Hysterectomy & the Eighth Amendment

Some time ago I found out, as I had suspected, that a cure to a rake of health issues that have been bothering me for a few years would be a hysterectomy.  Unfortunately, due to the cause (what turned out to be a 5kg, 28cm rugby ball sized uterine fibroid) the options were limited.  According to my Gynaecologist, a fibroid (that he guessed was at least 20-25cm) had only a 50% chance of being shrunk by 50%, which would make anything less than an abdominal operation difficult, and at my age 45, the uterus had probably (correctly) already served its purpose (i.e. in my case, nothing).

Ireland is not a stone age country, and despite what you might hear in the press, women's opinions are not entirely ignored in the area of reproductive medicine.  I do respect, however, that in the area of pregnancy, the presence of the 8th amendment brings the constitution into the consulting room, where really, it has little useful presence.  In my youth I felt this was no big deal, in my older and hopefully wiser years, I see the obvious problem with this influencing decisions, and preventing others.  I am lucky enough to have had the life I did, never experiencing the horrors other women go through.  Unwanted pregnancy and sexual assault are things I really don't know anything about, and I feel 25 years later, that really, the opinions of a 45 year old gay woman who hasn't experienced such things or ever had children, is really not the best person to decide for others.  Yet we are now on to the 4th such referendum where the opinion of a soon-to-be-infertile woman like myself is given the exact same power as a woman of 18 who faces a lifetime of reproductive decisions and challenges.

This is simply wrong.

It doesn't matter what your opinion on abortion is.  If you were 17 in 1983, decisions about your future reproductive health were made for you by others casting a vote, including men who could not get pregnant, and older women for whom it was no longer possible.  Most of these could, and did, walk away from responsibility when it came to caring for women and children who resulted from unpleasant situations.  Even now I read catty remarks online and even in actual publications written by people who persist in the belief that a group of women deliberately impregnate themselves in other to take advantage of what are considered to be generous welfare benefits for unmarried parents, without any idea of the stark reality of what it is like to have to raise one or more children on a single income, earned or the very low unearned income still just about available to lone parent families.

By the time the referendum comes around, any relevance of the law to me will be long gone. Therefore I will choose to repeal this flawed piece of law, in the hope that a more nuanced approach will allow decisions to be made by people who have an actual stake in the situation.  I don't think its a brilliant idea that woman can just decide to end problematic pregnancies, but the fact is that some will.  What we have known for a long time is that in Ireland, on the whole, very few women take up this option.  This does not mean that we criminalise such women, in an act of unspeakable cruelty.

Furthermore, time spent in waiting rooms and surgeries has led to many conversations with very ill women for whom further pregnancy is deeply problematic.  For example, a 30 year old recently diagnosed with MS, for whom an additional pregnancy would mean incontinence, spending life in a wheelchair, with immense pain - if they managed to survive, that is.  I really don't think the pro-life movement understand that are really are health conditions like this where women's subsequent health post pregnancy is likely to be so riddled with suffering and disability that the pregnancy really does justify termination.  The place of the current legislation means that women's doctors are hamstrung when it comes to having honest conversations about the options available to women, and this is unthinkable for women like that one. It is sad, that in this age, it seems to still be acceptable that women can be literally physically tortured in this way, and then put through 9 months of pregnancy and childbirth without a consideration of the scale of destruction this might have.  I understand this now, because it was something I chose to ignore in my conveniently inoculated pro-life youth.  Only a very tiny number of women face questions of life or death - but the options for those, just as the options for women with near certain foetal terminality, are almost unspeakable in the consulting room.

This is far more wrong than abortion.  If a foetal abnormality is so severe that the likelihood of surviving beyond 5 or 6 months is virtually nothing, there is nothing "moral" about physical and mental torture of the unfortunate parents.  If a woman is pregnant because of rape, and particularly if a minor is pregnant as a result of sexual assault (which we know is all too common) there is little to be gained in forcing her to carry to term the fruit of that assault.  It is all very well talking about building a proper support network for women with difficult pregnancies, as Mullen, McGrath and other dinosaurs in government demands - but the fact remains that they failed to do so in 1983, when it was needed, and in the last 35 years have not done a tap to improve anything for lone parents, poor families, large families and victims of sexual abuse.  The fact that poor Anne Lovett actually bled to death the following year should have been a wake up call: instead Irish women have had to go through years of persecution, silencing and simply being ignored when it comes to gynaecological needs.

For example, there is the still persistent refusal of the Catholic church to be genuinely remorseful in its part in sheltering sexual abusers, nuns who ran dreadful orphanages and mother and baby homes. Hell holes like the Tuam mother and baby home are met with silences from the church who were supposedly responsible, yet they are quick to shriek if someone demands wider access to contraception for young people or sex education in schools.  While same sex marriage is legal, nobody seems to be bothered at the fact that unmarried straight families are second class citizens in everything from tax to legal issues.  One of the saddest stories, from someone who is in reality quite a good catholic, Mary MacAleese, resounds about how a priest verbally abused her mother for having a hysterectomy at 40 because of her history of haemorrhages in her 11 previous pregnancies.

At the same time, the presence of the 8th creates a climate of fear for women going to visit health care providers.  I never even had a smear until I reported my anemia to my GP, and seriously dreaded going to see the consultant so much I took a whole day off work to prepare myself.  (In retrospect, I needed it).  The current situation with the 8th means that women are often fearful of visiting healthcare providers due to concerns about discussion of such issues, and a lot of old wives tales exist around common practice.  (For example, until fairly recently, it was not possible to have your tubes tied at the same time as having a caesarean - I'm told that now this is possible).  It creates a climate also where scandals exist such as the outrageous gynaecologist shortage in Cork leaving women waiting for up to 2 years for complaints such as prolapse (oh Google it, go on).  The waiting list last June was 4667.  Now if even only 1000 of those had fibroids (which would be considered non urgent) and the risk of cancer was 1/400, its likely that at least 2 of those women would have had cancer missed.

Saddest of course, is the long list of women waiting to see ob/gyns for fertility issues: going public can mean a wait time of up to 3 years.  So if the woman is already over 35 by the time she goes on the list, this means her fertility will have deteriorated further over the next 3 years, making it even harder to conceive.  It goes without saying that the 8th has created an attitude to women's healthcare that disregards women's needs, paints up real emotional and health problems as black and white irrelevances and degrades the quality of care.  We can and must do better.

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