By Emily Geminder
13 August 2008 [MediaGlobal]: Supporters have called her an extremist; critics, a pirate. But Dr. Rebecca Gomperts remains unfazed by the charges. Ultimately, it is the women who write to her, who call at all hours of the night, who constitute the core of her legitimacy.
The emails she receives range from simple queries to urgent pleas to stark statements of fact. “I am pregnant and living in Oman,” one woman wrote. “Abortion is illegal here.”
Some emails are most heart-wrenching for their naïveté: “My period is 3 days late. I am a virgin and was only having ‘petting’ with my boyfriend, I think I got pregnant by getting sperm on my hands or on my boyfriend’s hands. I am distraught and have had several sleepless nights. I am afraid to tell my parents and have thought of suicide as an answer to my predicament.”
Still others voice the anguished resolve of desperation: “I am 3 months pregnant, have no food for tomorrow for my 2 other kids. I am very poor, from a small village where nobody knows about my pregnancy, I am afraid of my husband’s reaction. I has been jumping from the furniture to cause miscarriage. I beg you for help.”
Every year 67,000 women die due to unsafe – and predominantly illegal – abortions. Many more are injured, in some cases permanently. An extensive global study released last year indicated that the rates of abortion in countries where it is illegal are consistent with those where it is not. In other words, women will seek abortions regardless of legal deterrents.
Those who abort under illicit circumstances are, however, far less safe. In Africa and Latin America, where abortion is overwhelmingly illegal, 95 percent of all abortions are unsafe. The World Health Organization estimates that some hospitals in these regions spend half their budget treating complications due to unsafe abortions. Such complications are also estimated to contribute to one in eight of all maternal deaths. In some countries, the figure is as high as one in two.
But Gomperts, her ship, and her crew are making small yet significant waves in the tides of abortion access. Her crew is no ordinary crew, but then, Gomperts is no ordinary captain. A team of doctors, nurses, and social workers, they travel the seas on a Dutch ship, providing abortions 15 feet off the coast, where international laws apply.
Gomperts, who founded the organization Women on Waves as a 32-year-old doctor in 1999, says the impetus for the ship could be traced back to her days as a resident doctor aboard the Greenpeace Rainbow Warrior ship. Traveling throughout South America, she saw firsthand the lethal mix of poverty and lack of reproductive choices.
“There were women who were raped. There were women who had no means of support. And there were women who were ostracized from their communities,” Gomperts told MediaGlobal, speaking from Amsterdam. “As a medical doctor, I knew how safe an abortion could be when done properly in a legal situation. I think it is a huge medical scandal that there are still women dying.”
While a woman dies every seven minutes from an abortion performed under unsafe circumstances, when the procedure is legal, abortion has a mortality rate of one in 500,000, making it high among the safest of all medical procedures. Indeed, it is safer than a regimen of penicillin.
Lack of abortion access does not deter abortion, but it does, Gomperts says, discriminate against poor women. “It is a question of women with means and information and women with no means,” she said. Restrictions on abortion access impact the most vulnerable women in any country, for they are the least able to maneuver the legal system, travel to places where the procedure can be performed, and procure the safest abortion available, legal or not.
“An unwanted pregnancy also has a major effect on the social economic status of women,” Gomperts added. “They can not finish their education, they are sometimes expelled from their communities, they can not improve their work situation anymore, and their other children are suffering because of the even more restricted financial resources.”
In Uganda, where abortion is illegal and abstinence-only sexual education programs have been widely promoted, it is estimated that the annual rate of abortion is 54 per 1,000 women. In the United States, the figure is 21 per 1,000. Western Europe, home to the word’s most liberalized abortion policies and readily available contraception, has the lowest annual abortion rate: 12 per 1,000 women.
Most of Africa and Latin America’s restrictive abortion laws can be traced back to Europe – the lingering spoils of the countries’ colonial inheritance. But Onyema Afulukwe, an attorney with the International Legal Program of the Center for Reproductive Rights, contends that contemporary discriminatory views of women and restrictive interpretations of religion play an equally large role in today’s abortion debate. “In many countries, there are elements of culture that still basically promote the singular role of women as child-bearers,” Afulukwe told MediaGlobal.
On an international level, there has generally been a failure to recognize the reproductive rights of women as part of the larger framework of human rights, though, according to Laura Katzive, Deputy Director of the International Legal Program, a gradual shift has emerged within the past few years. In 2005, the United Nations Human Rights Committee tried its first abortion case – that of a 17-year-old Peruvian woman who was forced to bring a fatally impaired fetus to term – and won. “For the first time, an international body held accountable a government for failing to provide an abortion,” Katzive told MediaGlobal. “So we are beginning to see a change.”
With the release of the annual United Nations Population Fund (UNFPA) report last week, the annual allocation of United States funds once again became the subject of highly politicized debate. In 2002, the administration of President George Bush blocked all Congressional funding to UNFPA and has continued to do so every year since. Though UNFPA does not include abortion in its roster of reproductive health and HIV-prevention programs, the Bush administration stated that its presence in China implicitly condoned the nation’s one-child policy.
The blocking of funds is consistent with the Bush administration’s broader international policy on reproductive rights. In 2001, on its first day of office, the administration reinstated the Mexico City Policy, commonly referred to as the Global Gag Rule, which curtails all support for international agencies and non-governmental organizations linked in any way to abortion. It prevents organizations receiving USAID family planning funds from using their own, non-U.S. funds from providing legal abortion services, lobbying their own governments for abortion law reform, or providing medical counseling or referrals regarding abortion. The administration has funneled its HIV/AIDS-prevention support to programs that promote abstinence over condoms.
“It’s important to remember that the restrictions on civil society groups do not apply to pro-life groups,” Katzive noted.
But while Akinrinola Bankole, Director of International Research at the Guttmcher Institute, agreed that the coming change in U.S. administration could have a potentially profound impact on abortion access throughout the world, he also emphasized the role of governmental reform in affected countries. “As important as [a change in the Mexico City Policy] is, it is not likely to go a long way to making abortion safer in the absence of law reform,” he told MediaGlobal.
In July, Gomperts’ ship embarked on its latest voyage to Ecuador, where abortion is illegal except in cases of rape in which the woman is mentally ill or retarded. But the voyage was derailed from its course by a storm. Undaunted, Gomperts forewent the ship and used local radio stations and newspapers to mobilize support for reproductive awareness. She created a 24-hour hotline to address reproductive health needs in the country, including guidance on how to safely perform an abortion with Misoprostol, a widely available blood pressure drug that can be used to induce labor. (Instructions are also available on the Women on Waves website in five different languages.) The hotline, Gomperts says, now receives upwards of 100 calls a week.
“We had expected very negative responses in Ecuador,” Gomperts said. “In contrast, people were very interested and supportive. It showed again that in countries where abortion is illegal, the media and government do not always reflect the opinion of the people.”
In light of the hotline’s success, Gomperts even ventured to wonder if the ship was still necessary. “This is the age of instant worldwide communication,” she mused. “With the Internet and mobile phones, what is the need for a Dutch ship?”
The goal, of course, was never to solve the problem of abortion access with a ship. Even with an entire fleet, Gomperts could never possibly make her way to all women in need. The ship’s success lay in its deft navigation of the conflicting axioms of power, its consequent subversion of authority’s central tenet: namely, that it is cohesive and untouched by the social processes of history. Above all. Gomperts’ voyages expose the lengths women will go to find an abortion.
Though the still largely uncharted terrain of the Internet presents new possibilities for abortion activism, it seems safe to say that Gomperts and her ship have not sailed their last voyage yet. In a world of instant communication, symbols are still – and perhaps especially so – powerful transmitters of social change.
And a woman commandeering her own ship, setting her own course, is an extremely potent one.