Recent Resources for Feminists
Colombia: Depenalised abortion, in three circumstances, to shrink deadly backyard market Print E-mail
 2006; 367:1645-1646

Court ends Colombia's abortion ban

Mike Ceaser

Until recently, Colombian law prohibited all abortions. Nevertheless, about 300 000 to 400 000 women undergo the procedure each year, often performed by untrained backstreet abortionists. A May 10 court decision has now depenalised abortion in three circumstances. Mike Ceaser reports.

Cardiologist Miguel Ronderos walks between the rows of small beds in Bogota's Cardioinfantil Foundation Hospital. Many of these newborn babies have congenital defects that will cause anguish for their parents and cost their families and society fortunes. “In North America and Europe, 90% of major malformations are detected in the womb”, says Ronderos. “Here in Colombia we don't reach 1%.”

Supporters of legal abortion hope this situation will change with a ruling on May 10, 2006, by the Constitutional Court that legalises the procedure in cases of rape, when the pregnancy endangers the woman's life or health, and when the fetus has severe malformations. Until the decision, Colombian law prohibited abortion in all circumstances, so doctors rarely bothered to undertake prenatal tests for even severe congenital defects, since women had no legal option to end their pregnancies.

Despite the prohibition, about 300 000 to 400 000 illegal abortions have been performed annually in Colombia. Until the new decision, Colombia, together with Chile and El Salvador, were the only three Latin American nations that prohibited abortion in all circumstances.

The court ruling came in response to a lawsuit filed last year by Monica Roa, an attorney with Women's Link Worldwide. She argued that Colombia's abortion law unjustly discriminated against women, especially the poor. One study estimates that clandestine abortions cause 28% of maternal deaths in Colombia, a disproportionate number of which are among poor women. “The women who live in rural areas are the ones who pay the cost in health, or even with their lives”, because abortions are illegal, she says.

Before the ruling, all abortions carried prison terms of up to 4·5 years for the woman who terminates her pregnancy and for the abortionist. In practice, in the few cases actually prosecuted, the women were usually sentenced to house arrest.

Advocates for abortion rights celebrated the court's decision, while Catholic organisations vowed to have it reversed. Observers debated the ruling's breadth, particularly whether the term “health” used in the decision included psychological problems and non-life threatening illnesses, and whether fetal malformations included non-fatal disorders such as Down's syndrome. Abortion-rights advocates also expressed concern that women have access to the procedure. In some other Latin nations where there is a legal right to abortion, women are still unable to obtain the procedure because doctors refused to perform it. While the court decision took effect immediately, the legislature and health ministry are expected to write regulations for its implementation.

Ronderos, for one, expects the court decision to be interpreted broadly, and that the public-health system even plans to cover the procedure. The decision “gives the doctor the prerogative to use his own evaluation”, of whether or not an abortion is justified, Ronderos said.

Colombia's prohibition has generated a flourishing underground abortion industry beyond the oversight of health officials. As a result, abortion providers have ranged from doctors operating in well-equipped medical clinics to untrained midwives.

Marcela Caicedo, a social worker with a women's health education programme in a poor area of Bogota, says that a woman nearby does abortions in a dirty house with peeling paint. Caicedo says she doubts the woman has even a high-school diploma, much less medical training.

Many of the more established clandestine abortion clinics are located in a central area of Bogota full of old homes, small restaurants, and store front clinics that offer ultrasound and other health services for women.

On the pavements, men hand out cards advertising treatment for “delayed menstruation”. In one clinic with a sign advertising general medicine services and varicose vein treatment with a “German technique”, a reporter posing as the partner of a Colombian woman was told the “procedure” would cost about US$50. In a second clinic two blocks away, an abortionist described the operation as fast and easy. He assured the woman that her fertility would not be impaired. “There are women who have abortions and get pregnant again right away”, he said.

But a 27-year-old woman who paid about $40 for an abortion in that clinic said she was not given anaesthetics and that when she cried too loudly the employees threatened her with the police and then hurried her out as soon as the procedure was over. Her post-abortion ultrasound was done in another clinic with a hair salon sign on its front. The woman, who requested anonymity, now fears she is infertile.

According to press reports, in early February, a 23-year-old mother of two named Viviana died in the clinic that offered the “German technique” while having an abortion. She had gone to the clinic with her sister, who later told reporters that Viviana had been 4 or 5 months pregnant and feared what the father of her two children would do if he found out. The sisters arrived at the clinic at about 1500 h, and Viviana paid 500 000 pesos ($222), which is a large sum for a lower-middle class family in a nation with a monthly minimum wage of $181. At about 1700 h, the doctor emerged to say that Viviana was bleeding badly. At 0400 h, he acknowledged that Viviana was dead and sent the sister home in a taxi after giving her 20 000 pesos and two beers, and telling her to say that she had been out drinking alone.

But the sister returned with her father and the police. They found the clinic vacant, except for Viviana's body and the doctor, who insisted that he had just dropped by to pay the rent, the sister told local media. “At no time did the [doctor] call an ambulance”, she told local television. The doctor was arrested and released pending an investigation. After Viviana's death, this clinic was closed, with yellow police tape in the windows. But nearby other clinics continued offering their services.

In a second recent case, a 34-year-old mother of four was diagnosed with ovarian cancer while 3 weeks pregnant. Doctors refused to perform an abortion or treat her cancer because that would harm the fetus.

In Bogota's Simon Bolivar Hospital, gynaecologists Daniel Montenegro and Fred Lozano treat about five women a month for complications after abortion. Almost all of their patients are younger than 30 years, the doctors say, many are teens and most are poor. While the doctors recall one case of a young woman who had had 22 abortions, they said that after one, most do not repeat their mistake. Years ago, they often saw “catastrophic” cases, such as a woman in 1982 who arrived with pieces of her intestine protruding from her vagina. Although surgeons found fragments of a fetus near her liver, the woman died still denying she had had an abortion, Montenegro recalls.

In recent years, however, the number of serious complications has declined, the gynaecologists say. They attribute this improvement to the increased availability of contraceptives since the early 1990s, as well as to the use of the morning-after pill. But the greatest decrease, they say, is owing to the popularisation of the use of misoprostol, a prostaglandin analogue used to treat gastric ulcers but which can also induce abortions.

However, in poorer, rural areas, the incidence of complications from abortion continues to be high. In the city of Ibague, with 400 000 inhabitants, health officials recorded three deaths from abortion complications last year. Ibague authorities became so concerned about the high incidence of sexual assault that late last year they began distributing free morning-after pills.

Montenegro and Lozano say Bogota's clandestine abortion industry has become so institutionalised that clinics often phone the hospital before sending over patients suffering complications. The gynaecologists add that most of the illegal clinics' abortionists are actually qualified physicians.

Both doctors support limited depenalisation of abortion, because they believe it will make the procedure safer for women in extreme situations. But even if abortion were completely legal, they say, they would refuse to do the operation except in the three situations included in the ruling. “When a pair of kids have their fun and then want an abortion, no”, says Montenegro. “That's an act of irresponsibility.”

Even providing care after an abortion can bring doctors ethical dilemmas. Attorney Roa says that since she filed her lawsuit, increasing numbers of doctors have reported to police women who seek help for post-abortion complications. Roa says that doing so violates a doctor's legal obligation to preserve a patient's privacy. Yet, although they say they have never done so, Montenegro and Lozano defend informing police when they see that an abortionist has committed malpractice “As a citizen, one has the obligation to denounce illegal acts”, says Lozano.

Ronderos of the Cardioinfantil hospital expects safe, legal abortion will become so accessible that the clandestine industry will shrink dramatically. And he expects to see far fewer newborn babies with severe deformities. “Having a non-viable baby isn't anybody's reason for being a parent”, he said.

US: Death risk from RU-486-based abortion appears approx 10 times that from surgical abortion Print E-mail

Refer Feminist Research 1991:

   

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Thursday May 11, 2006

Scientists Will Gather to Discuss Safety of Abortion Pill

By GARDINER HARRIS

Worried about a bacterial infection that led to the deaths of at least five women who took the abortion pill RU-486, scientists from the nation's leading public health agencies will gather in Atlanta today for the first meeting in 10 years on the drug's safety.
 

Dr. James McGregor of the University of Southern California [J. Emilio Flores for The New York Times]
 

Dr. Vanessa Cullins, a Planned Parenthood vice president [Marilynn K. Yee/The New York Times]

Scientists from the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health will consider whether the means of administering abortion drugs make pregnant women more susceptible to the bacterium Clostridium sordellii.

They will also discuss whether the deaths may signal the emergence of a new and more virulent strain of the bacterium that poses a threat to pregnant women generally, not just those who use RU-486.

The five deaths were confirmed as resulting from infection by Clostridium sordellii, which can induce toxic shock. The cause of a sixth death has not been announced, although the same bacterium is suspected.

Clostridium sordellii infections are rare, but pregnancy appears to increase the risks, said Dr. David E. Soper, vice chairman of the obstetrics and gynecology department at the Medical University of South Carolina.

Abortion experts have been at a loss to explain why four of the deaths occurred in California. Initially, the F.D.A. investigated whether the pills used in California might have been contaminated, but an agency official said tests had found no evidence of contamination.

Another theory concerned the role a dry climate might play in encouraging the growth of Clostridium sordellii, which lives in soil.

Some experts believe that pregnant women who take RU-486 with another drug, misoprostol, are more vulnerable to infection. RU-486 by itself ends early pregnancies, but the pill is routinely given along with misoprostol, which causes uterine contractions that expel the dead fetus.

After examining many studies, the F.D.A. in 2000 approved a protocol that requires women to take misoprostol orally. But abortion providers have instead instructed women to insert misoprostol vaginally.

Some scientists say the vaginal insertion may introduce bacteria along with the drug.

"The tablets are small, and women don't necessarily know where their vagina begins and ends," said Dr. Phillip G. Stubblefield, a professor of obstetrics and gynecology at Boston University.

If women are not careful, Dr. Stubblefield said, they can easily drag the tablet across the perineum, between the rectum and vagina, and contaminate the vagina with the bacteria.

Other experts dismissed the contamination idea. "I'm still using the vaginal route," said Dr. Mitchell Creinin, director of family planning at the University of Pittsburgh.

In 2004, the F.D.A. put strong warnings regarding the risks of infection on RU-486 labels.

There has been no hint that the F.D.A. is considering further restrictions on the use of the drug.

Abortion rights advocates are also concerned over the F.D.A.'s indefinite delay in deciding whether to approve over-the-counter sales of Plan B, an emergency contraceptive that has a use different from that of RU-486. Most agency observers blame politics for the delay.

After the deaths, the National Abortion Federation's insurer insisted that its clinics use the F.D.A. protocol when providing abortion drugs or face the loss of their medical malpractice insurance.

In the United States, some abortion doctors have decided against using RU-486 altogether. Among them is Dr. Peter Bours of Portland, Ore., a member of the federation.

"I'm not sure I want to be in a shared insurance group policy with people doing medical procedures because you share that risk," Dr. Bours said.

Until March, Planned Parenthood, the nation's largest abortion provider, continued to instruct its doctors to give misoprostol vaginally, said Dr. Vanessa Cullins, vice president for medical affairs. But with the sixth death, in March, the organization now uses an oral protocol.

The deaths linked to RU-486 have created an unusual split in the small world of abortion providers, a growing number of whom say that they will not dispense the drug. The risk of death with pill-based abortions now appears to be about 10 times that of surgical abortions.

Dr. James McGregor, a visiting professor of obstetrics and gynecology at the University of Southern California, said RU-486 might make women more susceptible to Clostridium sordellii in part because the drug may inhibit mechanisms that moderate immunity. In cases of toxic shock, the body's immune response becomes lethal.

"The body ends up attacking itself," and RU-486 may encourage this attack, Dr. McGregor said.

Dr. Soper, of South Carolina, said that once a Clostridium sordellii infection took hold, there was little hope.

"I'll never forget when I was a fellow in San Diego, and I had this post-partum patient literally die before my eyes," Dr. Soper said.

After the patient gave birth, she told her husband that she felt extremely tired. He took her back to the hospital, and she died quickly, Dr. Soper said.

The oral administration of misoprostol is more common in Europe, but vaginal use there has been growing.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, which provides 25 percent of all abortions in Britain, said her agency relied on vaginal drug insertion.

Clinics in Sweden and Hong Kong do the same, and vaginal use is growing in France, according to Gynuity Health Projects, a New York group that supports the use of RU-486 around the world.

In the debate over RU-486 versus a surgical abortion, women have diverging opinions. A 43-year-old New York mother of two who said that she had had "every kind of abortion," told her abortion provider during a counseling session recently that she would consider only a pill-based procedure.

"I do not like doctors and hospitals," said the woman, who did not wish her name to be used for privacy reasons. "Both of my children were born at home without anything. And that's how I want to have my abortion: in home, in my privacy, at my own pace and without somebody's other agenda over me."

Reached at home after taking both abortion drugs, the woman said she felt fine. After going to the bank, the pharmacy and the deli, she planned to nap much of the day, she said.

Anne Hawkins, 36, also of New York, said she, too, had had both pill-based and surgical abortions. But taking RU-486, she said, "was the worst experience, the most physically and emotionally painful thing, that I've ever been through."

Ms. Hawkins had another abortion in March, and she chose surgery.

"It was 10 minutes, max, and then it was over," Ms. Hawkins said of the surgical procedure. "The pill for me was the experience of having a baby. Contractions for 10 hours, sweating, screaming, being by myself. It was emotionally scarring and physically horrible."

Zeina [Not the courageous film-maker's real name]: Iraq: The Women's Story Print E-mail
 UK -- Monday 8th May, 20:00 hrs

Iraq: The Women's Story

 

The invasion of Iraq heralded promises of freedom from tyranny and equal rights for the women of Iraq. But three years on, the reality of everyday life for women inside Iraq is a different story. To make this film, two Iraqi women risk their lives to spend three months travelling all over the country with a camera to record the lives and experiences of women they meet. Dispatches: Iraq: The Women's Story provides a compelling account of a life inside Iraq that is rarely seen on news bulletins: stories of ordinary women whose struggle to survive has only worsened since the war.
Franny Armstrong: Drowned Out Print E-mail

 

Spammer Films

Click above banner, and scroll down to lower RHS "Of course we feel like crying WATCH" to view DROWNED OUT,  75 mins, 2002. UK/ India, Dir: Franny Armstrong

Shot over three years by Director Franny Armstrong (McLibel), Drowned Out tells the true story of one family's inspired stand against the destruction of their land, homes and culture. The 75 minute no-budget, no-electricity, no-Hindi documentary has been seen by more than 14 million people.

Three choices. Move to the slums in the city, relocate to a barren resettlement site with no drinking water or stay at home and drown.


The people of Jalsindhi in central India must make a decision fast. In the next few weeks their village will disappear underwater as the giant Narmada Dam fills.

Bestselling author Arundhati Roy joins the fight against the dam and asks the difficult questions. Will the water go to poor farmers or to rich industrialists? What happened to the 16 million people displaced by fifty years of dam building? Why should I care?

Drowned Out follows the Jalsindhi villagers through hunger strikes, rallies, police brutality and a six year Supreme Court case. It stays with them as the dam fills and the river starts to rise.  
 
"At once angry, compassionate, disturbing and yet empowering, it makes for urgent and necessary viewing" - TIME OUT

"Heartbreaking" - SAN FRANCISCO CHRONICLE

"Documentaries rarely, if ever, come better than this" - BERMUDA ROYAL GAZETTE

"Masterfully crafted" - ONEWORLD AWARDS JURY

"Quiet, fierce, beautiful" - NEW INTERNATIONALIST

"A real eye opener ... powerfully intimate" - FILM JOURNAL INTERNATIONAL

"A film of enormous heart, grit and insight, that is both taut political essay and enormously moving plea" - SAN FRANCISCO FILM FESTIVAL JURY

Muriel Spark: Feminist author, February 1 1918 - April 14 2006 Print E-mail

Sunday, April 16, 2006


Dame Muriel Spark at the Edinburgh International Book Festival 2004. Picture: Bill Henry via The Scotsman [scroll down for article]

Author Muriel Spark dies in Italy

Rome, Reuters: Nominated twice for the prestigious Booker Prize - in 1968 for Public Image and in 1981 for Loitering with Intent - Ms Spark won the Bram Stoker prize in 1987 for her biography of Mary Shelley.
 
Scottish-born novelist Muriel Spark, 88, died in Italy on Friday. She will be buried in Tuscany, an Italian official said.

Describing Ms Spark as an open person, Mayor Massimiliano Dindalini said, “She was both fascinating and down-to-earth at the same time. Her loss will be very difficult to overcome.”

Though Ms Spark wrote 24 novels, three biographies and several short stories, she is best known for The Prime of Miss Jean Brodie, a novel about a young teacher stirring thoughts of emancipation at an Edinburgh girls’ school before the second world war. The book was made into a critically-acclaimed film starring Maggie Smith in 1969.

Ms Spark died on Friday in Florence after battling health problems since last year. She was born in February 1918 in Edinburgh to a Jewish father and Anglican mother.

She married in 1937 and moved to Southern Rhodesia - now Zimbabwe - but the marriage did not last. During World War Two, she worked for the Foreign Office on anti-Nazi propaganda.

A self-styled “experimentalist”, Ms Spark was hailed as being far ahead of her times, both in her style of writing and the subjects she chose. She used sharp satire to expose the pettiness and vanity pervading all facets of life and death.

Her last novel, The Finishing School , was published in 2004.

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