Tuesday, January 27, 2009

'Global Gag Rule' Lifted

'Global Gag Rule' Lifted
By Barbara Crossette The Nation

January 25, 2009

On Friday evening, a time favored by officials trying to avoid attention, President Barack Obama issued a statement reversing one of the most damaging policies ever visited on developing nations by Republican administrations. This was the "global gag rule," which forbade US government support for any organization that in any way fostered, provided or even advised women about abortion. It was a policy foisted on an unsuspecting world by the Reagan administration at, of all events, a United Nations conference on women and development held in Mexico City in 1984.

What became known as the "Mexico City policy" was always a political football. It was rescinded in 1993 by President Bill Clinton, then reimposed in 2001 by George W. Bush, who also proceeded to deal a second harsh blow to the world's poorest families by cutting off American assistance to the United Nations Population Fund, the largest global provider of family planning assistance. The reason, or excuse--rejected by the administration's own internal report--was that the Population Fund was linked to forced abortion practices in China. The fund has lost about $250 million in American aid since 2002.

Millions of women and their families were the direct victims of these shortsighted steps, taken in the name of people who called themselves "pro-family," but appeared to be woefully ignorant of the harm they caused in homes around the world. The International Planned Parenthood Federation, based in London, estimates that in the last eight years alone as much as $100 million in US aid was lost to its affiliates in 100 countries because of their refusal to accept an abortion ban. The federation estimates this lost aid could have prevented 36 million unintended pregnancies and 15 million abortions, often acts of desperation. More than 80,000 women and more than 2.5 million children might not have died.

Not surprisingly, the rate of unsafe abortions is highest in the poorest countries, where at least 200 million women cannot get contraceptives. The World Health Organization, which supports safe abortion as a tool of last resort, estimates that of 45 million abortions globally every year, 19 million take place under unsafe conditions, causing at least 68,000 deaths. Forty percent of those most dangerous abortions involve teens and women between the ages of 15 and 24. A woman in the developing world--primarily in Africa and parts of Asia--is at least 100 times more likely to die of a botched abortion than a woman in the industrial North.

Which raises the question why President Obama--and Secretary of State Hillary Clinton, once an outspoken champion of women's rights in the developing world--made so little of this policy reversal. Is abortion still too skittish a topic to talk about in public? Even when a presidential order signals a promising new approach to development aid?

President Obama also pledged to work with Congress to restore contributions to the Population Fund, known as UNFPA. "By resuming funding to UNFPA, the US will be joining 180 other donor nations working collaboratively to reduce poverty, improve the health of women and children, prevent HIV/AIDS and provide family planning assistance to women in 154 countries," his statement said.

Not lost on Thoraya Obaid, the courageous Saudi woman who is executive director of UNFPA, was President Obama's focus on poverty reduction as a byproduct of family planning, giving millions of the world's poorest women some of the same reproductive choices and life opportunities enjoyed in richer nations.

"President Obama's decision could not have come at a more critical time," Obaid said in a statement hours after the White House announcement. It was, she added, "an essential step towards creating a world where all women have the opportunity to participate as equal members of society." The rate of death from pregnancy and childbirth--99 percent of which occur in developing countries--has fallen just one per cent between 1990 and 2005 around the world, the UNFPA statement noted. "Every minute, a woman dies giving life, totaling up to 10 million women during a generation," it said.

UNFPA has argued tirelessly at the UN, where population growth is not a fashionable issue, that high fertility (mostly not a woman's choice) lowers per capita income, reduces education levels and consumes resources necessary to sustain healthy, productive lives. It also creates a generation of poorly educated, unemployable young people shorn of hope and open to recruitment by militant organizations of all kinds, threatening the stability of countries trying to make still-shaky democracies work.

Secretary of State Clinton, who has said she will focus on democracy and development, now has her mandate.

Steven Sinding, a former director general of the International Planned Parenthood Federation, a Columbia University professor and advisor to the World Bank, was working on family planning in the US government in 1984 when the gag rule was first announced in Mexico City, taking American officials on the scene by surprise.

Sinding has been campaigning ever since against this destructive policy, which for the IPPF alone, he said in an e-mail, "necessitated clinic closures, staff layoffs and, ultimately, curtailment of family planning services to hundreds of thousands, perhaps even millions, of women in developing countries.

He described President Obama's reversal of the order as something akin to "a glorious sunrise after a long and exceptionally dark night."

About Barbara Crossette
Barbara Crossette, United Nations correspondent for The Nation, is a former New York Times correspondent and bureau chief in Asia and at the UN.

She is the author of So Close to Heaven: The Vanishing Buddhist Kingdoms of the Himalayas, published by Alfred A. Knopf in 1995 and in paperback by Random House/Vintage Destinations in 1996, and a collection of travel essays about colonial resort towns that are still attracting visitors more than a century after their creation, The Great Hill Stations of Asia, published by Westview Press in 1998 and in paperback by Basic Books in 1999. In 2000, she wrote a survey of India and Indian-American relations, India: Old Civilization in a New World, for the Foreign Policy Association in New York. She is also the author of India Facing the 21st Century, published by Indiana University Press in 1993.

Vatican Attacks US Abortion Move

Vatican attacks US abortion move
BBC News January 25th 2009

The Vatican has condemned President Obama's move to restore US funding for family planning clinics abroad that give advice on or carry out abortions.

One Vatican official warned against the "arrogance" of those in power who think they can decide between life and death.

Another official said it dealt a blow to groups fighting against "the slaughter of the innocents".

The White House says the move aligns the US with other nations fighting poverty and promoting health care.

On Friday, Mr Obama ended a ban on giving US federal money to international groups that perform abortions or provide information about them.

Robust language

In an interview published in an Italian newspaper on Saturday, senior Vatican official Monsignor Rino Fisichella urged Mr Obama to listen to all voices in America without "the arrogance of those who, being in power, believe they can decide of life and death."

"If this is one of President Obama's first acts, I have to say, in all due respect, that we're heading quickly toward disappointment," Mr Fisichella, who heads the Vatican's Pontifical Academy for Life, told the Corriere della Sera.

Another Academy official, Monsignor Elio Sgreccia, said it had dealt a harsh blow to US Catholics and people across the world who are fighting against "the slaughter of the innocents".

The criticism from the Vatican adds to concerns from evangelical Protestant groups that the US decision could presage a wider dismantling of the legal limits of abortion.

Critics of the former funding ban had long argued that it hurt some of the poorest people in the world by denying money to groups that might support abortion, but also work on other aspects of reproductive health care or HIV/Aids.

The ban was first introduced in 1984 by President Ronald Reagan. It was rescinded by President Bill Clinton, before being reinstated by President George W Bush in 2001.

Monday, January 26, 2009

Statement from President Obama, Secretary of Sate Hillary Clinton and UNFPA on Rescinding of 'Global Gag Rule'


Office of the Press Secretary


For Immediate Release January 23, 2009

Statement of President Barack Obama on Rescinding the Mexico City Policy

"It is clear that the provisions of the Mexico City Policy are unnecessarily broad and unwarranted under current law, and for the past eight years, they have undermined efforts to promote safe and effective voluntary family planning in developing countries. For these reasons, it is right for us to rescind this policy and restore critical efforts to protect and empower women and promote global economic development.

"For too long, international family planning assistance has been used as a political wedge issue, the subject of a back and forth debate that has served only to divide us. I have no desire to continue this stale and fruitless debate.

"It is time that we end the politicization of this issue. In the coming weeks, my Administration will initiate a fresh conversation on family planning, working to find areas of common ground to best meet the needs of women and families at home and around the world.

"I have directed my staff to reach out to those on all sides of this issue to achieve the goal of reducing unintended pregnancies. They will also work to promote safe motherhood, reduce maternal and infant mortality rates and increase educational and economic opportunities for women and girls.

"In addition, I look forward to working with Congress to restore U.S. financial support for the U.N. Population Fund. By resuming funding to UNFPA, the U.S. will be joining 180 other donor nations working collaboratively to reduce poverty, improve the health of women and children, prevent HIV/AIDS and provide family planning assistance to women in 154 countries,” said President Obama.


Memorandum for the Secretary of State
the Administrator of the United States Agency for International Development

Subject: Mexico City Policy and Assistance for Voluntary Population Planning

The Foreign Assistance Act of 1961 (22 U.S.C. 2151b(f)(1)), prohibits nongovernmental organizations (NGOs) that receive Federal funds from using those funds "to pay for the performance of abortions as a method of family planning, or to motivate or coerce any person to practice abortions." The August 1984 announcement by President Reagan of what has become known as the "Mexico City Policy" directed the United States Agency for International Development (USAID) to expand this limitation and withhold USAID funds from NGOs that use non-USAID funds to engage in a wide range of activities, including providing advice, counseling, or information regarding abortion, or lobbying a foreign government to legalize or make abortion available. The Mexico City Policy was in effect from 1985 until 1993, when it was rescinded by President Clinton. President George W. Bush reinstated the policy in 2001, implementing it through conditions in USAID grant awards, and subsequently extended the policy to "voluntary population planning" assistance provided by the Department of State.

These excessively broad conditions on grants and assistance awards are unwarranted. Moreover, they have undermined efforts to promote safe and effective voluntary family planning programs in foreign nations. Accordingly, I hereby revoke the Presidential memorandum of January 22, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), the Presidential memorandum of March 28, 2001, for the Administrator of USAID (Restoration of the Mexico City Policy), and the Presidential memorandum of August 29, 2003, for the Secretary of State (Assistance for Voluntary Population Planning). In addition, I direct the Secretary of State and the Administrator of USAID to take the following actions with respect to conditions in voluntary population planning assistance and USAID grants that were imposed pursuant to either the 2001 or 2003 memoranda and that are not required by the Foreign Assistance Act or any other law: (1) immediately waive such conditions in any current grants, and (2) notify current grantees, as soon as possible, that these conditions have been waived. I further direct that the Department of State and USAID immediately cease imposing these conditions in any future grants.

This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

The Secretary of State is authorized and directed to publish this memorandum in the Federal Register.


THE WHITE HOUSE, January 23, 2009.

# # #


Office of the Spokesman
For Immediate Release January 23, 2009


Repeal of the Mexico City Policy

President Obama's repeal of the global gag rule, which has prevented women around the world from gaining access to essential information and healthcare services, is a welcomed and important step taken during the first days of the Administration.

For the past seven years, this policy has made it more difficult for women around the world to gain access to essential information and healthcare services. Rather than limiting women's ability to receive reproductive health services, we should be supporting programs that help women and their partners make decisions to ensure their health and the health of their families.

As I said in Beijing at the United Nations 4th World Conference on Women, women must not be denied the right to plan their own families. I look forward to working with the President, my colleagues in the Administration, and the NGO community to promote programs and policies that ensure women and girls have full access to health information and services.

# # #


23 January 2009


UNITED NATIONS, New York, 23 January 2009- The United Nations Population
Fund (UNFPA) applauds today's statement from United States President
Barack Obama restoring U.S. funding for UNFPA's operations.
President Obama said: "I look forward to working with Congress to
restore U.S. financial support for the U.N. Population Fund. By resuming
funding to UNFPA, the U.S. will be joining 180 other donor nations
working collaboratively to reduce poverty, improve the health of women
and children, prevent HIV/AIDS and provide family planning assistance to
women in 154 countries."

UNFPA Executive Director, Thoraya Ahmed Obaid welcomes President Obama's
decision to restore funding and noted how quickly he addressed the
issue. "The President's actions send a strong message about his
leadership and his desire to support causes that will promote peace and
dignity, equality for women and girls and economic development in the
poorest regions of the world. And access to reproductive health is at
the core of all of these issues."

There is much to be done. More than halfway towards the 2015 target date
for the Millennium Development Goals, the goal that addresses improving
maternal and reproductive health has made the least progress and is the
most underfunded.

"We are confident that under the new President's direction, the U.S.
will resume its leadership in promoting and protecting women's
reproductive health and rights worldwide," said. Ms. Obaid. "This is an
essential step towards creating a world where all women have the
opportunity to participate as equal members of society."

Globally, the rate of death from pregnancy and childbirth has declined
just one percent between 1990 and 2005. Every minute a women loses her
life giving life, adding up to 10 million women over a generation.
Ninety-nine per cent of these deaths occur in developing countries,
particularly in Africa and Asia.

"President Obama's decision could not have come at a more critical
time," said Ms. Obaid. "If women are to stop dying in childbirth and if
reproductive health for all is to become a reality, we need increased
political and financial commitment at all levels to implement strategies
that we know will work. With the renewed US support to women and to
UNFPA, the odds of that happening are greatly improved."

Congressionally-approved funding for UNFPA has been withheld by the U.S.
Administration for the past seven years. During that time, the Fund has
not received a total of $244 million in U.S. funding. "Restoration of
funding will allow us to maintain recent gains during the current
financial crisis and provide support to women in some of the poorest
countries in the world," said Ms. Obaid. "Progress for all will not
happen without progress for women. This means working to promote, as an
international priority, the advancement of women's health, rights and

UNFPA also welcomes President Obama's decision to engage his
administration on family planning issues, restoring critical efforts to
protect and empower women. Access to voluntary family planning is one of
the most effective ways to prevent unintended pregnancies and reduce

"UNFPA stands ready to work with President Obama, Secretary Clinton and
the American people to achieve our dream of helping women and girls in
the poorest countries reach their fullest potential. We welcome the
opportunity to work with the United States again as a full partner."

UNFPA, the United Nations Population Fund, is an international
development agency that promotes the right of every woman, man and child
to enjoy a life of health and equal opportunity. UNFPA supports
countries in using population data for policies and programmes to reduce
poverty and to ensure that every pregnancy is wanted, every birth is
safe, every young person is free of HIV/AIDS, and every girl and woman is treated with
dignity and respect. UNFPA -- because everyone counts.

From Guttmacher Institute: Obama Rescinds 'Global Gag Rule', Commits to Funding UNFPA

Obama Rescinds “Global Gag Rule,” Commits to Funding UNFPA

President Obama on January 23 affirmed his administration’s strong commitment to women’s health and international family planning assistance by rescinding the “global gag rule” and by committing the United States to restoring support for the United Nations Population Fund (UNFPA). The global gag rule—also known as the Mexico City policy—prohibited overseas organizations from receiving U.S. family planning assistance if they used their non-U.S. funds to provide abortion information, services or counseling, or engaged in any abortion rights advocacy.

Tragically, the policy may have only increased the need for abortions (most of them unsafe) by reducing access to family planning services in many developing countries. It also created more obstacles for some of the world’s poorest women seeking information about how to avoid unsafe abortions. The global gag rule was first imposed by President Reagan in 1984, rescinded by President Clinton in 1993 and then reinstated by President Bush in 2001.

The Bush administration and other anti–family planning administrations had also denied U.S. support to UNFPA—which works to reduce the need for abortion by promoting voluntary family planning in more than 150 poor countries. The Reagan, Bush I and Bush II administrations all blocked any U.S. contribution to UNFPA on the grounds that it indirectly supported coercive abortions in China, despite U.S. government findings clearing UNFPA of any involvement in coercive practices.

Congress has consistently appropriated funds for UNFPA since the United States helped to found the agency in 1969. Most recently, UNFPA received U.S. contributions during the Clinton administration and the first year of the Bush administration. The Bush administration reversed itself in 2002 and subsequently blocked about $244 million in funding over seven years.

There is overwhelming evidence that helping women avoid becoming pregnant too early, too late or too often benefits them and their children. Currently, 500 million women in the developing world are using some form of family planning, thereby preventing 187 million unintended pregnancies, 60 million unplanned births, 105 million induced abortions, 2.7 million infant deaths and 215,000 maternal deaths (which would leave 685,000 children motherless) each year.

However, another 200 million women throughout the developing world who would like to delay or limit their births lack access to contraceptives. Filling the unmet need for contraceptives would further reduce global rates of maternal mortality by 35% and would lower the overall number of abortions by 64%, many of which would have been unsafe abortions. More than 95% of abortions in Africa and Latin America are performed under unsafe circumstances, as are about 60% of abortions in Asia. Almost 70,000 women die each year from complications following unsafe abortions, and thousands more suffer serious, permanent injuries.

Despite the clear benefits of family planning for women worldwide, both the global gag rule and the refusal to fund UNFPA were part of a broader erosion of support for international family planning assistance under the Bush administration. The Obama administration’s reversal of both policies not only will strengthen the global fight against maternal and child mortality. It also is firmly in line with President Obama’s goal of finding common ground in the abortion debate by focusing on preventing unintended pregnancies—including through the provision of contraceptives—and thereby reducing the need for abortion.

However, even with these policy changes, direct U.S. funding for abortions overseas will continue to be prohibited under the Helms Amendment.

Wednesday, January 14, 2009

The Safe and Legal in Ireland Abortion Rights Campaign has joined Facebook

Please find us on Facebook and join us!

Irish Women Still Subjecting Themselves To DIY Abortions

Irish women still subjecting themselves to DIY abortions
Sunday Business Post

We are well into the 21st century and yet Irish women are still subjecting themselves to DIY abortions
Sunday, January 11, 2009 By Jennifer O’Connell

Helen has other things to worry about apart from whether she’s part of a disturbing new social trend. She’s pregnant. Again. She already has two young children, and an unsupportive, disinterested husband.

Actually, he’s not totally disinterested. He did take it upon himself to go on the internet and order her an ‘online abortion’. She doesn’t want to take the pills that arrived in an unmarked, brown envelope a couple of weeks ago. She is worried about the consequences to her health, and the truth is that she really wants to keep the baby.

On the parenting website where she eventually wound up looking for advice, almost all those who replied to her urgent posting implored her not to take the pills. If she decided she didn’t want to go ahead with the pregnancy without her husband’s support, there were better ways, they said. Buying medication from the internet is no answer. But for a number of distressed Irishwomen, it appears to be the only answer.

Last summer, the soon-to-be swallowed up-by-the-HSE Crisis Pregnancy Agency reported falling numbers of Irishwomen seeking abortions overseas. The agency seemed slightly puzzled by this development. Perhaps more women were travelling to the Netherlands, it speculated. Or maybe people were being more careful about using contraception.

But Helen’s story might hold a clue to another, silent factor behind the decline. Once, having an abortion meant seeking a referral from an agency here; booking flights to Britain; finding someone to mind the other kids, if there are other kids; getting a sick note from work; finding between €600 and €2,000 to pay for it; and then travelling to the clinic to have the procedure.

Now, it’s all over with a click of the mouse, a payment of as little as €52 on your credit card, and a day or two’s sickness in the comfort and privacy of your own home. At least, that’s the theory. You can see that it might be an attractive route for a woman who finds herself pregnant and in despair.

As one Irishwoman calling herself simply C explains on one of the most reputable websites offering online abortions, Womenontheweb.com: ‘‘I was just over nine weeks’ pregnant when I carried out the medical abortion at home with mifepristone and misoprostol obtained from the web. I never told anyone, not even my partner, what I was doing. My partner knew I was pregnant. Once the cramps and bleeding started, I told him I was having a miscarriage. This was the only option I had, as I couldn’t afford to go to England. I did a lot of research before taking the tablets, and I would advise other women to do the same.”

But as C - who already had three teenage children and felt she couldn’t cope with another pregnancy - discovered, the procedure wasn’t quite as straightforward as she had hoped. ‘‘The bleeding and cramps were quite severe, more than I expected, even though I was over nine weeks. It was a frightening experience, and at one stage I thought of going to hospital. I would not recommend doing this on your own.”

Afterwards, she said she felt ‘‘numb’’. ‘‘The experience was frightening but after the worst of it was over, I did feel relieved but also sad for the loss of my child.”

C, it seems, was one of the lucky ones. According to the British Journal of Obstetrics and Gynaecology, 11 per cent of women who ordered their abortion medication through this website - and remember, this is one of the better ones - ended up needing a surgical procedure to stop excessive bleeding or complete the termination. But a far higher proportion (58 per cent) said they were simply grateful to have been able to have an abortion in this way.

The consequences of abortions being sold online are simply terrifying. Last year, the Irish Medicines Board warned of the emergence of this trend, urging women in the strongest possible terms not to use this - or any medicine - purchased over the internet, ‘‘as there can be no guarantees on the quality, safety, or effectiveness of products purchased in this manner’’.

Women buying from Women ontheweb.com can at least expect their medication to arrive in proper packaging, with a doctor’s signature enclosed. The website asks for a €70 donation, seeks reassurance from clients that they are less than nine weeks’ pregnant, and stays in touch with them afterwards. It has a discussion forum where they can share their experiences also.

Other websites cost even less and are not quite so careful, offering no information about possible risks and consequences, and dispatching packets of pills with no instructions, no labelling and no back-up if things go wrong.

For some years, Ireland has occupied an uneasy no-man’s-land on the abortion issue, opting to avoid answering the difficult question of where exactly we stand, and exporting the problem instead. Now, it seems, many women may be choosing to import their own version of a solution. And what an imperfect solution it is; little better, really, than a 21st-century version of the herbal remedy and the coat-hanger.

The advances in technology that allow people like Helen’s husband to order an abortion for his reluctant and frightened wife with the ease with which he could buy her a handbag on eBay may finally force us to get off the fence.

Because whatever our personal feelings about abortion, there is, and always has been, a demand for it from women desperate enough to do just about anything. Pretending that we can legislate away this demand is no longer an option.

If the prospect of hundreds, perhaps even thousands, of traumatised women subjecting themselves to DIY abortions, all alone in their bathrooms, isn’t enough to frighten us out of our complacency, then the European Court of Human Rights might just force us out of it.

The court is due shortly to hear a challenge by three Irishwomen to the government’s ban on abortion. The women claim that their rights were denied by being forced to terminate their pregnancies outside the state.

The government is planning to contest the claim, but the Irish Family Planning Association believes the women have a ‘‘strong’’ case.

It points to a ruling by the court two years ago, which resulted in Poland being instructed to guarantee access to legal abortions.

One way or another, this is an issue that’s back on the table. Sigh as the rest of us might, for women like Helen, it’s not coming a moment too soon.

Monday, January 05, 2009

For Privacy's Sake, Taking Risks to End Pregnancy

The New York Times January 5, 2009

For Privacy’s Sake, Taking Risks to End Pregnancy
Amalia Dominguez was 18 and desperate and knew exactly what to ask for at the small, family-run pharmacy in the heart of Washington Heights, the thriving Dominican enclave in northern Manhattan. “I need to bring down my period,” she recalled saying in Spanish, using a euphemism that the pharmacist understood instantly.

It was 12 years ago, but the memory remains vivid: She was handed a packet of pills. They were small and white, $30 for 12. Ms. Dominguez, two or three months pregnant, went to a friend’s apartment and swallowed the pills one by one, washing them down with malta, a molasseslike extract sold in nearly every bodega in the neighborhood.

The cramps began several hours later, doubling Ms. Dominguez over, building and building until, eight and a half hours later, she locked herself in the bathroom and passed a lifeless fetus, which she flushed.

The pills were misoprostol, a prescription drug that is approved by the Food and Drug Administration for reducing gastric ulcers and that researchers say is commonly, though illegally, used within the Dominican community to induce abortion. Two new studies by reproductive-health providers suggest that improper use of such drugs is one of myriad methods, including questionable homemade potions, frequently employed in attempts to end pregnancies by women from fervently anti-abortion cultures despite the widespread availability of safe, legal and inexpensive abortions in clinics and hospitals.

One study surveyed 1,200 women, mostly Latinas, in New York, Boston and San Francisco and is expected to be released in the spring; the other, by Planned Parenthood, involved a series of focus groups with 32 Dominican women in New York and Santo Domingo. Together, they found reports of women mixing malted beverages with aspirin, salt or nutmeg; throwing themselves down stairs or having people punch them in the stomach; and drinking teas of avocado leaf, pine wood, oak bark and mamon fruit peel.

Interviews with several community leaders and individual women in Washington Heights echoed the findings, and revealed even more unconventional methods like “juice de jeans,” a noxious brew made by boiling denim hems.

“Some women prefer to have a more private experience with their abortion, which is certainly understandable,” said Dr. Daniel Grossman, an obstetrician with Ibis Reproductive Health in San Francisco, which joined Gynuity Health Projects in New York in conducting the larger study. “The things they mention are, ‘It is easier.’ It was recommended to them by a friend or a family member.”

Dr. Carolyn Westhoff, an obstetrician at NewYork-Presbyterian/Columbia University Medical Center, said the trend fits into a larger context of Dominicans seeking home remedies rather than the care of doctors or hospitals, partly because of a lack of insurance but mostly because of a lack of trust in the health care system. “This is not just a culture of self-inducted abortion,” she said. “This is a culture of going to the pharmacy and getting the medicine you need.”

Physicians say that women can obtain the pills either through pharmacies that are willing to bend the rules and provide the medicine without a prescription or by having the drugs shipped from overseas.

It is impossible to know how many women in New York or nationwide try to end their pregnancies themselves, but in the vibrant, socially conservative Dominican neighborhoods of Upper Manhattan, the various methods are passed like ancient cultural secrets. In a study of 610 women at three New York clinics in largely Dominican neighborhoods conducted eight years ago, 5 percent said they had taken misoprostol themselves, and 37 percent said they knew it was an abortion-inducing drug. Doctors and community leaders say they have not seen any signs of the phenomenon disappearing, which they find worrisome because of concerns about the drug’s effectiveness and potential side effects.

Sold under the brand name Cytotec, misoprostol is approved to induce abortion when taken with mifepristone, or RU-486; doctors also sometimes use it to induce labor, though it is not approved for that use. A spokesman for Pfizer, which manufacturers Cytotec, declined to comment beyond saying that the company does not support the off-label use of its products and noting that the label includes “F.D.A.’s strongest warning against use in women who are pregnant.”

That warning, in capital letters, also notes that the drug “can cause abortion.”

But it does not always do so, not least because notions of how best to use it vary from inserting several pills into the vagina to letting them dissolve under the tongue. The side effects can be serious, and include rupture of the uterus, severe bleeding and shock.

“We do worry because we don’t know where women are getting the instructions from,” said Jessica Gonzalez-Rojas of the National Latina Institute for Reproductive Health, which was also a partner on the Ibis study. “We imagine that there is misinformation on how to take it, which is why it could be hit or miss.”

In 2007 in Massachusetts, an 18-year-old Dominican immigrant named Amber Abreu took misoprostol in her 25th week of pregnancy and gave birth to a 1-pound baby girl who died four days later; a judge sentenced her in June to probation and ordered her into therapy. In South Carolina in February, a Mexican migrant farm worker, Gabriela Flores, pleaded guilty to illegally performing an abortion and was sentenced to 90 days in jail for taking misoprostol while four months pregnant in 2004. A Virginia man, Daniel Riase, is serving a five-year prison sentence after pleading guilty in 2007 to slipping the pills into his pregnant girlfriend’s glass of milk.

Researchers studying the phenomenon cite several factors that lead Dominican and other immigrant women to experiment with abortifacients: mistrust of the health-care system, fear of surgery, worry about deportation, concern about clinic protesters, cost and shame.

“It turns an abortion into a natural process and makes it look like a miscarriage,” said Dr. Mark Rosing, an obstetrician at St. Barnabas Hospital in the Bronx who led the 2000 study, which was published in the Journal of the American Medical Women’s Association. “For people who don’t have access to abortion for social reasons, financial reasons or immigration reasons, it doesn’t seem like this horrible thing.”

Ms. Dominguez, for her part, said she had no insurance or money to pay for an abortion, and could not fathom getting one for fear her mother would find out. One of her friends had spent $1,200 on an abortion that left her with a uterine infection, and another friend endured the procedure without anesthesia, she said. In addition, Washington Heights is a tightknit community where abortion — as well as birth control — is shunned; if Ms. Dominguez were spotted entering a clinic, rumors could fly.

“There are scary moments, and you got to have a friend right next to you,” said Ms. Dominguez, now 30 and a mother of four. “It’s cheap but dangerous. Certain people are more delicate than others. But afterwards, I felt relief.”

A friend of Ms. Dominguez’s said her stepsister took the pills last year because she was in the country illegally, and worried that a doctor might turn her in. “She was just scared,” the woman said, speaking on the condition that her name not be published to protect the stepsister’s privacy. “She had no papers, no insurance, no nothing.”

The woman went to a free clinic afterward to make sure the pills had worked (they had). Health care workers and other community leaders say such visits are how they discovered widespread illicit use of the drug as well as homemade potions.

Dr. Rosing said he learned about Cytotec during his residency at NewYork-Presbyterian/Columbia hospital in Washington Heights, where he saw a lot of Dominican immigrants with incomplete abortions in the emergency room. They spoke of taking the “star pill,” a nickname for the hexagonal shape of one form of misoprostol. He suspected “that has to be the tip of the iceberg,” he said, “and it was.”

The pills allow pregnant women a degree of denial over what is taking place. Like Ms. Dominguez, many women in the neighborhood talk about the need to bring on — or “down” — their periods, not abortion. Afterward, they might tell doctors or relatives they had lost the baby.

The Planned Parenthood study concluded that women in both nations “seemed to see inducing the termination of pregnancy, or abortions, as a part of the reality of their lives,” in a community where, as one interview subject put it, “we are all doctors.” The report noted that in a culture steeped in machismo, birth control is generally seen as the woman’s responsibility.

“If I introduce the condom into a relationship, I’m basically saying I’ve had somebody else, and I’ve not been faithful to you,” said Haydee Morales, a vice president at Planned Parenthood of New York.

Debralee Santos, program director at Casa Duarte, a community arts organization in Washington Heights, said that while she had never had reason to distrust medical professionals, she understood the apprehensions that kept other women from seeking them out. “I get it, I really do,” she said.

“It’s a community that, even as it comes of age, always relies on itself first,” explained Ms. Santos, who was born in the United States to immigrant parents. “Women, in particular, continue to help each other in ways that speak to tradition and solidarity.”

Ms. Dominguez, who volunteers at Casa Duarte and is known as Flaca, Spanish for skinny, did not want her name or photograph published at first. But after some thought, she decided to allow it so more people would learn about the trap many pregnant Dominican women feel they are in.

“It’s a health risk,” she said. “There’s a lot of girls in situations like that, and they’re overwhelmed.”

The Huffington Post: On Abortion, Pro-Choice is the Compromise Position

From Sam Sedaei's blog, posted on December 22nd 2008.

The Bush administration is scrambling to issue a number of anti-abortion rights executive orders before leaving office. This is of course just a tip of the iceberg when it comes to all the hostile actions that the current administration has taken to make choice and family planning harder for women and families throughout the country.

The mainstream media and politicians -- including President Elect Barack Obama -- have presented abortion as an issue on which the country is evenly divided between two camps -- pro-life and pro-choice -- and the only way to deal with the issue is to come up with a grand compromise. However, a thorough analysis of the two platforms demonstrates that the pro-choice stance is the compromise position and the next administration must not negotiate away abortion rights.

One can explore this reality by looking at the specific list of choice-related issues that the Obama administration will face, and why he must support the pro-choice stance on them. The questions that the next administration has to answer are as follows:

-Whether to reverse Bush's newly implemented "Right of Conscience" view.
-Whether to overturn regulations such as one that makes fetuses eligible for health-care coverage under the Children's Health Insurance Program.
-Whether to cut funding for sexual abstinence programs, and whether to increase funding for comprehensive sex education programs that include discussion of birth control.
-Whether to allow federal health plans to pay for abortions.

But at the heart of these questions and the Supreme Court's decision on Roe v. Wade that started this 3-decade long debate on abortion is a central question: Is a fetus a human being?

If it is, it must possess all the characteristics of a human being, not the least of which is independent biological viability. Merriam-Webster defines viable as "capable of existence and development as an independent unit." According to The Endowment for Human Development, by 21-22 weeks (5 months and one week) after fertilization, the fetus's lungs gain some ability to breathe air, and this is considered the age of viability as "survival outside of the womb becomes possible for some fetuses." However, the fetus's dependence on the umbilical cord continues well into the third trimester of the pregnancy. While there may be other elements on which one can rely to determine the viability of a fetus, the concept of independent viability remains the central characteristic of any living organism, including human beings.

Science clearly establishes that an unborn or unhatched vertebrate cannot be considered to be a human even after attaining the basic structural plan of its kind - hence the term "fetus" to refer to all vertebrates at this stage. However, there continue to be millions of American who -- because of their church's teachings, genuine belief or as an excuse to control women's health decisions - matter-of-factly claim that a fetus is a human being while relying on no scientific or empirical arguments.

But even if one allows for some subjective discretion in defining the point at which a fetus turns into a human, the pro-choice position (one taken by the Supreme Court during Roe v. Wade in 1973) presents itself not as the liberal position, but the compromise position. What's important to note about the ruling is that while it did not declare abortion unconstitutional or force the viewpoint of the anti-choice camp over the pro-choice camp, it also did not force anti-choice Americans to accept the biological and scientific definition of what constitutes a human being. The ruling rather allowed those who believe a fetus is a human being to keep their fetuses and carry their offspring and those who believe a fetus is not a human being to choose whether they are socially, economically and emotionally ready to have a child.

But that was not good enough for most ardent anti-choice advocates. Since 1973, they have organized themselves around the ultimate goal of overturning Roe v. Wade and force their nonscientific and subjective definition of human being on everyone else. But in the mean time, they have also done what they could to make getting abortion as difficult as possible for women. Their efforts have ranged from violent means -- including bombing abortion clinics and killing doctors that perform abortions (ironic since the criminals commit this in the name of saving "life") -- to lobbying state and federal governments to take legislative and executive action to limit the accessibility of abortion. They use sensational language in making their arguments - such as calling pro-choice citizens "murders" and showing graphic images of abortion procedures to appeal to people's emotions so they no longer have to argue their point based on logic.

So how should President Elect Obama address the questions above in the context of existing national debate on abortion? Let's review the questions in greater detail.

Should Obama reverse Bush's newly implemented "Right of Conscience" view?
In the eleventh hour of his lame duck presidency, George Bush is trying to establish a "Right of Conscience," allowing medical practitioners and staff to refuse to participate in any practice they object to on moral grounds, including abortion, birth control and other health care as well. But think about the implication of opening the door of having the doctors decide what operations to conduct and what not to conduct based on personal moral beliefs; where would it stop? What if a doctor decides that heart transplants are immoral? Should she be allowed to willfully allow the patient to die? What if a doctor believes delivering a child is immoral because the world is over-populated, or that as long as gays do not have the right to marry and adopt children, justice is best served by preventing everyone from having children? Would these anti-choice advocates be willing to accept the risk that this doctor may be the only doctor on call when they take their pregnant loved one to hospital? The fact is that anti-choice advocates only wish to defend a doctor's "right" to refuse service based on moral objections if those objections fall in line with their anti-choice agenda.

The United States is a country of laws. One cannot drive through a red light if one morally opposes traffic lights because the laws are not written only to protect she who must follow it, but protect others from her actions. For the same reason, doctors are not legislators and have no right to impose their subjective moral view on everyone else. If a physician believes that his career choice forces him to compromise his moral beliefs, they are free to pursue other career options. Or alternatively, he can try to lobby the Congress or the American public to change the laws he opposes. But those physicians who decide to remain in the field must be legally obligated to follow the laws, whether they like it or not. The "Right of Conscience" view is an action that President Elect Obama needs to reverse immediately after taking office.

Should Obama overturn regulations such as one that makes fetuses eligible for health-care coverage under the Children's Health Insurance Program?
In order for one to be a child, one has to be a human being, and human beings are biologically independent and viable organisms, which fetuses are not. Therefore based on the discussion above, a fetus cannot be considered a child, and therefore should not be eligible for coverage under federal health insurance programs. And it is quite ironic that the Bush administration is interested in simultaneously blocking the passage of Children's Health Insurance Program and advocate for coverage of fetuses under the program. President Elect Obama cannot allow anti-choice advocates to play politics with important programs and reignite the social culture wars of the past in order to make statements and advance their narrow agenda.

Men's Rights in Abortion
It is important to discuss one aspect of abortion that President Elect Obama must bring into the national dialogue, and that involves a situation in which the right of a man must be protected. Pro-choice advocates rightly point out that as long as a fetus is not biologically viable, the woman carrying the fetus must have the exclusive right to decide whether or not to carry her pregnancy. If both the man and woman agree on whether to have the baby, there is complication in the decision-making. If the man wants the baby but the woman does not, the man must respect the decision of the woman. But what if a married woman decides to have the baby after finding out about her pregnancy, but her husband does not? Should a man be forced to fulfill child support and maintenance obligations for the child as required under Family Law? While the right to decide whether or not to have a baby exclusively belongs to the woman, the man should have the legal right within the first few months of the woman's pregnancy to choose and declare whether or not he accepts the financial obligations as they are required of the father under Family Law.

Should Obama cut funding for sexual abstinence programs and increase funding for comprehensive sex education programs that include discussion of birth control?
The goal of sexual abstinence program is to educate young people about how to prevent unwanted pregnancy and avoid sexually transmitted diseases (STDs). For that reason, teachers cannot teach their students that abstinence is the only way to prevent unwanted pregnancy, because it is not. There are many ways to have control over whether and when to have a child, including contraception, safe sex practices, sexual orientation and abortion. While the most comprehensive research done on the impact of abstinence-only programs showed that they had no visible impact in terms of delaying a teenager's sexual activities, latest data shows that nearly $175 million of federal spending continue to go into these programs every year. In comparison, teen pregnancy in the United States continues to be twice that in many European countries that advocate comprehensive sex education. In the meantime, more than 8 out of 10 Americans support education of both abstinence and other methods to prevent unwanted pregnancy and STDs. As part of his short-term agenda, President Elect Obama must push for the channeling of nearly all abstinence-only education funding to comprehensive programs that have both the support of the American public and have proven to be more effective.

Should Obama allow federal health plans to pay for abortions?
Even President Clinton who supported the right to choose did not allow any federal funds to be used to cover abortion costs. His argument was that he did not want to use federal funds that had come not just from pro-choice citizens, but anti-choice ones as well, toward an operation that did not have the moral support of all citizens. While the argument sounds reasonable, one cannot help but wonder why Presidents who use these arguments do not apply the same logic to other policies of the federal government. It is safe to say that most of the tax-paying citizens in this country have a moral objection to the continuation of the Iraq War. So why should they be forced to continue to support this war through their taxes (which by the way is leading to the killing of actual human beings)? The notion that anti-choice citizens should have the right not to have their taxes used under state and federal programs for an operation that is as legal and legitimate as any has no logical justification. President Elect Obama must make sure that as long as abortion remains legal, women have access to it. But as for any other operation, limits should be placed to prevent abuse.

President Elect Obama has presented himself as a president ready to compromise on important issues. But as he proceeds through the first few months of his presidency, he cannot treat abortion as another issue on which to negotiate. Instead, he has a unique opportunity to use his political capital to fundamentally reframe the debate and permanently establish one important fact: abortion is as legal and legitimate of a medical operation as any, and the government needs to do what it can to help women get educated about it and have easy and safe access to it.

Northern Irelands Record Abortion Figures Shock

Northern Ireland's record abortion figures shock
Friday, 2 January 2009 The Belfast Telegraph

A record number of women from Northern Ireland are opting to go to England and Wales to terminate a pregnancy, the Belfast Telegraph can reveal today.

Figures released by Health Minister Michael McGimpsey show that there were 1,343 abortions carried out in England and Wales where the woman gave a home address in Northern Ireland in 2007 — the majority of which would be regarded as illegal here.

According to the Department of Health statistics, 6,400 abortions were performed on women from Northern Ireland in hospitals in England and Wales between 2003 and 2007.

The latest figure was a rise of 48 on that for the overall 2006 tally while 179 more women went for abortions in 2007 compared to 2005.

However, it is feared that the number of women being forced to leave Northern Ireland for a termination is actually much higher as the figures do not include numbers of women travelling to Scotland or further afield for an abortion.

While abortion remains illegal in Northern Ireland, it can be carried out when a pregnancy causes a severe risk to the life of the mother and Mr McGimpsey has revealed that 99 such abortions were performed on women in Northern Ireland hospitals in 2007 — a rise of 36% from 2003.

The figures prompted a leading pro-life organisation to today call for the circumstances behind the terminations in Northern Ireland hospitals to be opened to public scrutiny.

Precious Life also said that the doctors who performed the 99 abortions in 2007 must be challenged about the legality of their actions and also called for police investigations into any believed to have been carried out illegally.

Director of the pro-life charity, Bernie Smyth, said: “These figures raise all sorts of further questions and we will be working to establish the answers in the New Year. A termination is illegal unless the life of the mother is at risk and there is a question as to whether these abortions were legal or illegal.

“It is a serious offence to take the life of an unborn child. We want to know why each and every one of these 99 abortions were carried out. I have been given information by someone with inside knowledge who said that an abortion was carried out at a hospital in Northern Ireland because the child was disabled.

“We want to know what happened to the bodies of these babies and whether death certificates were issued. If any of the abortions were illegal, the medical staff involved must be questioned by police and charged.”

The right of women in Northern Ireland to have a termination remains a controversial subject which threatened to collapse the Assembly earlier this year as a number of MPs from the mainland tabled a Parliamentary motion to bring legislation governing abortions in Northern Ireland into line with the rest of the UK.

Diane Abbott, one of the MPs who has campaigned to legalise abortion in Northern Ireland, said the figures released by Mr McGimpsey show there is a need for women to be able to access the same level of healthcare in Northern Ireland as the rest of the UK.

“The number of abortions and the number of women travelling from Northern Ireland to the British mainland for abortions continue to rise,” she said.

“This gives the lie to the claim by some politicians in the province that there is no demand for safe and legal abortion in Northern Ireland.

“In particular, I believe that women who travel from Northern Ireland to the British mainland for an abortion should not have to pay for the abortion. It is long overdue that this manifest unfairness was ended.”

Alliance MLA Anna Lo, a pro-choice campaigner, also said that the issue of legalising abortion in Northern Ireland is a matter of equality.

“Women who travel abroad for abortions are having to pay about £2,000 on top of travel and accommodation expenses so this is also a class, economic and social issue, and there are some women who can’t afford this option and go on to the internet to get tablets which cause a pregnancy to terminate, which can lead to medical complications,” she said.

Meanwhile, Dr Audrey Simpson, director of the Family Planning Association in Northern Ireland, said the figures prove there is a need for a Northern Ireland-based service whereby women can undergo an abortion without stigma or judgement.

“This highlights that fact that women in Northern Ireland will at certain stages in their life need to have an abortion and these women should be treated with respect and compassion,” she said.

“Politicians must recognise that women in Northern Ireland will always need abortions and they should fulfil their statutory obligation by legislating for easier access to abortions in Northern Ireland.”