Unsafe Abortion kills – the dangerous ‘pro-life’ war in Europe

Europe has a reputation for being one of the most liberal places in the world when it comes to sexual and reproductive rights. However, laws on paper do not necessarily reflect attitudes on the ground.  Ariane Osman investigates the growing attempts to repress abortion rights across the European Union and the consequences this could have on its women and girls.

On Sunday 21st of October, Savita Halappanavar, a dentist from India who was expecting her first child with husband Praveen, was rushed to hospital in severe pain. The medical staff informed her that she was going through a miscarriage and that – at 17 weeks – the foetus would not survive outside the womb. On Monday, Savita was in such a state of agony that she requested an abortion. She was denied due to the existing foetal heartbeat, which rendered the procedure illegal unless it was judged that there was substantial risk to her life. Savita spent the following day vomiting repeatedly and consultants continued to deny her repeated requests for the procedure. She collapsed that night but still, the foetal heartbeat meant that nothing could be done. On Wednesday the foetus died and its remains were surgically removed. Savita was placed under sedation in an intensive care unit with systemic blood poisoning. On Saturday her heart, kidneys and liver stopped functioning. On Sunday October 28th – she was pronounced dead. This scene did not unfold in an Indian hospital, it took place in Ireland, where abortion has never been legal and can land you 14 years in prison.

Hundreds crossing the Irish Sea each year

According to Amnesty International, over 12 women a day from Ireland went to the UK to access a safe termination between 1980 and 2012; however, these numbers, which are recorded by the UK Department of Health, are a gross underestimate according to Mara Clarke, founder and Director of the Abortion Support Network. “It only gives the number of women who attended a clinic in England and gave an address in Ireland or Northern Ireland,” she said. “It doesn’t count the women who give the address of a friend or family member in England, [or] the women who give a fake address.”

Savita’s death is a stark reminder that conservative reproductive laws are not only relegated to the developing world but are present within the European Union as well. Unknown to much of its population, legislative changes, which would make abortion illegal have been growing within member states over the past three years.

“One of us” citizen’s initiative

A European Union initiative has recently been employed to try and make abortion illegal across all member states.

On April 10 2014, citizen’s initiative “One of Us” was heard at the European parliament. According to the initiative’s report submitted to the European commission. the main objectives were that the EU, “establish a ban and end the financing of activities which presuppose the destruction of human embryos, in particular in the areas of research, development aid and public health”.

It utilised the European Citizens Initiative (ECI), which allows European citizens to propose new legislations to the European Parliament if they have support from one million people from across seven member states.

The European Commission struck down the initiative on May 28, stating that their campaign would destroy life-saving scientific advances as well as life-saving sexual and reproductive heath rights.

Although rejected, “One of us” reflects the potential for democratic processes such as the ECI to pass laws that could take away rights granted to European citizens at a state level.

Restrictive legislation being debated

Women who undergo illegal abortions could be sentenced to up to three years in prison under a proposed law currently being debated in the Lithuanian parliament.

The ‘Law on the protection of life in a prenatal phase’ would only allow for an abortion if the woman’s life is in danger or if she is pregnant due to rape. Allowance for rape would only be granted if the woman can prove that she has been raped by the 12 week gestation limit.

But legislation is not only being rolled back in Eastern Europe. The Spanish population has shown outrage at the attempt to backtrack on recent advances made to Spain’s abortion legislation.

The existing law, which was introduced by the Socialist government in 2009, allows women and girls to terminate their pregnancy. The proposed reform, by the conservative Popular Party (PP), would make abortion illegal in all circumstances, unless the health of the woman is in danger or if the pregnancy is a result of rape.

“We can’t allow the life of the unborn baby to depend exclusively on the decision of the mother,” Ruiz-Gallardon, the Spanish Justice Minister told reporters in December 2013.

Women and girls seeking abortions also have to consult two doctors and produce a police report if they have been raped. Abortion providers also have the choice of refusing terminations, decreasing access to facilities.

Various polls have shown that 70-80 per cent of Spaniards oppose the reform; however, the rightist government has pursued the change in legislation.

If the bill is implemented, Europe risks repeating the trends that existed before abortion became legal, including a rise of maternal mortality. “We will come back to the previous years where the women from Spain were travelling to France and to the UK to have safe abortions,” explains Dr. Luc de Bernis, Senior Maternal Health

Adviser at the Technical Division at the United Nations Population Fund (UNFPA). “Certainly we will see an increase of maternal mortality and morbidity.”

Not everyone holds this view. “The life of an unborn child cannot be sacrificed without a proportionate reason,” said Gregor Puppinck, Director of the European Centre for Law and Justice (ECLJ), in an analysis of the Spanish proposal. US evangelical media mogul, Reverend Pat Robertson, founded the anti-choice organization in the 1990s.

France bucking the trend

Unlike their European neighbours, French lawmakers voted to ease access to terminations on January 21 2014. The previous law, which was passed in 1975, stated that all “pregnant women whose condition puts her in a situation of distress” had the right to an abortion.

The wording was changed to a “woman has the right to choose whether or not to continue with her pregnancy” and does not force women to explain their choice in seeking a termination. “Abortion is a right in itself and not something that is simply tolerated depending on the conditions,” said minister of women’s rights, Najat Vallaud-Belkacem.

Abortion rights are widely supported in French society: according to a 2010 IFOP poll, 86 per cent of women support it, although there has been backlash from the Catholic Church.

European Union: Abortion is a human right

The European Union has made note of the growing threat to sexual and reproductive health in member states and re-confirmed it’s unwavering support for full sexual and reproductive rights for every citizen.

A 2013 draft report on sexual and reproductive health rights by the Committee on Women’s Rights and Gender Equality (FEMM) states that sexual and reproductive rights are “human rights” and any obstructions are “breaches of women’s and girls’ rights to equality, non discrimination, dignity and health, and freedom from inhuman and degrading treatment.”

Dr. de Bernis explained that the importance of making abortion legal and accessible stems from the consequences of unwanted pregnancy, which can result in child abuse and mental health issues. However, advocating for the legality of abortion does not equal taking the procedure lightly. “We (UNPF) are not promoting abortion, certainly not,” he said. “Abortion is not a means of contraception […] but abortion has to be considered if the women don’t want to be pregnant.”

Disparities between States

Despite recommendations by the EU, there remains disparity between the sexual and reproductive rights granted by member states.

According to official EU figures, 21 of the 28 member states allow for abortions on demand, mostly within the first 12 weeks.

In, Luxembourg, Cyprus, Finland and the United Kingdom (England, Scotland and Wales) abortion is available, but with limitations: including if the life of the women is in danger, health, social and economic reasons and if pregnancy is caused by rape or incest. Most circumstances call for two doctors to approve the termination.

In Ireland and Poland, abortions are severely restricted, with Polish law only permitting the procedure if the woman’s life or health is in danger, if it is the result of rape or if there is a malformation of the foetus.

In Malta, abortion is illegal under all circumstances.

Barriers regardless of legislation

But even in countries where the laws indicate that abortion is easily accessible, the facts on the ground tell a different story. Women must surpass multiple barriers including mandatory waiting periods, unregulated counseling services and conscientious objection’s practice to be granted a termination. The practice describes the ability of a healthcare provider to deny women access to a range of sexual and reproductive services.

According to the FEMM report, in Slovakia, Hungary, Romania, Poland, Ireland and Italy 70 per cent of all gynecologists and 40 per cent of all anesthesiologists conscientiously object to providing abortion.

The report explains that these barriers hit the most vulnerable women and girls the hardest. Having to travel long distances within their own countries due to lack of local services or having to travel to other EU states due to total bans adds to financial strain, which contributes to growing health inequities throughout the European Union.

Furthermore, the report states that making abortion illegal does nothing to decrease the amount of abortions that take place.

This is seconded by research conducted by the World Health Organisation (WHO). They found that although some western European countries have the lowest rate of abortion in the world (12 of 1000 women), countries in Eastern Europe including Hungary, Poland, Romania and Slovakia, had more abortions than live births in 2003 (103 abortions per 100 births) giving them the highest estimated abortion rates in the world.

“Unsafe abortion kills”

The FEMM report does describe a relationship between the legality of abortion and the safety of the procedure, which is supported by the WHO’s Fact and Figures about Abortion in the European Region. It concludes that, “women seek desperate measures if they cannot obtain safe abortions.”

According to WHO, common methods to self-abort include the insertion of tubes or liquids into the uterus, coat hangers, knitting needles and the insertion of a flexible rubber catheter into the uterus to stimulate labour. The report into unsafe abortions states, “the more invasive the technique, the more dangerous it was to the woman and the more likely it was to disrupt the pregnancy.”

Short-term effects are listed as life-threatening sepsis or haemorrhage, which may lead to a hysterectomy and gas gangrene from Clostridium perfringens and tetanus.

Long-term effects are more difficult to come by. WHO estimate that 20-30 per cent result in reproductive tract infections and 20-40 per cent in upper-genital-tract infection and infertility. Unsafe abortions also risk reproductive problems in the long run including ectopic pregnancy, premature delivery, and spontaneous abortion.

Why the backlash?

The question now is: why, having being liberalized in the majority of the EU, are governments changing their minds on abortion rights?

According to the FEMM report, the decreasing demographics across Europe are changing policies focusing on sexual and reproductive rights to so called “family policies” in order to increase the number of births.

The number of anti-choice movements in the EU has also increased. “ [It] has expanded and professionalized over the past ten years,” said Neil Datta, Secretary of the European Parliamentary Forum of Population Development. “Many anti-choice organisations themselves feel that their set of values is under threat from what they perceive as an overly ‘progressive’ EU.” He also notes that they have learnt from the tactics of the US Christian right. “ There have not been non-religious organisations involved in an anti-choice initiative.”

The Catholic Church’s links to anti-choice groups, as well as it’s own influence, is also adding pressure. The midwife looking after Savita Halappanavar admitted at the inquest into her death that she told her patient the reason she could not have an abortion was because Ireland is a Catholic country. “It was the law of the land,” she told the inquest, “there were two referendums where the Catholic Church was pressing the buttons.”

The re-interference of the church in governmental affairs across Europe raises questions regarding the enforcement of laws separating Church from state.

According to Dr. de Bernis, attempts to make abortion illegal are reminders that sexism is still rampant in European society. “It’s just because […] the fight for gender equality is still not fulfilled,” he says. “A number of groups […] want to maintain a number of rules which are making women dependent […] with less rights and this means that certainly even in the most developed country, gender equality is still not fully established.”

Remembering Savita

The lives and health of women and girls in the European Union have benefited greatly from the legalisation of abortion and it is up to member states to protect this right.

“The EU can facilitate the exchange of good practice,” said Neil Datta.“So that national decision-makers may benefit from the best practices across the EU and adapt their legislation and policies accordingly.”

Whether the legislation’s currently being debated pass, the case of Savita Halappanavar is a constant reminder of the possible consequences banning abortion can have on women and girls.

“I am distraught, I have lost my soulmate,” Praveen Halappanavar, Savita’s husband, told The Irish Times. “I hope they change the law and make it more people-friendly [rather] than on the basis of religious beliefs, no other woman should have such a tragic unexpected end like Savita.’


Written by Ariane Osman
Image: informatique

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