by Terry Bellamak

When considering people requesting abortion care, I have always thought that, even as the women knew they were lying to the certifying consultants, the certifying consultants also knew they were lying and helpfully pretended to believe them. But that might not actually be the case.

I was at the Royal Australia and New Zealand College of Obstetricians and Gynaecologists Conference in Nelson, presenting a talk on abortion law.

At one point I referred to the unexceptionable fact that women have told me how they had to lie to certifying consultants to get abortion care.

This was met with incredulity by some certifying consultants, who could not believe their patients were lying to them, even in face of the patients’ obvious motivation to do so, and the statistical unlikelihood of 98% of pregnant people who need abortions suffering from mental illness in the usual sense of the term.

Self-delusion or doublethink?

The result of this disconnect is an interaction that looks one way from the perspective of the certifying consultant, and completely different from the perspective of the person who needs an abortion.

Certifying consultants approach their task with certain definitions in mind, like the WHO standard for mental health, which is:

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

They ask the patient questions, prompting responses aimed at assessing the validity of her reasons for needing abortion care. A certifying consultant’s sole reason for being is to decide whether the patient meets the legal grounds under the Crimes Act. Once the patient has said enough to satisfy that standard, the certifying consultant can approve the abortion with a clear conscience, knowing the law has been satisfied, the patient has been satisfied (she gets her abortion), all the boxes are ticked, and they have done their job in accordance with the abortion bureaucracy.

From the perspective of a person who needs an abortion, however, she has to lie. She does not know the details of the standard the certifying consultant is using. She knows what mental illness is, and she knows she is not mentally ill. The certifying consultant asks her leading questions that hint at what the certifying consultant wants to hear. She says what they want to hear, and gets her abortion.

Sometimes, a patient struggles with the lies she has to tell, and tries to say, no, I made this decision because it is the best decision for my life right now, not because I am mentally ill. But under the sensitive, prompting questions of the certifying consultant, she caves in, as she must. And it feels like a betrayal of herself.

She believes the certifying consultant is trying to help her get the abortion she needs in the only way it can be done here in New Zealand. That’s sort of true: the certifying consultants is trying to get to the place where they can say, yes, she meets the grounds. Both respect the law, and struggle mightily to satisfy its demands.

The law itself is not respectable. It demands women sacrifice a tiny sliver of their integrity to get the health care they need. They do it willingly. They would do much more, as history shows. The alternative is childbirth.

The certifying consultants have made a sacrifice too, but I don’t think some of them realise it. They have unwittingly done their patients harm by forcing them to testify falsely against themselves.