Partnership for Women’s Health and Wellbeing: Submission to Parliamentary Committee Considering Abortion Law Reform


On Tuesday, June 5, 2018, Juliet Cuthbert Flynn, a Government Member of Parliament, tabled the following motion in the House of Representatives:

MOTION TABLED IN PARLIAMENT BY Juliet Cuthbert Flynn, MP, West Rural St. Andrew (JLP)

“BE IT RESOLVED that this Honourable House consider the recommendations of the Abortion Policy Group, which was established to provide guidance to allow women the right to choose;

“BE IT FURTHER RESOLVED that this Honourable House take steps to repeal sections 72 and 73 of the Offences Against the Persons Act, and substitute therewith a civil law titled “Termination of Pregnancy Act”, as recommended by the Abortion Policy Review Group in 2007”.

We have heard quite a lot of shouting from Dr Wayne West who blames evil feministsdescribing them as a “destructive force from hell,” and others. Now, please find below a submission from an ad-hoc group of hellish women (myself included) and men to the Human Resources and Development Committee of Parliament, which is currently considering Ms Cuthbert Flynn’s motion.

Member of Parliament for West Rural St. Andrew Juliet Cuthbert Flynn. (Photo: Jamaica Labour Party)

Please read, consider and share.

SUBMISSION TO THE HUMAN RESOURCES AND DEVELOPMENT COMMITTEE OF PARLIAMENT CONSIDERING THE MOTION FOR ABORTION LAW REFORM PRESENTED BY MEMBER OF PARLIAMENT JULIET CUTHBERT FLYNN

SUBMITTED BY:  THE PARTNERSHIP FOR WOMEN’S HEALTH AND WELLBEING[1]

DATE: 4thFebruary, 2019

Introduction

The matter of abortion law reform is again on the national agenda. DAWN Caribbean, the SISTREN Theatre Collective, Woman Inc., Women’s Media Watch, representatives of the United Church in Jamaica, Fathers Inc., the Jamaica Women’s Political Caucus, and the Kingston and St. Andrew Action Forum were among those who mobilized and organised in support of the reform recommendations of the Abortion Advisory Committee in 2007-2009. These efforts were aborted by the unceremonious abandonment of the Select Committee considering the recommendations by the then government, under pressure from anti-choice groups.

No government administration, either PNP or JLP, has so far had the courage to support women on this issue, by legislating to facilitate safe abortion. Women continue to die in the effort to control their reproduction amid the wide range of adverse circumstances that lead to unwanted pregnancies.

In this phase of the ongoing advocacy for decriminalization and access to safe abortion, Juliet Cuthbert Flynn (JLP MP) has again raised the issue through a motion in Parliament seeking to decriminalize abortion. Senator Sophia Fraser-Binns of the PNP has publicly expressed support for this reform. PNP MP Lisa Hanna has previously made significant efforts in this direction. Among the men, JLP Member of Parliament Alando Terrelonge has long and consistently spoken out in favour of women’s reproductive rights and decriminalisation of abortion.[2]We are aware that others in favour exist on both sides of the Parliament.

AS PRO-CHOICE WOMEN AND MEN WE THE UNDERSIGNED HAVE COME TOGETHER ACROSS POLITICAL, RELIGIOUS AND OTHER DIVIDES, TO SUPPORT AND STRENGTHEN THE EFFORTS:

Shenoweth Holmes, Karen Lloyd, Shakira Maxwell, Georgia Love, Lana Finikin, Nadeen Spence, Monique Long, Jaevion Nelson, Aziza Ahmed, Dalea Bean, Emma Lewis, Moji Anderson, Gaile Walters, Lisa Shoman, Mario Palmer, Sasha Gail Haase, K. Azikiwe Nelson, Adwoa Onuora, Joan Grant-Cummings, Hilary Nicholson, Carol Narcisse, Gillian Mason, Annemarie Bonner, Judy Salmon, Stephanie Martin, Afolashade, Blakka Ellis, Jenny Jones, Horace Levy, Leith Dunn, Carolyn Gomes, Gabriel Heron, Haidee Heron, Everton Cummings, Lij Heron, Beverley Manley-Duncan, Marcia Forbes, Honor Ford-Smith, Opal Palmer-Adisa, Stephanie Martin, Carolyn Cooper, Shirley Pryce, Nicolette Bryan, Alando Terrelonge, Dawn Frazier, Patrick Lalor, Kellie Magnus, Joan French, Linnette Vassell, Judy Wedderburn, the SISTREN Theatre Collective, WMW (formerly Women’s Media Watch), Women’s Empowerment for Change (We Change), the Institute of Gender and Development Studies Regional Coordinating Office (IGDS-RCO), the Women’s Resource and Outreach Centre (WROC).

HERE ARE OUR REASONS:

  • Women continue to die from attempts at abortion in the absence of safe alternatives.
  • Many of these women are already mothers, and leave orphans behind.
  • The World Health Organisation (WHO) estimates that over 22,000 abortions are performed in Jamaica each year. Jamaica is not unique in this regard, since for thousands of years women around the world, regardless of the religious, cultural, political and legal prohibitions, make the decision not to carry a pregnancy to full term and bring a child into the world.
  • In almost every group someone knows someone who has had an illegal abortion. Very few people want the people they know (or themselves) to go to prison for their decision.
  • The practice of unsafe abortions and the consequences of abortions performed by untrained non-specialist physicians can result in a number of complications for women, including severe infections, gangrene in the uterus, haemorrhaging, tearing of the cervix, uterine perforation, laceration of the vaginal wall and untimely death. (WHO, Unsafe Abortions, 2004).
  • Outcomes from unsafe abortion are now the 3rddirect cause of maternal mortality in Jamaica, with teenagers most at risk. (McCaw Binns 2018)
  • The World Health Organization includes in its definition of Sexual and Reproductive rights for both men and women:
  • the right to decide whether or not and when to have children
  • respect for bodily integrity (being in charge of one’s body and what happens to it, when, where and with whom).

 SOME REASONS WHY WOMEN CHOOSE TO HAVE AN ABORTION:

  • Contraception was used but it failed and the woman is not in a position to go through with the pregnancy and adequately support a child.
  • Carrying the pregnancy to term will compromise the ability to adequately educate and raise the other children.
  • The pregnancy resulted from rape or an abusive relationship.
  • The pregnancy places them at severe mental, emotional and/or physical risk.
  • The compromised development and health of the foetus.

Regrettably, pregnancy is often not a question of choice for women, not only in cases of rape and incest but also in the everyday dynamic of gender relations where many women are subject to domination and/or the threat of violence from men. Regrettably, one in four women, 25.2%, has been physically abused by a male partner (IDB/STATIN/UN WOMEN Women’s Health Survey 2016, Jamaica). In this context, responsibilities for others, particularly other children and the elderly, renders many women even less able to protect themselves against pregnancy and/or to cope with having a child.

We support the recommendations of the Abortion Policy Review Advisory Group, which reported in 2007, with minor revisions which do not affect the substance of the recommendations.

THESE RECOMMENDATIONS DO NOT PROPOSE ABORTION ON DEMAND. They set out the rationale and conditions under which women may legally seek abortions. They must be:

  • Conducted within the Health system
  • Performed by qualified medical practitioners
  • Are not recommended beyond 12 weeks
  • Require that persons involved be given specific training
  • Require pre- and post-abortion counselling
  • Have special provisions for minors i.e. persons under 18 years of age
  • Confidentiality must be ensured
  • The Ministry of Health is required to put in place a Monitoring and Advisory Board to oversee implementation

Draft Legislation embodying these provisions were also prepared and presented by the Advisory Committee.

A Public Opinion Survey on the Legalisation of Abortion, conducted in July 2006 to guide the considerations of the Advisory Committee, found that:

While the word “abortion” in itself, evokes a spontaneously negative response among many, when specifically asked whether “women should be legally allowed to access abortions in Jamaica”, 53% said “NO”. In contrast when asked whether “a pregnant woman should have the legal right to terminate a pregnancy”, (TOP) only 38% said “NO”, 54% said “under special conditions” and 4.3% said, “under all conditions”. A total of over 58% of respondents gave a positive response to the legalization of TOP. The “special conditions” emerged as including incest, rape, endangerment of the woman’s physical, mental and emotional health and/or life.

  • In the focus groups, all participants reported knowing that the practice of abortion, though illegal, is rampant in Jamaica. The majority said they would agree to abortion being legalised within strict guidelines and under specific circumstances.

To abort or not to abort is an extremely difficult decision for any woman.

There is not only the financial cost to consider, but risk to her mental and physical health as well. Adequate access to appropriate counselling services to help her consider all the options, strengthening of sexual and reproductive education at all levels and the strengthening of family planning services, help women make the best choices. To continue to criminalize abortion puts women’s lives at risk! It is time to end this now!

Once abortion is decriminalized, maternal health can be properly monitored. Under the current provisions of the Offences Against the Persons Act (1864), the public health system is unable to monitor, measure and account for a major public health phenomenon.

Because of the illegality of abortion a clandestine and dangerous market exists putting women’s lives at risk – causing complications often resulting in sepsis, haemorrhaging, requiring emergency hospital treatment, and sometimes death. Legalizing abortion under the recommended conditions would reduce this dangerous informal market activity that is so detrimental to women’s reproductive health.

Our position expressed above is also informed by the following:

  • The Government of Jamaica (GOJ), since 1975, recognized unsafe abortion and rates of maternal mortality as a significant public health problem affecting women. Attempts were previously made by the Government to address this issue through legal reform. However, religious suasion and a lack of resolve within and across political parties have derailed efforts to resolve this issue. Discussions on abortion have been overwhelmed by religious viewpoints.
  • While religious voices have the right, like any other group to express an opinion, there are certain consequences and circumstances which point to critical public health and human rights facts which if ignored, would be perilous to the country and injurious to many of its citizens. We therefore highly commend the GOJ for its efforts to resolve this issue despite the controversy surrounding it. We draw the attention of the Committee to the fact that the framework of the Jamaican constitution is that of a secular state. It is, therefore, the role of government to always represent the public good in all matters relating to arriving at solution-oriented policy and legal reform. We acknowledge that the Government should take all viewpoints into account, but ultimately its obligation is to protect all its citizens from harm.
  • Evidence in Italy, the Netherlands, Romania, South Korea, Guyana and Barbados shows that where abortion is legal maternal morbidity and mortality rates fall. Rates may initially seem to rise because of the previous underreporting.
  • The current illegal status of abortion in all circumstances exposes women to stigma and discrimination when they are faced with this choice. Women should not be punished for what is a difficult decision about their body, life and future. It is a misuse of government power to take that right from them. Denying women access to medical services that enable them to regulate their fertility or terminate an unwanted or dangerous pregnancy amounts to a refusal to provide health care that only women need. Women are consequently exposed to health risks not experienced by men. Repealing the prohibitive provisions under the Offences Against the Persons Act concerning abortion, as recommended by the Policy Review Group would restore this right to women and prevent further stigmatization and gender discrimination.
  • The illegality of abortion doesn’t allow women to come forward and discuss their experiences that policy and legal reform could benefit from. Those who publicly oppose and deny a right to life and choice (to have an abortion) are not at risk in ‘speaking out’. Removing the illegality will give voice to women whose experiences have been silenced and isolated.
  • Making pre- and post-abortion counselling available, as part of the legal reform, to women choosing to have an abortion will help reduce the rates of abortion, particularly repeat abortions, by promoting fertility management and family planning.

For women in the middle and upper-income groups, the law can be circumvented by access to financial resources to pay for private medical services to procure a safe abortion. The law is restrictive and unjust to women in the lower-income groups, who cannot afford private medical services and therefore resort to the illegal informal market. In both instances, the quality of the service that the woman receives is entirely determined by the ethics and integrity of the individual practitioner. There are no minimum standards and no norms. Legal provision of abortion by qualified practitioners in both the public and private health care systems as recommended by the Abortion Policy Review Group will ensure that safe abortions can be accessed by all women, thus protecting their lives and health.

  • The Jamaican State’s National and International Commitments to Reproductive Health and Rights and the Development and Well-being of Citizens
    • The Ministry of Health’s National Strategic Plan (2007-2010) is based on international health and development guidelines, strategies and actions for the achievement of safe motherhood and other provisions relating to reproductive health care. Indeed one of the objectives of the Ministry of Health’s Strategic Framework for Safe Motherhood within the Family Health Programme 2007-2011 stated its intention to “reduce maternal mortality and morbidity in keeping with the timeframes set by the Millennium Development Goals (MDGs).” This goal was not met and significant reduction cannot take place unless safe abortion is assured. One of the strategies outlined by the MOH in that document is “capacity building to ensure the ability to detect and care for maternal complications and emergencies.” (MOH, Strategic Framework for Safe Motherhood…2007). Incomplete/unsafe abortions reduce a woman’s chances of having children in the future.
    • Five international conferences and conventions, namely: (1) The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW, 1979), (2) the Convention on the Rights of the Child (CRC, 1991); (3) the International Conference on Population and Development (ICPD, Cairo 1994); (4) the World Conference on Human Rights (Vienna 1993) and(5) the Fourth World Conference on Women (Beijing 1995); all affirmed the human rights of women and adolescent girls in areas such as reproductive and sexual health. The programmes of action of these conferences and conventions were agreed to and ratified by the Jamaican Government committing “state parties to agree to take all appropriate measures, including legislation … so that women can enjoy all their human rights and fundamental freedoms”. This includes the commitment of states to establish local mechanisms to support the rights of women to have control over and decide freely and responsibility on matters related to their sexuality, including sexual and reproductive health, free from coercion, discrimination and violence. A few are highlighted here:
    • 7.3 of the ICPD Programme of Action[R]eproductive rights …recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to making decisions concerning reproduction free of discrimination, coercion and violence as expressed in human rights documents.
    • 38 of the World Conference on Human Rights: …[W]orking towards the eradication of any conflicts which may arise between the rights of women and the harmful effects of certain traditional or customary practices, cultural prejudices and religious extremism.
    • 96. of the Beijing Programme of Action: The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.
    • Para 106 (g) of the Beijing Programme of Action: [Government should] [e]nsure that all health services and workers conform to human rights and to ethical and professional and gender-sensitive standards in the delivery of women’s health services, aimed at ensuring responsible, voluntary and informed consent; [and] encourage the development, implementation and dissemination of codes of ethics guiding by existing international codes of medical ethics as well as ethical principles that govern other health professionals.
    • Article 2 (f) of CEDAW:[State parties undertake to] take all appropriate measures, including legislation to modify or abolish existing laws, regulations, customs and practices which constitute discrimination against women[.]
    • Article 12.1 of CEDAW:[S]tate parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on the basis of equality of men and women, access to health care services…
    • Article 24.1 of the CRC: [S]tate parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illnesses and rehabilitation of health. State parties shall strive to ensure that no child is deprived of his or her right to such health care services.
    • Para 7.45of the ICPD Programme of Action: Recognizing the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescent, appropriate direction and guidance in sexual and reproductive matters, countries must ensure that the programmes and attitudes of health care providers do not restrict the access of adolescents to appropriate services and the information they need, including sexually transmitted diseases and sexual abuse. …[I]n this context, countries should where appropriate, remove legal, regulatory and social barriers to reproductive health information and care for adolescents.

The PARTNERSHIP FOR WOMEN’S HEALTH AND WELLBEING supports all of the recommendations of the Abortion Policy Review Group, and we further recommend the following:

  1. The proposed specified centres in each health region for the provision of therapeutic abortion should be integrated into the public health facilities rather than be set up as stand-alone clinics. This would guarantee users privacy, freedom from stigmatization and physical attacks from extremists.
  2. A review of the range and types of counselling services offered by the health sector, NGO sector, various church outreach programmes should be conducted to assess the availability and potential for partnering with public health services in the provision of pre- and post-abortion counselling.
  3. While we recognize and support the establishment of pre- and post-abortion counselling, the type of counselling to be offered must ensure that providers recognize and accommodate the woman’s essential integrity and decision-making powers.
  4. To review and possibly use the WHO document, Safe Abortion: Technical and Policy Guidance for Health Care Systems, to establish guidelines and standards to govern a regulatory framework for abortion services in the public health care system.
  5. The right to conscientious objection is supported. However, the medical practitioner should be obligated to refer the patient to another qualified medical practitioner expeditiously so that the procurement of a safe abortion may still be accessed within the required period as stipulated by the Policy Review Group’s recommendations.

Conclusion

While debates on when life begins and ends may persist ad infinitum along the continuous range of religious perspectives, the realities surrounding this public health matter which affects so many women will not disappear unless addressed based on existing, objective health and wellness needs and rights of women.

While a man is the co-creator of the foetus and may offer emotional and other forms of support and be an active participant in the process, the woman is the sole bearer of the development of the foetus within her body. Ultimately, she should have the final say as to whether or not to carry the foetus to full term.

It is a woman’s right to have all the options available to her, to be provided with information that allows her to make an informed decision, and to not be persecuted for this decision.

The State has a responsibility to ensure that the rights of all its citizens are protected.

Women are citizens, with individual rights.

……………………………………………………………………………………………………………………………………………………

 

[1]The PARTNERSHIP FOR WOMEN’S HEALTH AND WELLBEING is an ad-hoc group specifically established to make policy recommendations to Government of Jamaica for the decriminalisation of abortion and the establishment of a civil law giving access of women to safe abortion as a health measure and as an individual right. It comprises persons and representatives of organizations supportive of this objective.

[2]The PARTNERSHIP FOR WOMEN’S HEALTH AND WELLBEING considers abortion to be one of many components in reproductive health. According to Para. 72 of the ICPD Programme of Action, “[r]eproductivehealth is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and its functions and processes”.

CONTACT: Karen Lloyd   Email: Karen.lloyd88@gmail.com  Tel: 876 787 2934

 

 


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