The last word on the maternal health initiative.

The announcements are starting to emerge from this 1.2 billion dollar boondoggle called the G8/20. Here is the PM's press release on the maternal health initiative. It's no surprise that the amount of money dedicated to the cause will be much less than the amounts that were thrown around prior to the summit.  And, as with HIV/AIDS funding and aid to African countries, will the promised money materialize, or will it disappear as soon as something else attracts someone's attention? For the record, I never believed for a second that Stephen Harper cared one whit for maternal health. It was just politics, the ultimate motherhood issue. And I've got to say that I'm glad it backfired on him and that his politicking on the backs of women was exposed. But I'm saddened that women and their children across the world will continue to suffer. This is the real heartbreak.

Ottawa report

Just back from the show in Ottawa, and want to say thanks to all the volunteers who gave their time to bring life to these characters. You all did a fantastic job. I hope you are all feeling proud of yourselves. The show looked really good, and the audience enjoyed it. There was good discussion afterwards and even people who have been thinking about this issue forever said they were going home with something new to think about. So, mission accomplished, once again. I'm delighted to be associated with all of you. Thanks for the great experience in Ottawa everyone!

And thanks to the First Unitarian Congregation for allowing us to use their beautiful space. What a lovely worship hall you have!

Next Show: Sunday June 27, 2010

Don't forget the upcoming show at The First Unitarian Congregation in Ottawa. All proceeds from this staged reading are going to Planned Parenthood Ottawa.

See you there!

More on Women, Harper and the G8

Here is another great article on Women, Harper and the G8 by Chris Webb. It is an excellent summary of what's going on and puts it in the context of Harper's attacks on women. Of course, let's put the whole thing in the context of Harper's attacks on dissent, generally. Not only has he ignored the official opposition and made question period into a joke (to be fair, he's had plenty of help here), not only has he shut down Status of Women, the Court Challenges program, defunded Kairos, CRIAW, International Planned Parenthood and a host of others, now he's spent $1.2 BILLION dollars to make sure there's no dissent on the street. That's some pretty significant desire for silence. When you silence options for dissent, what happens? Dissent becomes more radicalized.

Also read Stephen Lewis' comments in today's Toronto Star. He always tells it like it is, calls the whole maternal health initiative political opportunism and says the money will never come through, as has been the case with previous commitments to fighting HIV/AIDS in African countries.

Can of Worms: The New Brunswick Situation and anti-choice doctors (actually two cans of worms)

A blog reader checked out the G&M article about access and was also struck by what it said about the New Brunswick Situation. (Let's call it NBS for short.) Because I know her, she knows how to get through the no-comment facade of this blog (which you may have noticed has been lifted in an experiment on internet civility that may be short lived). Here's the gist of what she said, in a "to-make-matters-worse" sort of way.

"Two doctors must okay an abortion in NB. Did you know that doctors are able to refuse provision of abortion? It's their right as a practitioner. All they do is inform their employer that they're opposed to it/uncomfortable with it. And their motto is 'do no harm.' Discuss."

This comment makes me want to start a new section on the blog called "Can of Worms." And if I knew how, I would. Consider this the first in the "Can of Worms" installments (as if talking about abortion in the first place isn't it's own giant can of worms.)

Is it ethical for a doctor to refuse to provide a medically necessary service? (Those of us in the reproductive justice movement know that all abortions are medically necessary. After all, women can't do it themselves or in non-medical environments without signifcant risk of harm.) It is ethical to force a doctor to do a procedure that goes against their conscience? Or is this part of what they sign up for when they take up the profession? Or is this just a side issue that pales in comparison to the NBS requiring two doctors' approval in the first place?

My own answer is that I find all of it alarming. Firstly, how can NB get away with imposing conditions that the Supreme Court has already decided infringe on a woman's charter rights? (To read everything the Supreme Court had to say on the matter, click here.) This is clearly unacceptable. My sisters in NB don't have the same rights as I do.

And it's not just my NB sisters. Without access, the right to an abortion is moot. Anyone with barriers to access (say women in PEI who have to leave their province for an abortion, rural women, northern women, Aboriginal women and so on) don't have the same rights as I do as a southern, urban Canadian.

Of course, those who don't want anyone to have an abortion know this, and that's why making access difficult is a tool of in the kit bag of the anti-choice. So it's important to pay careful attention to what's happening to access out there, and stand on guard against incremental changes that eat away at access, even if it eats away at access in a way that doesn't yet affect me personally, at least not yet. Because believe me, if "they" can do that to "her," "they" can do that to me. That's one reason why the Canadian stance on funding abortion in foreign aid is a big deal for all of us, not just "other" women who live "over there."

So, we have to be concerned about the NBS, even if we don't live there.

Now, to the second can of worms. To be clear, it's not just doctors in NB who can refuse to provide abortion services. Doctors anywhere in Canada can. The National Abortion Federation's position on this is that in allowing this, the Canadian Medical Association is in conflict with it's own code of ethics. To see more on this, click here.

I wonder how many of us, when we go to our doctors for the first time, ask them if they are pro-choice? Do we make sure that if we find ourselves in need of their help in a difficult time in our lives we will have it? I bet most of us don't. I know I didn't. We have a right to know the limits of our doctor's willingness to care for us. After all, it speaks to their ethics.

And not only that, there are fewer and fewer medical schools even teaching how to perform the procedure. Why would a medical school refuse to make learning a procedure that one third of Canadian women undergo mandatory? It's not a difficult procedure, and given its frequency, you would think a doctor might want to have some skills in this regard. Oh dear. I think I just opened a third can of worms.

As my commenter suggested, "Discuss."

Thanks to Alumnae Theatre

Thanks to Alumnae Theatre for putting on such a great staged reading of the play, to all the actors and crew and everyone who contributed their talent to the night. Money was raised for Planned Parenthood Toronto and Choice in Health, and there were some terrific community connections made too. It was great to see young activists there.  I especially want to thank the actors who talked to me about their experience being involved in the play and what it had meant to them personally. Every time this show goes on, someone says something to me that makes me think, "Yes, this is why I wrote this," and it happened again tonight. Thanks for that.

Access still a problem

There is an excellent article on access to abortion today in the Globe and Mail. It's good to see these themes being taken up and the voices of real women being heard in their struggles. This is exactly what I hoped to contribute to when I wrote the play, and it is good to see this on the front page of the G&M.

I have a question. Why is New Brunswick allowed to impose the same conditions on women seeking abortions that were struck down by the Supreme Court of Canada because they violated women's charter rights?

Toronto Show June 20 SOLD OUT

Good for Alumnae Theatre! They have sold out tomorrow night's staged reading. Here's hoping there is a lot of money raised for Planned Parenthood.

You know, of course, that the Harper government has simply not renewed International Planned Parenthood Federation's funding this year. No explanation. No reason. No money. Of course, we all know the reason. The fact that they can't say it plainly is evidence enough that the reason is unreasonable.

I saw in some Toronto media that they said the monologues were based on true stories. Not true! They are all 100% fiction, although I certainly hope they capture the spirit and themes of what I have heard from women over the years. 

Hope you enjoy the show tomorrow!

That which must not speak it's name

A fantastic, well researched, thought provoking, and insightful article in Mother Jones, by Julia Whitty called "The Last Taboo" is a must read on the urgent need for population control.

It poses some challenging questions to those of us in the reproductive justice movement, especially to the very many of us who find it impossible to separate social justice from ecological justice. Where will we find the balance of personal freedom and social and ecological responsibility? I don't know the answer, but I know it is urgent to do so.

While you're there, read Masters of the Uterus. Again, really thought provoking. I wish they had also included some of the big moments in Canon law and English Common Law, like:

1140:   First authoritative collection of canon law states that early abortion is not homicide and accepts the views of both St. Augustine and early Christian theologians (and Aristotle, for that matter) that "animation," or the coming alive of the fetus occurrs forty days after conception for a boy and eighty days after conception for a girl. (By the way, this is one of my most favourite historical sexist facts and a good one for any righteous patriarchy blamer to know.)

1327:   The "Twinslayer's Case" in England in which the Roman Catholic judge refused to make causing the death of a fetus a legal offence. The same happened again in the "Abortionists's Case" of 1348, with another Roman Catholic judge.

1591:   Pope Gregory XIV declared that early abortion was not grounds for excommuncation, a policy which continued in the Catholic Church until 1869.

1670:   The question of whether abortion was murder came again before an English judge, Sir Matthew Hale. Hale decided that if a woman died as a result of an abortion, the abortionist was guilty of murder. The concern was for the life of the woman, not the fetus.

The source for the above four fantastic facts is a great little booklet called "Abortion in Law, History & Religion" by Childbirth by Choice Trust.

How do women feel after an Abortion? Relieved.

What's the most common feeling reported by women after an abortion? Relief. Yes. Really. And you thought it was something negative. Just shows how you've bought into the anti-choice views of abortion. I don't blame you. That is the version seen most often in pop culture. But let's look a little deeper, shall we?

There's some great reading on this from the World Health Organization, in a report called "Mental Health Aspects of Women's Reproductive Health: A Global Review of the Literature." Published in 2009, this is a fantastic resource for anyone looking for the best current information on abortion and mental health.

One thing I really like about this report is its balance. Count on WHO for that. As I've mentioned before, sources are important. The report notes that the conditions under which women become pregnant and seek an abortion matter to their emotional health afterwards. This makes sense. A woman who conceives under conditions of violence will feel differently than one who did not. A woman seeking an abortion in an atmosphere where it is illegal and unsafe will feel differently than a woman who seeks an abortion where it is legal and safe. The report finds more is known about women's emotional health in developed countries and in countries where abortion is legal. This makes sense too because it's more difficult to do research in an environment where abortion is clandestine. And it finds that even where research exists, there are flaws such as "methodological problems [which] have included ideologically motivated research seeking to demonstrate that abortion is either harmful or benign, and a relative scarcity of rigorously designed studies." (p. 54) Also, research into mental health outcomes has been overshadowed by research into physical health outcomes which are seen as a priority particularly in areas where abortion is unsafe. Given all of the problems and lack of data, what do we know for sure? For sure, we know we need more research. But what else?

We know for sure that most women do not regret their choice. "In a study of 386 American women, Cozzarelli et al. (2000) found that depression scores were significantly lower, and self-esteem scores significantly higher, at two hours, one month and two years after abortion, compared with some hours before the abortion. One month after abortion, mean scores indicated that women felt more relief than positive or negative emotions, and overall more positive emotions than negative emotions." (pp. 54-55).  And regarding adolescents, specifically,  "Eisen & Zellman (1984) reported similar findings: 80% of 148 adolescents who had an abortion reported satisfaction with the decision six months later" (p. 55). From the summary, "Typically, women (including adolescents) experience heightened distress facing a problem pregnancy and prior to safe elective abortion, but show significant improvement on mental health indices afterwards" (p. 55).

Wow. Relief. Most women report feeling relieved. What a relief. Let the bells ring out. At least for these American women. Again, it could be really different for someone else in another study, who terminates under different conditions, perhaps facing poor care in a situation where the procedure is illegal.

But wait, there is more. And in my fairmindedness, I will share it with you because it deserves examination. "However, 10.8% reported that they felt dissatisfied and had made the wrong decision. At two-year follow-up, the number of women reporting dissatisfaction had increased to 16.3%, and 19% said that the abortion was the wrong decision." (p. 55) Some anti-choicers use this to validate something they call some version of "post abortion syndrome."

First, before I really take this up, I want to emphasize and take heart in the fact that the vast majority of women feel RELIEF. It's normal. And look at another website I really like called "I'm Not Sorry," where women share their stories of abortion and aren't sorry.

Let's play a little game. It's called "Invent a Bogus Syndrome." It's fun. Are you ready?

According to the same report by WHO, there is considerable evidence to suggest there is a negative psychological impact of bearing an unwated child. "A rigorous, longitudinal study in the Czech Republic to examine the effects of denied abortion (David et al., 1988; David, Dytrych & Matejcek, 2003; Kubicka et al., 2003) found that women go to great lengths to obtain an abortion when one is initially denied. A significant minority of women who were twice denied abortion in a pregnancy experienced difficulties with longterm adjustment and mother–infant attachment and their children had higher rates of long-term, adverse developmental and emotional consequences than those born to a matched cohort of mothers who desired the pregnancy... [Others have] made similar observations in a 50-year study of unwanted babies in Quebec, Canada." (p. 53). Given this, let's invent a syndrome, and call it "post abortion denial syndrome." We can say that there is evidence to support it. The syndrome makes it difficult for women denied the right to choose to bond with their children. Now, let's get more money to do more research to validate the findings further.

Of course, this is as bogus as claiming that there is a "post abortion syndrome" and women are traumatized by their decision to terminate. See what I'm getting at?

We can't take the statistical edges of a group and call them the statistical centre. There is simply no evidence in any longitudinal study done anywhere that this invented "post abortion syndrome" is real. It's as bogus as the "post abortion denial syndrome" I just invented.  But that doesn't mean that some women don't feel regret. And it doesn't mean that women who are forced to continue unwanted pregnancies don't face psychological problems afterwards.

Just because these two groups of women are statistically small, doesn't mean they should be completely ignored. I'm concerned about both of them. The way to help the second group, the group who are forced to carry unwanted pregnancies to term, is to ensure all women have choice. But what about the statistically small number of women who exercise their choice and feel regret?

I say, let's do some more research and find out what happens to them in that time period. Any PhD students out there looking for a project? Meanwhile, I'm going to postulate a couple of theories, because it's my blog and I can do what I want.

Firstly, given the current judgemental, vitriolic and punitive narrative about abortion, it's not surprising that women start to feel bad sometimes. There's a lot of name calling going on, sign waving, a lot of people telling women to feel bad. It has to take a toll. I might suggest to those doing the name calling and sign waving that if you don't want women to feel bad and are concerned about their post abortion mental health, stop causing their trauma.

Secondly, it's hard to look at the road not taken and not wonder about it. It's human nature to think about what might have been if we'd taken that other job, married that other guy. Women are allowed to do this in only one direction though when it comes to motherhood. If we've terminated a pregnancy, we can think ruefully about what might have been if we hadn't. We can imagine some pastoral scene of a chubby healthy child running towards us in a field of wildflowers, (like in the opening credits to Little House on the Prairie). But we are not permitted outside of our heads to think ruefully about how great our lives might have been if we had not had that baby screaming in the nursery, that teenager in drug rehab, that adult child in prison who murdered eighteen people. That is unthinkable (outside our heads). So we see a kind of "survivor bias" being expressed.

There was an interesting take on this in Slate recently, kind of tucked into an article about Tim Tebow and the anti-choice superbowl abortion ad. Survivor bias is a skew in perspective, a wearing of rose coloured glasses. Just think, says the superbowl ad, a great football player may never have been born. Meanwhile, as William Saletan points out so well in the article, other women who failed to heed their doctor's advice and chose not to terminate a dangerous pregnancy may not have had such positive outcomes. They may be dead, as may the offspring. Our bias is towards the survivor.

Thirdly, there is another way in which we look at the world with rose coloured glasses. When our lives improve, we forget how bad the bad times were. Who wants to dwell on that? I wonder how many of these women had some significant improvement in their lives in the year(s) following a decision to terminate. We have a tendency to impose current life conditions, especially if they are better, on past life decisions. If really honest about the conditions under which they made their decision to terminate, could they still see it as the right decision at the time?

But this is what I really want to say. What would happen if we women lived in an evironment that was supportive of our choice, and our right to make it? Just as the research outcomes change based on the legal environment in which choices are made, it stands to reason that one's perspective also is affected by the emotional and social and cultural environment in which a decision to terminate is made. So let's do what we can to affirm women.

And remember, the most common feeling expressed after an abortion is... relief.

Cultural Imperialism and Abortion

Recently, I was accused of being a cultural imperialist because of my insistence that abortion be included in the maternal health initiative. (See The Munk Debates). Again note my fairmindedness in posting critiques of me on my own blog. Hmmm. This was quite a gambit from my opponent, I thought. After getting over my shock at being accused of cultural imperialism, I decided to respond that actually, excluding safe abortion is cultural imperialism because it forces women to continue pregnancies that they might not want by making the alternative impossible or unsafe. It is limiting choice and defining possibilities for others that is cultural imperialism. Giving women the choice to follow their own consciences respects their human rights, their right to freedom of conscience, their right to control their own body, and to put it in terms of the struggle for abortion rights in Canada, to security of the person.

As Professor Fred Sai, former Senior Population Advisor at the World Bank and reproductive health advisor to the government of Ghana, has said, “Abortion laws inherited from colonial powers are the main reason so many women in developing countries die.” (Thanks to Joyce for pointing me to this.)
This is from this great website called global safe abortion. It's fantastic. Have a good read.

On the same topic, this is a great article on how recent Canadian politics harms Africans.

Facts, Propaganda and Somerville

It's easy to use facts and statistics to support your own view of the world. And fun too. I do it all the time. How can we tell when something is a bunch of hooey? Well, Dear Reader, part of what you have to do is educate yourself. Look to good sources. And then look at some more. Let's take Margaret Somerville, for example. She's an ethicist and director at the Centre for Medicine, Ethics and Law at McGill University. Wow, good source. Or is she? This is a smart person, someone with excellent credentials, and way more letters after her name than me and my little M.Ed.

But when it comes to abortion, even the best vision gets myopic. MS is anti-choice and doesn't seem to think too much of me. In response to my point made in the G&M that restrictions on abortion are a way of punishing women for failing to conform to the ideals of the "good woman," she says "Restricing abortion is not a ruse of the patriarchy." (And please notice my fairmindedness, my willingness to put a critique of me up on my own blog.) I also love how she puts quotation marks around my identifier, "reproductive rights advocate." It gives me the feeling she doesn't think too much of that. I also get the feeling she doesn't much like feminists either. Well, I'm certainly both, so there you go.

Moving on, even though this ethicist says otherwise, restricing abortion actually is a tactic of patriarchy. And yes, it is a tactic, not a ruse. (For a good primer on patriarchy, try "I Blame the Patriarchy," one of my favourite blogs.) Restricing abortion is the ultimate means of denying a woman control of her own body. It's says, "Guess what? You thought you were in charge of yourself, but you're not." And if you're not, what or who is? That's a good question. Well, patriarchy is one option in the list of possible answers.

Do I have to say why the right to abortion is important again? Why don't you read this instead. This was feminism in 1971. All I could add now is that if I don't have control of my own body, I'm simply not a free person.

In another article, MS goes at it again. She's very prolific. She says firstly that there is no consensus about abortion (using Margaret Wente (!) as a source). In fairness, in my experience, ask 100 different people what they think about abortion, and give them some space for nuance, and you will get a hundred different answers. But there are identifiable themes within the nuance, and in the over-riding themes, there is consensus. The majority of Canadians identify as pro choice and there has been no change in this over the past decade.

But then it gets worse. MS goes on to say that there is a dearth of information about what abortions are performed in Canada and that this is purposefully done to invigorate the pro-choice side of the debate.

First of all MS fails to mention that, as with all medical procedures, the medical professions themselves have guidelines their practitioners must follow in order to remain in good standing in the professions. Their practice is regulated, and I personally feel that this regulation is more appropriately situated within the medical profession than put together by some random MP. I don't want said random MP telling me when my heart transplant is okay. I'd rather have my doctor do it. MS makes it sound like, without legislation controlling them, doctors are out there, willy-nilly, performing abortions at eight months and three weeks. They're not. "The majority of abortions occur in the first trimester. According to Statistics Canada, 0.7% of all abortions performed in 2003 occurred after 20 weeks of gestation, with 90% occurring in the first 12 weeks. The small percentage of late-term abortions which do occur were found to be primarily the result of discovering fatal or severe birth defects in the foetus, or because the mother’s life or health was at risk, or both." Stats Canada keeps the numbers. I personally used to receive an annual report on maternal outcomes from Alberta Health when I used to do more research. It had all the abortion numbers too. It wasn't hard to find at all.

At any rate the quote above comes from some real myth busting about abortion, and I encourage you to read the whole thing. This article does a much better job of it than MS.

And don't get me started on the anecdotal evidence. I can match anyone anecdote for anecdote. But this is already too long a post.

Here's another critique of MS, which I enjoyed. This critic takes on MS's anti-choice perspective. And here is one more, supporting the secular perspective on public policy.

On one thing MS and I do agree. Everything is ideological. Or in other words, to use the famous feminist maxim, the personal is political. In the post-modern world, there is no such thing as objectivity. What's the point?  Check your sources, and do your research.  And know the biases of the sources you use. Hopefully, they'll be honest about them. Have I mentioned I'm pro-choice?

Addendum: June 15, 2010

The critiques continue. I'll add this one from Vicki Saporta that appeared in the Letters to the Editor after MS's article was published in the Montreal Gazette. I'm printing this particularly because it clarifies the difference between where stats are avialable and who collects them. Stats Can reports the numbers, but they are collected by the Canadian Institute for Health Information. Good to know.

Facts are available


Re: "Busting the abortion myths" (Opinion, June 1). Margaret Somerville's article relies on anecdotal evidence that supports her personal ideology rather than speaking to the unbiased, statistical evidence concerning abortion.

The majority of abortions in Canada are provided in the first trimester and there is statistical data to support this fact. In 1995, the responsibility for collecting abortion data was transferred from Statistics Canada to the Canadian Institute for Health Information. Perhaps if Somerville had contacted the correct agency when writing this article, she would have learned that, according to the CIHT, in 2005, the percentage of abortions provided after 20 weeks was less than one percent (0.56 per cent).

Abortions after 20 weeks are provided in a hospital and data show they usually have a corresponding diagnostic code, which indicates a fetal or maternal complication. These are often heartbreaking cases of women who discovered late in very wanted pregnancies that their fetuses were diagnosed with fatal anomalies or that their health or life would be put at risk if they continued their pregnancies.

It is misleading and inaccurate to suggest that the facts on later abortion are somehow hidden from the Canadian people.

Vicki Saporta
President, National Abortion Federation Canada
Victoria, B.C.

Anti-Feminist Feminists and abortion

Two good recent articles on this particular phenomenon, as old as feminism itself.

The first is from Slate, and particularly brilliant. http://www.slate.com/id/2256184. The second is from the Washington Post and equally lucid. http://newsweek.washingtonpost.com/onfaith/guestvoices/2010/05/sarah_palin_is_no_susan_b_anthony.html

Women who've not merely internalized patriarchy, (let's face it, it happens to the best of us) but also work to advance it, and then use it to oppress other women horrify me.

G8 and the Maternal Health Initiative Commentary

I've said some, others have said more.
This was my contribution. For the record, the Globe and Mail was quite specific about me not using the word misogynist. They also edited out a lovely paragraph about how this decision was part of a larger pattern that worked against women. But here it is.

Yesterday and today, I've been reading about the Gates Foundation's plans. Even with the best education and family planning programs and the most effective contraception, there will always be unwanted and unintended pregnancies. I applaud the efforts she is making to reduce this as much as possible. Lots of people say some version of, "If we do everything else right, abortion won't be an issue anymore because no one will need it." Wish that this were so. Much as I admire and respect what the Gates' are doing, using the word abortion and making this part of the plan is still necessary.

Leaving out critical phrases like "safe abortion" and "family planning" is exactly what the Harper government did when they started the whole mess. But in their case, it was an attempt to obfuscate. Honestly, I still don't know if the Gates Foundation will fund safe abortion. That's the problem with not being explicit. Concerned parties were right to call the government on it, to make them be clear. And they were right to suspect that indeed, safe abortion would be excluded. And by the way, has family planning been specifically included yet? Or just not wiped off the table completely? In any case, it certainly has not been prioritized in any way. Another problem. But we are all distracted by the abortion debate. And why shouldn't we be? Abortion is a nexus issue, always has been, always will be. I'll take that up in some later post.

This is my favourite statement on the maternal health initiative from the Abortion Rights Coalition of Canada. It pretty much sums everything up.

The other angle on the whole fiasco is how it has further illuminated the refusal of Mr. Harper and his government to tolerate opposition. Read Gerald Caplan on what is happening to agencies that speak against the government agenda. Yes, we WERE a nation of diversity and debate. Not any more. Well said Mr. Caplan.

Upcoming shows

The Abortion Monologues will show in Toronto on June 20 at Alumnae Theatre and in Ottawa on June 27 at the First Unitarian Cogregation of Ottawa. Check out the website for details at http://www.abortionmonologues.com/.  Both shows were motivated by the mess being made by Mr. Harper and his government on the maternal health initiative in the upcoming G8. Is it politics or is it theatre? Can't it be both?