Hypocrisy and the Geneva “Consensus” Declaration


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(Sources: Chandelis Duster, “US joins countries with poor human rights records to denounce `right’ to abortion,” CNN online, 10/23/2020; Monika Pronczuk, “Why a New Abortion Ban in Poland is Tearing the Country Apart,” The New York Times online, 10/27/2020; Marc Santora, Monika Pronczuk, Anatol Magdziarz, “Polish Women Lead Strike Over Abortion Ruling Amid Threats of Crackdown,” The New York Times online, 10/29/2020.)  

It sometimes seems as if the world has slipped into an alternate universe, where facts are no longer recognized as facts, and politicians can blithely and sanctimoniously mouth blatant lies while they cavalierly subvert the democratic processes which purportedly underlie their country’s way of life.  A recent case in point is last week’s Geneva Consensus Declaration (GCD).  This declaration, signed by fewer than thirty-five of the 200 states of the world (thus revealing the word “consensus” in the title to be a falsehood), claims to affirm the “strength of the family and of a successful and flourishing society.”  How do they expect to accomplish this?  They repudiate international reproductive health guidelines, rejecting abortion as a necessary aspect of women’s human rights, and instead insisting on the “essential priority” of what they call “protecting the right to life.” 

Signatories of the GCD include some of the world’s most repressive governments, such as Poland (which has one of the strictest anti-abortion laws in Europe), Cameroon (accused of massive human rights violations), Uganda (aggressively attempting to criminalize homosexuality), Saudi Arabia, Brazil, Hungary, and Iraq.  The U.S. is a proud signatory of the declaration.  The Trump administration has consistently opposed mention of reproductive health and rights in UN documents and refuses funding to international organizations that offer abortion.  U.S. Health and Human Services Secretary Alex Azar has called the declaration “an historic document stating clearly where we as nations stand on women’s health” and Secretary of State Mike Pompeo has praised the GCD and boasted that under Trump’s leadership the U.S. has “defended the dignity of human life everywhere and always.”

These statements demonstrate the extent to which Trump’s sycophants have fallen into the alternate universe of lies and obfuscation.  Far from defending the dignity of human life, the Trump administration’s incompetence and politicization of the COVID pandemic has resulted in well over 220,000 excess deaths of Americans, and the end is nowhere in sight.  Moreover, the push by Republicans to confirm the ultraconservative Catholic jurist Amy Coney Barrett means that the right wing now has a clear majority on the U.S. Supreme Court.  The Court is likely to overturn Roe v. Wade as well as the Affordable Care Act (also known as Obamacare), thereby endangering millions of unemployed and impoverished Americans, many of whom have pre-existing conditions that will make them unable to afford private health insurance. 

U.S. public opinion polls have shown that most Americans disagree with Trump and his right-wing base on abortion, health care, gun control, and other key issues.  That is why Trump needs to rely on ultraconservative judicial appointees to push his agenda. 

Of course, it should be remembered that overturning Roe v. Wade will not criminalize abortion in the U.S. as a whole.  Rather, decisions on legality will be left up to the individual states.  Now more than ever a woman’s reproductive rights will depend on where she lives.  The so-called “blue” states will continue to offer safe and accessible abortion and contraception as part of their comprehensive reproductive health services, while the laws of the “red” states will force women to flee to more enlightened constituencies, risk abortion under unsafe conditions, or carry their pregnancies to term and hope for the best. 


Polish women lead protests against abortion ban.

It is worth noting that the Trump strategy of subverting the democratic process by appointing ultraconservative judges to do his bidding is not unique to him.  Demagogic politicians in Poland, for example, have circumvented the wishes of the majority of Poles who, like the majority of U.S. citizens, believe that abortion must remain legal under at least some circumstances.  Using what Polish women activists and international human rights organizations have called a subservient and right-wing judiciary, the ruling Law and Justice Party has achieved the almost total ban on abortion that it repeatedly failed to obtain through the Polish legislature.  For the last six days the Polish nation has been wracked by massive protests and strikes led by women.  Catholic Churches have been focal points for many of the women’s protests nationwide, since the Church is a key supporter of the increasingly authoritarian and anti-women measures of the government.  The largely female demonstrations have been joined by (male) taxi drivers, farmers, coal miners, and others, all of whom are dissatisfied with their government’s flouting of democratic processes as well as its incompetent response to the corona virus pandemic. (Poland is one of the hardest-hit countries in the world.) 

A Tale of Two Books


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Recently, I reviewed two books for a librarians’ journal. Although both examine the experiences of U.S. women who wish to terminate undesired pregnancies, the two books couldn’t be more different. Obstacle Course: The Everyday Struggle to Get an Abortion in America, by David S. Cohen and Carole Joffe, is as straightforward as its title. Using first-person accounts by abortion providers, clinic volunteers, reproductive rights activists, and women seeking abortion, the authors chronicle the difficulties that confront women in most parts of the country: a distressing tangle of TRAP laws, long waiting periods, harassment by anti-abortion protesters, and state-mandated falsehoods that physicians must deliver to their patients before an abortion. These obstacles—which of course disproportionately affect women of color, rural women, and the poor—make accessing abortion far more time-consuming, expensive, risky and stressful than it needs to be (and certainly far more difficult than it is in any other industrialized country).

Cohen and Joffe don’t just focus on the negative, however. They also describe the situation in areas of the U.S. where abortion access is routine. In these places reproductive health clinics are not subject to TRAP laws, women seeking abortions are rarely harassed or stigmatized, and state financial assistance is available. Also, in some states early abortion is possible via telemedicine, and in a few jurisdictions abortion by means of medication can be overseen by physicians’ assistants or nurse practitioners. Obstacle Course is readable, nuanced, and comprehensive; if I were still teaching, I would happily assign it to undergraduates.

The second book, The Pro-Life Pregnancy Help Movement: Serving Women or Saving Babies, by Laura Hussey, has a title that immediately reveals the author’s anti-abortion bias (“pro-life” and “saving babies”). Hussey frankly admits her early involvement in anti-abortion activism and her belief that human life begins at conception. Given her own anti-abortion advocacy, it is not surprising that Hussey’s treatment of the crisis pregnancy centers (CPCs) is admiring and uncritical. Because the CPCs have received negative press for their deceptive practices and intimidation techniques used against women seeking abortion, they have been rebranded by their supporters as “pregnancy help centers.” Hussey not only accepts the rebranding, but styles the women she surveys as benevolent, religiously-motivated “social reformers” whose opposition to abortion stems from their deep desire to serve women.

In Hussey’s account, CPC personnel distance themselves from the more extreme wings of the anti-abortion movement. Interviewees claim, for example, that they avoid what they euphemistically term “sidewalk counseling” but which personnel and patients at abortion clinics see as traumatizing harassment. CPC employees also claim that their work is non-political, and that they have nothing to do with lobbying for TRAP laws, mandatory pre-abortion viewing of ultrasounds and anti-abortion videos, and other barriers to abortion access so ably chronicled in Obstacle Course. (By the way, Karissa Haugeberg paints a very different picture of the women of the CPCs and their support for and in some cases participation in violent anti-abortion activities; see my review of her Women Against Abortion in this earlier post.)

There are numerous questionable aspects of Hussey’s laudatory treatment of the CPCs. To my mind, most damning is her refusal to take a stand on the junk “science” that the CPCs disseminate to their clients. CPCs routinely claim that abortions cause breast cancer, are more dangerous than carrying a pregnancy to term, negatively affect women’s long term mental and physical health, and so on.

These false claims have been refuted by professional bodies ranging from the World Health Organization to the American College of Obstetricians and Gynecologists. Yet Hussey portrays the CPC propaganda as having equivalent weight to those refutations. This stance is inexcusable. By spreading medical misinformation, the CPCs give the lie to their claims to be serving the interests of women.


Abortion Access During the Pandemic


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Last time, I commented on the efforts of anti-abortion politicians in Alabama, Oklahoma, Texas, and other U.S. states to restrict women’s reproductive rights by declaring abortion a “nonessential” procedure. An article that appeared on 14 June 2020 in The New York Times (“Coronavirus Created an Obstacle Course for Safe Abortion”) discusses the obstacles that exist in some other countries as well. That article, along with websites of UNFPA, WHO, and NPR, are the sources for this post.

Julie Burkhart, a former associate of the murdered abortion doctor George Tiller, founded “Trust Women,” a group that operates clinics in Oklahoma and Kansas. She has commented on the ways that anti-abortion forces are using the COVID-19 pandemic as an excuse to further corrode women’s abortion access. Desperate women have no choice but to travel hundreds of miles in search of abortion. Burkhart’s Kansas clinic has been registering huge increases in patients, many of whom are fleeing from the lockdowns in other jurisdictions. In a recent week, she noted, her clinic saw 250 women, compared to forty per week in more normal times.

The U.S. situation is particularly bleak for a so-called “developed” country, both because of the pandemic’s economic consequences falling disproportionately on poor women and women of color, and because of the highly politicized nature of abortion access here. But even in countries such as Germany and Austria, where women’s reproductive rights are less restricted, public health officials apparently forgot about abortion when they made lists of time-sensitive procedures that should be available immediately rather than postponed. Feminist activists had to remind regional governments and individual hospitals to consider women’s reproductive health and include abortion as an essential, time-sensitive medical need. Another problem in Germany is that some abortion providers themselves are in at-risk categories. In one rural district of Bavaria, for example, the only abortion doctor is over seventy and so had to stop to guard his own health.

There have been some bright spots. France, Ireland, England, Scotland, Wales and Colombia have loosened their restrictions on telemedicine. They now permit at-home use of pills for early abortions after a phone or online consultation with a doctor. Health activists are hopeful that this relaxation will continue after the dangers of the pandemic have passed.

In Colombia, professionals in the Orientame reproductive health clinics note that contraceptive access in rural and underserved areas can be erratic under the best of circumstances, so telephone and online consultations for early medical abortions are an important aspect of women’s reproductive health services in the country.


Dr. Natalia Kanem, Executive Director of UNFPA

As always, the worst effects of the coronavirus and the accompanying economic dislocations have hit and will continue to hit women of scarce resources all over the world. Women’s health rights activists and officials of the United Nations sexual and reproductive rights agency UNFPA have been sounding the alarm for months. In April UNFPA’s executive director Dr. Natalia Kanem warned that the travel restrictions and disruptions to regular clinic services caused by the pandemic could result in an added seven million unintended pregnancies worldwide. “As a corollary,” Kanem noted, “unsafe abortions will increase.” Earlier this month the World Health Organization went further, predicting dire consequences if poor countries either cannot or will not support continuing reproductive health services at pre-pandemic levels. “Even a 10 percent reduction in these services could result in an estimated 15 million unintended pregnancies, 3.3 million unsafe abortions and 29,000 additional maternal deaths during the next 12 months,” the WHO warned.

U.S. Politicians Use Pandemic As Excuse to Attack Abortion Rights


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Amy Hagstrom Miller, founder and CEO of Whole Women’s Health. Miller was the lead plaintiff in suing Texas to stop newly passed extremely restrictive laws designed to force the closure of abortion providers. In 2016 the U.S. Supreme Court ruled that those laws were unconstitutional. See the post “Cautious Optimism after a U.S. Supreme Court Decision”

It’s happened again. All reputable commentators are agreed that the medical and social consequences of the coronavirus pandemic will disproportionately affect the poor and people of color. Yet politicians in Texas, Ohio, Mississippi and elsewhere are seizing upon the excuse of the pandemic to make further attacks against the reproductive rights of the most vulnerable populations. Texas, for example, has banned all abortions other than to save the life of the woman on the grounds that abortion is a “non-essential surgical procedure.” First, this ignores the fact that an increasing number of abortions are not surgical at all; rather, they are medical. Moreover, the “non-essential” designation by the Texas attorney general flies in the face of the opinion of the experts of the American College of Obstetricians and Gynecologists (ACOG) and the American Board of Obstetrics and Gynecology, who have issued a statement warning against calling abortion non-essential. On the contrary, these highly-respected physicians say that abortion should be viewed as “an essential component of comprehensive health care” and as such should not be subject to COVID-19 restrictions. But of course, the Texas lawmakers and their ilk are less concerned with the public health of their most vulnerable citizens than they are with pushing through increasingly extreme anti-abortion measures.

Amy Hagstrom Miller (pictured above) is the founder and CEO of the Whole Women’s Health group of clinics, three of which are in Texas. Ms. Miller said that her clinics were forced to cancel more than 150 scheduled abortion appointments in one day, despite the tearful pleas of desperate women who needed the procedure, some of whom had traveled hundreds of miles because many abortion providers in Texas have been forced out of business by the state’s TRAP laws.

Ms. Miller and other reproductive rights advocates and health professionals have noted that it is absurd for the Texas officials to claim that their bans on abortion are intended to free up medical personnel and facilities to deal with the coronavirus pandemic. If it weren’t for draconian restrictions on abortion providers (insisting that the pills used for medical abortion be administered by a physician in person, demanding that patients make two or even three visits to a clinic for ultrasounds and anti-abortion propaganda lectures, for example), clinics could provide early (up to 11 weeks) abortions with one quick visit. Indeed, as some physicians have observed, the procedure for administering early medical abortion could even be handled online. Thus, the rational non-political response would have been to suspend enforcement of the TRAP laws for the duration of the pandemic.

Many women are likely to think that the coming months are not a good time to have another child. Because of the economic impact of the pandemic, which has already caused massive unemployment and especially affects poor and working-class women, the demand for abortion will probably increase. In addition, there are reports that pregnant women are at higher than average risk from COVID-19, especially if they have hypertension, which often occurs during pregnancy, or gestational diabetes. There are also predictions that the pandemic could last for as long as 18 months, particularly if there are two or three waves of infection. In that case some health care systems in underserved regions would be hard-pressed to handle routine medical matters such as prenatal care and childbirth.

In Ms. Miller’s words: “Abortion is essential health care, and it is a time-sensitive service, most especially now in this public health crisis when many people are already financially insecure and futures are uncertain.” She added: “We cannot sit idly by while the state is forcing Texans to be pregnant against their will” (quoted in the Huffington Post).  On March 25, Women’s Whole Health once again sued Texas in federal court. We can only hope that they will be successful. But time is running out for those women whose appointments have been canceled. They will be forced to spend more time, energy, and money in an attempt to secure the procedure in another state that adheres to the ACOG recommendation that abortion be considered an essential part of health care.

As of this writing, it seems that the epidemic has run its course in China with a death toll of under 3,300. In the U.S. projections are grim. A March 25 report from the University of Washington Institute for Health Metrics and Evaluation gave an estimate of 40,000 to 160,000 deaths, assuming a nationwide lockdown. One of the reasons for the human tragedy that’s being played out in the U.S. is that many politicians have refused to respond promptly and appropriately to the pandemic. Instead, they see COVID-19 as an opportunity to advance their anti-women agenda by attacking reproductive rights.

Clarence Thomas Race-Baits Abortion Rights Advocates


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Recently, the U.S. Supreme Court voted to block part of an Indiana law banning abortion based on the sex, race, or health defects of the fetus. In his dissent, Justice Clarence Thomas maintained that the current reproductive rights movement has disquieting similarities to earlier population control groups that sought to limit the birth rates of those they deemed unfit. He cited Margaret Sanger’s eugenic proclivities and allies, and stated that currently abortion rates are highest among racial minorities and the disabled — precisely the groups that old-style eugenicists had hoped to reduce. He insinuated that the abortion rights movement is racist.

Many anti-abortionists like the idea of associating present-day reproductive rights activists with the racist agendas of earlier zero population growth advocates, and right-wing commentators such as Ross Douthat of The New York Times welcomed Thomas’ remarks as if they contained some sort of profound truth.  (Occasionally in the past this line of argument has been used as a cover for opposition to women’s health rights. For example, in the 1960s and 1970s some male Black nationalists such as Amiri Baraka and several Black Panther leaders battled with their female counterparts and other Black women’s health activists over this point, with the men denouncing birth control as a genocidal plot and the women insisting on their right to limit family size.)

But Thomas’ efforts to link modern-day abortion rights proponents with 20th-century eugenicists are hypocritical and historically unsound. For one thing, except for a brief time in her more radical youth, Margaret Sanger opposed the legalization of abortion. Neither she nor even the most viciously racist eugenicists whose support she solicited (for example, the Nazi sympathizer and Ku Klux Klan member Lothrop Stoddard) advocated abortion as a means of limiting “undesirable” populations. Rather, they pushed contraception and in some cases sterilization of those they considered “unfit.” Abortion rarely if ever figured into the discourse of eugenicists.

Lothrop Stoddard (1883–1950)
Eugenicist, white supremacist, Nazi supporter, and co-founder of the American Birth Control League

Moreover, mid-19th century movements to make abortion illegal in the U.S. and other countries emerged not so much from some pious life-begins-at-conception notion but rather from fears that the wrong women were practicing abortion. Doctors and other upper-middle-class white professionals pointed uneasily to the relatively large families of people of color, immigrants and the working class, and lamented the propensity of affluent, educated white women to limit family size through abortion. Even in more recent times, echoes of these racist fears can be found among some foes of legalized abortion. In 2007, Portuguese Cardinal José da Cruz Policarpo couched his opposition to legalizing the practice in racist terms, saying that European (i.e., white) culture and values would be put at risk by low birth rates relative to those of (non-white) immigrants to his country.

Besides distorting history, Thomas’ argument blatantly ignores two basic facts. First, if women of color are disproportionately represented among women who seek abortions, it is because they are disproportionately represented among the poor. (According to research by the Guttmacher Institute, 75% of abortion patients in the U.S. are poor or low-income.) Yet self-styled “pro-life” crusaders are conspicuous by their absence when it comes to advocating comprehensive sex education, free prenatal care, onsite infant day care at Walmart’s and other low-wage employers, and similar measures that might actually help underprivileged women and their offspring. Until Clarence Thomas, Ross Douthat, and other opponents of legal abortion demonstrate concrete support for babies of the disadvantaged who have already been born, their professed concern for minority populations is disingenuous and hypocritical.


Second, anyone who has any knowledge of the historical or present-day statistics on abortion worldwide knows full well that prohibiting abortion does virtually nothing to prevent the practice. The procedure becomes more costly and more difficult to obtain, and desperate women without the means to flee to a more reproductive-health-conscious state or country are likely to attempt self-induction or fall into the hands of unscrupulous clandestine providers. Meanwhile, affluent women can virtually always obtain safe illegal abortions.

Safe, legal, accessible abortion is a vital necessity for women’s reproductive health and wellbeing, and this is especially true for low-income and minority women, who are the main victims of policies that restrict access. Right-wing jurists such as Clarence Thomas are no friend of minority women.
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An Opportunity for Indonesia?


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The New York Times recently published an article titled “With Joko Widodo’s Re-election Indonesia Bucks Global Tilt Toward Strongmen.” Indonesia is the largest Muslim-majority country in the world, just as the U.S. is the largest Christian-majority country. But while the U.S. head of state is a narcissist and compulsive liar who is taking his country in the direction of fundamentalism and intolerance and giving aid and comfort to extremists around the world, Indonesia’s leader is a moderate, self-effacing reformer who favors a syncretic, locally-inflected version of Islam and equal rights for women and ethnic minorities.

President Widodo’s cabinet of 34 boasts eight women, including the Foreign Minister and the Finance Minister, and he supports microfinancing programs that benefit large numbers of women in the informal sector — small traders, farmers, and market gardeners, such as the sellers in the floating market pictured below.

floating-market-lok-baintan-6Indonesia’s Lok Baintan Floating Market

President Widodo is far from perfect — he’s a politician, after all, and is no stranger to the vacillations and reversals characteristic of the breed. But observers are cautiously optimistic. He no longer has to worry about re-election, and has a fairly strong mandate for reform, since he defeated a right-wing Muslim fundamentalist on a platform of fostering pluralism.

Despite President Widodo’s opponent’s claims that Widodo’s platform is a betrayal of Islam, in fact it reflects the dominant beliefs and practices of Islam throughout its history. For example, Moorish (Muslim) Spain was an intellectually vibrant and religiously tolerant region for centuries. Only with the ascendancy of the Catholic monarchs Ferdinand and Isabella did Jews, Muslims, and other non-Catholics face persecution and expulsion from the realm.

Islamic traditions of tolerance have also extended to women’s reproductive concerns. As I explain in the first chapter of my book, Sex and Herbs and Birth Control, the Hanafi school of Islamic jurisprudence (historically the most influential interpreters of Islamic principles) accepts abortion until ensoulment, which for them takes place 120 days after conception. Other schools of jurisprudence, such as the Shafi’i and Hanbali, have debated when ensoulment occurs, but traditionally Islamic jurists never put it earlier than 40 days after conception. Thus, abortion before this time was no one’s business but the woman’s, and abortion has been widely practiced and condoned throughout the Muslim world from the time of Mohammed.

Since 2009, the only circumstances in which abortion is legal in Indonesia are to save the life/health of the pregnant woman, or (up to six weeks) in the case of rape. Of course, as in many (if not most) countries with restrictive abortion laws, illegality has little effect on frequency. Estimates are that approximately two million illegal abortions are performed in Indonesia each year. Although complications from illegal abortions are estimated to cause about 16% of all maternal deaths, it is interesting to note that an Indonesian woman is twice as likely to die in childbirth as from an illegal abortion.

President Widodo could enhance his reputation as a friend of women and opponent of fundamentalist extremism if he joined Indonesian health rights advocates in pressing for liberalization of abortion laws. That way, the world’s largest Muslim-majority country could honor the pluralistic, women-friendly traditions of mainstream Islam, while casting further into relief the misogynistic and backward-looking policies of the Christian-majority U.S.

Illogical arguments (even when well-intentioned) do not belong in The New York Times


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While consistently supporting women’s right to legal abortion, The New York Times writers on occasion seem unable to refrain from pushing illogical arguments that do not help the cause. I posted about this on two previous occasions in 2013 and in 2014. On September 7, 2018 the newspaper published an article by Pam Belluck with the title “Science Does Not Support Claims That Contraceptives Are ‘Abortion-Inducing'”. The article rightly points out that anti-abortion zealots run counter to established medical opinion when they claim that pregnancy begins with fertilization rather than implantation of the fertilized ovum in the uterine wall.

But then Belluck states that “a growing body of research strongly indicates” that emergency contraceptive pills don’t prevent implantation. “Instead, the pills, if taken up to five days after unprotected sex, work to stop fertilization from occurring. They do this by delaying ovulation… or by thickening cervical mucus so that sperm have trouble swimming and reaching the egg to fertilize it.”

A moment’s thought shows that this claim makes no sense. As Belluck says, the Plan B pills work for up to five days after intercourse. But ovulation in a large proportion of cases must have occurred before the pills were taken. If the pills worked only by preventing ovulation, then they would fail to prevent pregnancy in all those cases, and that is false.

When people say that some of the Plan B pills are effective up to 120 hours after unprotected sex, what they mean is that, among all women who would have otherwise become pregnant, most will not become pregnant if they take the pills within five days. As any fertility expert will tell you, in order to get pregnant you need to ovulate as soon as possible after intercourse. After 48 hours sperm rapidly lose motility, and the chances of sperm fertilizing an egg after waiting 120 hours for ovulation are near zero. Thus, among the women who take emergency contraception after four or five days and who otherwise would have become pregnant, almost all have already ovulated.

The fact that the pill is effective up to five days after sex obviously and incontrovertibly means that the later in the five-day window one has waited, the more likely it is that the drug is working post-fertilization. Clearly, if egg and sperm have already met, the pill is either directly destroying the fertilized ovum or preventing its implantation in the uterine wall. It defies logic to deny something so obvious, as The New York Times has done before (see my previous post “Well-Intentioned Junk Science Is Still Junk Science”).

Supporters of reproductive rights should not attempt to appeal to anti-abortion zealots with erroneous claims that the effective action of post-coital contraceptives is exclusively pre-fertilization. We need to freely acknowledge that the processes involved in establishing a pregnancy are complex, and the ways in which contraceptives impede these processes are also complex. We cannot disguise the fact that several common contraceptives, including morning-after pills, IUDs, and ordinary birth control pills, sometimes act after conception. Thus, all these methods are potential targets for those who claim that any destruction of a fertilized ovum is murder. Ironically, to be consistent, anti-abortion extremists should also oppose the rhythm method — the only form of birth control permitted by the Catholic church — as I point out in “Questions to Ask Your Priest”.

To support their extreme stance, the anti-abortion movement routinely makes fanciful, unscientific claims — that first-trimester embryos feel pain, that legal abortions are less safe than childbirth, and that most women are traumatized by abortion. We should counter their falsehoods by always giving accurate information. If we indulge in junk science, we are descending to their level.

The Outrage of El Salvador


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Maira Veronica Figueroa Marroquin (center) released after 15 years in prison

The government and legislature of El Salvador have once again shown their blatant disregard for women’s health and wellbeing by adjourning without voting on proposals to weaken the country’s draconian anti-abortion law. El Salvador is one of the remaining five countries in Latin America and the Caribbean to completely ban abortion under all circumstances. The situation is made even worse for women because the law is enforced with exceptional severity and arbitrariness.

In mid-April 2018 the Spanish-language cable network Univision aired a segment on “Primer Impacto” chronicling Salvadoran women’s rights activists’ attempts to get justice for women imprisoned under the law. At least two dozen women who suffered miscarriages or stillbirths late in pregnancy while not under a doctor’s care (in other words, women from the impoverished majority of the population) were initially charged with abortion, a crime bearing a sentence of up to eight years for both the woman and the abortionist. But prosecutors wound up getting the women charged and convicted of aggravated homicide, and they were sent to prison for up to thirty years. Protests by feminist and human rights organizations within El Salvador and throughout the world have succeeded in freeing five of the incarcerated women. But so far the Salvadoran government and judiciary have refused to review most of the cases. Meanwhile, the proposals to grant exceptions to the ban on abortion when the woman’s life is in danger or when a minor is pregnant as a result of rape have once again been stymied.

The bitter ironies in the Salvadoran situation are many. The tiny, densely-populated country has been experiencing an unprecedented upswing in violent criminal activity, in part because of deportations from the U.S. of Salvadoran gang members from Los Angeles, Washington D.C., and elsewhere (young men born in El Salvador but reared and introduced to crime in the U.S.), and in part because of the large numbers of ex-military and ex-paramilitary individuals left unemployed after the end of the U.S.-bankrolled counter-insurgency war against earlier movements for social justice and national liberation. Yet the government seems more concerned with policing women’s bodies and enforcing one of the harshest anti-abortion laws in the world than in trying to control criminal violence.

Another irony: Salvadoran anti-abortion fanatics have had the unmitigated gall to portray supporters of weakening the anti-abortion law as being under the influence of foreigners. The reality is that worldwide most of the funding of the most strident anti-abortionists comes from Catholic or Protestant fundamentalist organizations based in the U.S. The present Salvadoran outright prohibition is only twenty years old and was enacted in 1998 at the instigation of U.S.-based anti-abortion groups. Earlier Salvadoran anti-abortion legislation was not as sweeping, and enforcement was not so vicious.

In the early to mid-1990s it was possible to have discussions of the harmful public health consequences of illegally induced abortion without participants being intimidated and shouted down by anti-abortion zealots. I myself attended conferences in 1993 and 1994 in San Salvador at which speakers addressed the lack of sex education in Salvadoran schools, the horrible consequences for women’s health of abortion under unsafe conditions, the enormous costs to Salvadoran taxpayers, the need for freely distributed contraception, the injustice of safe clandestine abortions being available to affluent but not to ordinary women, and Salvadoran indigenous women’s use of native plants for abortifacient purposes. These conferences were well-attended and well-publicized, and both were co-sponsored by the Salvadoran Women Doctors’ Association. But by the late-1990s throughout Central America the situation had changed. Anti-abortion fanatics, largely funded by U.S.-based organizations, increasingly made it their business to harass legislators, gynecologists, and women’s health clinic personnel. The atmosphere of belligerence and intimidation has deterred many doctors from performing abortions in circumstances in which they would have had no qualms about performing them in the days before the anti-abortion zealots became so threatening. In the words of the independent legislator who proposed one of the bills that would have softened the ban, “There is a lot more tolerance for corruption than there is for discussion on abortion.”

And so the outrage continues. Groups of self-righteous misogynists directed from the U.S. hypocritically and sanctimoniously proclaim their love of (embryonic) life, while Salvadoran women die from clandestine abortions under unsafe conditions, and at least twenty Salvadoran women languish in prison because they couldn’t afford doctors to bear witness to their miscarriages.

“Lies, Damned Lies, and Statistics”


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These famous words, which Mark Twain attributed (probably erroneously) to British Prime Minister Benjamin Disraeli, have served as a warning that statistics, if used carelessly, can be as misleading as outright lies.

In the mid-1990s I was asked by the United Nations organization UNIFEM to examine cross-cultural statistics on women’s participation in science, technology and medicine (STM). The goal was the compilation of tables for the UN fact book The World’s Women: 1995 .

This being well before the days of easy internet data searches, UNIFEM sent me cartons and cartons of policy papers, data sheets, and women’s organization pamphlets. I poured over the materials for months, trying to contrive tables that would fairly put the status of women in STM in each country in comparative perspective.

I was forced to conclude that the task was impossible. Some data sets only included the percentage of women in STM in tertiary institutions, while others only included women in government research institutes; some collections lumped together women of different ranks or in different scientific specialties, while others meticulously differentiated ranks and subfields; some included even the social sciences and humanities in their definitions of “science,” while others included the physical sciences but not mathematics or engineering. Ultimately, I wrote a piece (the only signed one in the volume) explaining the absurdity of trying to derive meaningful comparisons from such sources.

We find a different sort of methodological morass if we examine the UN’s comparative Gender Inequality Index (GII) (Human Development Report,
United Nations Development Program, 2016). The GII is calculated from three components, one of which is purportedly a measure of reproductive health; it is that component that I’ll discuss here.

The reproductive health component of the GII is computed by combining two indicators: maternal mortality per 10,000 live births and teen pregnancy rates per 1000 women. Once could ask: What about other indicators that in some countries are much more significant than maternal mortality and teen pregnancy rates in assessing the situation? At the very least, the data should include availability of contraception and legality/accessibility of abortion. In the United States one should also track the number of abortion doctors harassed or murdered, the number of clinics and schools intimidated out of offering birth control and abortion information, the number of states with outrageously restrictive TRAP laws, the number of raucous demonstrations at abortion clinics, the number of “Crisis Pregnancy Centers” staffed by anti-abortion zealots masquerading as neutral reproductive health advisers, the decreasing availability of abortion and certain forms of contraception, and so on.

The likely explanation for the UNDP’s use of maternal mortality and teen pregnancy and nothing else is that those are the data that are readily available from most countries of the world with some degree of accuracy (although the ratio of reported teen pregnancy to actual teen pregnancy undoubtedly varies widely from country to country). This is the typical reason why “proxy data” are used: you use the data that’s easiest to get, not the data that would really be most revealing, and you hope that the proxy data at least correlate with what you’re trying to measure.

In the case of the UNDP’s proxy data for reproductive health, what they do correlate with is the overall wealth and level of development of a country. More than anything else, low maternal mortality means a relatively affluent population and a highly developed health care system.

Similarly, the use of teen pregnancy rates skews the results in favor of the wealthier countries, where in fact it’s reasonable to expect that a low teen pregnancy rate signifies widespread availability of birth control as well as adequate sex education in the schools. But note that `teen’ is defined to include 18- and 19-year-olds. In many low-income countries where most men and women do not go to college and a high proportion of the population is rural, early marriage and child-bearing are culturally accepted and not correlated with failure in life. (This was the case in the U.S. until well into the 20th century.) Why then should the GII penalize low-income countries for a high teen pregnancy rate?

Because of what is counted, and equally importantly, what is not counted, there are some curious oddities in the GII rankings. Take South Korea, for example, which ranks tenth in the world in the GII. Because South Korea has a reported teen pregnancy rate of 1.6/1000 (the lowest in the world) and a maternal mortality rate of 1.1/10,000, the reproductive health component of its GII appears close to ideal, and that leads to its high GII ranking. But abortion is almost completely banned in South Korea. Doctors have been prosecuted for performing the procedure, the illegal abortion industry is booming, and there is a large black market in abortion pills obtained illegally over the internet. Women activists have been trying to get the draconian abortion laws revised for years, and have only recently succeeded in convincing the legislature to revisit the issue.

To cite another example, Cuba has a GII ranking of 62 out of 159 countries, while the U.S. ranking is 43. Why does Cuba come out poorly compared to the U.S.? By far the main reason, ironically, is Cuba’s reproductive health component, which is greatly affected by its relatively high teen pregnancy rate of 45.6 per 1000 vs. 22.6 for the U.S. Meanwhile, Cuba has a health care system that is a model for developing countries, and it is the only country of Latin America that has had unconditional reproductive freedom for women for over half a century. (In addition, women constitute 48.9% of the Cuban legislature and 27% of the Cuban Academy of Sciences; the latter figure is the highest percentage in the world.)

My point is not to castigate the UNDP for using statistical methodology that favors the wealthy countries and underrates low-income countries such as Cuba that have progressive traditions in women’s health and women’s rights. Rather, the lesson here is that issues of reproductive health and gender equity are far too complicated to be captured by a single number, especially one that’s computed from proxy data.