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Mission abort: the need to legalise abortion

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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.

“How many?”

“Seven.”

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 servicespublicly, 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’sthalamocortical 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


This article was originally published on Feminartsy.

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BOOKS

The House in Smyrna – Review

A version of this review originally appeared in Lip Mag.

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According to Martin Amis, that sharp satirist and white male English literary giant, there are two things that literature can’t do. The first is sex. Amis agrees with his father, Kingsley (that bigoted white male English literary giant), who believed that sex has the effect of de-universalising the reading experience. Good sex, Amis junior opines, is out of the question. Fiascos are acceptable for their comic value, as are novels in which everything revolves around sex—for example, he cites the brilliant Lolita. The second is dreams. ‘Tell a dream, lose a reader,’ Henry James said. Tatiana Salem Levy’s debut novel, The House in Smyrna, tries to do both, with unexpected results.

Translated from its original Portuguese (Levy is Brazilian), The House in Smyrna is narrated by a suffering female who in alternating sections dialogues with her dead mother; addresses an abusive partner; and narrates her grandfather’s immigration from Turkey to Brazil, her parents’ temporary exile in Portugal, and her own journey to back to these countries. The switching between situations—each kept short, with spare prose—creates a dreamlike effect: the novel reads like a sequence of snippets of letters, memories, and indeed, dreams. The narrator has nightmares about being locked in her grandfather’s house in Smyrna, which in ‘real life’ she sets out to Turkey to find. In others sections, she says:

I tell (make up) this story about my ancestors, this story of immigration and its losses, this story about the key to the house in Smyrna, about my hope of returning to the place that my forebears came from,

implying that the writing process is a vehicle for her to resolve the pain caused by her mother’s death and her partner’s abuse. The narrator—as unreliable ones tend to do—blurs the lines between reality and fiction, and we don’t know whether her trip to Turkey is ‘real’ or written. As a result, the woman’s dreams are contiguous, rather than in conflict with the novel’s reality. Levy tells a dream and the reader reads on.

With respect to sex, Amis may have a point. There is plenty of sex in The House in Smyrna, much of it cringe-worthy. Often, the loftiness of the prose verges on comical in its incongruity: ‘I remained standing while you implored something between my legs, in a language understood only by the two of you, my clitoris and your mouth’; ‘Your penis was hard, upright, and I liked seeing it like that, as if it were looking at me too.’ There are also overcooked similes about vulnerability: ‘It was as if you were touching my organs directly, my blood, my flesh, without any protection.’ These scenes are, as Kingsley put it, de-universalising, because they create a rift between writer and reader by causing one to doubt whether people really think such abstract things when having sex, or as Levy puts more loftily, ‘making love’.

Sex, however, is important to the novel insofar as it relates to central ideas about the body. The narrator’s body is both an object of desire and a vessel through which she fulfils her own longings. On the first date with her partner, she recalls: ‘I listened to every word and felt my body quake: with fear, desire, happiness.’ Eventually, when their relationship sours, sex becomes the means by which the body is degraded, which removes agency and causes the paralysis the narrator professes to suffer from in the book’s opening paragraph: ‘I wouldn’t know what to do with this body that has been unable to move ever since it came into the world.’ The scenes in which the sexual assault is described are raw, confronting and genuinely tragic: disturbing reminders of the horrors of domestic violence. On top of her, her partner ‘delighted in my pain, and asked: Isn’t it good?’

Pain and physical suffering are acutely felt by the narrator, partly as an aftereffect of abuse, partly as a result of her mother’s death, and partly due to the weight of the past that she feels burdening her. Decay of the body is frequently alluded to: the narrator tends to her dying mother, ‘covered with sores, riddled with holes, filled with pus, with its acidic smell, its smell of death’; in another section, her own body is ‘Dilacerated, covered in open wounds, purple and yellow spots, boils.’ Death, she says to her mother, ‘had been lying in wait for us the whole time’. Saying goodbye is a major theme of the book. But beyond death, beyond the moving meditation about losing those who are dear to you, the novel is about what it is to love and to live.

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The House in Smyrna

by Tatiana Salem Levy

Scribe, 2015