she went undiagnosed of a fatal liver disorder that it was harder to diagnose Indian people with jaundice, a key indicator of liver failure.

I remember all these women, their partners, and their families and how they were not only mistreated appallingly by the Irish maternity system in life, not permitted as pregnant women to have the final say on their own bodies because of the existence of the 8th amendment, and how further indignity and injury was heaped upon their grieving families by the Irish state and maternity hospitals in refusing to address properly the causes of their death, apologise for them or treat their partners with the respect they deserved. I remember and I fight for change that sometimes seems as though it will never come, especially on days like today where the darkness closes in early and the memory of the horror and outrage and grief of 4 years ago weighs heavily on me. But I do fight.

Solidarity and love to those of you who fight with me, those of you who’ve fought for years and decades longer than me, and those of you who’ve seen more suffering caused by Irish law and Irish maternity hospitals than I can imagine. We will remember and we will bring about change.

This is my third time of posting this. I said this last year, and the year before; I say it again this year, and will every year until everyone in Ireland with a womb owns their own body.

Ungovernable Wombs – The Abortion Pill and the Erosion of the Eighth Amendment

Between 2010 and 2015 the rates of women travelling from Ireland to access abortion services in the UK fell from 4,402 per annum to 3,451 per annum. A total of 27,800 women travelled during this timeframe. Anti-choice groups congratulated themselves because of the drop in numbers, choosing to interpret the British Department of Health statistics as evidence of a drop in the rate of abortions taking place as a result of their work. Pro-choice groups were at pains to point out that this was incorrect; the British DOH stats simply show the decline in the numbers of women travelling from Ireland who access abortions in England in Wales, but they do not represent the total numbers of women from Ireland who are accessing abortions. The 27,800 figure was *never* accurate; it doesn’t include women who travelled from Ireland but gave UK addresses or in some cases used UK NHS numbers. It doesn’t include migrant women who travel to Eastern European states to access services there. It doesn’t include women who travel to other EU states that aren’t the UK to access abortion services there instead.

So the paper published today shows that during the period which *official* numbers travelling to the UK declined by 951, there were 5,680 women who requested the abortion pill to take at home within the island of Ireland from an organisation called Women on Web. The numbers willing to risk a criminal penalty to have an abortion at home are increasing year on year. That said, given that customs seize some of these packages, we don’t know how many made it through to the women who requested them or how many women actually took the medication once they managed to get them. But even if only 50% of women managed to get the abortion and actually take them, it pretty much cancels out the reduction of numbers women travelling to the UK for terminations. Fifty percent is actually a remarkably conservative estimate considering that Customs only managed to seize 68 of these tablets last year, and given that there are more websites than Women on Web who will provide the drug (including Women Help Women) and migrant communities who have their own word of mouth suppliers as well as less reputable black market suppliers online, it’s quite likely that there are a few thousand more who have requested and taken the abortion pill since 2010.

It’s good to see coverage of this issue, and specifically of Rebecca Gomperts’ research paper but it doesn’t tell the whole story about women who are willing to risk a prison sentence (such as the woman in the north who took pills and was subsequently reported to the police by her tout housemates). The pill was supplied by Women on Web to 1,642 women between 2010 and 2012 and they managed to conduct follow-up research on 1,181 of those women (72%).

What report does tell us is that the law that criminalises abortion north and south in Ireland, and allows the state to jail women if they breach it, is completely irrelevant to women who need to access terminations and can’t travel. They are going to take the risk and order the medication anyway. The women who accessed the abortion pill from Women on Web were generally between 20 and 30 years old and the majority of them were already mothers, and 97% of them reported that accessing and using the medication at home was the right thing for them with 98% saying that they’d recommend the experience to other women. The only negative thing for the women accessing abortions at home is doing it outside of the law.

While the Citizens Assembly pontificates on the rights of women in Ireland to bodily autonomy and control over their reproductive systems, women can and will break the law in order to end their pregnancies. The abortion pill is a safe drug, in fact, it’s safer than viagra, and while well-meaning obstetricians like to point out the risks of taking medicines without the supervision of a medical practitioner, it isn’t unreasonable to suggest that in an Irish context, those concerns are as much about women in Ireland challenging the State’s control over their bodies as they are about taking a safe dose of misoprostol following an online consultation with a medical professional overseas. Continuing the prohibition against abortion and forcing women to go to term with pregnancies they do not want to carry is a form of structural violence against women.

The fact that women ordering this medication clearly believe it is safe should tell the State and the Citizens Assembly something. More and more women are now taking the pill and recommending it to their friends who can’t or simply don’t want to travel. Furthermore, even if women don’t believe it’s safe, they are willing to take that risk as well as the risk of arrest and prosecution in order to end their pregnancies at home here in Ireland. At this stage, for women in Ireland whether they travel or order medication online, abortion is a pretty normal event. It isn’t certainly isn’t a rarity. No one is put off ordering drugs whether they are risking a 14 year prison sentence or life in penal servitude, or their own health or life when it comes to disreputable black market sellers. Women on Web and Women Help Women alongside the activists who are supplying them with information, contact details, assisting them in getting the medication and providing them with safe spaces in which to take their medication are changing women’s health care in Ireland. Of course, this medication is only available for early terminations, but the power of it becoming more normalised and giving women control over their own bodies should not be underestimated.

Recognising that taking abortion out of the constitution and criminal law and treating it as a public health issue, is absolutely essential. This is about women’s rights and self-determination There are clearly public health consequences as a result of this domestic criminalisation – not every seller is as ethical as WoW or WHW. Forcing women to a point where they order medication online, though potentially empowering from a bodily autonomy standpoint, is pretty demeaning and dangerous in the context of a potential jail sentence if they are caught; if you thought your home abortion wasn’t going quite according to plan and you were unsure whether you were bleeding a bit too much, would you ask a doctor knowing they might feel obliged to call the Gardaí?

The Eighth Amendment might still be in the Constitution looming over everyone with a womb in Ireland, but like the women of generations past who handed down details of Queen Anne’s Lace seeds and Pennyroyal tea; email addresses and website details and safe houses to have packages delivered to are handed down by the current generation. If there is no safe house for delivery there might be a drone delivery.  In all jurisdictions where abortion is illegal women will find a way around it regardless of criminal penalties. The existence of the internet makes a mockery of the 1995 Regulation of Information Act that tightly controls the circumstances under which you be given information about abortion; literally anyone with a smartphone could potentially tell you when, where and how much an abortion will cost. Whether you have the funds to access it is a different thing altogether. Even if you do have the funds, the ability to access it in a post-Brexit Britain is in question.

When the Eighth Amendment is repealed, it must not be replaced with a semi-liberalised system that allows for abortion in certain highly restricted circumstances that requires women to jump through bureaucratic hoops designed to degrade them by requiring the narration of their experiences for panels of doctors who decide whether their reason for wanting to end their pregnancy is good enough, or whether the risk to their health or life is risky enough. The treatment of Ms. Y during her engagement with the panel (that ordered the termination of her pregnancy by a c-section at 24 weeks rather than the abortion she requested at 9 weeks) has taught us that the State will not make owning your own body straightforward for women. The Eighth Amendment must be replaced by a system that allows for free, safe, and legal abortion where a woman decides it is best for her, in a venue that is convenient and accessible for her – whether that is in a clinic or in her home. Continued refusal to allow this to women will simply mean thousands more travelling every year and thousands more ordering abortion pills online.

The 1,642 women who received illegal abortion pills in Ireland between 2010 and 2012 are the tip of a very large iceberg that is not going away no matter what the Citizen’s Assembly decides.

 

Looking from the outside In: Why Mothers are outside the door of the feminist agenda?

Mothers Artists Makers Ireland

Lately, I have been getting some strange looks when I go out to public events like gallery launches, theatre symposiums, or conferences. I even occasionally get ‘looks’, quiet ‘tut-tuts’, and even shushes accompanied by glares. I look around, wondering what manner social faux pas I appear to have committed. Then, looking over my shoulder, I see a small child strapped to my back.

Why am I getting this reaction? What is the social or behavioural expectation I am transgressing?

I was an activist, theatre maker, and ardent feminist before I had kids, and my passion for equality and desire to work towards a fairer and more equitable society has only deepened since I have become a mother. If have a toddler with me, it’s not because he is an adorable fashion accessory (he is of course, everyone says so), or that I cannot bear to be separated from him (love…

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The political and personal landscape of choice in Ireland

This piece has been previously published in print by the Workers Solidarity Movement in the magazine Common Threads. Since its publication one of the pending prosecutions in the north referenced in the piece has resulted in a conviction for a young woman for having a safe though illegal abortion using the abortion pills.1383342_332492296896551_364124772_n.jpg

 

It is all but impossible, both in theory and in practice, to legally obtain an abortion on the island of Ireland, both north and south of the imaginary border that divides this island. It is completely impossible to safely and legally obtain an abortion anywhere in Ireland;  the legal framework in the south specifically requires that in order to obtain an abortion without being criminalised for so doing, the woman who needs it must be ill enough to die; thus it is rendered impossible for her to be safe in access to legal abortion.

 

In the north, the Offences Against the Person Act dating from 1861 – over a century and a half ago – is what renders women taking control of whether or not they give birth and remain pregnant illegal. It describes abortion as ‘procuring miscarriage’, a description which is very apt for what those who need abortions in the north of Ireland today are forced to do by this archaic piece of legislation; obtain the abortion pill illegally online via organisations like Women on Web, Women Help Women, or less reputable means. It states that anyone who does this “shall be guilty of felony, and being convicted thereof shall be liable [..] to be kept in penal servitude for life”. However there was an exception made to this under the Criminal Justices Act of 1945. This Act, while it created the offence of “child destruction”, defining it as “any wilful act [that] causes a child to die before it has an existence independent of its mother” allowed that such a “destruction” could be carried out without legal penalty if one is acting in good faith to preserve the life of the “mother”.

 

Unlike in the south, this has been interpreted by subsequent judgements to mean not only that the woman must be on the brink of death, but also that the woman’s health was important as well. (In the south, the Supreme Court ruling on X in 1992 specifically excludes the woman’s or girl’s health from being in any way relevant to whether she is permitted to access an abortion.) In 1994 a court in the north found that this “does not relate only to some life-threatening situation. Life in this context means that physical or mental health or well-being of the mother and the doctor’s act is lawful where the continuance of the pregnancy would adversely affect the mental or physical health of the mother. The adverse effect must however be a real and serious one and there will always be a question of fact and degree whether the perceived effect of non-termination is sufficiently grave to warrant terminating the unborn child.” However it is very difficult to establish clearly the criteria under which this is deemed to be the case; on the 26th of March of this year the Northern Ireland Executive finally agreed to publish guidelines for healthcare professionals on when it is legal for women to access abortion. This was following enormous pressure on the Executive owing to a ruling from Belfast High Court in November 2015 which found that to deny abortions to women carrying pregnancies that will not survive to term, or beyond birth, or pregnant as a result of “sexual crime” was a breach of their human rights. Again, as in the south, this legislative framework ensures that a woman cannot be safe if she is unwell and endangered enough to fit the criteria of being ‘permitted’ to access a legal abortion.

Despite the obvious outdatedness of the Offences Against the Person Act of 1861, there are nonetheless not one, but two pending prosecutions in Belfast at the moment under it. One is of a woman who procured the abortion pill for her teenage daughter; subsequent to its administration they presented at a hospital in search of medical treatment, worried for the daughter’s well-being. Though details of the case are as yet unclear, it seems that a (presumably anti-choice) medical professional they encountered there felt the need to report them to the police for something that would render them open to life imprisonment. The second pending prosecution is of a woman in her twenties who obtained the abortion pill for herself and apparently for others. Again, details of her situation are unclear, but given that there is no prosecution or pursuit of any of the over 200 women from the north who have openly and deliberately incriminated themselves under their full names in repeated open letters and publications in various media as people who have needed access to the abortion pill, it seems likely that this prosecution too came about under pressure from another party.

 

The legal structure in the south of Ireland is the 8th amendment to the Irish constitution. It states that “The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.” The obvious afterthought of the right to life of the carrier of the foetus granted was only included in the wording after a vigorous campaign from feminist groups of the time. The referendum for its inclusion in the constitution of southern Ireland was passed in 1983 after a vitriolic debate in a referendum in which only 53% of the electorate voted. 67% of those who voted, voted for it. This means that a decision made by a mere 35% of the electorate of southern Ireland 32 years ago, none of whom are likely to be women of reproductive age today (the youngest a voter in that referendum would be now is 50), is deemed relevant and appropriate to force every person capable of becoming pregnant in the south of this island to remain that way regardless of that person’s own opinion on the matter.

 

The 8th amendment also strips from any pregnant woman or other person the right to consent or refuse any treatment a higher power than herself(!) may deem necessary for the foetus she carries in pregnancy. It also means that it is at the whim of a medical treating power to deny a pregnant woman potentially lifesaving medical treatment if they consider it may damage the foetus she carries, as was seen in the case of Michelle Harte. Michelle Harte was a cancer sufferer who was receiving treatment denied to her by Cork University Hospital’s “board of ethics” (what a misnomer) when she became accidentally pregnant. The same ethics board denied her, a dying woman, access to an abortion and forced her to travel to the UK while incredibly ill with cancer to obtain the healthcare she needed – an abortion. She subsequently died. A Catholic bishop sits on that ‘ethics’ board.

 

Since the context of choice and bodily autonomy in most public discussions, even most leftist public discussions, seems only to be understood as the choice to continue or to end a pregnancy, it is imperative to highlight that the 8th amendment is used also as a tool of coercion against women and others in continued pregnancy and during birth. The 8th amendment is regularly cited to pregnant women wishing to go against what their doctor deems to be the best for them; the phrase, “I could bring you to court if I have to, you know” is one used against pregnant and birthing women in Ireland far too often. This is explicitly stated in the HSE’s National Consent Policy, which cites the High Courts as the appropriate place to determine what can be perpetrated upon the body of a pregnant woman without her consent. Doctors, midwives and social workers are more often those doing the coercing in this scenario; it rarely goes as far as the courts, as most women when told by the social workers who arrive on their doorstep (as has happened in more than one instance) that their existing children will be taken from them into care if they continue to refuse to comply with their doctor’s vision of what is best for them, do not feel capable of struggling back when in all likelihood they will lose anyway. However there is one instance in which the High Court has been invoked, in Waterford in 2013 in the Mother A case.

 

The Mother A case involved Waterford Regional Hospital taking a woman, known as ‘Mother A’ by the court, to the High Court in an attempt to secure an order coercing her into a caesarean section. They took this action despite the fact that Mother A was not utterly refusing to consent to a c section; she specifically said that despite her desire to have a vaginal birth, should an emergency arise, she would consent to a section. It was not an emergency situation; the spur for the coerced c section was a foetal trace which was categorised by the person interpreting it as “non-reassuring” rather than emergency. She also wanted to delay the birth by at least 24 hours, because her partner was out of the country until then and she wanted him to not only be present at the birth but also to be able to be there to care for their older child during the period she was in hospital. Further, while the hospital insisted she was 41 weeks and 6 days pregnant, she deeply disagreed with their assessment. (It is worth highlighting at this point a similar case in Our Lady of Lourdes Hospital in Drogheda in 2003 where a woman, Therese Darcy-Lampf, was coerced into a section at 34 weeks owing to the hospital having wrongly noted her gestation after a scan, despite the fact that she pointed this out to them repeatedly. Her baby, Jessica, died shortly after being born far too early.) All very reasonable things to want; yet all things that were utterly denied her at the apparently capricious behest of an obstetrician and a hospital that stripped her of her voice and her autonomy. No judgement was handed down in this case as the woman “consented” to the caesarean section before one became necessary.

 

The nightmarish reality of forced caesarean sections has now been publicly enshrined not only in Irish practice by the Mother A case, but also in law and in practice by the passing of the Protection of Life During Pregnancy Act of 2013. The first draft of this bill was called the Protection of Maternal Life During Pregnancy Bill; but clearly this concept, that women should not die because we are pregnant, was deemed far too radical by the Labour-Fine Gael coalition government to pass into law and thus it was renamed to ensure that nobody reading it should become confused and think perhaps that women’s lives matter. Such confusion is however highly unlikely given the content of the Act, which requires that a suicidal woman must prove that she is suicidal to up to 6 doctors before eventually being granted a lifesaving abortion. This despite the fact that suicide is a leading cause of death during pregnancy in Ireland, and despite the fact that we are constantly being reassured through ad campaigns telling us to ‘please talk’ (talk to whom is never made clear) that mental health is in fact real health. It is only real health until it comes to pregnant women, as was made obvious by the atrocities perpetrated on Ms. Y by the medical establishment and the state in the south in 2014.

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Ms. Y arrived in the south of Ireland on March 28th, 2014 as a refugee. At what is described as a “health screening”, six days later she found out she was pregnant; she made known to those performing the screening on behalf of the state that she had been raped and that she could not possibly under any circumstances have a child. She was very distressed. A nurse made an appointment for her two days later with the IFPA who informed Ms. Y that abortion is not accessible in Ireland and that travel for her “may” be difficult – as an asylum seeker travel documents and visas into and out of Ireland are time consuming, costly and difficult to obtain. The IFPA made an appointment for Ms. Y to have a dating scan and referred her to the Immigrant Council of Ireland for advice and support on travelling as a migrant. Four days later, Ms. Y had a dating scan performed and it was discovered she was 8 weeks pregnant.

 

At this point it would have been possible to hand her three pills and for her to have ended her own pregnancy as she wished, with minimal impact on her, minimal further violation of her bodily autonomy and integrity, and minimal pain and suffering. Three pills.

 

Instead, she was handed about from pillar to post, having contact with three separate NGOs as well as the HSE staff she initially encountered, and her situation appears to have slipped between the cracks of these, unnoticed by anyone except herself as with the continuation of her pregnancy her despair and hopelessness deepened. A doctor from Spirasi, one of the NGOs she had contact with, wrote to the GP of the direct provision centre she was consigned to, describing her as “having a death wish”. The GP of this centre says that the letter was not received. A co-ordinator at the ICI formed the opinion that Ms. Y might change her mind about needing an abortion based on apparently nothing whatsoever. A counsellor at the IFPA suggested adoption to her. For a further 16 weeks she was handed around and around until eventually, on the 23rd of July (almost four months after her pregnancy was first discovered and she initially declared herself utterly unable to contemplate going through with it) she had an assessment with a consultant psychiatrist who told her it was too late to have an abortion and then coerced her into being detained in a maternity hospital under constant surveillance, where she refused all food and fluids for several days.

 

By that time she had met a consultant obstetrician who was of the opinion, despite the fact that Ms. Y was so despairing and suicidal that she was even refusing water,  “that Ms Y could be maintained on the ward for as long as possible and hopefully to 30 weeks so that the baby could be delivered appropriately.” This would have meant another 6 weeks of detention against her will; another 6 weeks of sedation against her will in order to forcibly feed and hydrate her against her will in order that her body and autonomy undergo repeated violations in order to host a pregnancy she loathed so much she would rather have died than have it in her body any longer. Instead however, as Ms. Y continued in her determination to refuse fluids, a caesarean section was carried out on her several days later; enforced major abdominal surgery also against her will.

 

This horrifying and traumatic ordeal inflicted upon Ms. Y was torture; state-sanctioned, state-inflicted torture, state-legalised torture. And were another Ms. Y to arrive in the south tomorrow, in the same harrowing circumstances, the state would more than likely torture her in precisely the same manner.

 

It is important to note here the degree to which the maternity hospitals in the south are complicit in, and even the driving forces behind the denial of basic bodily autonomy to pregnant women; both in abortion and in continued pregnancy. It is for these reasons that those of us who are involved in the pro-choice movement should be deeply wary of embracing the “masters” (the word alone should be warning) of the Dublin maternity hospitals such as Rhona Mahoney and Peter Boylan when they declare themselves to be opposed to the 8th amendment. At least one of those ‘masters’ has been known to invoke the courts in order to coerce pregnant women into interventions during their pregnancies, labour and births, and both of them are opposed to women’s choice of type of care (midwife-led or obstetrician-led) and the choice even of birth position in the case of Peter Boylan. Furthermore Peter Boylan in 2015 testified in the High Court in defence of the barbaric practice of symphysiotomies. Tempting though it is to reach for a “higher authority” in defence of our stance, these are not our allies in the struggle for women’s bodily autonomy.

 

However those who are our allies in this struggle are, in fact, the majority of the voting public in the south. An exit poll carried out at the general election in February of this year found that 64% of people support the repeal of the 8th amendment. This number is all the more invigorating for those of us in the trenches of this fight given the increasing vehemence of the well-funded anti-choicers over the last number of years. It’s also all the more inspiring because there’s a general misunderstanding of what the pro-choice position is in the public discourse around abortion in the south; the case is constructed as “Would you agree with and support her decision in this case?” rather than “Would you personally stop her?”, a much truer reflection of what the pro-choice stance is and means.

 

As the fight continues, it becomes more and more important to avoid the slippery slope of only publicly advocating and arguing for abortion access in terms of the “hard cases”, such as where the pregnancy will not survive outside the womb or in the case of survivors of rape. The majority of those who seek abortions do not fall into these categories and would be left by the wayside. Only allowing abortion access for pregnancies conceived by rape and incest would not only be impossible to legislate safely for but also makes clear that the enforcement of continuation of unwanted pregnancy because the woman chose to have sex is outright misogyny; either one believes that an embryo or foetus has rights overriding that of the person carrying it or one does not.

 

We own our own bodies. We are not property of any state. We can and will birth where, how, and if we choose.