Prof Tom O'Dowd wrote recently in these pages of the need to move beyond the traditional pro-choice/pro-life or anti-abortion debate to address the real needs of women seeking abortion. Happily, that had already begun.
Last September I was involved, along with others such as Dr Patricia Casey, Dr Mary Henry and Dr Mary Condren in a well-attended conference called "5,000 Too Many", which looked at ways of reducing the numbers seeking abortion. This is of concern to all, no matter where they might place themselves on the pro-life or anti-abortion/pro-choice spectrum.
But I was very concerned that Prof O'Dowds speculated: "It is likely in Ireland that the barriers placed in the way of Irish women choosing abortion mean that a self-selected group of resourceful and psychologically robust women end up having abortions." I am sure he does not mean to imply that those who opt for lone motherhood are not psychologically robust?
His speculation is not supported by any evidence. Indeed, the recent Women in Crisis Pregnancy study states: "One of the factors invoked by a woman as a reason for her abortion is her fear of the stigma attached to pregnancy and the feeling she has disappointed her parents."
Surely an indicator of psychological robustness would be the ability to withstand pressure of this kind? Not that it is possible to stand in judgment on any woman who does not feel able to go through with a crisis pregnancy, because of the way our society perceives such pregnancies.
Pioneering research by Paul Swope in the US for the Caring Foundation declares: "Unplanned parenthood represents a threat so great to modern woman that it is perceived as equivalent to a death of self. While the woman may rationally understand that this is not her literal death, her emotional subconscious reaction to carrying the child to term is that her life will be over."
It would take a great deal of "psychological robustness" not to choose abortion in these circumstances.
More worryingly, Prof O'Dowd also claims, referring to Dr Dermot Walsh's correspondence in this paper, that warnings issued about post-abortion depression are not borne out. It is sad to see this coming from someone who is calling for more open discussion on the subject. Perhaps the most silenced group in this debate are women who have experienced severe psychological trauma because of abortion.
Catherine Spencer, a woman who chose abortion, believing, as all women do, that it was the best decision for her at that time, wrote of her experience in Swimming Against the Tide (Open Air, Dublin 1997).
She describes seeing several GPs with "oppressive and overwhelming" symptoms connected to her abortion and meeting what seemed like "blank incomprehension" from all of them. She wonders "whether doctors who regularly refer women for abortion cannot square this with an acknowledgement that at least some of them will be severely damaged by the treatment they have sanctioned?"
Looking at psychological consequences alone, a study in the British Medical Journal states that 10 per cent of women will experience chronic, persistent or severe depressive illness.
THE flippant response to this is to state that 90 per cent of women will not.
But this is unlikely to be the response of those who have experienced severe depressive illness or have witnessed it in a loved one. With the current concern regarding high levels of depression in Ireland, a question must be asked: what other surgical procedure carried out for non-medical reasons, which would result in 500 Irish women a year suffering from "chronic, persistent or severe depressive illness", would still be posited as a solution to anything?
In the journal Psychological Medicine it is stated that having had an abortion is a significant risk factor for depression in subsequent pregnancies.
A Finnish study found the mean annual rate of suicide was 11.3 per 100,000 in the general population, 5.9 after birth, and an astonishing 34.7 after induced abortion. So the risk factor for suicide is three times greater after abortion than in the general population, and seven times greater than after a completed pregnancy.
It was also disappointing to see that while Prof O'Dowd acknowledges the need to reduce numbers, the solutions he comes up with are so pedestrian, and hinge mainly on greater availability of contraception.
It seems impossible to point out any limitations of contraception without being labelled anti-contraception, but as Dr Mary Short, secretary-general of the European Society of Contraception, said at the "5,000 Too Many" conference: "Contraceptive accessibility or availability does not stand alone. Implicit in its provision and usage is a knowledge not only of its power but of its limitations."
In a study released by the Office of National Statistics in Britain, Contraception and Sexual Health, an extraordinary statistic emerges regarding under-25s. Among those who are at risk of pregnancy, that is, who are sexually active, have not been sterilised and so on, 99 per cent use some method of contraception. And yet abortion rates in Britain grew by 1.3 per cent last year.
Contraception alone will not solve this problem. Something more radical is required. Using Swope's research, TV and cinema advertising campaigns in the US were devised, which emphasised the woman as strong enough to continue with, to survive and even thrive after a crisis pregnancy. They have reduced abortion rates by 20-30 per cent in the states where they have been shown.
We need to tackle the stigma, career disadvantage, isolation and poverty associated with continuing with a pregnancy. We need to publicise the changes in adoption procedures which would make it a much more viable option for some women. We need to include men and not to always demonise them as irresponsible.
Prof O'Dowd acknowledges women who choose abortion see it as ending a life. We need to ask ourselves what kind of a solution it is to anything which necessitates the taking of one life and the damaging of others. Why do we work for peaceful non-violent solutions in the North, but simply shrug and declare it to be the lesser of two evils when it comes to abortion?
Breda O'Brien is a writer and broadcaster