Abortion Is Legal in South Africa — But Illegal Clinics Are Thriving. Why?, by @sianfergs

Cross-posted from: Sian Ferguson
Originally published: 03.04.17

faded poster with the word ‘ABORTION’ in purple capital letters is plastered on a lamppost near my house in Grahamstown, South Africa. At the bottom of the poster, a phone number is printed in large font. Similar posters can be spotted in cities like Johannesburg, Port Elizabeth, and Cape Town. It might be on an electricity box in a small town, or on the side of a traffic light in a coastal area. The posters live all over South Africa — in fact, they’re so ubiquitous I rarely noticed them until a foreign friend mentioned them.

“Are these clinics legal?” she asked. “Because, I mean, abortion is legal here, right?”


Read more Abortion Is Legal in South Africa — But Illegal Clinics Are Thriving. Why?, by @sianfergs

Women’s health: the patriarchal paradox at FemmeVision

cross-posted from FemmeVision

orig. pub. 2012

‘Health – bounding saucy health – is the fountain from which all true beauty springs.’1

This quote, from The Girl’s Own Book of Health and Beauty, sums up the perception of girls’ and women’s health in the late 19th and early 20th centuries. A woman’s health was never just about her physical condition, but was related to her mental health and, most importantly, her appearance.

The commonly held view, propagated by ‘experts’ such as Dr. Henry Maudsley, was that girls had a finite store of energy, which needed to be reserved for the processes of pregnancy and childbirth. Any woman who was too active before marriage would exhaust this supply of energy, making for a weak, frigid and mentally deficient adult.

Some medical professionals and social commentators used this popular belief as an argument to petition against women’s education, for example, Maudsley, who wrote of the ‘excessive mental drain as well as the natural physical drain’ caused by school or college study.2 For women to reach the ideal of motherhood, therefore, and produce many strong and healthy children, the safest and most healthy pre-marriage lifestyle involved remaining in the home, inactive except when engaging in sedentary, non-intellectual pastimes.

The ‘New Girl’

In the post-First World War era, however, the ideal image of female health and beauty underwent a radical revision and the ‘New Girl’ emerged. Sport and outdoor activity were encouraged and beauty was linked with physical strength and the shapeliness that comes from regular exercise. Bodily beauty was linked with sexual attractiveness, and the role of the wife as a sexual partner, rather than as a mother, was emphasised, placing value on youth and women’s responsibility for their own lives and winning a husband.

The link between health and sexual attraction persists in our current popular culture. Newspapers and magazines promote diet and exercise, primarily in order to achieve a desirable body.  Even in supposedly health-focussed publications, physical shape and appearance, not intrinsic health, is the real subject of the advice, as a recent blog piece on the magazine, Women’s Health, points out.

Despite the more than 100 years that have passed since Gordon Stables published The Girl’s Own Book of Health and Beauty, we are still transfixed by the idea that health is linked with appearance. In the media, women promote health products to other women through their appearance; we should be attractive, active, always striving for self-improvement and always, always thin (yet still constantly engaged in an on-going effort to lose weight). Furthermore, we are also responsible for each member of our family’s health. Possibly the only indulgent product women are ever seen to promote is chocolate, which is represented as a guilty, sexualised pleasure to indulge in secretly (see every Galaxy ad ever made).

However, while women are placed as instigators and protectors of their own and their family’s healthy eating habits, advertising aimed at men encourages indulgence in laziness and greed through the consumption of unhealthy drinks, snacks and junk food.  But despite the preoccupation with women’s health in the media, it is the bad eating habits in men promoted by such gender-specific marketing that have been blamed for a far greater cancer risk in men than women. Yet the stereotyped images persist.

Doctor knows best

The late 19th century saw the development of obstetrics and gynaecology as discrete specialisms, opening a new market in the medical landscape. The effect of this was that doctors now had even greater control of women’s bodies, administering questionable and barbaric treatments for disorders such as epilepsy and ‘hysteria’. For example,  genital massage and the development of the vibrator for the treatment of hysteria, or Dr. Isaac Brown Baker, who claimed success in treating epilepsy and other nervous disorders in female patients by excising the clitoris. In the case of the development of the vibrator, as Rachel P. Maines highlights, ‘Doctors were a male elite with control of their working lives and instrumentation, and efficiency gains in the medical production of orgasm for payment could increase income.’

At this time, the female anatomy was shrouded in mystery. As Maines points out, Thomas Laqueur says that physicians writing of anatomy ‘saw no need to develop a precise vocabulary of genital anatomy because if the female body was a less hot, less perfect, and hence less patent version of the canonical body, the distinct organic, much less genital, landmarks mattered far less than the metaphysical hierarchies they illustrated.’ Therefore, treatment for women was much more fluid, experimental and ambiguous; for the female patient it all came down to trust in the physician’s knowledge and methods.

The image of the doctor as profit-focussed businessman, who capitalises on the lack of knowledge of his patients is reflected in the recent case in Bluegrass Women’s Healthcare Centre, where the owner pleaded guilty to misbranding non-FDA approved forms of birth control. In addition to the immorality and illegality of this action, the fact that these were intrauterine devices adds an extra level of violation. Women, against their will had had a potentially dangerous object placed inside them by someone they should be able to trust.

The paradox

Women’s health, therefore, has always been a strong preoccupation for patriarchal society. The womb is seen as public property and the health of its owner crucial to the that of the society as a whole. Though we are now somewhat more scientifically informed, many of the beliefs around women’s health of the late 19th and early 20th centuries persist today. We still equate women’s health with sexuality, and place the responsibility for the wellbeing of the family, and therefore society as a whole, on women’s shoulders.

Yet, ironically, it is often women that suffer the most when it comes to cuts in health services. Take this open letter from a resident of Ravalli county in the US, in which commissioners voted to eliminate funding to women’s healthcare. To these commissioners, the woman writes, ‘somewhere down the road you may meet a woman who has no hair and less hope due to an advanced breast cancer that, if you had voted differently, could have been caught earlier’. And elsewhere in the US, politicians have been accused of backing policies that are anti-women’s health.

In the UK, a discussion on the BBC’s Woman’s Hour on NHS funding for IVF revealed that 50% of those polled believed that, as a non-emergency treatment, the NHS should not fund IVF at all. Of course, access to IVF is not something that solely affects women but this is another area in which women can be attacked and made to feel guilty about their health. By taking away the universal right to fertility treatment (even just by raising the question in discussion), the message is sent that if you cannot conceive naturally your health must be at fault and you must live with the consequences. The technology that has been developed that could help you can only be accessed by the elite.

This shows that, when it comes to women’s health, there has really been very little progress made since Victorian times. Evidence shows that, when and where there are resources and a market in which to make a profit, women are made to feel their health is imperative, and that there is something inherently unstable in being a woman that makes her mind and body vulnerable to disease, which must be remedied with medicine without question. However, when resources are scarce, it is women’s healthcare that is the most dispensable.

References

  1. Gordon Stables, The Girl’s Own Book of Health and Beauty, London: Jarrold and Sons, 1891.
  2. Henry Maudsley, ‘Sex in Mind and in Education’, Fortnightly Review, 15, 1874, 466–83.

 

Abortion: My 13 Year Secret

(Cross-posted from Helen Blogs)

Her name would have been Sophie.
His name would been Jack.

She/he would have been 13 now. A teenager.
A teenager who would probably have been grounded a few times by now, if they had taken after me anyway. A teenager who probably had a girlfriend or boyfriend. A teenager who would have started secondary school and hopefully be thinking about what subjects to take for GCSE’S. A teenager who hopefully wouldn’t be making the same mistakes as I did.

I often wonder what Sophie or Jack would have looked like. Would they have looked me? Would they have looked like him? Would they have had blue eyes, brown eyes, blond hair, brown hair, black hair. Would they have been tall, short, slightly built or more well built like me?
Would they have been quiet and calm, or loud and boisterous? Would they have been activists at heart like their mother and father were?

I often wonder what they would have been like.

And I, especially most recently regret massively the fact that Sophie or Jack only lived for a very short amount of weeks, inside my body.

And that I made the decision to not continue their life.

I made the decision to have an early abortion. Distinguishing the life that was starting to grow inside of me.
Why am I writing this blog? Why am I telling you this?
Why after 13 years of total silence am I breaking that silence and speaking out?
Why after years of pro choice believing am I about to probably upset some people off by saying out loud that I cannot think anything other now than that life is precious, life starts at conception, and the life I carried did not deserve to be aborted.
Why after years of silence am I writing about the abortion that I had that will probably upset some of you reading this who have faithfully followed my writing and blogs online over the years and feel like you know me?
Why after years of silence am I sharing this that will probably get the Pro Life tweeters online condemning me and my actions because in their seemingly graceless world that is what they feel they should do (with the exception of a couple of people I’ve recently tweeted with whose brutal grace put tears into my eyes)

Why after years of silence am I telling you this?

The simplest answer is because it feels like I have come full circle.
When I first started blogging years ago it was a space to write about the things I could not vocalise. It was a space to write the things that my head was screaming but that I could not express whilst sitting in front of someone. And as life changed, so did I, and as I battled life, I wrote about it. ‘Fragmentz’ the identity was created, as a blog and as a tweeter. And I talked/wrote about life. And was grateful for the support I gained and received through that season from people I didnt know as I often went to places that were uncomfortable for folks, and where there were ‘no holds barred’ so to speak.

When I became a Christian again in October 2013 life changed. So did the need to write anonymously about absolutely everything in my life that had and was happening. And I started to explore life as a more ‘cohesive’ person, joining together the ‘Fragmentz’ who could only discuss the horrors of the past online with strangers (and a very small handful of people offline who didn’t live locally to me) with ‘Helen’ who had found a community safe enough/close enough offline to start exploring them properly face to face with people.
Blogging took a back seat a bit, and I started to write much less about what was going on and what I was experiencing. I remember some of you (people I’ve connected with solely online over the years) being quite hurt when I chose not to record/blog/publish transcripts of my baptism last year. I got to a place where whilst I love and need my online relationships I also needed privacy and space to explore and ‘do life’ in relationship with people offline. Something that was a different experience for me, and at times VERY challenging. I discovered it is one thing being ‘vulnerable’ online via twitter and a blog and a totally different thing being totally vulnerable face to face with people offline.
To look people, people I was learning to trust and can say I do trust now, in the eyes and be vulnerable with. It was tough.

But its what has happened. And it has been life changing. Life giving.

A few months ago during one of my many hospital stays which seem to be frequent at the moment I remember spending most of the time reading my Bible and praying. And felt a real sense of needing to ‘complete’ what had been started in terms of vocalising my story.
A real need to complete what had been started by God in terms of accepting who I am as a person and my past.
I felt like God was saying to me that if I was going to die then I needed to have made my peace fully with Him. And in that moment realised that IF I was going to die that I didn’t want to die with out having ‘become’ right with Him. Fully.

And that my ‘story’ was largely about what people had done to me. It was about the abuse as a child. The rape as an adult. And other stuff in-between, like the self harming, down ward spirals of depression and the overdose. The consequences of what happened to me.

But what I also realised was that my ‘story’ needed to become about things that I have done too.
I’ve needed to forgive much over the years, but I have also needed to be forgiven of much too.

My ‘story’ needed to include the realisation and acceptance that I have made mistakes. Huge massive big deep profound heart ripping mistakes that have held me condemned for many years.

A mistake that some people who identity as ‘pro life’ would call murder.
A mistake my pro choice friends and people I’ve identified with for years would call a choice I had every right to make.

But as I’ve journeyed life with people, offline, I’ve journeyed what it means. Life. What ‘life’ means. And being part of the lives of people who have become pregnant and carried their babies until they have been born, and seeing that process made me reevaluate my thinking. I remember the day when someone who has become an amazing friend showed me her first scan picture of the baby they longed for for so long. I could have cried. And just kept looking at it going ‘oh my God, theres its nose, feet, toes’ etc. It was so clear.

I realised in that moment, that very moment, in the pub over lunch that day looking at that scan picture, that having always been a pro life thinker (life in every shape or form, including the life of animals which was my big activist heart back then) I had become ‘pro choice’ in order to live with what I had done. Because by having an abortion I had gone against everything I believed in.
I had gone against the fact that I once believed life is life and is so from the moment it is conceived. I had gone against believing that all life, including the life of animals deserved to live.
And to live with myself I made myself believe that the baby I had aborted was not a baby. Just a mass of cells. Just a thing. Just a fetous. With no heart beat. With no feelings. With nothing. I made myself believe it was not life.
And I closed my heart and my head down. In order to survive. Which is what I’ve had to do numerous times over the years.

In order to be the ‘survivor’ that my twitter profile says I am, I had to close my heart and head down many many times to the horrors of life, in order to just keep on going. In order to take that one more step in front of another. In order to just make the day through. In order to live.

My baby has always been called Jack or Sophie though. So perhaps I didn’t close my head and my heart completely. Just enough to survive. Because if I believed what I had done was perhaps not the best thing back then I don’t know how I would/could have carried on.

But I also know, back then I didn’t know how I could/would have carried on when I discovered I was pregnant.
My living situation was volatile and difficult. The situation with my ‘boyfriend’ difficult. He didn’t care. I remember the day I told him, and he told me he didn’t care. I could do what I liked. I could have an abortion. He did not want to know. I could have the baby. He did not care or want to know. A week later he text me and told me to not contact him again, changed his phone number and ‘moved on’. (He lived from house to house with friends). He disappeared from my life. I’ve never seen or heard from him again.
I felt if I had gone to some of the Christians I knew at that time that they would have been more concerned about my ‘sin’ than anything. And shocked that Helen had got herself pregnant. Whether or not that would have happened I don’t know. But I felt it would.

I was alone. Totally alone. I was drinking a lot. Self harming. And still battling with other peoples behaviour towards me.
I had no money. No support. No where to go.
I was alone.
I felt like I simply could not bring a child into the chaotic world I lived in. Into the chaotic world my mind was. Into chaos.
I went alone to the clinic that day.
I went alone into the room to see the Dr’s, with just the nurse whose name I don’t even know alongside to get the medication I needed to take. I went back the day after, alone.
I walked in alone. And I walked out alone. I walked the next few days alone.

And I’ve continued to walk this particular walk alone. I’ve held this secret, alone. For 13 years.
And as I’ve come to value life more and more over the last 12 months the more painful the choice I made that day has become.
The more the condemnation and shame has hit.

The stronger I’ve got especially over the last year, the more I’ve come to realise life can be lived fully, the more Ive journeyed with people offline in community, the more I’ve become part of peoples lives, and the more they’ve become part of my life the more I’ve come to realise I don’t want to carry secrets. Because with those secrets come shame. And the condemnation. And the feeling that what I did could never possibly be forgiven by anyone. And if you read the tweets from pro life tweeters online you would be led to believe that it can’t be forgiven.

But thats not the case.
One of my favourites quotes is by Brene Brown. It is ‘shame cannot survive being spoken and met with empathy’.
And I discovered I needed to speak my shame.
And so I did. At the end of last year.
I spoke my shame.
I spoke my shame to the handful of close friends who have journeyed with my over the the years who I simply could not do life without. I spoke my shame to them fearful that this might be the ‘last straw’ in what they could cope with – having thrown lots at them.
I spoke my shame to my immediate church leaders, who have journeyed the last 18 months with me, whose baby girl changed so much of my thinking, fearful that this might the ‘one’ thing that would make them think ‘that Helen, she is too much’.
I spoke my shame to my church Pastor fearful that this would change his thinking of me, that he would treat me differently, that he would tell me this was the one thing that God could not forgive. That he would not want me in his church any more.
I spoke my shame to God.
I spoke my shame, to them all. Fearful of rejection.

But in that speaking of my shame, I discovered freedom. It wasn’t instant. But I found it.
I discovered I was wrong. Wrong to expect rejection which has been such a big part of my life, from the people I love. And who I have discovered and finally(!) accepted love from. I discovered that in speaking my shame to them, they were able to respond with love. And empathy. And its changed me.
I have discovered that despite there being absolutely nothing left to hide now, no part of my ‘story’ unspoken that these people, these friends that have become my family still love me. Still accept me. And still want to walk with me.

And I discovered I could speak my shame to God, who already knew it anyway, and still come to Him.

The last few months have been a painful journey.

The last few weeks have been a revolutionary journey.

With experiences of God that I simply cannot put into a blog, so personal and profound, that have made me fully realise and accept that I have been forgiven. And if I am gong to die, tomorrow because I’m hit by a bus or if I’m going to die because my respiratory system shuts down during an asthma attack and I can’t breathe any more, or if i’m going to die because my immune system is not working properly and my white blood cells are so high there could be something much more serious going on than we know about then actually that is OK.
It IS OK in as much as I am at peace now. I am at peace with my story. All of it. I am at peace with the people who have hurt me. I am at peace with the decisions and mistakes I have made.
If I am to die, I am at peace with God.

I have forgiven much. I have been forgiven much.

And so as I said above, we have come full circle. Having journeyed this journey over the last fews months, offline, it feels right to journey it with people online now. It feels right to speak out to people who have followed and supported me via twitter and fragmentz/helenblogs and to be fully open and transparent. Honest. About who I am as a person.

If you have shared my blogs/tweets over the year’s I’d be grateful if you were able to share this one. Because I want as many people as possible who have had contact with me to know who I am. What I have done and where I am at.

It feels especially right to be sharing this now because more recently I’ve had an influx of ‘pro choice’ and ‘pro life’ tweets being put into my timeline due to the political status in the States, and some big pro life marches that have recently taken place there.
It feels especially right to publish this blog, a blog I’ve actually written over quite a few times over months now because I am desperate to see more grace, especially within the pro life movement. A movement that seems to forget the life of the mother. A movement that online especially comes across as far more concerned with condemnation than anything else.
I beg you, if you, like I am now, are a pro life thinker that you consider love, and grace and mercy as you tweet what you tweet and say what you say.
Remember as well as the life of a baby you are ‘protecting’ you have the life of a woman to think about too.
And she deserves more than being shamed and condemned.

If you are reading this having had an abortion, there is no condemnation. you are loved.

Thank you for reading.

This is it.
This is me.
This is my story.

#sharedgirlhood: puberty

(Cross-posted from Bella Solanum)

Have been reading this wonderful article on experiences of starting periods: The Day I Got My First Period

There are some wonderful stories there, I’ve laughed at some (Call the Cops), cried happy tears at others (Bring us together), and felt saddened by others (Cosmopolitan Past). While they are all different stories by individuals from different eras and backgrounds they all have a common thread. 

I have no love for menstruation, you’ll find no desire for period parties here. I see no strength in the menstruation itself, for me personally it’s been hellish from the very start. But there is great strength in the shared experiences of women, it transcends age and location.

Every born woman will have past experience of menstruation, yes, even those whose bodies didn’t do as they were meant to. Because they too will have grown up watching their peers go through it, and felt the worries related to it though multiplied. We all experienced the stigma and the status of menstruation. We all knew it’s significance of changing us from children to women, and the knowledge that we were expected to use this bit of our biology to bear children. Even at that young age we knew that our bodies were seen as ready for sex and procreation, and that to be unable or unwilling was seen as transgressive.

I remember there being a lot of talk of periods just before I started, one of the girls in our year had started at 9 years old and most of us had been told or read that we were likely to start any time after we turned 11. We were 10 years old, already feeling like we weren’t properly children as our age was in double digits. We weren’t like the little ones playing skipping rope in the playground. Instead we’d gather around teen girl’s magazines that someone had pinched from an older sister, or copies of Judy Blume books. We’d devour all the information we could on starting our periods. Alongside it we’d read about sex acts and how we were meant to look, the three seemed to always be packaged together.

We were simultaneously terrified of starting, and excited at the same time. We knew it marked the leap from girlhood to womanhood, we also knew it meant that our bodies were about to go through some massive changes. Some sounded great to us, let’s face it we all wanted boobs – some sounded awful, just how painful could period pain be?

We’d go through lists of what puberty entailed, trying to spot if any of us were showing any signs.

The girl who’d started early was our mentor, we all looked to her for advice and support as she was the “woman”, she’d been there. Through starting she’d suddenly been catapulted from being a girl like us to something else. We were proud to be friends with her, we were respectful of her experience, and we also felt pity for her as we knew it was scary to be first. We were both jealous that she’d been through it, and relieved it was her and not us.

We took bets on who would be next? Who would be last?

There was status in being on of the first, but also fear. We were worried it would hurt, and nervous of others (specifically boys, younger children and adults) knowing.

Conversations in whispered groups shared our hopes and fears. What if it hurt? What if it never happened? Did it mean we had to have sex? How did you use tampons? Did you need to have sex first to use tampons? How embarassing would it be to buy sanitary towels? What if only our dad was home when it started? What if we started in public? Or at school? What if boys spottted sanitary towels or tampons in our school bags? So many questions.

Then as different girls started we talked over what had happened, commiserating, celebrating and mentoring each other. In many ways it was a great equaliser, despite our differences we all shared these moments with each other. We all knew that despite our differences we were all together, and our shared experiences were a shelter in which we could be scared and vulnerable but safe.

We felt like the only ones to go through it, but also knew it was something bigger. For some of us it helped forge a closer bond with female relatives, for some with girls they’d previously been at odds, female teachers changed from distant and unknowable creatures to someone you relate (in a small way) to.

We were part of a club, not with the intent of exclusion, but one of support and safety. We needed to not take this first step into womanhood alone. Over the years I’ve spoken to women who’ve been supported through it, and those who haven’t. And no matter how things were at the time they started, all have been helped by discovering at some point that they are not alone – that they share this part of girlhood.

Bella Solanum: “I’m a gender critical feminist who thinks we would all be a lot better off in a world were we could be full people rather than fit into limiting gender boxes.”

Connecting the attacks on abortion access and the attacks on our bodies at Liberation is Life

Cross-posted from: Liberation is Life
Originally published: 22.11.13

Speech given at Reclaim the Night Perth 2013

The connection between domestic violence and the attacks on women’s crisis services and on abortion access is something the organising committee wanted to draw out, and it’s linked to why we are having a women-only march tonight.

It’s become more forbidden for women to do anything by ourselves. (Have you noticed that even in feminism, any rare, female-only activities are seen as unfair to men?) And this has been accompanied by physical attacks on us, attacks on our legal rights to bodily autonomy, attacks on our crisis services, and fewer accessible abortion services. If we do anything by ourselves or press for rights for ourselves, this is increasingly treated as an imposition on others’ rights, even though a central part of our oppression is the denial of autonomy over our own bodies and lives. So the organising committee feels that standing up for women’s rights to be and act by ourselves is an important part of this event.

 

You can read the full text here.

 

Liberation is LifeRenewing a feminism that’s scientific and fighting (marxist) rather than individualist/consumerist. That opposes neoliberal reasoning-via-identity arguments along the lines of ‘I identify as feminist/marxist/radical and therefore my position is feminist/marxist/radical and I have no need to justify it’. This leads only to sectarianism – to the abandonment of solidarity with women who ‘identify’ differently – and to the dumbing-down of feminism.

Fertility and the Media: Unravelling the Hype by @lisaaglass

(cross-posted from Femme Vision)

Originally published 30.09.13

Each week in the UK, news and feature pieces on fertility, pregnancy and childbirth proliferate in the mainstream media, in tabloids and broadsheets alike. Stories based on results of clinical studies on topics such as advances in fertility treatment, practices to ensure a healthy pregnancy and so on appear on a regular basis. But how accurately is the science being interpreted, how much is being omitted and how misleading are some of the headlines?

Headlines such as ‘1 in 3 will be infertile in 10 years’ (Daily Mirror, June 2005) and ‘Babies given Calpol and other forms of paracetamol are more likely to develop asthma’ (Mail Online, November 2012) certainly grab readers’ attention, but they also cause fear and anxiety in parents and prospective parents, who may not have the relevant medical knowledge to be able to look objectively at the evidence presented. (For those who are aware of it, the NHS does a valiant job of combating some of the inaccuracy and misinterpretation of clinical evidence in these stories with its Behind the Headlines section of the NHS Choices website.)

The commodification of fertility and childbirth  

It is a sad fact that there is a high level of commercialisation around women’s health, which has undeniably increased in recent years, as health services become privatised. The areas of maternal health and fertility treatment are particularly affected. Vicky Garner wrote recently of seeing sales reps from a commercial ‘parenting club’ lurking on maternity wards handing out child benefit forms. Under the guise of offering support to complete the form, they were taking down the details of new mothers with a view to contacting them to market their services. She argues that the reps exploit women who are at their most vulnerable and anxious to give their newborns the best start in life; an anxiety that is heightened by the scare-mongering headlines we see every day.

When it comes to fertility treatment, it is easier to see where there are opportunities for profit to be made by private companies, given that fertility treatment is not universally available on the NHS (eligibility depends on where you live and other criteria). It therefore falls to private clinics to offer IVF treatment, and they can market and advertise their services as they wish.  However, as Miriam Zoll wrote in an op-ed in the New York Times, ‘marketing and advertisements’ play their part in selling hope to ‘customers who are at their wits’ end, desperate and vulnerable’. Zoll speaks of the ‘debilitating trauma’ associated with failed IVF cycles and treatments, highlighting that, though fertility clinics offer, advertise and market services to paying customers as if they were any other for-profit company, when treatment fails it takes a significant psychological and emotional toll.

Hype and hope

A recent event at City University, London, looked at the intersection between science, the media and public engagement, in reporting advances in fertility treatment. The meeting, entitled ‘Hype, Hope and Headlines: How Should Breakthroughs in Fertility Treatment be Reported?’ questioned where responsibility should lie for accurately reporting advances in fertility treatment. Speakers Prof Simon Fishel, Managing Director of the CARE Fertility Group, who was part of the original team whose work produced the world’s first IVF baby in 1978; Prof Nick Macklon, Professor of Obstetrics and Gynaecology at the University of Southampton, and Director of the Complete Fertility Centre; and Dr Hannah Devlin, Science Editor at The Times, discussed the issues around this controversial topic.

Ahead of the meeting, Profs Fishel and Macklon and event organiser Connie St Louis spoke on BBC Radio 4’s Woman’s Hour. St Louis said that PR teams at IVF clinics often put out ‘overblown’ press releases, and she cautioned science journalists to be wary when producing stories based on clinical trials, particularly when a study is being publicised by the organisation that funded it. She also pointed to the lack of balanced argument in healthcare stories, and said that journalists should seek out a range of expert opinions in order to include different voices in stories on IVF.

On the other side of the argument, Fishel, though he agreed with the need for robust reporting of results and for peer review, cautioned that the best must be done to push the science of the field forward via mainstream media.

The City University event following the Woman’s Hour discussion was organised by the Progress Educational Trust (PET), an independent charity that aims to raise awareness of embryo and stem cell research, genetics and assisted conception and to engage with policymakers and medical professionals to inform debate. Fiona Fox, Founder and Director of the Science Media Centre – a charity that improves public trust in science by persuading scientists to engage more effectively with controversial science stories in the media – chaired the meeting.

Media engagement

Fishel stated his position on the debate topic, saying that information on developments in reproductive technology must be accessible to patients as and when it becomes available. As the pace of reproductive medicine moves so quickly, he said, it takes time for cutting-edge technology to filter through the medical profession, meaning that GPs and even some specialists do not understand or appreciate the breadth of the work done in fertility research. He pointed out that even the National Institute for Health and Clinical Excellence (NICE) can be too slow to issue guidance when seen from the perspective of a couple seeking new, improved therapies. When looking for clinical evidence to recommend a fertility treatment procedure, it is problematic to consider randomised, double-blinded, controlled trials to be the ‘gold standard’, he said. Because of their lengthy duration (15 years), by the time the results are available it will be too late for many couples, he argued, suggesting that other types of trials, such as cohort observational studies should be considered.

It is not always easy for journalists or the public to grasp that all scientific knowledge is provisional, he said. In other words, science is progressive, with improvement and advances being made all the time; however, the time in which a couple want and are able to have a baby is limited and they should be able to be access information on all current treatment options. The key lies in responsible communication to the media, he argued, so it is up to trial investigators, clinics and press officers to accurately communicate their evidence to the media and it is up to the media to look at the evidence before reporting.

False hope

Presenting a contrasting view, Macklon argued that when a couple see a headline proclaiming breakthroughs in fertility research, there is a danger of giving false hope that they will not only be able to access this new treatment, and that it will be successful. A relationship with the media is necessary to raise awareness and encourage funding of potential new treatments, he acknowledged, but if the relationship between clinics and the media is ‘too cosy’, this can lead to false hopes being raised. Macklon, in his argument, reminds us that there is a third party, the potential patient, who stands to lose out financially and emotionally, when ‘unproven technology’ is being offered in IVF clinics for profit. The patients are the ones paying the price for uncertainty, he said.

Devlin countered Macklon’s argument by accusing him of being ‘patronising’ to potential patients. She acknowledged that, as a journalist, IVF stories are always welcomed as the science is ‘easy to follow’ and is relevant to everyday life, encapsulating controversy, morality, life-changing events and they can be illustrated with ‘cute baby pictures’. Agreeing with Fishel, she posited that it is the job of journalists to filter out anything that might give false hope to patients, but that all developments, no matter what stage they are at, should be reported. She also highlighted that there is pressure from editors to cover stories reported by the majority of most national papers, to maintain competitiveness.

Considering responsibility

In the discussion following the speakers’ presentations, there was clearly a split in the audience between where it was felt that ultimate responsibility should lie for the accurate communication of clinical results to the public. One commenter suggested that patients seeking fertility treatment would not go to a medical journal to seek out the original research, thereby placing emphasis on the newspaper/journalist to offer balanced and accurate information. Another questioned the role of the PR or press officer in drafting a press release free of language and phrasing that might appear to sensationalise the facts. Concern was also raised over not withholding or omitting information and the need for the wider debate to move forward.

It was also emphasised that other expert opinions should be presented in a story and this would be the journalist’s responsibility to present alternative viewpoints. Macklon pointed out, however, that some doctors may have a vested interest in recommending a particular treatment (or, conversely, in not recommending it).

Does knowledge empower?

Fertility treatment is unlike any other area of medicine in many respects. Being largely provided in private practice, there is the market and, therefore, the finance available to plough into technological development; however, this means that the availability of evidence from (the so-called ‘gold standard’) randomised, controlled trials cannot keep up with the pace of development or the demands of the consumer/patient.

From the speakers’ presentations at the City University event and the discussion that followed, it seems clear that a collaborative approach is needed in order to responsibly and accurately communicate developments in the field of fertility treatment. Perhaps, as one commenter highlighted, this all points to the need for better-quality are more accessible patient information in the UK. But in lieu of this it would seem that it is the responsibility of all involved – press officers, journalists, and clinicians to communicate accurately and put in context any available information. Mutual trust, it would seem, is crucial when communicating science to the public.

Conclusions

The argument that knowledge is empowering for the patient certainly has merit, but it is important to bear in mind that both the media and the clinic stand to make commercial gain from the publishing of fertility stories. And as long as treatment remains in the private sector, there will remain a ‘cosy’ relationship between the media and the provider, however well hidden; the danger is that the patient, who should be at the centre of the discussion, will be open to exploitation.

It’s only 9 months to save a life, by @Herbeatittude

(Cross-posted with permission from Herbs & Hags: Meanderings of a Hag)

“It’s only nine months! Isn’t that worth it, to save a human life?”

So goes the argument made by those idiots who are in favour of forcing girls and women who get pregnant with an unplanned foetus, to continue with the pregancy and give birth to it against their will.

As anyone who has actually been pregnant knows, it’s not 9 months, it’s 40 weeks, which is actually nearer to 10 months. The reason tradition has it as 9 months, is because in the old days most women didn’t know they were pregnant in those first few weeks.

There is a modern myth abroad which declares that “being pregnant is not an illness” and that it is in fact, nearly exactly like not being pregnant. Again, as anyone who knows anything about it knows, that is simply not true. However for many of us, we have NO IDEA, not a single conception, of just how unlike not being pregnant, being pregnant can be, unless we ourselves experience some of the risks and side-effects or know someone who has done so.

I did a little bit of research on this. Oh all right, I didn’t, I went on Mumsnet and asked them – this should not be taken as a comprehensive list or a serious meta-analysis. It’s just a list of things people on Mumsnet have had happen to them as a direct or indirect result of being pregnant and giving birth. Some of them are relatively trivial, some are vair serious indeed, like Death. Anyway it’s my starting point for a list of potential risks that women undergo, when they decide to keep a pregnancy. Or when somebody decides they have to keep it whether they want to or not. When you see it written down, you wonder how much hatred pro-forced-birthers have for women. For the real hardliners, none of this means anything, they hate us anyway and don’t believe our lives have any value. But for the thoughtless knee-jerkers who aren’t that committed to the forced-birth arguments, this list might be a useful thing to contemplate. Anyone wanting to add anything, I’d be interested to hear from you.

Anaemia
Anal fissures
Anal incontinence
Anaesthetic mistakes leading to permanent disability.
Asthma – 1/3 of women who have it finds that pregancy makes it worse.
Back pain
Bell’s palsy
Blindess (tearing retina during delivery because of pressure of pushing)
C-sec wounds getting infected, haematomas associated with C-sec wounds, keloid scarring.
Carpal tunnel syndrome
Cascade renal colic
Change in digestive system
Change of body shape – breasts and hips do not return to form prior to pregnancy. There are implications for psychological harm there alone.
Coccyx problems – some women have difficulty sitting down forever after.
Constant nausea sometimes for the whole 10 months
Cutting of bladder during caesarean
Death
Decreased suppleness (particularly bad for women who do sport).
Dental problems
De Quervain’s Syndrome or Mother’s Thumb?
Diarrhea and vomiting lasting for 2 or 3 years after the pregnancy.
Eclampsia
Eczema can be made worse
Episiotomy wounds can open up
Eye prescription changes.
Fistula
Gestational Diabetes. About 8% of women are affected by this.
Guilt and self-loathing from giving child up or not bonding if kept.
Gum disease and wobbly teeth
Haemorrhage
Hair colour change
Hands and/ or feet can grow and not go back to their old size.
Hernia
Hip pain
Hormonal effects on pre-existing conditions ie psoriasis, acne, etc
Hyperemesis, with severe dehydration
Increased risk of gallstones and kidney stones
Increased risk of osteoporosis
Increased risk 12 months post partum for Pelvic Inflammatory Disease (inflammation of the uterus, ovaries, FTs) – can leave permanent scarring, cause infertility, ectopic pregnancy etc
Iritis (a horrid auto-immune inflammation of the iris, which leads to blindness if not treated quickly and efficiently. A sudden change in hormones can cause an attack).
Less intense orgasms
Lochia can be retained, causing distention of the uterus.
Lowering of the immune system
Mastitis
Memory implications
Mental Health conditions are often exacerbated by pregnancy.
Months of sleeplessness. Sleep deprivation recognised as serious health risk by most medical authorities in the world.
Muscle tears
Multiple Sclerosis has been known to be triggered in pregnancy
Negative impact on finances that will affect mental health, lifestyle, access to jobs.
Nerve damage
Nipple thrush causing nipples to permanently invert. Leading to lack of confidence, lowered libido etc.
OCD can be triggered/get worse post partum.
Pain of the milk coming in.
Permanent increase in blood pressure
Piles
Plantar fasciitis
PND
Post partum hyperthyroidism, leading to the need to take thyroxine for the rest of ones days.
Post-birth complications. Poor stitching followed by repair operation months later.
Post natal psychosis
Pre-eclampsia
Pre-existing conditions like Arthritis, need drugs to control them. These drugs are harmful to foetuses and need to be stopped, leading to the woman with arthritis ending up in constant pain for years, possibly life and needing to use a wheelchair.
Pre-natal anxiety and depression is generally not discussed but common.
Prolapse
PTSD
Restless Leg Syndrome
Scarring
Sexual problems (libido, sensations)
Skin changes like patches, spots etc. Sometimes patches never clear up.
Snoring and sleep apnoea
Spinal migraine
Sore and painful joints, sometimes lasting months or years.
SPD – a syndrome which can lead to serious disability and pain, no cure.
Splitting of chest muscles (can’t remember term, but colleague could fit a fist in the space between her muscles)
Tears into urethra and clitoris as well as vaginal and anal.
Thrombosis- deep vein and superficial vein
Tokophobia
Urinary Incontinence – stress incontinence, urge incontinence and both. This would be considered a major effect in a man, but for some reason women are supposed not to mind. This can lead to lack of confidence, depression etc. (Which since this is how patriarchy likes women to feel, should possibly be seen as not a side effect at all, but a lovely womanly enhancement.)
Varicose veins
Women who suffer Gestational Diabetes are more likely than average to develop diabetes later on in life. Sometimes gestational diabetes will be permanent.

Only 9 months eh? I don’t think so. Now imagine telling a man that he should risk any of the more serious things on this list (or even some of the less serious things), in order to save the life of a child, because human life.

It just wouldn’t happen would it? Because unlike women, men matter.

HerbsandHags: Meanderings of a Hag: I have no fixed subject matter for my blog, it tends to be whatever grabs me, but for some reason lots that has grabbed me has been about rape or other male violence. It’s all with a feminist slant though. [@Herbeatittude]

Three Years in Prison Without Trial for a Miscarriage

Cross-posted from Hiding Under the Bed is not the answer

Virginia, a young indigenous women from Guerrero, suffered a miscarriage in 2009. Since then she has been in prison in Huamuxtitlan, Guanajuato, charged with murder. There has never been an autopsy to determine the cause of fetal death. All judicial proceedings against Virginia have been carried in out in Spanish and she was not offered a translator who could explain proceeding in her native Nahuatl. Neither did she have access to a defense lawyer who could speak her language.

In January this year, thanks to the work of the NGO Las Libres and the volunteer law students from the Centro de Investigación y Docencia Económica (CIDE) in Mexico City, a federal judge ruled that her human rights had not been respected. In the light of the fact that there was no evidence to support the charge against her, the judge also ordered that she should be released. However, this has not happened. Instead, the local judge re-issued a warrant for her arrest on the same charges.

Verónica Cruz, director of Las Libres, told news agencies that this new warrant was a “reprisal” against Virginia for exposing the abuses committed by the judicial authorities in Huamuxtitlan. She also observed that her plight was the result of the “triple discrimination” Virginia has been subjected to in the judicial process as a poor, indigenous woman.

As I reported last week, this “triple discrimination” is sadly the norm for the Mexican justice system. However, in the case of Virginia, there is also a further difficulty. Guanajuato is one of the most conservative states in Mexico. It was one of the first states to reform its constitution in 2010 in to declare that the right to life began at conception. As I reported recently, its governor has openly opposed federal directives which oblige health service providers to grant abortions to women who have suffered sexual assault.

Guanajuato has a long track record of imprisoning women for miscarriages and still-births. As is the case with Virginia, the strategy of the judicial authorities is to charge them with murder –which can be punished with sentences as long as 25 years– rather than for procuring an abortion, which has a five-year tariff. Two years ago, Las Libres and students from the CIDE law school successfully championed the cases of six women who had been in prison for as long as eight years. Like Virginia they were convicted of murder after losing their pregnancies. None of the women jailed had actually procured an abortion; rather each one had suffered a miscarriage, which due to family circumstances, poverty and/or ignorance they had tried to conceal. Once they had been forced to seek medical attention, one of the people who attended them (doctor/social worker) had then made the accusation with the relevant authorities. All of the women were from the poorest areas of the state and lived in conditions of poverty and social marginalization. They were unable to neither defend themselves personally against such charges nor pay someone competent to do it for them.

Cruz is certain that Virginia can be absolved if only the judicial process could be concluded. The fact that she is merely charged and not formally sentenced means that there is a limit to what her defense lawyers are able to do. It is evident that the local authorities in Huamuxtitlan know this and are purposely dragging their feet to stall the case being sentenced. As a result, Virigina has now been in prison for three years.

As I wrote last week, life is extremely difficult inside prison for women such as Virginia who don’t speak Spanish and are far away from home and access to support networks. It is testament to the deep misogyny of Mexican society that its most vulnerable women are treated in this way.

An edited version of this article was published on e-feminist

Hiding Under the Bed is not the Answer is the blog of historian of Mexican politics Cath Andrews who also writes for e-feminist and Toda historia es contemporánea. She tweets at @Andrews_Cath

Pro-Life is Lies

Cross-posted with permission from The Real Thunder Child

Thanks to the recent underhand behaviour of the Telegraph regarding “sex selective” abortion, and the clear stated intent of the Times, I would like to re-iterate my own rebuttal of the pro-life narrative- a letter I wrote to the Guardian in 2011, as follows here;

http://www.theguardian.com/world/2011/may/27/abortion-debate-government-pro-life

In case the link doesn’t it I have re-produced it verbatim…..

“What the “pro-life” lobby fails to be honest about (which is why their influence is increasingly dangerous) is that – unlike the “pro-choice” lobby – they seek to remove from women their ability to choose a course of action best suited to their own circumstances and conscience.

I am a Catholic. I am against abortion*. But – as the mother of a girl – I’m fervently “pro-choice”. As much as it’s every woman’s right to choose not to terminate a pregnancy, it’s also her right to choose the opposite action. Every person has the right to complete sovereignty over their own body, and the right to deal with whatever consequences exercising that choice involves. “Pro-choice” only advocates a woman’s right to a termination if that’s what she chooses and, unlike “pro-life”, seeks neither to coerce or legislate (or coerce via legislation) over a person’s ownership of their reproductive destiny.

Medically speaking, allowing choice is ethical; removing it is not. Along with the abolition of the death penalty and the creation of the NHS, the 1967 Abortion Act stands out as the most ethical, humane piece of legislation in British history. It’s about time we of the “liberal left” grew a backbone and defended it as such.

Sinead Connolly”

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* when I say I’m against abortion, I must clarify that I’d prefer to live in a world where it was never necessary. But that world MUST be created on women’s terms, not those deemed by patriarchy, or nothing will have changed.

** I have nothing further to add, anything else would be hyperbole – and the subject has enough of that without any of mine.

The Real Thunder Child can also be found on Twitter as @resurgamblog.