Therapeutic Abortion

Ravic, the hero of Eric Maria Remarque’s splendid novel ‘The Arch of Triumph’ was a distinguished surgeon in  pre-war Germany, who was forced to flee to Paris because he refused to join the Nazi party. There, he acted as a ghost surgeon for two maladroit specialists. After he had patched up a young woman following a botched backstreet abortion, he decided to visit the abortionist and remonstrate with her. Towards the end of their conversation, Madame Boucher, the abortionist says, “I tell every one of the girls who come here that something might happen. And none of them leaves. They beg me to do it. They roll on the rug and entreat me!  They cry and are desperate. They would commit suicide if I didn’t help them."   This quotation is perhaps a fictional account of the desperation that many women and girls experience when they find out that they are carrying an unwanted pregnancy. It is mirrored in real life. As a young intern, in London, well over fifty years ago, I remember being part of the team that had to patch up a young woman who was the victim of a backstreet abortionist. That experience and the girl’s fate left its mark on me and is part of the reason that I have always been a great advocate for a woman’s right to choose and to have free access to the necessary services provided by fully licensed healthcare workers in properly certified hospitals or clinics.

And yet, these rights and services are by no means freely available even in the most advanced and richest of the developed countries of the World. Three pieces of legislation thats are wending their way through Parliaments in the United Kingdom, Canada and the Northern Territory of Australia are heartening whereas developments in the USA and India less so.

 In the United Kingdom, Diane Johnson, a Labour MP, has introduced a bill to decriminalise abortion in the United Kingdom. More particularly she hopes to scrap sections 58 and 59 of the Offences Against the Person  Act of 1861. As things stand now, a woman who orders mifepristone and misoprostol, on-line, and takes them while at home to produce cramping and then bleeding will go to prison if she is found out. Similarly, doctors, nurses and midwives, who provide these drugs for use at home face prison sentences if they are discovered. Pregnancies of less than 24 weeks may only be terminated in a licensed clinic by a registered physician, who has obtained a second opinion from a colleague.

The Northern Territory parliament in Australia has just decriminalised abortion, thereby bringing the territory into line with the rest of the country. From now on drugs such as RU-486 can be used in the first nine weeks of pregnancy; medical terminations can take place in clinics and not solely in government hospitals. Doctors, who have conscientious objections to abortion, must now refer women to more amenable colleagues. “Safe zones” will be established outside clinics to prevent activists harassing women seeking the procedure. In many parts of the United States, for example, women visiting known abortion clinics have had to fight their way through crowds of screaming bigots - hardly an ideal prelude to what is bound to be an emotional experience.

 The federal government in Canada recently tabled legislation to remove anti-abortion provisions from the criminal code and confirmed the Supreme Court's 1988 decision in the Henry Morgantaler case. The new legislation was introduced symbolically on International Women’s Day. The Minister of Justice, Judy Wilson-Raybould said, “Our government, without equivocation, recognises and acknowledges the constitutional rights of women and we are taking the courageous step to ensure that we remove these prohibitions from the Criminal Code.” Predictably, Mr Brad Trost,  from the Conservative party proclaimed his intention to contest these changes.

Canada will, indeed, have come a long way if these new laws are enacted. Thirty odd years ago, woman seeking a therapeutic abortion was obliged to appear in front of a committee of doctors to plead her case. When such ordeals were deemed to be unreasonable, the regulations were changed such that the committee was only charged with reviewing the case file.

One of the very first actions taken by the new President of the United States was to cut  off finance to non-governmental organisations around the world that provide abortion and abortion counselling. He reintroduced the Mexico City Policy  a.k.a. the Global Gag rule. Happily, Canada has stepped up to the plate with $20 million to replace US funding. During his campaign, Donald Trump suggested that women who seek abortion should be punished. He did not specify what form this punishment should take. He also undertook to fill vacancies to the Supreme Court, as they arose, with very conservative judges. It looks as if he wishes to overturn the 40-year-old Roe v. Wade case, which makes therapeutic abortion legal in the United States. Unfortunately many states of the union have gone out of their way to erect all kinds of barriers to easy access. Some even require pregnant women to undergo trans-vaginal ultrasound screenings and to watch the images of the foetus. Surely, this amounts to exquisitely designed brutality.

 It is estimated that more than 600,000 abortions of female foetuses are carried out annually in India. Indian families prefer sons. Many struggle to find the resources to pay for the dowries of their daughters. It is common for families to have early ultrasound examinations to establish the sex of the child. Ultrasounds performed for that purpose are illegal. Similarly, the payment of dowries is also illegal.

There are many people in the world who regard abortion as child murder and feel that it should not be available under any circumstances. Of course, such folk are entitled to their view. Most of those who take such a hard line are motivated by religious doctrine. As was suggested in the opening paragraph of this essay, desperate women will resort to extreme measures to rid themselves of unwanted pregnancy. These measures can frequently lead to serious medical complications and even death. 

The consequences of engaging in casual sex are very much greater for women than for men. The young man can emerge from such encounters largely unscathed. Not so for the girl. I have written elsewhere about a bright and ambitious eighteen-year-old girl, who had her heart set on a medical career. She was raped by the boy next door,  with whom she had declined to begin a relationship. She became pregnant and had to choose between an abortion and her career. Circumstances such as these are not part of the male experience but it is men who make the most noise about the desirability and legality of therapeutic abortion. 

Can the girl’s choice to undergo abortion be regarded in any way sinful? Only a person whose religious beliefs were so absolute  or whose conscience was so inflexible would think so. Religious objectors are hard pressed to explain why approximately one third of all conceptions are spontaneously aborted. Does their God wish it to be so? 

The arguments for and against abortion rage on and there appears to be little common ground between the pro-life and the pro-choice viewpoints. The question is a classical example of where it is necessary to agree to differ. Those espousing the pro-life point of view must somehow persuade their womenfolk, who find themselves with unwanted pregnancies, to put up with the situation. They must also hope that these women are not tempted to seek a unorthodox and dangerous means of ridding themselves of their pregnancies. The pro-choice group have more options for they can seek either chemical or surgical abortion, which will be carried out hygienically in suitable premises.  Or, they can freely decide to continue with the preganancy. No sane person adopts an insouciant attitude to the procedure. Even someone like the young woman cited above, who appeared to have every reason to rid herself of a pregnancy forced upon her by violence,  is likely to experience grief, even regret, which in some cases is serious enough to require professional help. Whichever side of the argument readers adopt, they should not seek to force their views on those in the other camp.   

Comments, please.

David Amies,

Lethbridge, Alberta.

April 12, 2017