AN ESSAY BY LEYLA EROGLU Nottingham, UK Our society needs to pick a stance on the uncomfortable issue of how we feel about life before birth. As it stands, if you are one of the every five pregnant women who will miscarry in your first trimester, your personal tragedy will rarely be regarded as more than an unfortunate but regular medical occurrence. Adversely, if you are one of the every three women that require an abortion in the UK, you will have to face under-funded and oversubscribed services that entail longer waiting times than any pro-life evangelist could hope for. In both cases you will be offered woefully inadequate care, having been given zero formal education from the age of consent to towards the end of your fertility. As such, upon extremely rudimentary research of both these subjects, you will find scores of women who were more traumatised about the care they received than the event itself. In the same way that not being a foul racist gets dismissed as being “politically correct,” having an ounce of concern over these issues gets lumped into the women’s issue category, an irrelevancy listed alongside ladies instagramming their menstrual stains, “#freeingthenipple” and generally clouding the feminist sphere with trivial matters that only serve to parody the whole feminist school of thought. It is in day to day legislation and negligent medical practice like this that societal misogyny really rears its ugly head and needs to be called out as an anomaly for modern times. At a time in the UK when the rate of conviction for rape is as low as 5.7%, the sex education offered is so dire and the reproductive health services are as insufficient as they are limited, could it be that the UK state is still set up to shame women for being remotely sexually active? Abortion is legal in the UK; you can get an abortion up until the end of your first trimester on the NHS or up until the 22nd week of your pregnancy (yikes) via free organisations like BPAS or private but legitimate and safe Marie Stopes clinics. The law cannot stop or criminalise you for accessing abortion but the state can refuse to educate you on it at the age of consent, prolong your unwanted pregnancy experience by delaying your termination with medically unnecessary appointments regardless of your circumstances and then lie to you about what to expect from the procedure. Although the current state of affairs is insidious as it is commonplace it remains, just about, within the law. So abortion begrudgingly exists in our society as testament to our half-dead reputation of having an autonomously liberated female populace, which we like to wheel out and parade when it suits in times of moral crusades but in reality, abortion rights in the UK are so poor that instead of being testament to the fact that UK women have the much-coveted, sanctified right to choose what to do with their bodies and futures, it is in fact yet another extension of the ever-present and archaic patriarchy. In other words, we’ve only evolved about one single moral inch away from the days of being prescribed a large gin and a very hot bath. When we know that 1 in 3 women in the UK have had abortion, why is adequate reproductive education and access still so controversial that it is scarce? Surely this only serves to stimulate the stigma around reproductive rights and promote a culture of isolation that, when faced with the statistics of the UK abortion rate, so many women must share. Unplanned pregnancy options, miscarriage and abortion are all explicitly absent from the UK curriculum about sex education. The latter is revered as a go-to religious education, foreign languages or public speaking topic from as young as year 8, - as long as the issue is addressed from a moral, rather than biological viewpoint- but the realities of what to expect and its necessity in a society - that knows birth control fails, that knows rape is pervasive and that knows it sexualises its youth from an age that would make our European counterparts grimace, - is entirely absent from UK education. Could it be that the UK Sex Ed curriculum is complicit in rape culture? Why have we accepted that premarital abstinence is outdated and unrealistic if we are not prepared to adequately educate about unplanned pregnancy options and miscarriage? Is its absence from formal educational discourse indicative of a greater, systemic misogyny? Bafflingly, even Consent remains a fairly recent addition to Sex Education. Although your reproductive rights and health as a woman are an integral part of your Sex Ed, such information isn’t being taught in secondary schools on presumably “ethical” grounds, out of fear abortion will somehow be promoted as a contraceptive option. In the same way that the medical abortion pill has faced controversy in its efficacy in very early pregnancy, but access to it is seemingly wilfully impeded with systems laced in pro-life agenda for the same reasons, via medical insistence upon unnecessary and invasive TVS and option-discussing appointments that prolong the pregnancy to further torment women on their choices, perversely leading to a longer gestation of the unborn child only to then be aborted. As if you don’t know your own body, your own future, your own values. This is vastly less ethical than prescribing the abortion pill at a stage so early in the pregnancy that it could be misconstrued as a contraceptive last resort and far more punitive an experience, that a woman of a supposedly civilised society should not have to endure. You would think that this was only going on in the Deep South but it’s happening in the UK today. (Although hotly debated, the abortion pill however is not the coveted embodiment of feminist ideals, and is indicative of other systemic cruelty that will be covered later.) The people who administer such waiting times and choices about your “choices” actu- ally have no real idea about how you came to be in that position unless you choose to prosecute your rapist, which if you’re aware of the staggeringly low conviction rate in the UK (5.7%) you would have valid apprehensions about pursuing; if you find yourself in that situation following a non-consensual encounter, the entire experience must feel like little less than an extension of the assault. Lack of education on these issues leads us to the alternative that we are faced with at the moment where women in the UK are only being presented with information of their options and what to expect from an unwanted pregnancy, termination or miscarriage at the time it occurs. Meaning that over 1 in 3 pregnant women in the UK had no real idea of what they were going to do or were in for prior to hopelessly flicking through a pamphlet either pregnant, or miscarrying on an Early Pregnancy Unit. It’s unacceptable. This is hardly sustainable when it’s common knowledge in the EU that the UK has the highest rate of teen pregnancy, in the face of such evidence it is safe to suggest these preg- nancies were not planned. Furthermore and most importantly, the less women and indeed young men are properly informed, the less the choice to be made is actually her choice. Leaving women uninformed leaves them open to being talked into the decision to terminate the pregnancy by their partners or talked out of it by their parents, when really a decision of such magnitude should be yours and yours alone. There has actually been a sharp increase in the number of terminations in the UK among women in their thirties. Married mothers in their thirties are having more abortions than any other female demographic in the UK at the moment. From this we can infer that the main causes of these terminations are financial, as these women already have children, which is perhaps interesting to consider alongside the current economic climate and increase in suicides amongst men in their forties. Therefore if The Patriarchy is only willing to inform women on their reproductive health through their own personal anecdotal retrospective wisdom as opposed to formal education, then it cannot be said that these women were somehow suffering the consequences of being irresponsible, chlamydia-afflicted, binge-drinking and promiscuous teenagers. These are grown women and mothers who are being routinely misinformed and treated appallingly, especially in instances of miscarriage. That being said, there is no shared socio-economic, racial or religious similarity to be seen between women who access abortion services. This is something that has been reported in all nation states that officially offer the service legally. Adequate abortion services or lack thereof is not a women’s issue, it’s not even a feminist issue as making vast swathes of the population suffer in silence like this is a human problem and only contributes to societal malaise wherein women’s rights are alienable. If the life of your unborn child is indeed so sacrosanct, why then are so many women’s miscarriages treated at best with silence and at worst, blasé? If you need an abortion, which you can only access through the NHS until the twelfth week, you will face prejudice about your decision to terminate the pregnancy for the rest of your life. It’s true. Yet if you miscarry – and most miscarriages occur in the first twelve weeks also- your baby will often thereafter be referred to by your doctor and disregarded as “the product of conception,” or even “POCs” for short. Such insensitive euphemisms are surely illustrative of a greater indifference, inferring you should pull yourself together because this happens all the time. Our society needs to make its mind up about how it feels about life before birth because as it stands we seem to be picking and choosing how much we care dependent on the measure of the mothers torment. If we know from empirical evidence the frequency in which these internal injustices must be happening to women in private, what implications does this have upon the modern, female psyche? How does this affect the modern masculine experience if men are either oblivious to or complicit in the neglect of women when they are at their most vulnerable, their most alone and their most desperate? Everybody knows how high miscarriage rates are – a fifth of people who know they’re pregnant will miscarry. Up to 20% of pregnancies end in miscarriage – and yet most women never reveal they have had one. Everyone knows what it is per se, but no one tells you what to expect when what you’re expecting isn’t meant to be. But why is miscarriage also omitted from education until it happens? Surely any shame associated with such age-old tragedy has no place in modern society and a lack of information thereof would only serve to perpetuate any outdated myths surrounding the issue. Could it really be that any sexual health education that doesn’t really affect men directly is simply left from the syllabus? We can reject the prejudices surrounding abortion choices but it is evident where they stem from, yet it is the absence of miscarriage education that substantiates this notion that anything that doesn’t affect a man in his life is rendered irrelevant from formal public knowledge. How grim. Miscarriage culture is, from a feminist perspective, an amplification of the shame involved in being female in the first place. Like motherhood, it’s the territory on which you discover that the one thing more deficient and embarrassing than holding the female apparatus, is to hold it wrongly. Naturally, though, a culture in which the loss of a pregnancy is unmentionable affects women and men, and heaps loneliness indiscriminately across the genders, so it is only a feminist issue in so far as it’s a human one. The ample male-centric miscarriage support networks available to men online, who have been mortified by the realities of miscarriage and miscarriage aftercare, substantiate this claim that more information would serve society in general as opposed to being dismissed as a Women’s Issue. The topic of educating women on the facts that they can bear death after life within them, may be legitimately divisive, but at least some formal acknowledgement of the fact that there is no real reason why miscarriage can occur would be undeniable progress for the completely unprepared female populace, and evade any consequential prejudice or shame thereafter. So ... in the UK right now, if you miscarry outside of business hours (!) you will be made to wait until a Monday morning opening to confirm if your baby has survived. Some women have reported being made to wait up to a week unassisted to find out if they are still pregnant having started bleeding. Having been told that their pregnancy has not survived, many women will be told to simply go home and “let nature take its course.” If this occurs after 8 weeks, your pregnancy will no longer be an embryo. If, having been seen by a Doctor you are legitimately frightened of returning home to do this, the only place you can stay on the hospital will be the Mother and Baby Unit surrounded by people celebrating what you have lost. Other than “Nature” as a course of action, you have two other choices that involve taking either medication or having uterine surgery. At least, in both of these cases your aftercare will be on the Gynae ward, but all three of these options will entail a potentially long wait in A&E, with considerable blood loss, where your baby will herein be blithely referred to as “the product of conception.” Anything after 22 weeks of pregnancy is a Stillbirth, not a Miscarriage and involves going into full-on, induced labour. There aren’t any independent miscarriage clinics like there are with other reproductive health services so you will be at the mercy of the underfunded NHS, but there are a wealth of charities that operate counselling and emotional aftercare services. You may have to navigate these and their value alone. Thankfully, there are organisations like SANDS that exist to ease mothers with their trauma and bereavement but the only pastoral after care you can receive through the NHS will involve seeing a councillor on a GAU ward, again surrounded by pregnant women and babies. You will also be enduring this in a society that has conditioned you to aspire to child bearing above all else, that thinks you merit pity if you choose not to marry or reproduce, a life choice where if you were male you would be affectionately referred to as a “bachelor.” If you have suffered this more than twice you can be referred to a programme for Early and Recurrent Pregnancy Loss, where all manner of tests can be run on you and your partner as to the cause, but other than that there is no separate ward, no specialist care, no reason offered other than misfortune and your own guilt. Neither Miscarriage nor Abortion in any circumstances other than a threat to the mother’s life is regarded as a medical emergency. The vast majority of surgeons - even in these instances - are unfortunately male. So you can request to have a female present at all times as standard, but you are going to have your feet in stirrups as well as having to see a man at the end of the bed. Should you require a termination of pregnancy - in a society that offers but does not condone it and has given no regard throughout the 50 year old ethical debate towards the immorality of impregnating, then abandoning a woman - on the NHS women are not deceived about what to expect, but made to wait so long by the oversubscribed service that it would be easier to access the procedure if living in Virginia. If you don’t wish to wait to be seen at a Hospital, you can be seen much earlier through the British Pregnancy Advisory Service (BPAS) or pay upwards of at least £700 with Marie Stopes. BPAS are funded by NHS trusts yet are situated and organised independently, if anything goes wrong at a BPAS or Marie Stopes clinic, the patient is sent to a hospital. With BPAS, to reduce cost, risk and panic the description of your procedure is kept vague if not entirely false, in order to promote the options that don’t involve general anaesthetic; but with the NHS you will be made to wait, pregnant, for weeks and weeks to be seen due to the disparity between access and demand. Your choice. Of the three options (Awake, Asleep, Medical,) “Gentle Aspiration Awake” is the only option you can have if you cannot provide a chaperone on the day of your procedure. Instances where you may not be able to find someone to come with you include privacy, shame, stigma, rape, religion, race, or the cost of a flight back to Ireland. It is offered until 16 weeks and is marketed as “Gentle,” but is actually trans-uterine surgery and cervical dilation whilst conscious through- out. If you are raped in Ireland by someone you know and cannot face prosecuting or find someone you trust enough to accompany you, this is the only termination option available to you for your pregnancy of rape or incest. Many women especially in London, complain of being harassed on the way to these clinics, whereas clinics in the North near Airports where Irish as well as English women are seen are often over crowded. Even in 2015, the people who work at these clinics also face intimidation. Emotional or psychological support prior to and after these procedures is notoriously difficult to navigate as lots of free support services are in fact run by religious organisations. So even fifty years since the Abortion Act you still have to navigate your own way round the ideological minefield of support services supposedly available to you. The medical abortion pill, although highly coveted in places where hygienic, legal abortion does not exist is in lots of respects a duplicitous weapon against women, but to critique it is to only play into the hands of baffling pro-life activists and any honest debate around it has already been absurdly successfully manipulated by MALE senators in the US to reduce American women’s access to their basic human rights. It fails UK women in two ways: pregnant women who cannot keep their baby are being made to carry the child for longer, in order to wait for an obligatory Trans Vaginal Scan, which are medically unnecessary but assess what stage the pregnancy is at in order to administer the pill safely within the first 9 weeks. The scan itself is also incredibly invasive. If you’ve no idea what the options or your rights are because you weren’t told at the age of consent or thereafter (cc: anyone educated in the UK with a vagina,) you won’t know that this stage in your pursuit of a termination is only necessary if you would like to take the pill. Secondly, you might be even more inclined to opt for a surgical procedure over a medical one once you know that the information provided by Marie Stopes and BPAS is indeed false, prompting outrage from women who have taken the pill online. Women who have been given the pill are leaving BPAS clinics with parac- etamol, being told to expect cramps akin to normal menstruation and sent home to pass their pregnancy unassisted. Whereas when the same procedure is administered by the NHS, a nurse is always present, tranquilizers are offered and patients are warned of the potential agony, incontinence and allegedly that “they may feel like they are going to die.” Unlike the NHS, BPAS also administer this pill after 9 weeks, given its reviews from women who have had it while the pregnancy was still in its early embryonic phase, this is presumably a medieval ordeal. Telling women honestly about this will only frighten them when they are already in desperate situations. Banning the pill will force women to have surgical procedures, so at least the chemical option diversifies the legal methods available to you. Telling recently sexually active teenagers about this might terrify them. But if the state won’t inform women about what to expect, not condemn those who are happy to leave you in that situation, how is that “choice” a choice at all? No one is going to have a positive abortion experience, a lot of women feel overwhelmingly relieved and there is only so much that can be done to alleviate the invasiveness of these situations when the services are heavily criticised and underfunded as it is. However, it is irresponsible of UK reproductive health services to misinform, and then abandon women like this. The debate around women’s rights may well be tired and only being reheated in English speaking media at the moment due to the absurdities emerging from the US Republican 2016 election campaign, (where perhaps the abortion debate has only flared up again as a ruse to not discuss other more glaringly pertinent issues in America like, perhaps, Race?) but actually in times where women’s self-worth is routinely being reduced to what is between her legs, that “empowerment” is the epithet of female sexuality, then we need to talk about it more than ever. Similarly to the domestic violence fatality statistics in the UK dwarfing the deaths as a result terrorism in the past decade, any issue that is a women’s issue is so absent from current affairs or public discourse that it is sinister. Whether or not such discussions will lead to even further under funding of the NHS or more control given to Pro Life organisations is unclear, but the current state of affairs cannot continue.
REFERENCES: http://www.theguardian.com/lifeandstyle/2014/jun/16/miscarriage-baby-womens-needs-not-met-mumsnet-report http://therumpus.net/2012/03/the-alienable-rights-of-women/ http://rhrealitycheck.org/article/2013/03/01/challenges-in-the-trans-vaginal-ultrasound-debate/ http://www.theguardian.com/commentisfree/2015/aug/02/social-media-miscarriage-mark-zuckerberg-pregnancy http://www.brook.org.uk/about-brook/brook-position-statement-relationships-and-sex-education http://www.miscarriageassociation.org.uk/information/types-of-pregnancy-loss/miscarriage/ https://en.wikipedia.org/wiki/Abortion_in_the_United_Kingdom http://www.thedadnetwork.co.uk/2015/05/coping-with-loss-after-miscarriage.html https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=stillbirth http://www.miscarriageassociation.org.uk/information/types-of-pregnancy-loss/miscarriage/ http://www.brook.org.uk/about-brook/brook-position-statement-relationships-and-sex-education https://www.uk-sands.org/ http://rhrealitycheck.org/article/2013/03/01/challenges-in-the-trans-vaginal-ultrasound-debate/ http://therumpus.net/2012/03/the-alienable-rights-of-women/
Appeared in ISSUE #2