In my wayward years as a medical student, I did a month-long placement at a large hospital in Shanghai. Early in the second week, in the general surgical ward, we saw a woman who was scheduled for surgery to fix a hernia. For female patients with gastrointestinal symptoms, it’s standard practice to ask questions about their reproductive history.
“How many children have you had?” asked the doctor we were shadowing.
“One,” she replied. “A son.”
“Have you had any abortions?”
“Yes,” she said.
He nodded, translated, and then proceeded to examine her abdomen, while we foreign students exchanged shocked glances.
A medical history of multiple abortions isn’t uncommon, the doctor later told us, particularly for women in rural areas – including this patient – who are less likely to have access to contraception or sex education. In China, abortion is not a controversial topic. The procedure is a legal and government-provided service, hospitals advertise their services publicly, and the right to abortion is nowadays not largely seen as morally problematic.
In the self-proclaimed progressive West, women’s bodies and their rights to choose have become a moral battleground. Those in the anti-abortion camp invoke the sanctity of life and make emotive appeals that conflate existence with intent. All babies want to be born, pro-lifers argue. No matter that at least 98 percent of terminations are performed by 20 weeks, and consciousness is accepted as arising around the 24-week mark, when the brain’s thalamocortical connections develop. Christians inevitably cite God as the only rightful giver and taker of life, forgetting that centuries ago the Catholic church tacitly permitted abortions and only began anti-abortion campaigning in the 1800s.
When it comes to the legality and availability of abortion, moral debate should play no part in practical implications. All evidence points to the fact that women have abortions whether they’re legal or not. “Highly restrictive abortion laws are not associated with lower abortion rates,” reports the World Health Organization. When you look globally, the abortion rate in countries where the procedure is illegal is 37 per 1,000 women of childbearing age. Compared to the rate in countries where abortion is available on request (34 per 1,000), there’s no statistically meaningful difference.
One effect that restrictive abortion laws do have is to drive women to perform dangerous, often medically unsupervised procedures. When the procedure was legalised in South Africa in 1997, for example, the annual number of abortion-related deaths fell by 91 percent between 1994 and 1998–2001. A close friend of mine, Louise*, who is a nurse and aid worker, once saw a patient in a hospital in Uganda, a majority-Christian country where abortion is outlawed. The girl, aged 12, had been raped, fallen pregnant, and then perforated her uterus while trying to abort her own foetus.
Given the clear correlation between abortion’s legality and safety, it’s perplexing that abortion still isn’t legal Australia-wide. Comparatively speaking, access to abortion services is relatively unrestricted, and cases as horrifying as the Ugandan girl’s are certainly rare. Yet women and doctors can technically be convicted under criminal law in Queensland and New South Wales; the laws in these two states are based on century-old legislature. A Queensland woman was actually charged in 2009 for procuring her own abortion, and faced up to seven years in jail. (At trial, a jury acquitted in less than an hour, no doubt a relief after months of publicity).
While doctors in Queensland and NSW can lawfully perform abortions if they believe a woman’s physical or mental health is in serious danger, the technical illegality is a disincentive to doctors and creates access problems for women who are disadvantaged or living in rural areas. Earlier this year, a 12-year-old Queensland girl was only allowed to have an abortion after a ruling from a Supreme Court judge, despite the fact that she and her parents had consented, and that five different doctors had also recommended the procedure in her case.
Of the estimated 10,000 to 14,000 abortions in Queensland each year, only 1 percent are performed in public hospitals. Private healthcare is expensive, and abortions shouldn’t be limited to the privileged. Louise, my aid worker friend, had an abortion in Brisbane a few years ago. “I paid $550 for my procedure,” she told me. At the time, she was a full-time student and also worked in the evenings to cover costs. She had fallen pregnant despite using two forms of contraception, which is not uncommon. The experience, “was the first time I felt trapped as woman. It makes you want to blame yourself.” While she was supported and fortunate in her decision, “money should never be an impacting factor in your access to healthcare,” she told me. “That there are women in Australia who can’t afford to get an abortion horrifies me.”
Currently, the Queensland parliament is debating a bill that would amend the Queensland Criminal Code. Both major parties have agreed to allow a conscience vote, which if passed would decriminalise abortion. Earlier this year, Greens MP Dr Mehreen Faruqi released a draft amendment bill for NSW, which also seeks to establish 150-metre safe access zones around abortion clinics – zones that are already mandatory in Victoria, the ACT and Tasmania. Many clinics are targeted by anti-abortion groups. Sydneysiders, for example, may be familiar with the clinic on Devonshire Street in Surry Hills, outside which vocal and occasionally violent protestors have gathered for decades.
The practice of abortion dates back millennia. In a 1954 study of abortion in 350 ancient and pre-industrial societies, anthropologist Georges Devereux concluded that there “is every indication that abortion is an absolutely universal phenomenon…it is impossible even to construct an imaginary social system in which no woman would ever feel at least compelled to abort.”
Women will continue obtaining or inducing abortions irrespective of opinion, religion or lawfulness. The best way of ensuring their safety while doing so is to provide universal access to reproductive healthcare by legalising abortion.
*name has been changed
Image: Morre Christophe