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Thank you for visiting The ASAP Blog. We have now moved to a different blog site, so you can check out our latest blogs and pro choice discussions here

We’re also on SoundCloud now, where you can listen to our podcast ASAP Conversations on issues ranging from abortion rights across Asia to the work being done by activists in their countries on reproductive rights and to increase abortion access for all.

 

 

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The more things change, the more they stay the same.

AbortionMeraHaq-4

Many of us greeted the news with cautious optimism when we heard that yesterday the Union Cabinet, chaired by the Prime Minister had approved the Medical Termination of Pregnancy (Amendment) Bill, 2020 to amend the Medical Termination of Pregnancy Act, 1971. The Bill will be introduced in the ensuing session of the Parliament. But on reading the details of the amendments proposed one is forced to wonder if this is just fussing around over minor details while continuing to ignore the larger issues of women’s autonomy and agency?

For these amendments to truly bring about wide ranging change we must remember one crucial thing about true change—it happens only with a shift in power. Until the archaic patriarchal notions of the need to criminalize various sexual and reproductive aspects of our lives (such as Section 377 in the Indian Penal Code) are done away with, any legislation like the MTP Act which is mainly meant to protect the doctors and not the women involved, is not likely to result in genuine change. For example, on closer review of the features of the proposed amendments that have been reported in the government press release there are certain areas of concern that we need
to address:

  • The Medical Termination of Pregnancy (Amendment) Bill, 2020 is for expanding access of women to safe and legal abortion services on therapeutic, eugenic, humanitarian or social grounds. The proposed amendments include substitution of certain sub-sections, insertion of certain new clauses under some sections in the existing Medical Termination of Pregnancy Act, 1971, with a view to increase upper gestation limit for termination of pregnancy under certain conditions and to strengthen access to comprehensive abortion care, under strict conditions, without compromising service and quality of safe abortion.
  • The proposed increase in gestational age will ensure dignity, autonomy, confidentiality and justice for women who need to terminate pregnancy.

How do we define humanitarian and social grounds? Who gets to decide that?

If that were truly the intent of the proposed amendments to expand access of women to safe abortion services then the Bombay High Court as well as the Supreme Court Bench that deliberated on the Right to Privacy have already articulated a far broader interpretation:

“Recognising a woman’s prerogative to make decisions about her health and body, the bench ruled that “there is no doubt that a woman’s right to make reproductive choices is also a dimension of ‘personal liberty’ as guaranteed under Article 21. It is important to recognise that reproductive choices can be exercised to procreate as well as to abstain from procreating.” The judgment further states that “a woman’s freedom of choice whether to bear a child or abort her pregnancy are areas which fall in the realm of privacy.”

Read more here.

In a suo motu PIL concerning the deplorable condition of a female prison inmate, the Bombay High Court categorically stated in 2016 that a “woman alone should have the right to control her body, fertility and motherhood choices.” The high court also addressed the status of the legitimate state interest in protecting “potential life.” It stated that since pregnancy takes place within a woman’s body and profoundly affects her health, mental well-being and life, an unborn foetus cannot be put on a higher pedestal than the rights of a living woman.” Thus, the Bombay High Court and Supreme Court have both emphasised women’s autonomy to take informed decision regarding their own bodies.
The phrasing “to strengthen access to comprehensive abortion care, under strict conditions” hints at the fact that the underlying attitude is that abortions need to be controlled somehow. One has to question what makes an abortion such a different concern compared to say neurosurgery or cardiac surgery? There are laws which already provide for criminal punishments for grievous injury which would encompass any such surgery without consent or done with negligence or criminal intent.
Why can those similar laws not apply to abortions also and the decision of providing the service be left to the person who is pregnant and their doctor? If we can trust doctors with the training to do brain surgery, which can have the potential for irreversible damage while an abortion is the removal of a feus that one could potential make again or adopt a child or become a parent through surrogacy then why is an abortion law needed when a
neurosurgery law isn’t?

How come the woman’s fetus and the choices she makes about continuing to host it inside
her body or not warrant an Act of parliament is the question we need to ask?
And if we believe that somehow it does, then we need to ask is this amended MTP Act is something that is going to protect a woman’s right to control her body and her life? If not then, well, the more things change the more they remain the same! What we would need from a good law is that it should ensure no women is turned away or forced into an unsafe abortion or into continuing a pregnancy that is unwanted. These current proposed amendments do not address that nor do they in any way hold the government and the public health sector facilities accountable for ensuring any of this. They do not provide for better access to Medical Abortion Pills, or for making sure that all government hospitals are providing the full range of abortion services including second trimester abortions and without any coercion for contraception.

The reason why women end up going to the informal or formal private sector is because of the lack of sensitive and confidential good quality services in the public sector combined with the coercion for contraception. The amendments would be truly powerful if they could address that also.
We already have a rather large collection of laws meant to ‘empower’ and ‘protect’ women from a vast range on injustices and inequalities, whether they actually result in any change in women’s lived realities or not. This includes the Female Infanticide Prevention Act, Dowry Prohibition Act, Prohibition of Child Marriage, Protection of Women from Domestic Violence Act, Maternity Benefits Act among others.

The amendments also do not make any mention of the clause allowing failure of contraception as a valid reason for any woman, married or unmarried.
Given that the Indian Penal Code, absorbed mostly un-changed from the British penal Code of 1860, still criminalizes miscarriage, perhaps we need to look at first de-criminalizing it from there and then creating a law which protects women’s right to their body by providing and ensuring that they have access to free and good quality safe abortion services (surgical and medical) at all public health sector facilities, without any coercion for contraception.

That is the law we really need.

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Women don’t need an instruction manual on how to behave in society. We have it memorized.

We were given that manual when we were mere children, not old enough or even mature enough to understand the sexual nuances of a simple touch.

The concern that people have for women’s safety in this country is justifiable, and yet it is so misplaced. Stop policing women on how they ought to dress in order to prevent rape. Stop telling them how they need to act in public, how they need to wear their hair and what kind of clothes they need to avoid wearing in order to avoid the attention of rapists. And most of all stop telling women that they need to learn martial arts to protect themselves. Why is the onus of someone else violating our bodies put upon us?

Rape Culture

Why is this fear of us losing control over our bodies instilled in us since day 1?
Why do little 9 year olds know that jutting their elbows out while walking in crowded spaces will discourage strangers from touching them? Why are14 year old girls carrying chilli powder packets and pepper sprays in their bags? Why are grown women afraid of walking home alone late at night, desperately wedging keys between their fingers to use as a weapon against sexual predators?

I am all for stricter law enforcement, severe and capital punishments for the rapists, but what good are these if all they will do is simply establish a fear of authority but never create an understanding of why one person should respect another person’s choices and their body.
We cannot ignore the fact that along with all these measures, real change will only occur if we begin at the grassroot level. In our homes. Within our families. Amongst our friend circles. Within the system itself.

As people of sense, it’s our responsibility to spread awareness amongst ours and the next generation. Here’s what we can do at our level:
We can start by teaching our little cousins and nephews about consent. Tell them that when a woman or anyone else for that matter, says no, it’s not an invitation to pursue them, unlike what most of Bollywood movies and media tells us.
If they ask you questions about sex, do not cower away, answer them sincerely, create a safe space for them to ask doubts, have an open discussion about it. It’s important they know that sex is an extremely normal part of life.

We have to start calling out our friends, cousins, uncles, fathers on their rape jokes and sexist jokes. Open a conversation with them about how making light of these matters makes them sound trivial because, one person’s joke is another person’s validation.

Stop condoning content that perpetuates or glorifies sexism, misogyny, non-consensual activities. This one is difficult considering how everything has sexist undertones these days, but we can definitely try to steer clear of it.

But most of all, we have to start teaching our men that women are not their “property”, that this whole concept of “woh meri bandi hai”, “she’s mine”, “she belongs to me”, that media has perpetuated over the years is utter rubbish because every human is born free on this planet, every human is born as an equal on this planet.
And honestly, that’s all women want. To be treated not as sex objects, but as humans, as equals.

The blog is written by Ardra, a Youth Champion from India in the wake of increasing incidents of rape in India (The recent rape cases that shook India) and as a response to the idea of one-point justice, being demanded by angry citizens, but who fail to realize it as an outcome of consistent and in many cases, structured rape culture. 

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Posted in Blogs By Youth Champions, Dec 10: Human Rights Day, Feminism, VAW, SRHR, International Days, Stigma, Religion and Social Barriers, Youth, Youth Corner | Tagged , , , , , , | Comments Off on Women don’t need an instruction manual on how to behave in society. We have it memorized.

Being a Feminist Gynaecologist in the Patriarchal World of Medicine | #MyGynaecStory

This piece has been published as a part of the Health Over Stigma campaign, which is aimed at dismantling the stigma surrounding sexual health of unmarried women, and demanding accountability from medical service providers for stigma-free, non judgemental sexual and reproductive healthcare services. Join the #MyGynaecStory wave by sharing your own story as an unmarried woman accessing sexual and reproductive healthcare by posting it on your social media or emailing Feminism in India. In this piece, a senior gynaecologist who is associated with the campaign reflects on being a feminist gynaecologist in a patriarchal medical universe.

As a woman and a feminist I am beyond delighted to see this campaign!

It is time for us to claim rights over our own bodies and the narratives of our sexual and reproductive lives. It is critical to start holding accountable the systems that have ignored, oppressed and failed us repeatedly. It is vital to create a new world where this becomes the norm.

The stories being shared are all uniquely personal as well as frustratingly universal. From my experience of work across Asia region, I can say with confidence that these will resonate with all women and girls across all the countries.

And as a practicing gynaecologist I wanted to just offer a glimpse of what this world looks like from the other side of the consulting table/ examination bed.

Here is a short outline of what makes a gynaecologist in our country: what information is taught, what values are inculcated, what kind of a work environment one has to survive and what happens next.

We start off as 18 year olds who have managed to get into a medical college after two years of intense back-breaking studies and classes. Then follow five and a half years of even more intense and exhaustive training which is exclusively biomedical. Facts, formulae, signs, symptoms, diagnosis, etiology, pathology, treatment. 

The patient is only a collection of signs, symptoms, history, and pathology. 

Identify pathology. Solve problem. 

It is a lot like Sherlock Holmes and House MD combined. We are trained to solve puzzles and mysteries, not hand hold and coddle. 

Yes many of us do join it because we want to help people, because we have romantic notions of being like Dr. Livingstone and change the world with our innovations and cure cancer and all that. 

Like any other 18 year old we have our dreams and desires.

But like any other 18 year olds we are also impressionable, insecure, ambitious, lonely, anxious, with feelings, desires, prejudices, ignorance, ideologies, families, friends, obligations, limitations.

We learn from what we see, hear, are told is right. We accept as truth what is taught to us by seniors and experts.

Ward rounds would be mostly impersonal recitals of pathologies and management. We had the very rare teacher/ professor who would speak to patients as if they were real people. In any case when you have 20 patients in each ward and four such wards to cover, names and life stories don’t really matter much beyond when did you first notice this growth/feel the pain/injure yourself/miss a period.

When we were 19 and doing the Paediatric wards rotation, some of us fall in love with a 5 year old child called Ranee admitted for treatment of a brain tumour. We get books and toys for her. We try to drop in during lunch time and play with her. One day when we drop by, her bed is empty. We don’t really allow ourselves to get attached to any other patient like that ever.

We have seniors who routinely crack ‘dirty’ jokes and make derogatory remarks about the women lying naked on the operation table. We have sexist mnemonics to learn things– for example: She Looks Too Pretty Try To Catch Her.

We stand by and hear our Gynaec Professor, a woman, tell the weeping mother of an unmarried girl seeking an abortion “She opened her legs then so why is she resisting now?” She does not offer the girl any pain killer during the abortion so as to ‘teach her a lesson.’

We stand around in the OT silent and upset but unable to articulate why. No one says a word about rape, consent, what happened to the man/boy who made her pregnant, the consequences on the mental health of this girl and the shame felt by her mother.  We feel complicit in this torture and have no idea what to do.

The hospital I worked in had thousands of deliveries in a year and we knew that sometimes when a woman gave birth to a girl the family would not come to take her home. We took rounds in the Burns ward to examine women who would say with their dying declaration that it was their fault and not to blame the husband for anything. No one ever discussed with us how come it was always young mothers with two daughters or how come so many young women’s sarees caught fire because the ‘stove burst’ at 2 am. 

We never discussed domestic violence, rape, dowry, police and legal system abuses. 

We were taught that India has a population problem and the solution is female sterilization. Poor people and illiterate people ‘don’t understand what is good for them’. We never discussed why no man ever came in and asked for a vasectomy. 

Our forensic textbook said we needed to do a two- finger test to ‘prove’ rape. We learnt about gay and lesbian sex in the chapter under deviant sex, along with bestiality and necrophilia. We laughed over the idea of having sex with animals, we stood in grim silence observing post mortems. We threw up, we cried, we fainted, we soldiered on.

Yes there were a handful who never cared so much, yes there were more than a handful who were in it for a lucrative career. But the vast majority would have definitely benefitted from a regular mainstreaming of gender and rights and a connecting to medicine as a healing art. 

The residency training was brutal the seniors were hostile and uncaring and thoughtless. We had no place to sleep or even pee when we were on call. No one looked out for us to eat any meals or even have water. The hostel rooms had barely any hot water, toilets were often un-useable, rats came into the rooms at night. 

Until you have ever run through a corridor at 2 am with a patient on a trolley because the helper staff is busy, while also carrying blood bags , gloves and stethoscope on an empty stomach and knowing that you will be awake all the way till 4 pm the next day, don’t judge your ObGyn too harshly. 

We made it through 8 years of training without ever hearing the word patriarchy or sexism or misogyny. We had no internet. We had no contact with the feminist movement.

I know someone who did medicine from the Army and told me that during surgery the anaesthetists would wink and let everyone cop a feel of the woman’s breasts since she was unconscious. It made him sick to tell me this. It makes me sick to write it.

My story is now 25 years old but even now I know of medical students who say there are rape jokes on ward rounds, college festivals have questions about gang rape and female students are policed about the clothes they wear at fests.

So, yes they may be judgemental and patronizing and even uncooperative and that sucks. But remember that they are as much a product of the system as any one of us. Check out this brilliant video where Philip Zimbardo of the famous Stanford Prison experiment tells us about how good apples and bad apples may not matter as much as the barrels and the barrel maker. 

https://www.ted.com/talks/philip_zimbardo_on_the_psychology_of_evil/transcript?language=en

Remember that modern medicine emerged from a strong patriarchal uprising which resulted in the witch hunts. It was never a women- centered touchy-feely happiness- and- joy system. 

It started with barber surgeons and flirted with leeches and purgatives. It also included Hail Marys and branding. If you study the history of medicine you will come across a hundred Fathers. Father of Psychology Gather of Radiology even a Father of Gynaecology ( who studied a certain surgical technique on slave women without any anaesthesia based on the belief that they had a high pain threshold). 

There are no Mothers of Pathology or Microbiology or anything because women were not allowed into medical colleges. Women were seen as ‘natural’ nurses due to their maternal and caring instincts. They were of course underpaid, over worked and never received the kind of professional respect and opportunities that the male doctors did. 

The system has been anti-women from its very inception.

Of course it is now the VERY NEW New Age and we must demand better but it’s not going to come out of a vacuum. 

Out of a thousand doctors who undergo this harsh training only a handful become the kind of rich and successful that people imagine everyone does.  Out of the thousands trained with only bio-medical focus, hardly a handful discover feminism for themselves.

When I first started working in the development sector and learnt with awe that there was a whole language an entire field of work that resonated with and validated my feelings –words like feminism, gender justice, social justice, accountability, I remember asking a very prominent women’s rights academic—Where was the women’s rights movement when I was studying medicine??

I have been to many women’s rights meetings where I have had women look askance at me as soon as I introduce myself as a gynaecologist.

We need to remember that we are all in this together. Doctors can be feminists and women can be patriarchal. Yes doctors have more power in the current scenario. They will continue to have the power of knowledge, but let us work to find common ground whereby they don’t feel they need to be the arbiter of your morals or private lives. 

I will leave you here with a quote from Rudolf Virchow, considered to be the Father of Public Health. It is still relevant and we can see the resonance in it of a very established feminist principle—The Personal in Political!

“Medicine is a social science, and politics is nothing more than medicine on a large scale.”

Asia Safe Abortion Partnership and Haiyya are coming together to organize their first Youth Advocacy Institute in Delhi from 17th – 19th January, open for youth leaders – doctors, paramedics and women working in SRHR Spaces. To know more and apply, see this form

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Posted in Access and Barriers, Access For Young People, Advocacy, Collaborations, Feminism, VAW, SRHR, Laws and International Conventions, Other SRHR Fields, Power of Partnerships, Pro-Choice Discussions, Services, Providers and Hotlines, Stigma, Religion and Social Barriers, Youth Corner | Comments Off on Being a Feminist Gynaecologist in the Patriarchal World of Medicine | #MyGynaecStory

Awareness: The only approach to abort stigma

When the removal of a foetus can save the life of an adult, therefore avoiding mishaps of sacrificing two lives at a time, termination of pregnancies should gain its approval.

 In Malaysia, abortion is permissible when a pregnancy may pose physical or mental danger to a pregnant woman. When safe abortion is not available, desperate pregnant women tend not to keep their foetus till delivery but to head for unsafe abortion.

Global data indicates that 13% of maternal deaths were caused by unsafe abortions and topping the list was haemorrhage (severe bleeding), which was 25%. This clearly shows the impact of having an unsafe abortion.

Imagine handing over a woman’s fate to another person who has no medical qualifications, no proper tools, not even a proper clinic, but claims to be “experienced” in terminating pregnancies. That would be more cruel to both mother and foetus in comparison to a safe abortion.

Stigma in society is the reason for these helpless women to resolve to unsafe abortion.

When having physical relationship is taboo, sexuality education will automatically be hindered. On the other hand, an open-minded society would lead to a more formal education system and abortion would be permissible in certain circumstances.

Unfortunately, the Malaysian education system is lacking the elements of CSE (Comprehensive Sexuality Education). CSE is extremely essential due to the fact that age of consent in Malaysia is 16 years old. This explains why teenagers are still not well equipped with knowledge about sexual relationships upon reaching the minimum age to consent to their participation in them. This contributes to unplanned pregnancies and unsafe abortions as well as heart-breaking cases of baby dumping.

According to the Reproductive Rights Advocacy Alliance Malaysia (RRAAM), among 120 doctors and nurses asked about the law pertaining to abortion in Malaysia, only 57% correctly knew it. This shocking result indicates that medical personnel may be debating on whether a pregnant woman should carry on her pregnancy based on false perceptions. All decisions made are at the expense of the woman.

Awareness is the only approach to abort the stigma. Therefore, abortion ought to not only remain legal in Malaysia, but the knowledge of abortion and sexuality education should also be implanted in the education system to protect the rights of pregnant women.

The rights of pregnant women should not be ignored when making decisions, especially when their safety is threatened. Their final choice should be respected after consultation with a professional doctor.

This letter was written by our Youth Champion SUWEETA XIAO WEI from Malaysia in response to the article- Abortion is definitely not the way to solve the problem

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Posted in Access and Barriers, Access For Young People, Advocacy, Archives, Blogs By Youth Champions, International Campaign For Women's Right To Safe Abortion, It's Her Right, Pro-Choice Discussions, Stigma, Religion and Social Barriers, Youth, Youth Corner | Comments Off on Awareness: The only approach to abort stigma