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Current Affairs Repeal The 8th

Repeal The 8th Resources

If you’re looking to campaign to repeal the 8th amendment in Ireland, I’ve gathered some resources that I’ve found helpful in answering questions, or encouraging further reading. I may edit this post again to add further links/resources as I come across them.

General Links
The Guttmacher Institute is a great source for clear, easy-to-understand information and statistics about abortion. https://www.guttmacher.org/united-states/abortion

Waiting Periods
In particular, I have found this section on waiting periods to be particularly useful: https://www.guttmacher.org/evidence-you-can-use/waiting-periods-abortion. I’ve summarised some of that info myself here: https://www.zenbuffy.com/2018/03/waiting-periods-for-abortion/

Mental health / regret / women hurt
There are a wealth of studies which show that women, by and large, don’t regret their decision to have an abortion, a few of which are listed here:

Mentioned in some of the studies above, and also in another linked below (specific to the Irish situation) is some discussion about why women who do feel sadness and regret may feel this way – it’s linked heavily to a lack of community support, stigma about sex, stigma about their decision, etc.

Physical harm
There’s no links between abortion and breast cancer, failure to conceive later, etc. Abortion itself is not a risky procedure, and has lower rates of risk at all stages than pregnancy.

 
Abortion as contraception / repeat abortions
There’s a lot of chatter about repeat abortions and the stats are often used to imply that people will frivolously choose abortion, or that they are using it as contraception. People are often using contraception when they become pregnant, and one contraceptive failure doesn’t protect you from further contraceptive failures or make it less likely that it’ll happen to you again. The same logic applies when discussing fatal foetal abnormalities – if you have had a pregnancy where a fatal foetal abnormality has been diagnosed, this doesn’t make you less likely to have another, and may even make it more likely.

Floodgates
Countries where abortion is legal have similar or lower rates than countries without legal abortion, so the evidence from other countries doesn’t support the idea that legalising abortion here would significantly change the number of people accessing abortion. Abortion rates are typically under-reported in countries where abortion is illegal, so the numbers may even be higher than we know for Ireland. Rates of abortion in developed countries are actually in decline in general, and greater access to contraception has led to steady declines in unintended pregnancy also.

 
Notable incidences in Ireland
There’s a number of incidences of the 8th interfering in pregnancy, or the treatment of pregnant women, in Ireland.

Implications in pregnancy (consent, etc.)

Important Stories

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Current Affairs Repeal The 8th

Waiting periods for abortion

There has been much coverage recently of the policy paper on what the law might be if the 8th Amendment is repealed. The Times highlighted point 8 in this policy paper, a policy which would potentially add a waiting period for women who request a medical abortion, i.e. abortion prior to 12 weeks using pills, and notes that this might be a 3 day waiting period. I have written to Simon Harris and my own local TDs, urging them to reconsider this, in the hopes that they will examine the evidence which suggests that a waiting period is not beneficial and is, in fact, detrimental to women in a number of ways.

Waiting periods for termination present a number of barriers for women hoping to access this service. Many people will have difficulty getting time off work to attend an appointment in the first place, especially those in less secure jobs, jobs without sick leave, jobs with zero hour contracts, etc. and to force them to take two days off will be prohibitive. Many GPs have long waiting lists for appointments, and regularly run over-time and behind schedule – my own GP needs to be booked at least a week or two in advance for an appointment, and unless you are the first in the door, you will likely be sitting in the waiting room for a long time beyond your appointment. In some cases, I’ve waited for over an hour or more beyond my scheduled time. To ask women in a vulnerable employment situation to do this twice, while employers chastise them for lateness or missing work, or to ask women attempting to seek a termination without letting others know to explain prolonged absences like this not once but twice is prohibitive, and will prevent women from accessing the care they need.

Waiting periods are almost never required for other medical procedures, so there isn’t a good medical reason to apply a waiting period to this procedure. I, for example, have had my appendix removed, and have had laser eye surgery, and I was able to access both of those irreversible medical procedures on request, without the imposition of a waiting period.

All the best evidence shows that when women arrive at a medical facility seeking termination, they have made their decision and that decision is fixed. Waiting periods are rooted in the idea that they may change their minds, but evidence shows that a majority of people do not. Moreover, there is an infantilising and slightly insulting undertone to the waiting periods that women may simply be too emotional, too flighty, or otherwise unqualified to make and commit to a decision, or to make a decision and then not change their minds afterwards.

Waiting periods, far from making sure women are able to change their minds and protecting them from regretting or being upset by their decision, are actually detrimental to the mental health of women. One third of surveyed patients in Texas, for example, felt that the mandatory waiting period had a negative effect on their mental state.

Adding a waiting period also led to difficulties with women accessing termination, which often led to later term abortions taking place. While the risk for all kinds of abortion is very low, that small risk does rise with later gestational age, and waiting periods delay this treatment for an unspecified amount of time, as there is no guarantee that a woman might be able to return precisely three days later, either due to her own schedule, or to the GPs schedule.

I understand that there is a perception that people might be pressured into a termination, or might regret it or change their minds, but the evidence overwhelmingly does not back this up. The vast, vast majority of people are sure of their decision when they seek a termination, and they don’t regret it afterwards either.

Women are confident in their decision to have an abortion. Mandated waiting periods only add a delay between a woman’s decision and her procedure. See below from the Guttmacher Institute.

  • A study of Wisconsin’s 2013 mandatory preabortion ultrasound law found that 93% of women were certain in their decision to obtain an abortion, both before and after the law was implemented.5
  • A nationally representative survey of abortion patients conducted in 2008 found that 92% of women reported they had made up their mind to have an abortion prior to making an appointment.6
  • According to a study of women seeking abortion at a U.S. clinic in 2008, 99% of abortion patients reported being “sure” or “kind of sure” of their decision to have an abortion, and 98% reported that “abortion is a better choice for me at this time than having a baby.”7
  • A 2015 qualitative study on travel-related barriers to abortion found that facing multiple barriers, such as limited access to clinics and financial constraints, had a cumulative impact on abortion access.8 The study authors considered waiting periods to be harmful in the context of these barriers.
  • In a 2014 study of Utah women seeking an abortion, 74% of participants said that the 72-hour waiting period did not affect the certainty of their decision to have an abortion and 17% said that the waiting period made them more certain about the decision.9

The percentage of women who regret having a termination is very small, and has been over-blown and misrepresented by pro-life advocates during their campaign. There is ample evidence which tells us that the majority of women believed it was the right decision for them. All of these studies confirm that women felt their decision was the right one for them, with no regrets, or regrets only that they had to do something illegal in their own country.

In summary, women don’t change their minds because of waiting periods, and they feel their decision (which was already made when they sought a termination) was the right one for them. The primary contributing factors in women who did have negative feelings was the stigma associated with abortion, something which will not be helped by a waiting period and the associated perception that women might choose abortions on a whim, or change their minds if they sleep on it.

Adding a waiting period just imposed a barrier and makes it more difficult for a person to access the healthcare they need. It adds a time and travel barrier, a cost barrier, an access barrier. It adds no benefit. None. Adding a waiting period is not compatible with any system which would claim to “trust women” as it implies that we can’t be trusted.

Please trust us to know our own bodies and minds.

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Current Affairs Repeal The 8th

Do Women Hurt After Abortion

Note: I generally prefer to be more inclusive, and use the term “pregnant people/person”. However, throughout this, I will sometimes use the term “women hurt” in response and reference to the “Women Hurt” slogan being used by pro-life campaigners.

A frequent claim by pro-life groups is that “women hurt” after abortion, and that these women are ignored or marginalised by Repeal campaigners. I wanted to look into this, to see what the statistics said about how people felt after abortion.

Having looked into it, I’m certain that this claim (like many others) does not hold much water.

There have actually been numerous studies to examine how people feel about their decision to have an abortion. One study in the US, which examined both people who had early terminations, and people who had terminations closer to the term limits for abortion, found that 95% of those questioned felt that abortion was the right choice for them. 95%. 90% of people in this study felt relief that they were able to obtain an abortion. Even when people who had an abortion felt primarily negative emotions, like regret and sadness, more than 80 percent still said that it was the right choice.

And this isn’t the only study. Here’s another, with similar results – its conclusion notes that “The finding that the incidence rate of psychiatric contact was similar before and after a first-trimester abortion does not support the hypothesis that there is an increased risk of mental disorders after a first-trimester induced abortion. In fact, study after study supports this.

Every time people are asked, in all the countries they have been asked, they report that abortion was the right choice. 

Another article (about a paper in British Journal of Obstetrics and Gynaecology) notes that far from hurting, the only regret expressed by Irish women who obtain abortion pills online is “that they are having to do something that is illegal in their country. They express anger and disappointment that they could not access a safe, legal abortion and felt they were treated as second-class citizens.”

These studies don’t report 100% percent of people, and a frequent claim is that the 5% of women who do hurt are ignored. What about the other 5%? The women who hurt, who the pro-life campaign claim are not being acknowledged by the campaign?

Well, some people do experience negative feelings after and abortion. Why? Because of negative social attitudes, low social support, stigma. This study talks about how higher perceived community stigma about abortion was associated with negative feelings. And this is a whole thesis exploring the impact of this stigma on the mental wellbeing of people who have accessed abortion.

In other words, “women hurt” because pro-life campaigners stigmatise their decision. In other words, “women hurt” because pro-life campaigners lie about statistics and cultivate an atmosphere of shame.

The negative feelings people have after abortion are associated with an atmosphere which stigmatises people who have abortions, and which does not support or care for people after abortions. When you cultivate an atmosphere which shames people for making choices about their reproductive health, it is inevitable that some people will feel ashamed. People need support after abortion the same way any individual needs support after making an important life decision, and when they don’t get that, they may hurt. Not because of the abortion, but because of how they are isolated by those who stigmatise abortion.

The issue of emotional hurt is difficult because abortion (like all decisions surrounding reproduction) is a highly personal experience. There is another aspect to address, however, and it is the issue of physical hurt. There are many claims about the physical after-effects of abortion which have been repeatedly shown to be false.

So what about physical hurt? The ARC says that abortion has fewer risks at any stage than pregnancy and they are not alone in saying this. 0.23% of all abortions in the US lead to major health complications. That’s less than 1%. Less than 1/4 of 1%, in fact. It is an incredibly safe procedure. Nor is there any evidence to support a link between abortion and any of the conditions to which it has been falsely linked. Abortion doesn’t increase your risk of cancer, or affect your fertility.

Moreover, pregnancy and birth are not without risks. Here is an excellent thread by a nurse which discusses some of the risks associated with pregnancy and birth (please click through to twitter to read in its entirety):

These images say that “no one told me I would suffer after my abortion” but that’s not true. Pro-life campaigners regularly tell people they will suffer, and imply that they should. They cultivate an atmosphere of shame and stigma which discourages people from speaking openly about abortion. Women don’t hurt because of abortion, they hurt because of the lies that are told about why they choose abortion. They hurt because of the aspersions that are cast on tough decisions they have made. They hurt because they are repeatedly told that they must. It’s not ok.

Overwhelmingly, the evidence says that a majority of people do not hurt, physically or emotionally, after abortion. Those who do have their hurt exacerbated by people who lie about abortion statistics, and who cultivate an atmosphere of shame and stigma about their reproductive decisions. I acknowledge that some people may regret their decision, just as individuals may regret any major life decision, but I will not contribute to the regret they may feel with half-truths or lies about what they have done. People deserve better than this. People deserve the support of their friends, family, and community when they go through difficult times, and denying them this support is what truly makes women hurt.

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Current Affairs Repeal The 8th

On repeat abortions.

Some lies are particularly prevalent when people are discussing figures about repeat abortion. Some people have had more than one abortion. This is true. There are figures which show this clearly. Many imply (or outright say!) that these people should have “learned their lesson” the first time, or that these people are simply lazy or ignorant of contraception, or should “keep their legs closed”. (At this point, it seems prudent to point out that many people who would like others to “learn their lesson” are also people who do not accept that pregnancy is a burden which someone may not be able to bear, but insist that every child is a blessing.)

Let’s address these points in order.

The sex education system in Ireland has a lot to answer for, not the least is the woeful understanding that many people seem to have about contraception. So here comes a primer.

Contraception is not perfect. It is incredible to me that I have to say that aloud. It is not perfect. Even with perfect use, contraception is not 100% perfect. And it doesn’t have perfect use. With typical use, pregnancy happens. Even when you are using contraception.

In fact, in 2014, over 50% of people accessing Marie Stopes services were using contraception when they became pregnant. Over half of the people were using contraception. Let that sink in. Almost 60%, actually. Not lazy, not about “lessons”.

Contraception failure happens. More often than you think. It’s insulting to imply that person didn’t “learn a lesson”. What’s more, contraception failure happening once certainly doesn’t preclude it happening a 2nd or 3rd time. The idea that you should just use contraception and then you would never need an abortion is laughable. Contraception isn’t magical, it fails. And it can fail more than once. There isn’t a lesson to be learned, or a conclusion to be drawn. You can do everything by the book, and even everything by the restrictive “good, moral sex” book, and still end up pregnant. It happens.

Further, the idea that one can simply keep their legs closed in order to avoid pregnancy, in our current culture, is laughable. Marital rape in Ireland was only made a crime in 1990, and since then, just two people have been convicted of it. Two. Some people seem very concerned that people will be coerced into abortion by doctors after a FFA diagnosis, but they do not seem to be as concerned about the fact that many will end up pregnant as a result of being coerced into sex.

Leaving aside the issue of imperfect contraception, we also know that many people are faced with the diagnosis of a FFA (fatal foetal abnormality). What people seem to be ignoring is that abortion may not be a one-time choice for these people either.

If you are a carrier of a genetic condition, and your partner is too, then your child has up to a 50% chance of developing that condition (This percentage varies depending on autosomal dominance, etc.) The chances vary depending on the type of genetic disorder, and whether both parents are carriers, or whether it is autosomal dominant, recessive, etc. There are many factors which play into this. But with two autosomal dominant parents, the chance of a child inheriting a particular condition can be as high as 1 in 2. It may be possible to lower these odds, but it usually requires significant medical intervention – IVF, embryo selection, donor sperm or egg, etc. It is not trivial.

But, importantly, it doesn’t disappear because you’ve had more than one pregnancy. The chance is always present. In fact, if you’ve had one pregnancy with a genetic malformation, the chance of you having a second is often higher.

There are too many iterations of different conditions and different ways of inheriting conditions to go into in extensive detail. A decent overview of some of this information can be found here

It discusses, in easy to understand language, the different risk factors for genetic disorders.
In short, having a pregnancy where a foetus is diagnosed with a condition which is incompatible with life may not be a once-off for prospective parents. Unfortunately, they may find themselves having to travel more than once for the same reason. Tarring these women with some sort of “too lazy to use contraception” brush helps no one. It is insulting and hurtful in the extreme.

People like to imply that women are just lazy, or just casually using abortion as contraception, but the truth is that we can’t know for sure why women have more than one abortion. We do, however, know that contraception is not infallible. We do know the risks of genetic conditions being passed from parent to child. We do know that those risks increase when a previous pregnancy has had issues. It is lazy and ignorant to imply that women are simply too lazy or ignorant to use contraception, and I’m tired of hearing it.

Women are not helped by judgemental comments about their decisions. They are not helped by implications that they are too stupid or lazy to use contraception. This is not how you love both.

Women need access to free, safe, legal abortion, without judgement about the reasons for accessing abortion.

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Current Affairs Repeal The 8th

Abortions for “cosmetic” reasons

I wanted to address something that I keep seeing, over and over again, in relation to the Repeal campaign – the assertion that “children are aborted right up to birth in the UK for cosmetic reasons”, and links to articles talking about a “huge increase” in this.

Here are just two examples, both linking to the same article:

I did some research and found that (as so often is the case) the figures are being misrepresented, and the truth is a good deal more complicated than these tweeters would have you believe. We keep seeing the statement that babies are aborted “up until birth” for “cosmetic reasons”. The implication is that hundreds of foetuses with cleft lips are being aborted at late foetal age, above and beyond the usual termination limits. As per usual, the truth is just a little bit different.

There’s a report, which logs the number of, and reason for, abortions. In 2015, 11 terminations with cleft lip / palate as a reason. The number after 24 weeks was zero. In 2014, the number was 10. The number after 24 weeks was still zero. In 2013, the number was 9. The number after 24 weeks was still zero.

So between 2013-2015, that’s an astonishing rise of 2. Just 2. And still none over 24 weeks.

We have to look back to 2012 to see a smaller number, which was 4. The number after 24 weeks was, you guessed it, still zero.

So, now that we’ve addressed the claim of “up to birth”, let’s look at “just for cosmetic reasons”. Note, also, that the various linked documents state not the sole reason, but the “principal medical condition”. Meaning that it may not be the only one. Why is this important? Well, it is well established that cleft lip / palate is often associated with other malformations / issues. It is more than cosmetic.

A study in Pakistan, for example, found that the most common associated condition is congenital heart disease. The Royal College of Obstetricians and Gynaecologists also has an information page detailing the numerous foetal abnormalities which may be associated with cleft lip/palate. In fact, there is a lot of research surrounding conditions which are associated with cleft lip / palate, which include Van der Woude syndrome,22q11.2-related disordersRobin sequenceStickler syndrome and Treacher Collins syndrome. More than 40% of children with a cleft palate but not a cleft lip also have one of these associate conditions. Here, the Cleft Lip and Palate association of Ireland, discusses conditions associated with a cleft lip and/or palate.

In short, while cleft/lip palate may have been the primary diagnosed condition, it’s possible (and in some cases, very likely) that another or multiple other issues were subsequently identified which led to a pregnant person choosing termination. There are many reasons why a pregnant person may choose termination. To dismiss these reasons as “just cosmetic” does everyone a disservice. Unless they choose to share them, we can’t know the reasons a person chooses termination. Making repeated (false) claims about cosmetically motivated abortions up to birth casts aspersions on the motivations of pregnant people and implies flippant, superficial, selfish behaviour, or behaviour that one might want to be ashamed of – which is, of course, the exact emotion these claims are designed to evoke. These claims are based on a falsehood that is simply not borne out by the numbers.

People are wilfully misrepresenting this number, and straight up lying about these abortions being performed up to birth. And people are misrepresenting the decision that these people made, and the statistics, to manipulate others. So many people, and groups, are misleading the public about these numbers, about this information. Enough is enough. It is not good enough to imply that many foetuses are being aborted up to birth for cosmetic reasons when the actual numbers do not support this assertion. This is a claim designed to shame, based on a lie. Don’t repeat it.