Bringing abortion care home

What to say about Savita? What to say about the story of a woman who dies from septicaemia in Galway, after termination of a miscarrying pregnancy was refused?  The lawyer in me knows that we haven’t heard the full account yet.  But the critic in me thinks about the outpouring of emotion provoked by her husband’s story.  I batter the keyboard to try and stop my own frustrations from taking hold.  What use is yet another comment on yet another woman who has been failed by a health system which refuses to provide abortion care?  But I don’t want to be quiet either.  I want to try and make sense of the awful spectacle of Savita’s seemingly needless death.

I talk to a pregnancy counsellor who works for a Irish pro-choice service.  She has worked for years supporting women with unplanned pregnancies, many of whom decide to travel for abortion.  She has been having a bad time recently in the wake of a sting on pregnancy counselling services, which accused counsellors of giving women poor advice.  She says: “I know why I do what I do, and why I say what I say”.  Everyday she negotiates the moral and legal complexity, which has baffled the politicians for 20 years since the X case.  She doesn’t have the luxury of getting overwhelmed and throwing her hands up in the air because ‘abortion is complex’.  While 6 governments have failed to implement the 1992 X case ruling, which allows abortion when there is a real and substantial risk to the life of the woman, she has listened to women’s assessment of their options.  She knows that women need abortions, even women who have anti-abortion views.  She knows that women make complicated moral judgments about the best course of action in their particular reproductive circumstances.  This public servant has found a way through the legal uncertainty to support women as they travel in search of abortion care.  Imagine if we valued her experience more.  Imagine how abortion law would benefit from understanding complexity as an element of, not an obstacle to, reproductive decision-making.

I listen to Mary Favier of Doctors for Choice on the Pat Kenny show on RTE radio.  Mary calls for the decriminalisation of abortion and the recognition of women’s right to control their own fertility.  She calls on doctors to act and to push up against the imagined boundaries of lawful abortion in Ireland.  It’s such a relief to hear Mary claim public space not just for women in life-threatening circumstances, but also for ordinary pregnant women.  One of the most distressing things has been hearing so many media commentators fixate on the narrowest of legitimations for abortion.  At times the scope of the argument has seemed limited to the meaning of life-saving abortion.  But we know thousands of Irish women end their pregnancies every year for all kinds of reasons.  Yet the mainstream public debate seems to proceed as if medical practice is never about tackling risks to health, or promoting patients’ well-being.  It’s as if women can’t be trusted with moral decisions, decisions whose consequences they will bear.  It’s as if a non-conscious, non-sentient, non-viable foetus has the same moral status as a conscious, sentient, viable woman.  It’s as if there is only an audience for the most distressing, blood curdling stories of abortion need.  But as Mary points out, Savita was also a woman whose request for a termination was refused.  Mary shows us what Irish abortion care could be like if it supported women’s moral agency.  Others like her – Clare Daly, Ivana Bacik, Susan McKay – allow us hope for a politics which addresses the ordinary everyday stories of pregnancy and abortion.

Hungry for information, I flick through my tweets and watch an older clip of Mara Clarke of the London-based Abortion Support Network tell the Dublin Pro-choice Rally, 28 September 2012, about the women they’ve helped over the last 3 years.  Mara talks about the vulnerability and resourcefulness of all kinds of women: rape victims, mothers with families, young asylum-seekers, students, women in gender transition.  She makes ordinary ingenuity come alive as she tells stories of the friends who raise funds and mind children so that women can travel.  Imagine having to ring a complete stranger for help, she says, when you’re under this pressure and need access to abortion.  These ‘strangers’ open their homes and their lives to women who need them for a day or two.  They take it on themselves to reduce the harmful effects of a healthcare system that ignores abortion-seeking women.   And before them ESCORT in Liverpool and the Irish Women’s Abortion Support Group in London (Rossiter, 2009) looked after women who travelled during the 1980s and the 1990s.  This hospitality of strangers makes caring across borders a reality as people connect over the simple act of wanting to help.

The reaction to Savita’s death has made the ‘distant suffering’ (Boltanski, 1999) of abortion-seeking women a little less distant.  Ordinary people keep apologising for not having taken action against Irish abortion law before now.  They’re taking moral responsibility for the legal and medical regime which produced Savita’s death and routinely sends abortion-seeking women abroad.  This failure in our public institutions – in law and in medicine – is at odds with a clear desire to care in other public spaces.  And perhaps that’s all I want to say at least for the moment: This is a terrible tragedy for Savita and her loved ones.  But the wave of revulsion is not just revulsion at what Enright has called the bloodthirsty nature of Irish abortion law.   It’s a wave of connection that’s bringing together these different challenges to an anti-abortion ethos.  We have to find a way to bring abortion care home: to take domestic abortion care beyond questions of life and death and into a respect for the ordinary moral messiness of people’s lives.