Paternity, Patriarchy, and Reproductive Rights

By Joyce Arthur

(speech, December 2, 2006 “Remember Me” memorial, Vancouver BC)

How does the right to abortion intersect with the issue of violence against women?  In many ways, as I hope to explain in my talk today. First, I think there’s three main types of violence against women, including physical violence, emotional violence, and socio-political-economic violence. An example of the latter is the just-announced closure of Status of Women offices across the country. But all three types of violence against women are features of the anti-abortion mentality, perhaps physical violence most of all.

Forced motherhood is violence against women. But that’s just one example of the violence done to women because of their sexual and reproductive capacities, which is wide-ranging and systemic. I’d like to make a broad generalization, and I hope I’m not being too simplistic, or obvious.  But in my view, the biggest difference by far between men and women, the only one that’s really important – is that women can bear children and men cannot. I think that difference, in one way or another, directly or indirectly, accounts for virtually all the oppression and violence against women we see in the world today.

What it all comes down to is sexuality. We need to have sex to have children (unless you can afford to do it in a petri dish.)  How we express ourselves sexually, or more accurately, how we’re expected to express ourselves sexually, is closely tied to our cultural notions about procreation and motherhood – which in turn has everything to do with oppression and violence against women.

Let’s go back to our patriarchal history for a moment. The key to the origin of patriarchy probably lies in the biological need for people to invest in their own children, rather than someone else’s. In the animal world for instance, animals do not normally look after the offspring of others, unless they’ve been tricked into it. Males will even kill another male’s offspring so the female will be free to mate with them instead. Now, women always know that the children they bear are related to them, but men can never know for sure who their genetic offspring are. This male dilemma doesn’t matter much to women, because women are more interested in finding someone reliable to help provide for their children – and that someone does not have to be the biological father. In fact, female deception in this regard has always been common—it’s been estimated that up to nine percent of children in the world are being raised by men who only think they are the fathers.[1]

In ancient human societies, the obvious and most practical way for men to ensure that they invested only in their own children was to dictate and restrict women’s sexual behaviour. Throughout patriarchal history, society has guaranteed men’s paternity by controlling women’s reproductive capacity. Here’s a list of some common ways this happened, and still happens today in various countries:

Most of these terrible injustices need no further comment, we’re quite familiar with most of them.  But I want to add to this list the crime of raping women, in particular, the type of deliberate rape that is done in some regions of the world in order to “ruin” the woman and “dishonour” her family. This type of rape leads directly to such abominations as male family members abandoning or killing their daughter or sister in order to protect the family honour, or forcing her to marry her rapist. In a similar way, mass rape during war is used as a weapon to humiliate and dishonour the enemy – not the raped women themselves, but all the men of their society. So, instead of rape being a crime of violence against women, it’s seen as an insult to men’s honour. That attitude comes from the patriarchal tradition that women and their sexuality must be owned and controlled by men to protect their paternity.

These traditional patriarchal systems that control women’s sexuality and reproduction are still protected today by laws, governments, judicial systems, religions, social institutions, and even by most men and women. By definition, those who set these right-wing, restrictive norms based on their traditional religious and cultural values are opposed to a woman’s right to autonomy – the right to control her own body and her fertility. (By the way, I have a tendency to divide the world into two factions – right-wing versus progressive, and I just want to make clear that lots of women are right-wing and anti-choice, and lots of men are progressive and pro-choice. So when I’m talking about the evils of patriarchy, I’m not blaming men in general, and certainly not the many wonderful pro-choice men out there.)

It’s only in the last 50 years or so that women, at least in the western world, have really achieved the means to control their own fertility. Many reliable methods of contraception exist to choose from, and when all else fails, we now have legal and safe abortion. Abortion is a crucial backstop for contraception, it’s the birth control method of last resort. It’s impossible for women to really control their fertility without access to abortion because no contraceptive is 100% effective, and because women can’t always access birth control or may not use it correctly. Of course, women have always tried to control their fertility in one way or another. Birth control has an ancient history, and some early natural methods were actually quite effective, including crocodile dung and honey placed in the vagina as a barrier method, a tea made from beaver testicles boiled in alcohol, and half a squeezed lemon used as a diaphragm. Also, women have always resorted to abortion, in every era and every culture. But it’s been clandestine, and often unsafe. As long as it was hidden, it didn’t really exist, so it wasn’t an issue for male authority.

But today, for the first time in history, it’s official and it’s public that women no longer need to be slaves to their biology. Contraception is widely available and legal throughout the world as part of public healthcare, and so is abortion to a lesser extent. Unfortunately, the very idea that women can control their own fertility is a frightening development for a lot of people. Because it really gives women power over paternity – they can decide, on their own, which man should father their child, and which won’t. They can decide when to have children, or whether they want any at all. And they can decide to abort any particular pregnancy. Men have lost control over women because they’ve lost control over paternity. That’s why we see such a backlash by right-wing governments and groups today against pre-marital sex by women, contraception, and especially abortion. Abortion is the flashpoint in this war, because the patriarchal right-wing can’t stand the thought of women having the power to abort men’s babies – the ones put there by men’s actions, by men’s seed. A woman deciding to have an abortion is the ultimate insult to male authority.

It’s obviously true that for human beings to survive and prosper, a lot of women need to have babies – it’s a biological and social imperative. And we’re all pro-life - we love babies and children and we want to protect them.  But hard decisions have to be made, in order to ensure the health, well-being, and very survival of one’s self, and other members of one’s family or community, and that’s why women have abortions. Of course, voluntary pregnancy and motherhood are absolutely wonderful things. The power and strength of women to bring forth life through pregnancy and childbirth is sacred. Unfortunately, it’s not nearly celebrated or respected enough in the world today. Instead, it’s taken for granted, like it’s a woman’s natural duty to bear and raise children, regardless of her own wishes or circumstances.

Actually, it’s even worse than that. The health needs of pregnant women are routinely overlooked and ignored in many parts of the world, and that leads to over half a million preventable deaths of women every year due to pregnancy, almost all in the developing world.[2] While one woman in 2800 can expect to die from a pregnancy in the developed world, one in 16 will die in poorer regions. This represents the largest disparity between developed and developing regions of any health statistic. Here’s a more specific comparison – in Afghanistan, women die during pregnancy at a rate of 1 in 6, in the United States it’s 1 in 2,500, and in Sweden, it’s 1 in 29,000. Africa is home to a disproportionate number of maternal deaths—just over half of the world's total. In some parts of the continent, 1 in 7 women die from pregnancy.

For every pregnant woman who dies, about 30 suffer serious injury, infection, or disability—that's over 15 million women a year. Babies often don't survive either—three million infant deaths and stillbirths occur every year as a result of pregnancy complications and maternal death. And when a pregnant woman dies, her existing children have a much higher risk of dying within the next two years.[3] Maternal mortality doesn't affect just women, in other words—it devastates entire families and societies.

Maternal mortality numbers are a glaring example of politics trumping human rights. Women and their children are not valued or respected; if they were, basic resources would be made available to ensure their well-being and guarantee their rights.

The causes of maternal death are almost all preventable. The leading cause is severe bleeding (25%), followed by infection (15%), and then unsafe abortion (13%). Various other treatable medical problems account for most of the rest.[4]

The most common situation that pregnant women in developing countries face, according to the WHO[5], is no access to healthcare or poor quality healthcare, both of which are caused by, or made worse by poverty and ignorance. All these factors reflect a lack of commitment to women's health and welfare by governments and policy-makers.

There are many other risk factors for maternal deaths in developing countries[6]. Some of the more tragic ones include female illiteracy, teenage pregnancy because of forced early marriage, malnutrition, lack of obstetric drugs, harmful traditional medical beliefs and practices, and of course unsafe abortion in countries where it is still illegal. Women in developing countries often have little or no access to contraception, either.

Reduction of maternal mortality is one of the major goals of the World Health Organization, but so much remains to be done. High rates of maternal deaths have persisted since the International Safe Motherhood Initiative was launched in 1987.[7] The struggle has been hampered by many logistical problems, such as difficulty in counting maternal deaths. It's also very difficult to provide healthcare in remote or war-torn areas, obtain resources and funding, educate women in countries where most women are illiterate, and persuade local governments to implement progressive laws and policies. For example, criminal laws against abortion should be repealed because they do nothing to stop abortion.

Abortion is probably the world's most common surgical procedure. About 45 million abortions are performed every year, 19 million of them illegal. Abortion is practiced widely by women all over the world, across all social classes, and regardless of laws against abortion. Roughly one-third of the world's women live in countries with strict abortion legislation, where women are not allowed abortion under any circumstances, or only in cases of rape, incest, or where the woman's life or health is in danger. As a result, of the 19 million women who resort to dangerous illegal abortions every year, 68,000 of them die. Five million more are injured or left infertile. That means women are experiencing serious complications at a rate of over 25%, for a medical procedure that is normally one of the safest and simplest of all. Unsafe abortion is the only cause of maternal mortality that is entirely preventable.

On the bright side, more and more leaders and governments understand that the death toll related to unsafe abortion is unacceptable, and that imposed childbearing is a serious denial of women’s rights. But these changes are slow in coming, and they still face stiff opposition from right-wing countries and the global anti-choice movement, including the Vatican. They claim to value life and want to protect life. But this is not what it’s really about for them. Most so-called “pro-lifers” do not actively oppose the death penalty, war, or environmental degradation. They do not support contraception and universal access to health care. They do nothing about the 4 million infant deaths per year from preventable causes like malnutrition and infectious diseases. The bottom line for the anti-choice movement is they don’t want women to have control and autonomy.

I’d like to expand a bit on the statement I made at the beginning: “Forced motherhood is violence against women.” I’m not talking in the abstract, I mean real physical violence, as well as emotional and socio-political violence. Pregnancy entails profound physical, psychological, and long-lasting consequences for a woman—it is not a mere "inconvenience" – a woman’s freedoms are significantly restricted if she is forced to carry to term. Also, going full-term and delivering a baby is far more medically risky than having an early abortion. Every pregnancy carries some risk, even normal healthy ones. In fact, full-term pregnancy and childbirth has a complication rate 25 times that of early abortion, and a risk of maternal death that is 10 times higher than early abortion. Even though women rarely die from pregnancy now in the affluent western world, some still do, while many others come close to death or damage their health in some way. There are many contraindications for pregnancy, and often, women with risk factors, such as diabetes or heart disease, simply choose not to get pregnant to protect their health. Women in the developing world usually don’t have that luxury.

The point is, a woman must have the right to decide whether or not to accept such a risk to her health and life, whether that risk is small or large. I’d like to quote a Canadian Supreme Court decision, Dobson vs. Dobson from 1999, which said that a woman and her fetus are considered "physically one” person under the law. “The legal unity of pregnant woman and fetus precludes the finding of a duty of care” to her fetus, because that “would amount to a profound compromise of her privacy and autonomy.”[8] This finding essentially gives a woman the right to defend her life and health by having an abortion.

In Canada, abortion rights were granted to women based on their constitutional right to “security of the person” under our Charter of Rights and Freedoms. This clause also encompasses a person’s right to obtain or refuse medical treatment, and to physically defend oneself from attacks by another. Now, a fetus is not a legal person in Canada, but it may have rights in other jurisdictions to some extent. However, it can be argued that women have the right to abortion even if the fetus is a person with legal rights—because abortion rights can be advocated from a framework of self-defense, instead of “choice.”[9]

That’s mostly because of the physical risks of pregnancy that I just mentioned. But there’s another important aspect to this, which relates to the fetus itself. A fetus is not innocent, as anti-choice people claim. Although an unwanted fetus has no ill intent, it’s co-opting the woman's body and endangering her life and health against her will.  No-one is legally obligated to risk their own life and health to save someone else, whether it’s by donating a kidney, jumping in the river for a drowning victim, or even just donating blood – not even if it’s to save their own son or daughter. So how can a fetus have even more rights over the woman’s body than her born child? It can’t. Even if a fetus has a right to life, a pregnant woman cannot be required to save it by loaning out her body for nine months against her will. Once a woman is pregnant, she must give her consent for the pregnancy to continue,[10] otherwise it constitutes an act of violence against her person.

Coming back to Canada and our Supreme Court, it’s been 18 years since the court threw out Canada’s old abortion law, and there’s been nothing to replace it since. Canada is the only democratic country in the world with no laws restricting abortion since 1988, and we’ve proven that we don’t need an abortion law – and neither does any other country. Abortions in Canada have become earlier and safer, and the number of abortions has become moderate and stable. Current abortion care reflects what most Canadians are comfortable with, and women and doctors act in a timely and responsible manner, with no need for regulation. In contrast, a wide variety of laws restricting abortion exist throughout the world, some harsh, some more lenient. But not one of them has anything to do with protecting women’s health and lives. The 68,000 women’s lives lost each year to unsafe abortion are happening mostly in countries that have total bans on abortion except to protect the woman’s life. The hypocrisy of laws that pretend to save women’s lives, but which actually slaughter them by the thousands, demands their immediate repeal. All anti-abortion laws and regulations should be repealed. Only when abortion has the same legal status as any other health procedure can it be fully integrated into women’s reproductive healthcare. Until then, the violence of forced motherhood will continue.

Although Canada is a good model in many ways for other countries, we still have problems. We do have one very annoying, and very illegal, restriction. A provincial regulation in New Brunswick says abortions can only be funded by Medicare when they are approved by two doctors and done in a hospital by a specialist. This law is in direct violation of the 1988 Supreme Court decision on abortion and the Canada Health Act. The effect of this law is that poor women have to jump through bureaucratic hoops, endure long waits for a hospital abortion, and sometimes end up having to carry to term, because they can’t get a hospital abortion in time. That’s violence against women.

Over half of abortions in Canada are still done in hospitals, because clinics only exist in the larger cities. But about 80% of hospitals don’t even perform abortions. In addition, some hospitals have long waiting lists, a requirement for doctor referrals, quotas or gestational limits, and anti-abortion staff who misinform or judge patients seeking abortions. It’s harder for rural women to access abortion services than it is for city women. Many women must travel long distances to find an abortion provider. Access is also poor in more conservative areas, especially the Atlantic provinces. These hospital problems and other access problems are caused by, or made worse by, politics and anti-abortion ideology. Abortion is still a political football in Canada, a hot potato that many politicians and even health care institutions, don’t want to touch with a 10-foot pole. Because of the ongoing stigma of abortion, and harassment and intimidation by the anti-choice movement, there’s a lack of willing doctors to do abortions. When access to abortion is reduced for political and ideological reasons, it means some women are unable to get an abortion, or they’re too afraid to even try, or they have to wait too long for an abortion, which increases the medical risk. Forced waits, and forced motherhood, are violence against women.

What can we do to help the situation?  Many Conservative MP’s are chomping at the bit to restrict abortion by law again. We expect two private member bills against abortion to be introduced anytime, in fact. Right now, about one-third of all MP’s in Parliament are publicly anti-choice, so in a free vote, we’re still safe. But of the 124 Conservative MPs right now, only 8 are known to be pro-choice. So we must stop the Conservatives from winning the next election, especially from gaining a majority, because that could result in an anti-choice majority in Parliament. Support pro-choice candidates, and ask your MP to advocate for better access to abortion across the country, so that no woman feels pressured to have a baby against her will. If you’re in a riding with an anti-choice MP, tell them to protect women’s rights by voting against any anti-choice bill.

This is not just about abortion, remember. Abortion is like a litmus test of where a candidate stands on a range of issues. Most anti-choice politicians are also against things like pay equity, childcare programs, Status of Women funding, gay marriage, and women’s equality in general. And what is the unifying thread to these issues, the thing that threatens the right-wing?  It’s their loss of control - over women, over sexuality, over women’s reproduction, and ultimately, their loss of control over male paternity.