Tuesday, November 02, 2010

Medb Ruane: Why turning to abortion care on the internet signals a real crisis in healthcare for women

Google the words 'abortion pills' and you'll find more than 475,000 results in 0.18 seconds. 

You can order the medication privately and hope to avoid an expensive, lonely journey to a British or Dutch clinic. 

The whole transaction can cost less than €75, which is much cheaper than travelling abroad for a termination. Left click, activate PayPal and wait a few days for An Post to deliver them to your chosen address. 

Ethics apart, it's an economic no-brainer in recessionary times -- but it's very risky, the sources are suspect and it's wholly illegal in Ireland. Here, you can't even get a morning-after pill without a doctor's say so.

Customs authorities seized 1,216 parcels of early abortifacients in 2009, which translates into three women a day ready to put themselves at risk because the Irish health and legal services exclude them. 

This news, which comes through a Freedom of Information request, signals a real crisis in female healthcare.

The crisis isn't about abortion. 

It's about what happens when lack of safe, affordable early abortion causes women to self-medicate. 

The medication can be effective if it comes from a reputable source and is administered in early pregnancy by a trained professional. 

If not, women who take it themselves risk overdose, which could damage their fertility, as well as risking underdose, which could cause an incomplete termination and complications from excessive bleeding.

Who might these desperate women be? Most likely, women of every age up to menopause. 

Mothers, sisters, daughters, friends -- anyone who can use an iPhone or access a netbook, which amounts to many, many people.

You can't be certain of exact figures or backgrounds because no Irish agency monitors this aspect of reproductive health. The only hard evidence is the 'by default' information coming from Revenue's customs service. 

So no one knows whether the same number of parcels reached their destinations and no one knows how many women presented to a hospital or doctor later because things went wrong. 

Or became infertile as a result.

These DIY terminations are new twists on the old practice of backstreet abortion, which always puts women at grave risk, physically and economically. 

The high numbers are no surprise to anyone who has followed debates on reproductive healthcare, especially since the X case almost two decades ago.

Put in a global context, Ireland is the richest country of a 25pc minority worldwide that doesn't allow legal abortion on grounds other than an immediate threat to the woman's life. In other words, it's a third world for reproductive health.

Third-world conditions imply third-world solutions but, as everyone knows, backstreet abortions were mostly avoided by using backdoor facilities -- such as taking a boat or plane off the island, having a safe termination and returning home with your lips sealed. 

This happens in some cases of fatal foetal malformation, as well as rape and incest.
 
Of course it's unpleasant. 

No one likes it. 

But the ready availability of on-line medications threatens the edifice of denial which keeps the problem at a distance and lets politicians off the difficult legislative hook. 

Exporting the problem has encouraged politicians to wrap themselves up in a spurious moral integrity by pretending that Ireland was abortion-free. 

It was also a dishonest way of fooling themselves they were ethical, while letting bankers and speculators ride roughshod over whatever and whomever they wish. 

This high moral ground kept (and keeps) Ireland in line with Catholic theology, making the state one of only three EU countries where female citizens are subjected to Vatican rule, no matter what. The others are Malta and Poland. 

Irish-based women were at the mercy of whomever they could find to perform a termination, until Britain's 1967 Abortion Act. Home remedies included overdosing on gin and the gruesome prospect of performing a uterine scrape with a coat hanger. 

The horribleness shows the despair and vulnerability that can affect women with crisis pregnancy. It's a good reason to take this news seriously. 

But let's be in no doubt. 

This is especially dangerous because it encourages women to self-medicate rather than go abroad. And going abroad has been the lynchpin supporting the Government's paralysed stand. 

The Customs authorities seized the parcels because they're co-operating with Gardai and the Irish Medicines Board. 

But there was something incomplete, I thought, in how the Medicines Board commented on the finds. 

"Counterfeit and illegal medicines pose a serious threat to public health," the Medicines Board said. 

"The board, in conjunction with the Revenue's customs service and An Garda Síochána, continually monitors and investigates instances of illegal supply of medicinal products via the internet and other avenues and we actively enforce suspected breaches of the law." 
 
This is literally true, but we're not talking head shop highs, overdosing on sedatives or using untested herbal supplements here. 

The medications in question are licensed in many other countries and used to treat millions of women worldwide. 

If they were licensed here, there could be open discussion, proper supervision -- and women's health need not be put at such risk.

SIC: II/IE