How can I obtain information about abortion reliably and urgently?
If you need information about contraception or abortion, you can call the PATENT helpline: +36-30-982-54-69 (on Mondays between 10am and 2pm, Wednesdays between 2pm and 6pm and Fridays between 10am and 2pm)
What is the Abortourism Travel Office?
A fictional travel agency. A non-profit creative project. With its slogan “Personal boundaries beyond state borders” it aims to highlight how in certain countries women are not able to exercise their rights for bodily autonomy and human dignity, as their access to reproductive technologies such as contraception and abortion are limited. We chose to highlight the phenomena of abortion tourism.
The Abortourism Office publishes up to date information for citizens of Hungary and the region. The particular modes through which reproductive rights and reproductive technologies become curtailed reveals how relations between the state and the citizens are negotiated. The offers of the Abortourism Travel Office compare the different health care protocols of different states, to highlight the politics governing the legislation, standardization and distribution of these technologies.
The aim is to unmask the oppressive propaganda, the hysterics and false beliefs, and through this to highlight the medical system’s role in reproducing misogyny. The Office would like to draw attention to the fact that abortion is a social issue, and not a “women’s issue” and putting the blame on women and inducing guilt is unacceptable, and through this promote equality and legal awareness.
Political lobbying is not an aim, we would like to reach the citizens themselves.
What is abortion tourism?
Abortion tourism is an existing phenomena. It means the “pilgrimages” of women who have to travel to have an abortion in safe and dignified circumstances.
Among the European countries with the strictest abortion legislations, the most common routes from Ireland lead to the UK, from Poland the better off usually choose Western Europe, and the less economically advantaged Eastern Europe, and the Maltese usually go to either the UK or Italy. In Hungary abortion is legal, but only surgical abortion, and roughly 4-6 women a week travel to Vienna to have the abortion pill. Slovakia is also a favoured destination, where women travel to have surgical abortions without compulsory registration and counseling. Medical abortion is available in most Romanian town, and thanks to cheap air travel an abortion in the UK would only not cost necessarily much more than in a neighboring country.
What are reproductive rights? In what way are they being harmed?
Reproductive rights are the rights associated with fertility and conception. According to UN conventions, denying such rights is a form of sexual violence.
According to the WHO:
“Attaining the goals of sustainable, equitable development requires that individuals are able to exercise control over their sexual and reproductive lives. This includes the rights to: Reproductive health as a component of overall health, throughout the life cycle, for both men and women, reproductive decision-making, including voluntary choice in marriage, family formation and determination of the number, timing and spacing of one’s children and the right to have access to the information and means needed to exercise voluntary choice, equality and equity for men and women, to enable individuals to make free and informed choices in all spheres of life, free from discrimination based on gender, sexual and reproductive security, including freedom from sexual violence and coercion, and the right to privacy.”
What are the stages of pregnancy?
During pregnancy the cell-growth in the uterus is called a zygote in the first 3 weeks, then until the end of the 8th week an embryo, and then becomes a foetus.
In Hungary, during the compulsory counseling for abortion, guilt-evoking rhetorics such as calling the zygote/embryo/foetus a child or a baby is unlawful, as it is outside the boundaries of the official tone of the counseling, just like talking about abortion as if it was “infant murder”.
A 2011 pro-life campaign depicted a foetus beyond 12 weeks “begging for life”, despite selective abortion in Hungary being only legal until 12 weeks. With this willful manipulation the pro-lifers try to tell the public that for example a 9 mm long, 6 weeks old embryo, with barely discernible organ buds equals a completely developed person possessing cognitive abilities, despite it being more structurally simple than a snail or a sea urchin. If they would show actual photos of zygotes and embryos, they would have a hard time making people believe these are actual persons, just because they arbitrarily call them“children”. With the abortion pill, pregnancy terminations are possible practically from week 0, when the fertilized egg has no whatsoever resemblance to an actual human being, so the introduction of the abortion pill would strongly undermine such rhetorics, as it would be very hard to make people believe that a late, strong, crampy period induced by medicines equals an actual murder.
As the New York times writes about the Portuguese TV appearance of Rebecca Gomperts, founder of Women on Waves/Women on Web: “Two and a half years later, Portugal legalised abortion. As word of Gomperts’s TV appearance spread, activists in other countries saw it as a breakthrough. Gomperts had communicated directly to women what was still, in many places, a well-kept secret: There were pills on the market with the power to end a pregnancy. Emails from women all over the world poured into Women on Waves, asking about the medication and how to get it. Gomperts wanted to help women “give themselves permission” to take the pills, as she puts it, with as little involvement by the government, or the medical profession, as possible.”
How to get the morning after pill in Hungary?
In Hungary the morning after pill is not over the counter. The prescription can be obtained either from a GP, or a gynaecologist, and after regular office hours from special “emergency contraception units”. The non-stop helpline 00 36-30-30-30-456 is run by the manufacturer of the pill, and it informs the caller of the closest “emergency contraception unit”.
In most neighbouring countries (e.g. Austria, Slovakia, Romania, Serbia, Slovenia) the morning after pill is available over the counter. In Ukraine too, the regular contraceptive pill is available over the counter, of which certain types exert the same effect in larger doses. See our map for details! In 2011, the morning after pill almost became over the counter in Hungary too, but due to professional differences the Hungarian Pharmaceutical Institution revoked its new licence at the last minute.
How is abortion legislated in Hungary?
The legal framework of abortion in Hungary is set in the Act LXXIX of 1992 on the protection of fetal life and ensured by it’s implementing regulation, the 32/1992 (XII. 23.) NM regulation.
In Hungary, women who would like to terminate their pregnancy have to refer to a ”serious crisis situation” and the procedure has to be carried out in a state hospital. Only surgical abortion is legal. A doctor has to confirm the pregnancy, and usually this happens via transvaginal ultrasound. Before the actual procedure, one has to take part in a two-step counselling procedure, done by the “Family Protection Service”, with at least 3 days between the two appointments. In order to book an appointment the medical certificate is needed.
How much does an abortion cost in Hungary?
The total cost is 29.710 HUF.
The full sum is only covered by the state if it is done for purely medical reasons. The patient may receive a 50%, 70% or a 100% discount from the state based on their social status, and financial dependence. For example, the patient gets a 50% discount if they receive child care benefit, child care support, temporary benefit, regular social aid, health impairment annuity, pension, disability benefits, or disability pension. The patient is entitled to a 70% discount if they receive unemployment benefits, jobseeker’s allowance, care allowance, temporary aid, annuity for minors, regular child protection benefit, emergency social aid, annuity for business, income supplement or availability support. Those who receive higher family benefits, disability support, annuity for blind people or regular social aid and registered asylum seekers are entitled to a 100% discount.
At the second appointment with the Family Protection Service, the patients are given a yellow postal check which needs to be paid at a post office, and the stub as proof of payment presented at the hospital along with the rest of the documentation. As long as public clinics and public hospitals are used, the 29.710 HUF should be the only cost.
Private clinics that cater specifically to foreigners will help by making the necessary appointments, and providing English-speaking staff and doctors. Altogether, the gynaecology visit, the administrative fee, the hospital stay and the fee for the procedure would likely cost a total of HUF 200 000 to 300 000 depending on the private clinic and hospital.
If someone would like to terminate her pregnancy after week 12, what are the possibilities?
In this respect the Hungarian legislation is very similar to most European state legislations, it allows the terminating of the pregnancy for up to 24 weeks if there are serious medical reasons – the limit of elective pregnancy termination is 12 weeks. Beyond this time limit one can travel to countries where the legislation is different, for example in the UK the cut off is week 24, and in Sweden it is week 18.
According to the Act LXXIX of 1992 on the protection of fetal life – The Fundamental Law of Hungary, Article II (Apr. 25, 2011)
6. § (1) Pregnancies may be terminated up to the 12th week if:
a) the pregnant woman’s health is severely endangered;
b) the fetus is likely, on medical indications, to suffer from a severe disability or other impairment;
c) the pregnancy is the result of a criminal act, or
d) the pregnant woman is in a severe crisis situation.
(2) The pregnancy may be terminated up to the 18th week if the circumstances under subsection (1) are met and if the pregnant woman
a) is partly or fully incapacitated;
b) did not recognize the pregnancy in time due to a health reason for which she cannot be held responsible, or due to a medical error, or if the period under subsection (1) elapsed because of the failure of a health institution or authority.
(3) A pregnancy may be terminated up to the 20th week, or in the event of a delay in diagnostic procedure up to the 24th week, if the probability of the fetus’ having a genetic or teratological malformation reaches 50%.
(4) A pregnancy may be terminated irrespective of gestational age where
a) the life of the pregnant woman is endangered by a medical condition, or
b) the fetus has a malformation that renders postnatal life impossible.
Which further procedures are specific to Hungarian abortion legislation?
A Hungarian particularity is that the pregnancy has to be officially confirmed by a doctor. Foreigners can’t have abortion without a residence permit, which has to be older than two months. Women have to go through a two step state-mandated counseling and there is a waiting period of three days. Read more about the barriers around abortion here.
In the UK, the NHS guidelines on abortion deem home urine tests very accurate, that a GP will not necessarily perform an other urine test before they would start booking the prenatal appointments. In a normal pregnancy, transvaginal ultrasound (or any vaginal exam for the matter) is not part of routine care. The first ultrasound is usually around week 12, and it is done abdominally.
Regarding compulsory transvaginal ultrasounds, it is worth referencing the public dispute around Virginia State’s ultrasound bill proposal. The conservatives proposing the mandatory transvaginal ultrasound before abortion did not even bother pretending that it has any medical cause. The bill would have been called “A women’s right to know” (appropriating the language of informed consent and empowerment) assuming women would not be able to decide about wanting to carry a pregnancy to term or not without having a transducer forced into their vagina, and seeing an ultrasound image (for reference, here is an ultrasound image at for example 7 weeks)
In case of first trimester terminations, usually done non-invasively by the abortion pill the ultrasound would have had to be transvaginal, because it has a potential to provide a clearer image.
Reflecting on the bill, a journalist in Forbes poses the question: “Can an individual sue the state for medical malpractice? Or, can a state government be held accountable for practicing medicine without a license, even if the state issues the licenses?”
A doctor writes this about the proposed bill: “I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise… After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women. Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls.”
The bill was changed last minute, and women got the right to choose which type of ultrasound they are willing to accept.
Home pregnancy tests are generally very accurate. One justification for transvaginal ultrasounds is to rule out ectopic pregnancy in asymptomatic women. However, just like in many other countries, in the UK routine transvaginal ultrasounds are not part of pregnancy care, and the mortality rate from ectopic pregancy is just as low as in Hungary (respectively 0,02).
An other interesting counterexample would be Montenegro, where all medical examinations with the potential to reveal the sex of the foetus before the legal limit of selective abortion (week 10) are forbidden, among them the ultrasound.
What about the countries, where abortion is either illegal or hard to access?
Among European countries Ireland and Poland restrict seriously the reproductive rights of women.
In Ireland, 2012, a woman had to die, because the doctors in the Galway Hospital refused to surgically finish her miscarriage, despite her having a life-threatening bacterial infection. Also, an asylum seeker rape victim, who went on a hunger strike was forced to give birth by caesarian, and it was also in Ireland where the scandal of the “catholic maternity homes” broke out.
In these institutions, women who did not behave in the way that was expected of a good catholic (for example, if they got pregnant out of wedlock, got raped, engaged in sex work, or did not pay a court cheque) were forced into slave labour, and they often had to work for state run institutions, for example doing the laundry of prisons. In 2012 in one of the courtyards of such a home around 800 childrens’ skeletons were found in an unmarked grave.
In Ireland right until the middle of the 80s, a risky and controversial surgical procedure called symphysiotomy was used sometimes instead of the c-section pressured by the Catholic church, as the c-section would have only allowed the woman to have 3 or 4 children, whereas with symphysiotomy she would have been able to give birth 8 or 10 times. The Irish hospitals also did the training and the research for African hospitals run by the Catholic church. The survivors campaigning for justice, many of whom are barely able to walk up to this day still did not reach an agreement with the Irish State.
According to the official statistics, roughly 12 women a day travel from Ireland to the UK to terminate their pregnancy.
In Poland the abortion law is so highly restrictive, that the illegal “menstruation regulation” and abortion tourism are widespread. A whole advertising campaign was based around telling Polish women on billboards how they can have a free abortion on the NHS in the UK. The number of illegal abortions are estimated at between 80-190 thousand by local researchers. The local pro-life movements estimate is about 3000 a year. The official figure is 450.
What should be known about the use of the abortion pill?
The abortion pill would enable medically supervised pregnancy termination, as a safer, and medically less harmful alternative to surgical abortion.
The abortion pill chemicals, Mifepristone and Misoprostol are on the WHO’s list of essential medicines (life saving medicines, which should be available in every country). As a safe and effective medicine, since its introduction in the 1970s, it is being used all over the world. Clinical experience shows that it is less damaging to the female body then the surgical procedure, but it lasts longer, is usually accompanied by varying levels of pain, and the bleeding can last for a few weeks. It can also have side effects, such as sickness, vomiting, diarrhoea, and prolonged bleeding which requires medical attention.
A big advantage of the medicine is that it can be used in infrastructurally less developed areas. In 2011, American research involving 449 women found out that the abortion pill used via telemedicine is just as effective as if the doctor had met the patient in the clinic.
What is the difference between medical and surgical abortion?
The abortion pill has less potential to cause permanent harm, and there is no need to wait, even very early pregnancies can be terminated with it. Also, it eliminates the risks of anaesthesia and surgery, among them the possible injuries of the uterus which could cause fertility complications later on. Paradoxically, in Hungary “protecting the foetus” is often a reason given for the prohibition of the abortion pill, especially in light of the fact that the type of surgical abortion procedure they provide here could cause injuries and infections and later fertility complications such as ectopic pregnancies and preterm birth.
As the geneticist Endre Czeizel says: “Last year the EU has warned Hungary because of dangerous and primitive abortion methods, but to no avail, the KDNP (the local Christian democratic party) and Szócska Miklós state secretary has banned everything else. Szócska is involved in every year roughly in 110-120 preterm babies’ death. I find it disgusting, that a woman can not make a decision she would be entitled to make wherever in Western Europe” – says Czeizel, who finds it unacceptable, that politicians dictate doctors which methods they may or may not use.
This type of operation can be only done from roughly about week 8, or whenever the foetus has a “heartbeat”, and it is invasive, done via the vagina of the patient via someone else.
“For many women the solution is medical abortion. Maybe they want to avoid a surgical procedure, maybe their pregnancy is too early, and doctors would not be willing to do the surgical procedure, or simply they find it less burdening” – says the managing director of a Viennese abortion clinic, who thinks many are angry at the Hungarian system deemed patriarchal.
One of the main principles of medical ethics is nil nocere, the principle of doing no harm.
Despite surgical abortion being generally very safe, it has its inherent risks, just like any other surgical procedure. The above principle demands the reduction of risks to minimal, so if surgery could be avoided, the medical alternative should be available.
There is favourable clinical evidence related to medical abortion, and even the College of Hungarian Obstetrics recommended its introduction. They had all the reasons, because in the beginning of the nineties the WHO has initiated a trial comparing medical to surgical abortion, and the Szeged Ob-Gyn Clinic took part in this trial, and the results were published by the WHO. The trial’s conclusion states that both in surgical and medical abortions, the rate of complications are almost the same, apart from fever, which happens more often after surgical abortions. Medical abortion induces a state similar to natural spontaneous miscarriage. The uterus regenerates faster than after surgical abortion, but the procedure itself lasts longer, and it is likely to be painful. The risk of death associated with abortion increases with the length of pregnancy, from one death for every one million abortions at or before eight weeks to one per 29,000 at 16–20 weeks — and one per 11,000 at 21 weeks or later. See more facts about induced abortion here.
- Why is there no abortion pill in Hungary?
Is it true that many types of contraception are abortifacent, that is they cause the body to reject the fertilised egg?
There are many false beliefs around the abortifacent effect of various means of contraception.
The contraceptive pill can indeed cause an egg, which got fertilised despite the pill’s prohibitory effect on ovulation, to be rejected by the uterine wall, because the contraceptive pill changes the uterine wall as well. It is part of the mechanism of the coil to not allow the egg to plant into the uterine wall. Among the women, who do not use any contraceptive method, minimum 50% of all fertilised eggs are rejected by the body, so many women have a miscarriage without ever knowing it, and even about 1 out of 5 confirmed pregnancies will be spontaneously miscarried.
The morning after pill does not terminate already existing pregnancy, and there is no proof of it causing birth defects. The 120 hour emergency pill (ulipristal acetate) has a similar mechanism to Mifepristone (a component of medical abortion), they are both progesterone receptor modulators. Besides blocking ovulation, this type of pill is capable of counteracting the implementation of an egg already fertilised. Read more about the mechanism of the pills here and here.
What contraceptive methods are there for men?
The condom, the pull-out method, and vasectomy are the most popular male contraceptive methods. A hormonal pill for men does exist, but due to its severe side effects it is not widely used. There is a technology called “RISUG” (ongoing phase III trials), which is similar to vasectomy, it is a gel-like substance injected into the tube that sperm pass through to reach the penis. Unlike vasectomy, this method is reversible. A similar technology called “Vasalgel” is also in development.
How to obtain the contraceptive pill in Hungary?
In Hungary the contraceptive pill is prescription only. GPs can prescribe it as well, but the initial prescripton has to come from a gynaecologist. Regarding the clinics around Budapest, some would like to add extra services(pelvic exam, cancer screening, transvaginal ultrasound), and some would prescribe it for a 10.000 HUF “consultation fee”.
How could the abortion rate be reduced?
The WHO has consistently shown that banning abortion doesn’t solve demographic problems, all it does is fuel abortion tourism and clandestine abortions. For example in Poland the birth rate has been on a consistently declining trajectory despite the ban on abortion on demand. The lowest abortion rate is in Western Europe(12/1000 women of childbearing age), where abortion laws are generally very permissive, and for comparison, this rate in Latin America, where abortion is strictly regulated and hard to access is 32/1000.
In Western Europe abortion rates have either been near stagnant or decreasing since the gradual introduction of the abortion pill.
The main difference between countries with easily accessible, legal and safe abortion, and the countries without is that in the former women do not have to resort to dangerous and illegal methods to end a pregnancy, and in the latter the legal restrictions fuel abortion tourism and unsafe, clandestine back alley abortions.
The way to reduce the rate of abortion is through eliminating unwanted pregnancies. A 2012 research in the USA has revealed that making contraception free of charge would reduce the abortion rate by 62-78%. Encouraging and funding easily accessible and up to date contraceptive practices, fighting misogyny and sexual violence, focusing sexual education and sexual culture on consent and human rights, and making contraception affordable would be the way forward to reduce the number of abortions.
Libby Anne, the blogger who grew up in an American family indoctrinated into “Christian patriarchy” explains why is she not pro-life anymore:
“The cause of abortions is unwanted pregnancies. If you get rid of unwanted pregnancies the number of people who seek abortions will drop like a rock. Simply banning abortion leaves women stuck with unwanted pregnancies. Banning abortion doesn’t make those pregnancies wanted. Many women in a situation like that will be willing to do anything to end that pregnancy, even if it means trying to induce their own abortions (say, with a coat hanger or by drinking chemicals) or seeking out illegal abortions. I realized that the real way to reduce abortion rates, then, was to reduce the number of unwanted pregnancies. And the way to do that is with birth control, which reduces the number of unwanted pregnancies by allowing women to control when and if they become pregnant.
I realized that the only world in which opposing birth control made any sense was one in which the goal was to control women’s sex lives. After all, birth control allows women to have sex without having to face the “consequences” of sex. But I had never opposed abortion in an effort to make women face the “consequences” of having sex. I had always opposed abortion out of a desire to save the lives of unborn babies.”
Why encouraging people to have more children is a problem?
The birth rate tends to grow in countries, where the interests of women and families are acknowledged and privileged by policy makes. For example in the polish diaspora of the UK women tend to have almost twice as many children as in conservative Poland where on-demand abortions are not available.
A study published in 2014 in the Economic Journal highlight that it is only a myth that highly qualified women have less children, in fact the fertility rate is actually an U-shape, with the most and the least educated on the ends. They suggest that the growing gap between rich and poor may help explain why fertility rates among highly educated women are rising. Society becomes divided, and those who can afford to buy help to raise their children and run their homes are willing to have many children. The study can to the conclusion that the notion that women choose career over children is simply not true. If someone can afford it, they are likely to be willing to have many children.
About the necessity of medical examinations
In numerous countries it is possible to be tested for sexually transmitted diseases and infections, have the contraceptive pill prescribed, terminate a pregnancy or carry it to term and give birth to a child without any involvement of a gynaecologist, or without the need of any vaginal examinations.
You can read the NHS guidelines for prenatal care here:
ACOG, the American College of Obstetrics and Gynaecologists states that women do not have to go through a vaginal exam in order to be tested for sexually transmitted diseases and infections. and the same organsisation recommends the contraceptive pill to be available over the counter:
“The doctors group made clear that:
Birth control pills are very safe. Blood clots, the main serious side effect, happen very rarely, and are a bigger threat during pregnancy and right after giving birth. Women can easily tell if they have risk factors, such as smoking or having a previous clot, and should avoid the pill. Other over-the-counter drugs are sold despite rare but serious side effects, such as stomach bleeding from aspirin and liver damage from acetaminophen. And there’s no need for a Pap smear or pelvic exam before using birth control pills.“
According to the WHO and the Royal College of Obstetrics and Gynaecologists only a blood pressure check is medically indicated before starting on hormonal contraception In the UK it is possible to obtain the pill after an online consultation.
In selected pharmacies in which in the frame of a clinical pilot the pill was available over the counter. The results were so favourable that the National Health Service has recommended widening the access to the pill by making it over the counter without a GP’s script.
In the USA a campaign for making the pill over the counter is just about to start. The morning after pill is usually accessible without a doctor’s script, also in all the countries neighbouring Hungary, except for Croatia and Ukraine, but in Ukraine the regular contraceptive pill is available OTC, and some types of it taken in a large dose cause the same effect.
The morning after pill almost became over the counter in Hungary too in 2011, but the GYEMSZI (the regulating authority) has abruptly changed the license it issued beforehand. A freedom of information act, requesting the medical evidence that supports the prescription only status of the morning after pill is in process.
Why adoption can’t be mandated as an alternative?
For the same reason why someone would not be held down and have their kidney taken away, despite a serious shortage of organ donors in Europe. Human dignity and self-determination are constitutional rights, regardless of biological sex.
What are the direct medical risks of juxtaposing the access to contraception with medical surveillance?
All medical encounters are inherently risky. For example iatrogenic death, that is, death caused by the medical industry is one of the leading causes of death in the USA. Rough estimates put the number of deaths caused by among other things medical malpractice, hospital infections, medicine side effects around 250.000 Unnecessary medical examinations are especially problematic.
One of such examinations, spread by decades of aggressive propaganda is the annual “well-woman exam” about which the American College of Physicians has reported in July 2014 what many have known for decades: there is no reason to do an annual pelvic exam on asymptomatic women. In the new clinical guidelines the college discourages doctors from doing such examinations on women who have no pelvic pain or other symptoms which would indicate gynaecological conditions. The new guidelines were drafted based on 70 years of clinical evidence. After decades of research, the studies don’t show any benefits to performing this annual exam.
“Additionally, when low-risk patients are examined, the vast majority of abnormal exams end up being false alarms. The findings turn out to be false, however, only after additional workup is done. This workup may include ultrasounds or CT scans, specialty referrals, and even biopsies or surgeries. These procedures and evaluations may expose patients to radiation, put them at risk for complications such as bleeding or infection, and add costs. One study showed that pelvic exams resulted in a 1.5 percent increase in unnecessary surgeries. Even normal results from a pelvic exam may be problematic, because a pelvic exam’s ability to detect ovarian cancer is so poor that a normal result may be a false reassurance.”
It is not only a coincidence, that such material comes from the USA.
‘I suspect many British women would assume a pelvic exam was to look at hip bones and not genitals’ -says one of the commenters on a 10,000+ posts long Blogcritics thread.
“I kid you not, it happened to my friend who still sees a therapist once a month here in London, she has PTSD and reacted to the “exam” as if it were a sexual assault. (which it was) When a woman goes in asking for the Pill, you get a blood pressure check and that’s it, you might get pestered about a pap test if you’re 25, but you can refuse and still get the Pill. In the States doctors basically assault women with permission from the Police and authorities – no one protects women there and a Dr can do anything he likes.” – says an other commenter on the same site, about the experience of her friend who tried to get the pill in the USA.
The aforementioned USA consistently produces one of the worst statistics in the developed world when it comes to teenage pregnancies, pregnancies and births, and sexually transmitted diseases (Read more here and here) and every third women has her uters removed before menopause.
The mortality rate of gynaecological cancers is not particularly lower than in any other developed country.
Why are the protocols of reproductive medicine so different in certain countries?
Each respective country has it’s own specific political, social, historical and cultural context, which influences its health policies.
Let’s take the aforementioned USA for example, with its private insurances, and profit oriented health care system. The so-called “founding father of gynaecology” was an American as well, slave owner called Marion Sims, who believed that black people feel no pain, and he performed human experiments on his slaves without any anaesthesia or consideration of hygienic requirements. He still has statues in the United States, among them one in the Central Park in New York.
Why does the history of this profession affect the present so much?
The profession of gynaecology and obstetrics has failed to confront its past, of which nazi medical experiments also constitute an integral part. Besides the speculum invented by Marion Sims, the other tool of gynaecologists, the colposcope was invented by a nazi war criminal. LINK Cervical cancer screening has not changed much since the 1940s.
Both in the USA and Germany gynaecology is historically entangled with psychiatry, for example even in the 1950s clitoridectomy, the surgical removal of the clitoris was used as a cure for psychiatric diseases.
As the European Society of Human Reproduction and Embryology reports:
“Researching the history of reproductive medicine during the Nazi era is still taboo, a leading German professor will tell the 20th annual conference of the European Society of Human Reproduction and Embryology today (Monday 28 June).
However, it is vital that such research is conducted, because if Germans do not understand what motivated the behaviour of doctors in the past, they will struggle to make decisions about ethical issues that confront doctors and scientists working in gynaecology, embryology and reproduction today, he will say.. ..’For instance, the head of the Brandenburg gynaecology hospital in Neukoelin, Benno Ottow, remarked that ‘never in the history of mankind has the doctor been so integrated into the people’s fate and in the people’s state as he is under National Socialism’. Full of pride, he stated that the first chamber of the hereditary health court that he belonged to as a judge ‘agreed in mutual assessment and consulted thoroughly more than 1,000 people with hereditary diseases in half a year about the requirement for their sterilization’. He then discusses, as greater length, the practicalities of sterilization and how to deal with psychiatric patients who had to be forced by the police to the operating table.’”
If gynaecological cancer screening “saves countless lives”, why would it be a problem to require it before someone is prescribed hormonal contraceptives?
In Hungary out of all cancer death roughly 1% is caused by cervical cancer, and the rate is similar in most European countries. And there is no whatsoever evidence for the statement often echoed by the media that “no-one should be allowed to die in cervical cancer”, because the test is very inaccurate, and completely ineffective against a subtype of cervical cancer. Besides not discovering real cases, very often it leads to unnecessary and damaging procedures. According to the British Medical Journal, to save one woman from cervical cancer, over 150 women have an abnormal result, over 80 are referred for investigation, and over 50 have treatment. Promoting this test for young women is especially dubious in light of the fact that in the last five years in Hungary cervical cancer has claimed one life out of the under-25 cohort.
The relevant scientific literature does not even talk about actual, existing tests to screen ovarian or uterine cancer. Cervical cancer has always been rare in industrialised countries, and population-based screening was introduced without clinical trials. As the Spectator says:
“Epidemiological comparisons do not necessarily favour the test. There are parts of the world in which its widespread application has not been accompanied by a fall in death rates, and parts of the world Where death rates have fallen without it having been applied. It is at this point that goalposts tend to become nomadic: to explain the former phenomenon it is said that death rates would have risen without the test, while in the latter case it is said that the natural trend downwards would have been accelerated if the test had been used. hi any case, the argument correlating the use of the test with death rates is a
rather crude one: rather like saying that because intelligent men are statistically likely to wear bigger than average shoes, they think with their feet… …This is surely a cultural phenomenon of some significance.”
Here a doctor explains why she chose to not participate in cervical screening:
“I’m not against screening, but I am against unthinking screening. I weighed up my personal risk factors for cervical screening (for example, smoking is a risk factor), threw in my own priorities – and decided not to have it. And here’s the problem. The NHS persists in sending me red-ink letters despite my written declaration to opt out. I’m made to feel a risk-taker in not having cervical screening – yet I’d also be taking my chances if I had it done. This is at the heart of the screening problem. Most information sent to us, as potential participants, doesn’t make clear that it’s a personal choice, and a balance of pros and cons. We can end up being screened without knowing that it was an option, not a foregone conclusion. This is important because it’s apparent from research studies that when people get balanced information about screening tests, fewer people want them.”
Breast cancer screening is not any less problematic. It is worth looking at this parliamentary debate from the UK: which has resulted in the “Science and Techonology Committee” stating that the public is not informed sufficiently about the risks of cancer screening. Or the report of the Cochrane Institute which has stated that it is not clear whether mammography does more harm than good.
Barbara Ehrenreich, a holder of a Phd from cellular biology, who had breast cancer herself comments:
“Has feminism been replaced by the pink-ribbon breast cancer cult? When the House of Representatives passed the Stupak amendment, which would take abortion rights away even from women who have private insurance, the female response ranged from muted to inaudible. A few weeks later, when the United States Preventive Services Task Force recommended that regular screening mammography not start until age 50, all hell broke loose. Sheryl Crow, Whoopi Goldberg, and Olivia Newton-John raised their voices in protest; a few dozen non-boldface women picketed the Department of Health and Human Services. If you didn’t look too closely, it almost seemed as if the women’s health movement of the 1970s and 1980s had returned in full force. Never mind that Dr. Susan Love, author of what the New York Times dubbed “the bible for women with breast cancer,” endorses the new guidelines along with leading women’s health groups like Breast Cancer Action, the National Breast Cancer Coalition, and the National Women’s Health Network (NWHN). For years, these groups have been warning about the excessive use of screening mammography in the U.S., which carries its own dangers and leads to no detectible lowering of breast cancer mortality relative to less mammogram-happy nations. Nonetheless, on CNN last week, we had the unsettling spectacle of NWHN director and noted women’s health advocate Cindy Pearson speaking out for the new guidelines, while ordinary women lined up to attribute their survival from the disease to mammography. Once upon a time, grassroots women challenged the establishment by figuratively burning their bras. Now, in some masochistic perversion of feminism, they are raising their voices to yell, “Squeeze our tits!” When the Stupak anti-choice amendment passed, and so entered the health reform bill, no congressional representative stood up on the floor of the House to recount how access to abortion had saved her life or her family’s well-being.”
Regarding the breast-cancer lobby, especially the Komen Foundation it is worth mentioning the Hungarian connection:
“In fact, Komen has a long and cozy association with the Republican Party. George W. Bush rewarded founder Nancy Brinker’s generous donations to the GOP—more than $175,000 since 1990—by awarding her an ambassadorship to Hungary in 2001 and later, the position of chief protocol officer. The Komen board has a couple women of color and several democrats, but is predominately rich, white GOP donors.”
Forcing such screening onto women by arbitrarily attaching it to contraceptive use denies women’s right to make informed decisions free of coercion and propaganda, and follows exactly the same dynamics as the authoritarian political debates around reproductive rights: the objectification of women and the denial of their autonomy. If promoting these tests were really about the well being of women, then the legal (and for the healthcare providers legally binding) protocol of informed consent would be honoured, and instead of misleading and patronising rhetorics (‘only a few minutes of discomfort’- as if would be up to anyone other than the actual patient to decide) everyone would be free to decide whether they find the tests, and the risks of the tests acceptable, and such non-invasive technologies as for example the HPV-self test, or self-sampling to test for STIs would also be promoted and more accessible.