When China renounced its notorious one-child policy in October, it seemed like draconian family planning rules were a thing of the past.[1] One of the most powerful countries in the world had finally decided to relax its tight grip on family planning and women’s health, relinquishing a policy that had frequently placed it at odds with international opinion. As this development made headlines around the world, it seemed like reproductive rights were on a path towards progression in 2015.

The state of women’s health in the rest of the world has provided a stark antithesis to this assumption. While Myanmar has introduced its own draconian population control legislation,[2] progress in European strongholds of anti-abortion sentiment has stagnated, and pundits have been shocked by state-level rollbacks[3] on reproductive health services across the United States. These developments have painted a bleaker picture of what life was like for women in 2015. While it is hardly shocking that women’s rights have faced setbacks in the aftermath of bloody internal conflict in Myanmar, women’s health has suffered marked regressions and periods of inertia in some of the most ‘liberal’ parts of the world in the past few years.

Jenny Lee Silver

Image courtesy of Jenny Lee Silver, © 2006, some rights reserved.

In Myanmar, population control legislation has been passed in accordance with a nasty underlying agenda: to antagonize and degrade the country’s minority Muslim population. In late May, President Thein Sein brought The Health Care for Population Control law into affect, allowing local authorities to determine if ‘resources are unbalanced because of a high number of migrants in the area.’[4] Authorities can then request that the central government impose a 36-month interval between pregnancies in the region. The penalties for violating such an ordinance are unclear. It is additionally unclear if birth control measures could be administered without the explicit consent of the user.[5] Fears have emerged that this legislation could potentially be used to force incarcerated women to have abortion procedures performed against their will.

The bill blatantly carries the malevolent taint of nativist, anti-Muslim sentiment. It was proposed and advanced by the Race and Peace Protection Organization (Ma Ba Tha), a group that is purported to have ‘an ultra nationalist and anti-Muslim agenda.’[6] The wording of the bill, stipulating that it is to be utilized in an area with a ‘high number of migrants,’ is a thinly veiled reference to the Muslim Rohingya minority settled in Rakhine, who are regarded by the government as illegal immigrants from Bangladesh and called by the derogative term ‘Bengali.’[7] It is under this guise that the Rohingya are denied citizenship, making them essentially stateless. Ma Ba Tha, partially composed of nationalist Buddhist monks, is notoriously fearful that the 10% Muslim population will ‘take over’ the country due to their high birth rates. Extremist monk Ashin Wirathu, who maintains close relations with the group, has stated that the law will ‘stop the Bengalis who call themselves Rohingya, who are trying to seize control.’[8] Such sentiments were integral to creating new birth restrictions in ‘migrant’ heavy communities, and the bill was passed in tandem with legislation that seeks to restrict religious conversion and inter-religious marriages.[9]

The few voices that spoke out against the population bill have been essentially silenced. Representatives from Aung San Suu Kyi’s party, the National League for Democracy, were some of the only people to vote against the bill.[10] Delegates were threatened in parliament and photographed when they stood to oppose the vote in a clear attempt at intimidation. Feminist groups received similar treatment, facing threats when they renounced the legislation. The Kachin Women’s Peace Network reported that its workers had faced sexual harassment while advocating against the bill, and had been branded as treasonous for speaking out.[11]

Human rights observers and democratic governments were quick to respond. The American government released a statement, warning that this legislation ‘could place limitations on the reproductive freedom of women and girls and their ability to make informed and voluntary decisions about their sexual and reproductive health.’[12] Human Rights Watch has stated that the bill is ‘likely to escalate repression and sectarian violence,’ and expressed extreme concern with the implication that birth control can be administered without the ‘full and informed consent of the user.’[13] This legislation has provided yet another disappointment for human rights advocates, who have long hoped that Myanmar was moving towards a more peaceful and democratic future. As the government continues to tighten its control over private reproductive decisions and family planning, women of minority status are being placed in an increasingly perilous situation.

In some parts of Europe, the situation was not significantly better in 2015. Women in the Republic of Ireland and neighbouring Northern Ireland who wish to terminate their pregnancy are forced to make expensive and secretive journeys abroad, or administer a risky at-home abortion without medical assistance. In Northern Ireland, reproductive rights advocate have been faced with a number of disappointing setbacks in 2015, quashing hopes that the year would bring liberal progression.

Since 2013, abortion rates in Northern Ireland have declined considerably. This is primarily due to the abortion guidelines passed that year which stipulated that terminations could not be allowed for fetal abnormalities, and simultaneously reminded doctors that there are legal repercussions for giving abortion-related advice to patients.[14] Medical professionals have since faced a harrowing dilemma: caught between the fear of legal repercussions,   preventing them from providing accurate health information to women, and the knowledge that these procedures are potentially lifesaving . Abortion is allowed only when a woman is a ‘physical or mental wreck,’ a prerequisite that forces doctors to use the mental state of the mother to legally justify abortion procedures even when the foetus might not live.[15] A Guardian editorial highlighted the perplexingly vague nature of this criteria, ‘as well as being shot through with misogyny, this anachronistic legal test is hopelessly ambiguous.’

Legislation passed this past year has done little to clarify the legal complexity surrounding abortion procedures. On 16 December , Judge Mark Horner ruled that Northern Ireland’s abortion code did not comply with Eurozone human rights law, but did not mandate a court-ordered revision of the existing legislation.[16] He stated that such a shift is the explicit responsibility[17] of the local assemblies, but did not compel lawmakers to pass specific bills. Horner additionally remarked that ordering change in line with the European Convention of Human Rights Act of 2003, which allows abortion in the case of fatal fetal abnormality, rape and incest, would be taking his ruling ‘a step too far.’[18] The semi-state owned Irish newspaper, Raidio Teilifis Eireann reported that ‘it is highly unlikely that any form of consensus on such a controversial issue will be reached by Assembly members in advance of the May elections’ and cited Attorney General John Larkin’s intention to launch an appeal against Horner’s ruling.[19] The first female leader of Northern Ireland, Arlene Forester, has acknowledged the ruling must be addressed, but has unequivocally stated that expanded abortion rights will not be extended into the region under her watch.[20]

Such statements have quickly put any hopes of reform to bed in Northern Ireland. Guidelines remain unclear and perplexing, entangling women and medical professionals in a complicated legal quagmire. A guideline drafted in 2013, by the Health Minister, suggests that two doctors should be required to prescribe abortion as treatment.[21] It does not address whether doctors can advise a woman to leave the country to receive a termination, regulating the contentious issue to a legal grey area. The Family Planning Association prosecuted the government for its notorious ambiguity in 2001, stating ‘the timetable of consultations, votes, legal challenges, and delays for more than a decade is dizzying.’[22] In the meantime, women are left with little choice but to make an illicit and expensive journey to England, where Marie Stopes Centre treats ‘500 women from Northern Ireland each year.’[23]

When neighbouring Republic of Ireland legalized gay marriage in a May referendum, the global community assumed that the historically conservative, Catholic country was going through a period of modernisation and progression.[24] However, this liberal mood did not extend to legislation of abortion: the government has retained its conservative stance on abortion despite the changing tides of public opinion. An Amnesty International poll conducted this year reported that eighty one percent of Irish citizens believe that the government should expand access to legal abortion, concluding that, ‘Irish views on abortion have undergone a major transformation.’ [25] The poll additionally revealed stark unawareness ignorance on the topic: a mere 9 per cent of citizens knew that having an illegal abortion carries a fourteen-year jail sentence.

Despite this significant change in public opinion, things are unlikely to change in the near future. Heather Horn likened the issue to the American gun debate: legislation on the issue is directed by powerful, organised interests groups who hold wholly disproportionate sway at the polling booths.[26] The topic remains a strict deal-breaker for a small proportion of the electorate who will vote consistently against candidates who support changing the status quo. Politicians are forced to pander to this minority, moderating or completely abandoning their support of reproductive rights in exchange for the vote of organised interests.

Despite the fact that doctors are now allowed to terminate a pregnancy in instances of fatal risk to the mother, medical professionals site a ‘chill factor’ hanging over their heads.[27] Fear of legal repercussions prevents these professionals from performing abortions on women who should be applicable for the service under the Protection of Life During Pregnancy Act passed in 2013.[28] The Regulation of Information Act simultaneously criminalises doctors who give women information on how to receive a safe abortion outside of Ireland.[29] Dr. Peter Boylan, the former clinical director of the National Maternity Hospital, has vehemently opposed the fatal ambiguity of Ireland’s practices; ‘under the current law we must wait until women become sick enough before we can intervene. How close to death do they have to be? There is no answer to that.’

In the meantime, the situation has become increasingly grisly. After Savita Halappanavar died having been refused a potentially life-saving termination, public opinion increasingly turned against the government’s policies.[30] Unfortunately tragedies like this have not diminished since Halappanavar’s frequently publicized death. Amnesty International’s ‘ ‘My Body, My Rights’ campaign has collected shocking cases of negligent healthcare administered to pregnant women.[31] A woman named Lupe was forced to travel to Spain after being denied an abortion: she carried a foetus with no heartbeat for fourteen weeks. Another woman was refused a cesarean section because doctors feared that it would harm the baby, ardently stating that their job was ‘to look after the baby, the baby comes first.’ The woman was then forced to undergo a gruelling thirty-six hours delivering her child. In 2014 a clinically dead pregnant woman was kept on life support for 24 days, until a High Court panel ruled that she could be taken off because the foetus had little chance of survival at fifteen weeks. Dr. Peter Mckenna, the director of the hospital that was treating the woman, remarked that continuing life support would be ‘going from the extreme to the grotesque.’[32]

These cases demonstrate that extreme conservatism on reproductive issues is still alive and well in Europe. Women in Ireland who receive abortions face some of the heaviest penalties in the world and, despite Northern Ireland’s acknowledgement that laws are in violation of European human rights reform, progress is being made at a glacial pace. However, the most blatant regression of the year took place in the United States. Despite the legal precedent set by Roe vs. Wade, American women are facing increasingly insurmountable obstacles to receiving reproductive health services.

Since Obama took office, abortion providers have been increasingly targeted in a series of state-level legislation. The Guttmacher Insitute reported that fifty-seven new abortion provisions have been introduced in 2015 alone.[33] This number is indicative of the trend seizing Republican-led state legislatures in the Midwest and South; since 2010, 288 abortion restrictions have been enacted. These laws have been described by their legislators as ‘common sense’ protections of women’s health: they include mandatory counselling and waiting periods, limiting second-trimester and pill-induced abortion, requiring the doctor to have local hospital-admitting privileges and clinics to meet ambulatory surgical standards.[34]

The latter requirements have provoked an impending Supreme Court hearing over Texan laws that require local-hospital admitting privileges by local doctors, in addition and adherence to incredibly high ASC standards. This legislation, described by critics as a ‘targeted regulation of abortion providers’ or a TRAP, would close all but ten abortion clinics in the state.[35] These regulations have proved a huge impediment to the many out-of-state doctors who travel to Texas for specified ‘abortion days.’[36] It would be nearly impossible for these professionals to gain admitting privileges at a local hospital. Other restrictions have no immediate apparent medical rationale, aimed instead at limiting the window of time where a woman can use pills to induce a medical abortion or criminalizing a common procedure used to terminate a pregnancy of more than twelve weeks.[37]

Anti-abortion legislation is being produced at an alarming pace. Pro-life groups, like Americans United for Life and the National Right to Life, have created templates for anti-abortion bills that can be replicated across state capitals at a moments notice.[38] Missouri is currently considering ten different anti-abortion bills, despite the fact that the state has one remaining clinic.[39] Legislature now requires women to wait an unusually long 72-hour period between their mandatory counselling session and their procedure. Abortions are thus rendered inaccessible for women from low-income backgrounds that cannot afford the additional cost imposed by three days of travel. This breed of regulation is becoming increasingly common: states are now more likely to pass laws aimed at restricting women’s ability to receive abortions, rather than targeting the clinics that provide them.[40] Arkansas and Tennessee also require women to make two trips to the clinic to receive counselling before their procedure, creating logistical barriers for women seeking a termination. Arizona and Arkansas have even passed laws requiring doctors to provide their patients with medically dubious information about the possibility of ‘reversing’ a pill-induced abortion.[41]

In this climate, anti-abortion crusaders have set their sites on dismantling the nation’s largest reproductive health resource: Planned Parenthood. A smear video was widely circulated by the GOP, claimed to show villainous doctors haggling over the price of aborted baby parts.[42] In reality, the organisation does not profit off of foetal tissue sales, but accepts stipends of $30 to $100 for the tissue’s transportation. Although no federal funds contribute to the organisation’s   abortion procedures, efforts to defund their numerous reproductive health services soldier on.[43] Abortions actually constitute three per cent of the organisation’s operations; more popular services are administering STI testing, contraception and cancer screenings.[44] Planned Parenthood is also responsible for providing some of the only free and low cost reproductive services to America’s poorest women.[45]

Dwindling access to clinics has led to an inevitable peak in self-induced abortions. A Texas Policy Evaluation Project report estimated that 100,000 to 240,000 Texan women age 18 to 49 have attempted abortions at home without medical assistance.[46] The women who were mostly likely to risk these procedures were Latina, living near the US-Mexico border and facing significant obstacles to receiving health care. This poll revealed a rather scary trend: in a country where abortion has been legal for over forty years, impoverished women have been reduced to punching their stomachs and taking herbal supplements in the vain hope of ending unwanted pregnancies.[47]

In 2015, women’s health has faced insurmountable political obstacles. Myanmar has reminded the world that forceful family planning laws are still alive and well, and being used to target the most impoverished and disempowered women in the country. The Republic of Ireland and Northern Ireland’s strict opposition to abortion has been retained and defended, while pregnant women are placed in an increasingly dangerous and legally ambiguous situation. Despite clear recognition that these laws fall short of the human rights standards endorsed by the European Union, pro-choice reformers face a long and perilous battle. In the United States, Republican efforts to restrict and undermine abortion procedures have proceeded with no clear end in sight. The health of America’s poorest women lies in the balance as the crusade to defund Planned Parenthood catches steam.

[1] Tom Phillips, “China Ends One-Child Policy After 35 Years”, The Guardian, 29 October 2015. http://www.theguardian.com/world/2015/oct/29/china-abandons-one-child-policy

[2] The New York Times, “The Reproductive Rights Rollback of 2015”, December 19, 2015. http://www.nytimes.com/2015/12/20/opinion/sunday/the-reproductive-rights-rollback-of-2015.html?_r=0

[3] ABC News, “Myanmar population control bill signed into law despite concerns it could be used to persecute minorities”, May 24, 2015. http://www.abc.net.au/news/2015-05-24/myanmar-president-signs-off-on-controversial-population-law/6493198

[4] Ibid

[5] Sara Perria, “Burma’s Birth Control Law Exposes Buddhist Fear of Muslim Minority”, May 25, 2015. http://www.theguardian.com/world/2015/may/25/burmas-birth-control-law-exposes-buddhist-fear-of-muslim-minority

[6] Human Rights Watch, “Burma: Reject Discriminatory Population Bill”, May 16, 2015. https://www.hrw.org/news/2015/05/16/burma-reject-discriminatory-population-bill

[7] Avaneesh Pandey, “Myanmar’s New Birth-Spacing Law Criticized as “Anti-Muslim””, 25 May 2015. http://www.ibtimes.com/myanmars-new-birth-spacing-law-criticized-anti-muslim-1937330

[8] Sara Perria, “Burma’s Birth Control Law Exposes Buddhist Fear of Muslim Minority”, May 25, 2015. http://www.theguardian.com/world/2015/may/25/burmas-birth-control-law-exposes-buddhist-fear-of-muslim-minority

[9] Ibid

[10] Human Rights Watch, “Burma: Reject Discriminatory Population Bill”, May 16, 2015. https://www.hrw.org/news/2015/05/16/burma-reject-discriminatory-population-bill

[11] Sara Perria, “Burma’s Birth Control Law Exposes Buddhist Fear of Muslim Minority”, May 25, 2015. http://www.theguardian.com/world/2015/may/25/burmas-birth-control-law-exposes-buddhist-fear-of-muslim-minority

[12] Jeff Rathke, “Concerns About Burma’s Health Care for Population Control Bill”, US Department of State, May 19 2015.   http://www.state.gov/r/pa/prs/ps/2015/05/242596.htm

[13] Human Rights Watch, “Burma: Reject Discriminatory Population Bill”, May 16, 2015. “https://www.hrw.org/news/2015/05/16/burma-reject-discriminatory-population-bill

[14] The Guardian, “The Guardian’s View on Abortion: Northern Ireland’s Shame”, January 7 2016. http://www.theguardian.com/commentisfree/2016/jan/07/the-guardian-view-on-abortion-northern-irelands-shame

[15] Ibid

[16]William Welbling, “Northern Ireland judge: abortion law ‘incompatible’ with human rights”, Jurist, December 16 2015. http://jurist.org/paperchase/2015/12/northern-ireland-judge–abortion-law-incompatible-with-human-rights.php

[17] Douglas Dalby, “Judge Leaves Northern Ireland’s Abortion Laws to Lawmakers”, The New York Times, December 16 2015. http://www.nytimes.com/2015/12/17/world/europe/judge-leaves-northern-irelands-abortion-laws-to-lawmakers.html?_r=1

[18] Ibid

[19]RTE News, “NI Unlikely to Change Abortion Law Soon Despite Ruling”, December 16 2015. http://www.rte.ie/news/2015/1216/753950-northern-ireland-abortion/

[20] Henry McDonald, “No extending abortion act to Northern Ireland, first female leader says”, The Guardian, January 6 2016. http://www.theguardian.com/world/2016/jan/06/no-extending-abortion-act-to-northern-ireland-first-female-premier-arlene-foster-court-ruling-rape

[21] BBC, “Draft NI Abortion Guidelines Published by Minister”, March 8 2013. http://www.bbc.com/news/health-21712388

[22] Juliette Jowit, “Northern Ireland’s Abortion Laws Remain Restrictive and Unclear”, The Guardian, January 6 2016. http://www.theguardian.com/world/2016/jan/06/northern-ireland-abortion-laws-restrictive-unclear-legal-women

[23] ibid

[24] Matt Schiavenza, “Well Done: The Legalization of Gay Marriage in Ireland”, The Atlantic, 23 May 2015. http://www.theatlantic.com/international/archive/2015/05/ireland-gay-marriage/394052/

[25] Amnesty International, “⅔ majority in Ireland Want Abortion decriminalized”, uly 8 2015. https://www.amnesty.org/en/latest/news/2015/07/two-thirds-majority-in-ireland-want-abortion-decriminalized/

[26] Heather Horn, “What Makes a Country Legalize Abortion?”, The Atlantic, December 3 2015. http://www.theatlantic.com/international/archive/2015/12/ireland-abortion-rights-election/422190/

[27] Henry McDonald, “Doctors in 44 countries call on Ireland to relax abortion laws”, The Guardian, November 20 2015. http://www.theguardian.com/world/2015/nov/20/abortion-laws-ireland-doctors-countries-call-relax

[28] http://www.irishstatutebook.ie/eli/2013/act/35/enacted/en/pdf

[29] “Protection of Life During Pregnancy”, http://www.irishstatutebook.ie/eli/1995/act/5/enacted/en/html

[30] BBC, “Woman dies after abortion request ‘refused’ in Galway Hospital”, November 14 2012. http://www.bbc.com/news/uk-northern-ireland-20321741

[31]Amnesty International, “Ireland’s abortion laws treats women like vessels”, June 9 2015. https://www.amnesty.org/en/latest/news/2015/06/ireland-abortion-vessels/

[32] Elizabeth Nash et al, “Laws Affecting Reproductive Health and Rights: 2015 State Policy Review”, Guttmacher Institute. http://www.guttmacher.org/statecenter/updates/2015/statetrends42015.html

[33] Cheryl Wetzstein, “States enacted 57 provisions to regulate abortion in 2015”, The Washington Times, January 4 2016. http://www.washingtontimes.com/news/2016/jan/4/57-provisions-to-limit-abortion-added-by-states-in/?page=all

[34] Adam Liptak, “Supreme Court to Hear Texas Abortion Law Case”, The New York Times, November 13 2015. http://www.nytimes.com/2015/11/14/us/politics/supreme-court-accepts-texas-abortion-law-case.html

[35] Cheryl Wetzstein, “States enacted 57 provisions to regulate abortion in 2015”, The Washington Times, January 4 2016. http://www.washingtontimes.com/news/2016/jan/4/57-provisions-to-limit-abortion-added-by-states-in/?page=all

[36] Molly Redden, “2015 in reproductive rights: Arkansas sets off year of abortion restrictions”, The Guardian, December 29 2015. http://www.theguardian.com/us-news/2015/dec/29/abortion-laws-2015-reproductive-rights-arkansas

[37] Tara Culp-Ressler, “The Massive Push to Restrict Abortion in 2015”, Think Progress, February 11 2015. http://thinkprogress.org/health/2015/02/11/3621701/states-abortion-bills-introduced-2015/

[38] Nadja Popovich, “72 hours and counting: Missouri’s last clinic confronts new abortion reality”, The Guardian, June 22 2015. http://www.theguardian.com/us-news/2015/jun/22/missouri-abortion-st-louis-planned-parenthood

[39] Molly Redden, “2015 in reproductive rights: Arkansas sets off year of abortion restrictions”, The Guardian, December 29 2015. http://www.theguardian.com/us-news/2015/dec/29/abortion-laws-2015-reproductive-rights-arkansas

[40] Editorial Board, “The Reproductive Rollbacks of 2015”, The New York Times, December 19 2015. http://www.nytimes.com/2015/12/20/opinion/sunday/the-reproductive-rights-rollback-of-2015.html

[41] The Editorial Board, “The Campaign of Deception Against Planned Parenthood”, The New York Times, July 22 2015. http://www.nytimes.com/2015/07/22/opinion/the-campaign-of-deception-against-planned-parenthood.html?module=ArrowsNav&contentCollection=Opinion&action=keypress&region=FixedLeft&pgtype=article

[42] Ibid

[43] Janell Ross, “how Planned Parenthood Actually Uses Its Federal Funding”, The Washington Post, August 4 2015. https://www.washingtonpost.com/news/the-fix/wp/2015/08/04/how-planned-parenthood-actually-uses-its-federal-funding/

[44] Ibid

[45] Danielle Paquette, “Defunding Planned Parenthood Could Cut Off Many Women from Birth Control”, The Washington Post, September 9 2015. https://www.washingtonpost.com/news/wonk/wp/2015/09/09/defunding-planned-parenthood-could-cut-off-many-poor-women-from-birth-control/

[46] D. Grossman et al, “Knowledge, Opinion and Experience Related to Abortion Self-Induction in Texas”, Texas Policy Evaluation Project, Research Brief, November 17 2015. https://utexas.app.box.com/KOESelfInductionResearchBrief

[47] Ibid