The Limits of Abortion as a Health issue

Earlier this year we had a blogswarm for world health day "Abortion is a Health Issue Not a Crime."  I never finished my post, partly because I am have deep reservations about "Abortion is a Health Issue" (which is what the post ended up being about).  I'm posting it today as part of a week of pro-choice posts in the run up to the release of NZ's abortion statistics on the 28th.  I'm posting three posts this week, and I realised they have a theme - the importance of keeping "Trust women, and all pregnant people"* at the centre of any struggle for any abortion rights.

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In 2004, a woman in New Zealand was told she was not allowed in abortion when she was diagnosed with a heart condition in the 21st week. She was told it was too late in the pregnancy and that she did not meet the criteria. She died after the baby was still-born.  Of course access to abortion is a health issue - women die when they don't have access to abortion. Abortion is a health issue, because women die when they don't have access to safe abortion.

But abortion is not only a health issue or even mostly a health issue.  Abortion is about autonomy, freedom, survival and social relationships.  The slogan "Abortion is a Health Issue" suggests a strategy which narrows the lens and focuses our struggle for abortion away from these wider issues.  Now I'm uncomfortable about this because autonomy is the core of why I support abortion rights.  But on top of that I think this strategy may have fish hooks - the discourse of 'health' may not be as useful for us as it first appears.

First off, abortion as a health issue appears to be an area where anti-abortion people are actively taking the abortion struggle. Incrementalism - the anti-abortion tactic of making things just a little bit worse -  is based on a facade of treating abortion as a health issue.  Whether it's 'informed consent' (those are heavily sarcastic scare quotes in case you can't tell) or states putting in ridiculous regulations about the height of the ceilings in the abortion clinic.  Anti-abortionists are actively interested in fighting abortion as a health issue.

On one level this is quite a strange position for anti-abortionists to take - because the science is really heavily not on their side. The only reason they manage to even engage with health is they take conveniently ignore that by the time someone is seeking an abortion they are choosing between continuing pregnancy and abortion - and abortion is safer than bringing a pregnancy to term.

I may think that anti-abortionists are have to be some combination of: lying, deluded, misogynists, who are incapable of argument, reason, empathy, compassion or logic.  But they have a goal, and there has to be a reason they do the things that they do (besdies the fact that they're lying, deluded, misogynists, who are incapable of argument, reason, empathy, compassion or logic).  There are some areas that they deliberately try to avoid: the reality of women's experiences, women's autonomy, and who should be the decision-maker.  They know these are losing strategies for them and they will just say 'but what about the baby' to try and distract from the fact that they don't want to talk about any of these things.

But they are prepared to talk about health? Why is that?

By talking about abortion and health we're bringing in a discourse that already exists, and those discourses can serve anti-abortionists purposes as much as ours.  Take their incrementalist demand for parental notification/consent for under 16 year olds.  At the moment abortion is treated as exceptional within the health system.  For other medical decisions children are legally treated as unable to consent, and parents have to give their consent.  Those who are trying to punish young girls, can use normal health practice and rhetoric about involving the family, and parents' responsibility for children's health to support their cause.**


The existing discourse about health serve anti-abortionists purposes as much as they serve ours. They can play on the idea that 'health' means there is one right decision and that people are not well equipped to make decisions about their own health. Discourses of health in our society are not about autonomy and liberation. They are moral discourses that are based on an ideal way of being. In order to be healthy you must do some things (exercise, eat certain foods) and not do other things (smoke, eat other foods). In health discourses people are not treated as competent decision makers, but people who have to be persuaded to adopt a limited array of behaviours.


Women can go through the process of being certified as needing an abortion under the mental health provisions in this country, and not realise it, and not realise how restrictive the laws are. One of the reasons for this, is because we're so used to gatekeepers to get access to health procedures, diagnoses, and pharmaceuticals, that talking to so many doctors seems normal.

The existing models and meanings for health are not the sort of abortion services I am fighting for. As Anna Caro points out: "The whole way our medical system’s set up seems antithetical to anyone’s autonomy." The slogan of last year's pro-choice demo was 'No More Jumping Through Hoops'. But for many people jumping through hoops is part of engaging with the medical system (The End is Naenae has an example of how much work, and how many gate keepers there can be to get what you need. Amanda W has a great post on second shift for the sick).


There were many brilliant posts written as part of the blogswarm. I think talking about abortion and health is a really important way of connecting with some people we need to connect to.  But focusing on abortion and health is an incredibly risk strategy.  I wished we lived in a world where discourses of health were always discourses of autonomy and liberation - but we don't. So we have to always keep the autonomy and liberation of women (and all pregnant people) at the centre of our demands around abortion.

* 'Women, and all pregnant people' is a phrase I'm trying out. I'm struggling to talk about abortion in a way that acknowledges that not all people who get pregnant identify as women and also acknowledges that the politics of abortion are about misogyny and the struggle for freedom of women as a class.  I welcome ideas and feedback

** I think there are two answers to that - .  The first is that children should have control over their own health care before the age of 16 and the law in general should change.  And the second is that abortion is specifically different from other health care.  However, I think this demonstrates the problem of trying to argue abortion as a health issue.  Either you are also trying to change the nature of the health system - or you're also arguing that abortion should be treated differently.

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This is part of a week of Pro-Choice Postings hosted here at The Hand Mirror starting on Friday 28th October 2011.  For an index of all the posts, being updated as they go up, please check the Pro-Choice Postings index.  And if you'd like to submit a post for cross-posting, guest posting or linking to please email thehandmirror@gmail.com. 

Bullies and how people enable them

I don't like bullies. I don't like adults who threaten and yell and generally throw their toys to try and get their own way, who belittle others to wield power over them, particularly when it is their default setting in life to operate that way. I guess that's one of the reasons Paul Henry's behaviour bothers me so.

The big problem with bullies is always how to deal with them effectively. When I'm talking to someone else about how to deal with a bully the first step I always suggest is to get together with anyone else who is being bullied, or who may not support the bully. Bullying works on the basis of isolating victims from each other, encouraging people to keep their heads down so that they will avoid the unwelcome attentions of the bullies. If you can overcome the isolation you are halfway to winning. At least you can bitch about the bully with someone else, and acknowledge between you that it is bullying, and take a bit of the power back.

Personally I'm a big fan of naming stuff what it is. I remember pointing out to someone once that they were trying (somewhat ineffectually) to bully me. She was outraged and proceeded to prove that she was not bullying by standing between me and the door, in a small space, hectoring me with her finger, leaning over me and yelling. I believe there may have been spittle. Major not-bullying FAIL.

Right now I have a problem with a bully, and it's got me musing on the theme.

I should start by saying this is not a work-related issue. It's not my workplace and it's not anyone else's either.

The Bully has a long long history of this behaviour. She goes straight to the Yelling Place, and I have literally had to hold the phone away from my ear more than once. She once wrote another target of her bullying a twenty page letter outlining all the times she had been sinned against by this person. Who has time to write a twenty page letter about anything, unless they're being paid to write it, or maybe it's about love. Or like your first novel or something. Anyway, the point is that twenty pages of hate is pretty hard to sustain, for most people.

The Bully in this case has basically burnt off almost everyone else. There's one person staunchly in her corner, two people pretending this is all Someone Else's Problem,* and then me and one other who reckon the bullying sucks. So we have one Bully, one Bully-supporter, two Bully-enablers (by refusing to take any responsibility and looking away), and two Bully opposers. For those yet to be rescued by National's Crusade For (Literacy &) Numeracy, that's four versus two. Not looking good for the Bullying Must Stop camp.

And there is one other person in this equation too, who is in a leadership role, and it's their special brand of enabling that is really getting to me.

To my way of thinking leaders, whatever their actual title, have an obligation to ensure the good running of whatever group they lead. Implicit in that should be to deal with any bullying amongst the group. But too often leaders too get bullied, and to make it worse they don't see that's what's going on, because then they'd have to do something. So they pretend, to themselves and everyone else, that they are just being neutral and rising above a spat between those they lead.

This approach solves precisely Nothing.

It undeniably hard for leaders to deal with bullying, especially when they too are suffering from the Bully's activities. It's even harder when a leader is in denial, and just avoiding confronting the Bully about anything, even when the Bully does stuff that really is beyond acceptable. Contact the Bully makes with the leader only serves to reinforce the Bully's view that they are in the right, because the leader says soothing things to avoid being bullied themselves. Stuff like "of course I can see that you are both coming to this with Good Intentions and think you are doing the right thing" and "it's my role to remain neutral and not get involved in disagreement between you people down there."

So what do you do about a leader who abdicates their responsibility in this crucial area? Who is okay with giving power up to the Bully rather than confront behaviour that is unacceptable and should be dealt with?

Today I'm at a loss.


* Props to the irreplaceable Douglas Noel Adams.

On the metaphor of the closet

When I wrote a post which praised people for breaking silence around abuse, I expected some push back. The push-back was the reason I'd written the post - I knew it was coming and wanted to get some praise in first.

I haven't received much response to me personally.* The one negative response I did receive was critical that I 'outed' Ira Bailey. I can see that the point of my post, which wasn't to name him myself but celebrate those who did name him, was lost because the silence around abuse is so strong, that any break in that silence is shocking.

But I was taken by the word 'out' - by the metaphor of the closet for abusive men. I've seen it used before, when someone got angry at a survivor of abuse for 'outting' her abuser. To me it seems so horrificly inappropriate, that I can imagine where people who use it could possibly stand on issues of abuse. But then it occurred to me that it may be a word people use without thinking about it, and that unpacking the implications of this usage might be worth doing.

The closet is a powerful idea and the metaphor carries important ideas about people's sexuality, and society's attitudes towards your sexuality. In particular the idea that 'outing' someone's sexuality is wrong is based on an analysis of the way society treats people's sexuality.

The first aspect of this analysis is that society unjustly judges people's sexuality as shameful. People stay in the closet because they are ashamed of a part of themselves. Coming out of the closet is worth celebrating because its a rejection of society's shaming.

Abuse is not a part of a person, it is a way they have hurt other people. Any (very limited in this society) judgement and shame that abusers experience is a reaction to what people have done, not who they are.

The second aspect of this analysis is that the negative consequences of being open about your sexuality can be significant. People die, they lose their jobs, they get harrassed - all because of an aspect of who they are. The unjustified shame around some people's desires has serious consequences.

The negative consequences for being abusive are much less pervasive than the consequences for being open about your desires. While there are some notable exceptions (particularly violence against pedophiles), generally people's response to those they know are abusive will be muted. If people don't want to be around someone who has been abusive that is a boundary that they are perfectly entitled to draw, and it is the person who has been abusive who should face the consequences of that boundary.

The third aspect of the analysis Your sexuality is yours and yours only. Your desires are yours to keep secret or share, when and where you want to, or feel safe.

Abusive actions do not belong to the person who did them - they something that you do to someone else. No one is entitled to ownership of the way they have hurt other people.

These three aspects of the closet, shame, consequences, and ownership do all in our society apply to people who have been abused. But they do not apply to abusive men (or women).

I'm sorry if this post seems to basic and didatic, but it offends me so much when people misappropriate the language of the closet for abusers. The metaphor does not apply to them and they do not deserve it's protection. I imagine that some people who use this language are not thinking about what they are saying, and are making an honest mistake. But words do matter, so I've tried to articulate why this usage angers me so much.

* The push-back against the women who named Ira Bailey has been significant though. Climate Camp, and particular their safer spaces comittee, have a lot to be ashamed of.