Female infallibility

Imagine if I rocked up to the doctor and said look “I’m really unhappy with the fact that after having four babies, I’ve got a few flabby bits, my breasts have lost some of their youthful perkiness and so I need you to refer me to a cosmetic surgeon as soon as possible as I just can’t cope with the body that I’ve got”.

Their response would register somewhere on the scale between amusement and exasperation, and even if I professed a suicidal intent or poor quality of life due to dissatisfaction with my post-childbirth figure, most likely they would advise other measures such as diet and exercise alongside psychological counselling to get to the root of the problem. The same would apply in the case of serious body or gender dysmorphia; no doctor would refer a patient for an amputation as an instant salve for a distorted body image or would straightaway prescribe hormonal treatment for a woman who believed she should have been born a male.

But what if in any of these cases the woman wailed “but I’m a woman, it’s my body and I know my body and healthcare needs better than you and your years of medical training. I know that I need this procedure now and the NHS needs to provide me with it”? The answer would still be a resounding no, although patient intuition, rationale and desires should never be excluded when forming a clinical judgement, the role of the doctor or medic should be to objectively examine the facts of the case and use their medical expertise and experience to determine the appropriate outcome, which will at times be at odds with what the patient was hoping for.

Factors such as gender, sexuality or race are only ever considerations, never the determining factor. You can’t just go to the doctor with a set of expectations which you believe should be met on the basis of your sex.

Yet this is precisely what BPAS, one of the UK’s largest abortion providers are aiming for with their ‘trust women’ campaign, expounded here by Clare Murphy one of their directors, which has the express purpose of formally liberalising the abortion law. When a decision involves fertility and reproduction, then the woman’s gender should take precedence in the decision, regardless of whether or not she may be misinformed in some way, or whether or not her decision is a sensible or even moral one.

The argument is slickly framed in the usual compassionate terms about women getting the care that they need and deserve and is superficially reasonable and appealing – a woman should be able to decide the course of action that is right for her, but the massive elephant in the room, is the unborn baby who as ever, is conspicuous by their absence.

If the decisions about reproduction didn’t involve an unborn child, no reasonable person would attempt to dictate to a woman what she should do with her body (although they could make a reasonable case as to whether or not the NHS ought to fund such decisions), but there is not simply one body involved in the case of pregnancy.

The simple fact of the matter is that an unborn child is not a part of the woman’s body, it has an entirely separate genetic code, often a separate blood type or race and crucially it is possible for a foetus to die while a mother lives and vice versa. This would not be possible if the mother and baby were one and the same. Even the late atheist Christopher Hitchens who was himself an abortion advocate admitted that embryology conceded morality, stating that an ‘uborn child, even when used in a politicized manner, is a material reality’.

The existence of an unborn child undermines the entire crux of this argument which is wholly centred around a woman’s body. ‘Trust me to make the decision as to whether or not to kill my unborn baby, because I’m a woman.’

I’d love to see how a similar campaign waged by males would play out. “Trust me as to whether or not I want to pay child support, or form a relationship with my child, I’m a male and therefore best placed to know whether or not I want to be a father. Only men can determine the extent to which they should be involved in their children’s lives”.

Perhaps the most disingenuous and ironic aspect of the campaign is the attempt to conflate decisions about childbirth with abortion when the aims and outcomes of both procedures are in direct contravention of each other. Murphy convincingly argues that “women should have access to unbiased, evidenced-based information about all their options, delivered in a way that seeks to inform, but not persuade a woman with all modes of delivery on the table”.

It sounds all very wonderful and idealistic, but the reality is that childbirth is a messy, unpredictable business with the potential for things to go disastrously wrong and therefore while women should be informed of their options, there are instances where certain scenarios should be off the table, especially when we are talking about a taxpayer-funded health care system and taking into account that there are two lives at stake.

When it comes to giving birth, it is important that a woman is in as comfortable and stress-free environment as possible, but the choice of surroundings or pain relief should never endanger her safety or that of her unborn baby. Unusually perhaps for a woman who has never managed to give birth without direct medical intervention, I am a big advocate of home births and natural births where at all possible and wary of the over-medicalisation of childbirth, which in my case has led to a cascade of cesarean sections.

But when, as in my case, a midwifery supervisor tells you that if you were to give birth at home, it’s likely that you would bleed to death due to a previous history of hemorrhage, and that she cannot sanction it, is that unbiased and not persuasive? Does that really leave all options on the table? What about when an obstetrician informs you that your baby is presenting in a transverse or oblique position and cannot therefore be born naturally without killing you both?

As every mother knows, you can do all the reading you like, be as informed as possible, but when it comes to childbirth you need to be flexible enough to rip up that treasured dream of floating in a pool of candlelit water and do whatever is necessary to get the child out as safely as possible.

If abortion is to be compared with birth, then the doctor’s assessment of best interests is paramount. The idea that a woman’s gender makes her judgement and decisions unimpeachable is infantalising dangerous baloney, which does women no favours whatsoever. Since when did being a women render one’s medical and moral judgement infallible? Where is the evidence demonstrating that being in possession of specific set of reproductive organs improves one’s critical thinking or decision making skills?

If it’s true that we might not always like or approve of certain reproductive decisions, whether childbirth or abortion related, then it is certainly legitimate to question whether or not the NHS funded by the taxpayer, ought to encourage and endorse them. We know for example, that all other things being equal, that a cesarean section is a much riskier, more complicated and costlier method of delivery than normal childbirth. An elective c-section ought not to be offered as a standard choice for women, unless there are compelling medical reasons which would make a natural delivery unsafe. Equally it is not the general public who should challenge a woman’s decision to home-deliver a complicated pregnancy, as Clare Murphy suggests, but rather her medical team.

The same goes with abortions. In a staggering admission, this director of BPAS says that there are women who might have abortions for reasons which are not quite good enough, but those decisions must still be respected, because it is the woman who has to bear the consequences of those choices. So it’s alright to stand on the sidelines and watch a woman take a disastrous decision because any negative repercussions and resulting suffering is hers alone? She’ll have to cope with it if it all goes wrong and we should make no attempt to interfere, in the same way that presumably we should not attempt to dissuade people from setting off on other destructive courses of actions. All that matters in life is that people have come to their own decisions about their bodies, even if they are bad ones?

In short then, a woman can abort a perfectly healthy baby until 24 weeks on whatever grounds she likes. such as the gender of the baby, or that she’s had an unexpected holiday invite, she wants to appear on the television or even because to continue with the pregnancy puts her at fear of violence or reprisals from her partner or family. A woman’s decision must always be trusted, supported, encouraged and paid for, even if it is born of dubious motives or self-interest. A woman aborting her healthy twins at 23 weeks  whom she’d previously decided to keep, because of family pressures, is the price we have to pay?

Even if the decision is blatantly flawed, unjust and terminates the life of another for no good reason (not that there ever can be a good reason to kill), society must turn a blind eye for the greater good of the (female) cause. Now where else have we seen this logic employed? It all sounds eerily familiar.