The Reprieve

The Reprieve

by Terry Bellamak

The United States Supreme Court has struck down Louisiana’s law requiring abortion providers to have admitting privileges at local hospitals – a requirement made both unnecessary and impossible to fulfil by the very safety of early medical and surgical abortions. To maintain such privileges, doctors have to admit a certain number of patients each year, but complications requiring hospitalisation are extremely rare – too rare to maintain their admitting privileges.

If the facts of the case sounds familiar, well spotted. This law is almost identical to the one the Supreme Court struck down in Whole Women’s Health v Hellerstadt in 2016.

Chief Justice Roberts cast the deciding vote. But please, don’t make the mistake of imagining for a minute that this means his heart is in the right place. His concern is not for anyone’s bodily autonomy or moral agency, but for his court’s standing in the eyes of the world, and its legacy in the eyes of history.

Roberts cast his vote on the strength of stare decisis – the legal principle that courts should decide similar cases in similar ways, so that people can have a reasonable expectation they know what the law is. The Supreme Court reversing itself in such an obviously indistinguishable case would have brought the court into disrepute amongst those who still believe legal principles should not give way to political considerations, at least in the courts.

Abortion cases that arrive on the court’s docket in future may not fare so well. American conservatives, like those on the court, seem hell-bent on returning the USA to the 1950s. As Mary Ziegler notes in her New York Times op-ed of 29 June 2020, modern conservatives demonstrate

“a candid willingness to ‘legislate morality,’” including in cases of abortion, sexual liberties, free speech and contraception.

Some are attacking Roberts and the court for not having overturned Roe v Wade already.

But with this decision, defenders of reproductive rights live to fight another day.

Tribute to De Rex Hunton MBE

Tribute to De Rex Hunton MBE

by Dame Margaret Sparrow

I first met Rex soon after the opening of the Auckland Medical Aid Centre in May 1974. It was a great relief to those of us who were having to refer women to Australia at that time and I wanted to see for myself to where I was referring patients. I was impressed with his openness and humility and greatly admired his initiative in establishing the clinic. It was a courageous act in the face of huge opposition. As a lecturer in Community Health he had been asked to identify issues that needed attention and he identified two – homosexuality and abortion.  But he didn’t just identify a problem, he did something about it.

Rex preferred to be independent and never joined ALRANZ but was always supportive. He had the support of a number of ALRANZ members:  inaugural President Isobel Stanton worked at the clinic as social worker, counsellor and supervisor, ALRANZ secretary Anna Watson became clinic administrator and Professor John Werry became an operating doctor.

It was frustrating when the clinic was raided by the police in September 1974 and even though the confiscation of patient files was later deemed illegal, police were able to use the files for prosecuting the operating doctor, Dr Jim Woolnough. Twelve selected cases were brought to trial and as I was involved I saw more of Rex at this time. He was stalwart in defence of the clinic and had always maintained high professional standards. He introduced suction curettage, sending Dr Woolnough overseas to learn this technique. He was the first to introduce abortion counselling and this remained a priority. After two High Court trials, the first resulting in a hung jury, Dr Woolnough was acquitted and the not guilty verdict was upheld by the Appeal Court.

Then came the Royal Commission and the December 1977 legislation which closed AMAC because of the Wall clause “and the danger cannot be averted by any other means”. We were back again referring women to Australia until the law was modified in July 1978. However even then there was a legal battle to restore the licence to AMAC and this did not happen until August 1979. Having endured all the upheavals of the 1970s it was understandable that Rex then moved on to other less controversial areas of medicine. Rex was respected and admired and an inspiration to those of us who followed in his footsteps.

He wrote of his strict upbringing and how difficult it was for him to come to terms with abortion but how “gradually I came to realise that only the woman herself can know the correct course of action.” New Zealand women owe a great debt to this very caring physician. His death cannot pass without paying a tribute to his long lasting influence.                                                                                                                   

The Legacy of Norma McCorvey

The Legacy of Norma McCorvey

by Terry Bellamak

Norma McCorvey was ‘Jane Roe’, the plaintiff in Roe v Wade – the landmark US Supreme Court case that recognised Americans’ constitutional right to choose to receive abortion care. 

In the 1990s abortion opponents hailed McCorvey’s supposed religious conversion to evangelical, born-again Christianity. They trotted her out in front of audiences, congregations, and cameras to sell their anti-choice message. She was a trophy – if Jane Roe no longer supports reproductive rights, then…

But it turns out McCorvey’s religious conversion was actually her retirement plan. In a ‘deathbed confession’ she admitted to filmmakers that she did it for the money – almost half a million dollars.Was it cynical? Of whom? McCorvey says anti-choice leaders were well aware that her ‘conversion’ was a fantasy. CNN writes: ‘Rev. Rob Schenck, an evangelical minister who worked closely with McCorvey, said she was “coached in what to say” and was paid because there was concern that she “would go back to the other side. What we did with Norma was highly unethical. The jig is up,” Schenck said in the documentary.’

They were happy to use her name and image to sell domination and control over pregnant people’s bodies as the moral high ground, knowing full well they paid her off to pretend her born-again conversion, and had to keep paying her off to keep her on message.

That is the anti-choice movement in a nutshell – tricking people into wasting time in ‘crisis pregnancy’ standover centres, pushing long-debunked myths about abortion causing breast cancer or mental distress, trying to frame bullying and harassment outside clinics as ‘sidewalk counselling’, crying over ‘full-term abortions’ as though they weren’t a result of medical crisis. Selling propaganda using melodrama, even when they are paying to stage-manage it. 

But in spite of the harm McCorvey’s actions did to the cause of reproductive rights in the USA, I can’t find it in my heart to condemn her. She had a hard life, and suffered insecurity from poverty, discrimination as a lesbian in the 1960s, and alleged sexual abuse in her family. Bottom line, she needed the money. That’s capitalism for you.

At least she came clean in the end. In so doing, she set the record straight – she always believed in the right to choose abortion care. 

Rest in peace, Norma.

The Ripple Effect

The Ripple Effect

by Terry Bellamak

 Last week, supporters of reproductive rights in Aotearoa had an historic victory. Parliament voted to reform our abortion legislation to recognise a pregnant people’s right to bodily autonomy up to 20 weeks, and to streamline abortion care, bringing it into line with international best practice. This is a change campaigners like Dame Margaret Sparrow have been working towards for over four decades.

These changes are a huge step forward for New Zealand. Pregnant people will be able to refer themselves to an abortion service without having to go through their GP as a gatekeeper. Early medical abortions can be completed at home. The Director-General of Health will be responsible for ensuring equitable access to abortion care and emergency contraception across the country.

The bill is not perfect. Health practitioners will still be allowed to refuse contraception without warning or notice. Safe areas did not make it into the bill, which may dissuade health practitioners from providing abortion care in small communities.

But the perfect should not be the enemy of good. We will continue fighting for improvements to our law, but this victory will do more than just change New Zealand.

The passage of the Abortion Legislation Bill is part of a larger story. It’s a story of change on an international scale. Around the world, nations are recognising the rights of women and pregnant people to refuse pregnancy. Each law change is another stone in the pond sending ripples across the globe.

When the Republic of Ireland succeeded in changing its constitution to allow for abortion law reform, it created a lot of ripples. Countries like New Zealand, Germany, and Argentina noticed that suddenly Ireland – Ireland, of all places! – had more sensible and liberal abortion laws than we did. Suddenly our longstanding legislative compromises did not look as reasonable or necessary.

Now, the change we have made to our old, retrograde laws has sent out new ripples. An editorial in a Jamaican newspaper has cited New Zealand’s decriminalisation to argue for abortion law reform there. And so it continues.

The Rev. Martin Luther King said the arc of the moral universe is long, but it bends towards justice. If he is right, and I hope he is, then abortion law reform in Aotearoa will give rise to many more celebrations around the world, as the human right of bodily autonomy is recognised more and more widely.

Anti-abortion Scaremongering: Reproductive Coercion

Anti-abortion Scaremongering: Reproductive Coercion

by Terry Bellamak

Reproductive coercion is what happens when someone overcomes another person’s reproductive decisions through intimidation or force. It can take many forms, like forcing someone to become or remain pregnant, forcing them to seek abortion care, or forcing them to give up their newborn for adoption.

Forced adoption was how the old “mother and baby homes” worked back in the 20c. Single motherhood was so stigmatised back then that parents would send their pregnant children to such places to save the family’s reputation. They would stay there, alone and far from family, until they gave birth. Then the baby would be forcibly taken from them and put up for adoption. The fact that adoption is still so disfavoured hints at how terrible it must have been for pregnant people to have their babies literally stolen from them.

Of the other types of reproductive coercion, forcing someone to become or remain pregnant is the most common sort, according to research by NZ Womens’ Refuge. It is also insidious, because it can occur outside the view of anyone in a position to help the pregnant person.

This kind of coercion can include hiding or sabotaging contraception, or sexual assault – reinforced by the isolating tactics abusers use to control their partners, like not letting them use the car, monitoring their phone, or other types of physical control. It can include emotional abuse, like shaming someone for wanting to receive abortion care.

Abusers can perpetrate this kind of abuse behind closed doors, away from anyone else’s view. Keeping a pregnant person away from the health system until their 20th week, when abortion becomes more restricted, is not nearly difficult enough.

In many cases, the purpose of such behaviour is to trap the partner in a relationship. Once a child is born, the pregnant person is forever tied to the abuser.

Forcing someone to receive abortion care is about half as prevalent as forcing someone to remain pregnant. Fortunately, the health system is in the position to ask about reproductive coercion before someone receives abortion care. Part of the standard practice for receiving fully informed consent is to get the person alone to talk about whether they really want an abortion.

It can also be an opportunity to have a discussion about leaving the abusive partner, and accessing services to help make that happen. The pregnant person may not be ready to leave yet, but the conversation has to start somewhere.

Anti-abortion forces are very concerned about reproductive coercion.

But the only kind they ever talk about is the less common kind of reproductive coercion – the kind where a person is pressured into receiving abortion care against their will.

You would almost think it’s the only kind they disapprove of.

Anti-abortion Scaremongering: Informed Consent

Anti-abortion Scaremongering: Informed Consent

by Terry Bellamak

Informed consent is a big deal in health circles. The New Zealand Bill of Rights Act recognises the right to refuse medical care. That right cannot be fully exercised without the full information about the medical condition, and treatment options.

The NZMA Code of Ethics requires doctors to accept this principle of ethical behaviour: “Respect the rights, autonomy and freedom of choice of the patient,” and makes doctors responsible for providing information needed for the patient to exercise informed consent.

The Abortion Supervisory Committee’s Standards of Care for Women Requesting Abortion Care in Aotearoa New Zealand is even more specific about the information people must be given as they make the decision whether to receive abortion care:

Women should be offered the following information to assist in their decision and abortion experience:

  • Basic anatomy and physiology as relevant to their gestation
  • An understanding of the process of abortion and its possible complications
  • Fetal development (which may include showing pictures of the stage of fetal development)
  • Information about the advantages of having an abortion earlier rather than later in a pregnancy and the differences between a medical and surgical abortion
  • Products of conception – kai atawhai or disposal options
  • An understanding of how people make sense of the loss of conception in abortion, grief and loss processes, and variabilities within a contemporary cultural context in Aotearoa
  • Contraception education

It’s clear informed consent is important in abortion care.

So why are abortion opponents on about informed consent being inadequate? What is missing?

Hard to say, because abortion opponents are not very specific about what improvements they believe we need to make to the informed consent process. They sometimes talk about ‘life affirming supports and services’ or ‘waiting time to think of alternatives’ or ‘warning them about the adverse effects of abortion.’

Am I the only one to whom ‘life affirming supports and services’ sounds like ‘talk people out of receiving abortion care’? Biased counselling is something nobody actually wants except those with a bias.

Same with ‘waiting time to think of alternatives’. Pregnant people are pregnant, not stupid. The alternatives are abortion, childbirth followed by adoption, and childbirth following by raising the child. Waiting periods add to the expense and delay in receiving abortion care, especially for people who live far from abortion services. Look no farther than Ireland for evidence of their uselessness.

And the ‘adverse effects’ are mythical. Abortion is safe, routine health care –14 times safer than childbirth. Longitudinal studies have shown 95% of people do not regret their abortions, and adverse life consequences like anxiety and financial trouble are more closely associated with NOT receiving abortion care. Abortion does not cause breast cancer.

It seems to me the problem abortion opponents have with informed consent is what it leaves out: an anti-abortion hard sell, of the sort required in certain American states with TRAP (Targeted Regulations against Abortion Providers) laws. The documentary TRAPPED shows doctors in Alabama forced to read a script prepared by the state legislature, full of unscientific nonsense, before they can provide care. Doctors preface the script by telling patients everything they are about to read to them is false, so as to fulfil their ethical obligations not to lie to their patients.

New Zealanders don’t want a bar of that. We want informed consent to be actual medical information. Which is what it is now, and will continue to be, for abortions as for other forms of health care.