Submission on Amendments to Abortion law, 2004

Comments on Amendments to the Choice on Termination of Pregnancy Act, 1996
Students for Life Society, University of Cape Town
                                                                                                                                                    28 July 2004

Please note: whenever Termination of Pregnancy (TOP) is referred to, we will use the word “abortion” as this is the word which correctly describes the premature ending of the life (killing) of the unborn child.
This document includes:

  1. Comment on the Preamble to the Act
  2. Comment on the definitions described in the Act (section 1)

2.1.             registered midwife

2.2.             severe malformation

2.3.             trained counsellor

  1. Comment on the circumstances in which and conditions under which pregnancy may be terminated (section 2)

3.1.             The physical and mental health of the woman

3.2.             The social or economic circumstances of the woman

3.3.             The risk of a severe malformation of the foetus

3.4.             The continued pregnancy resulting in a severe malformation of the foetus

3.5.             The continued pregnancy injuring the foetus

  1. Comment on the Health Facilities approved for Abortion (section 3)
  2. Counselling (section 4)
  3. Comment on Consent re: Mental Disability and Continuous Unconsciousness (section 5)
  4. Comment on Information concerning Termination of Pregnancy (section 6)
  5. Addition of a Conscientious Objection Clause (proposed section 10A)
  6. Addition of  a Protection of Students and Interns Clause
  7. Appendix A: Letter on Birth Deformity
  1. Comment on the Preamble

1.1.             “Recognising the values of human dignity, the achievement of equality, security of the person, non-racialism and non-sexism, and the advancement of human rights and freedoms which underlie a democratic South Africa”

Although this statement is right and noble, it has been shown that abortion, which was meant as a way to put women on equal footing with men, has done just the opposite: it has degraded women, making them more vulnerable to be used with impunity by men, due to the fact that pregnancy is no longer as severe a consequence for their sexual actions.

It has been shown that life begins at conception (this fact can be verified by any medical text on Embryology). Also, it is a scientific fact that all abortions are performed on children who have beating hearts and active brainwaves – signs of life, according to the medical criteria for diagnosis of death. Thus we are able to prove that the unborn child is alive and human. Therefore the above statement, which is the first statement in the Preamble to the Choice on Termination of Pregnancy Act (CTOPA), is not upheld by the legislation written in this Act as it removes all human dignity, equality and security that was once afforded the unborn child.

1.2.             “Recognising that the Constitution protects the right of persons to make decisions concerning reproduction and to security in and control over their bodies”

The idea that the unborn child is a part of the mother’s body is unscientific and plainly wrong. “Decisions concerning reproduction” have normally been made by the individuals concerned long before abortion can be considered, because reproduction has already occurred. Medical evidence show clearly that the unborn child is not at any stage of its development a part of the mother’s body. The child from fertilisation onwards, has a separate body and its own genetic code. The mother and child do not even share the same blood and often have different blood types! The placenta prevents any mixing of blood, but allows nutrition and oxygen to pass through it. If the child’s blood were a different type to that of the mother, then any of her blood entering the child would kill it! The idea that the child is at some stage part of the mother is simply abortionist propaganda. Therefore the right to “control over their bodies” is not a reason to have rights for abortion.

This idea can also be looked at from the point of view of the unborn child: the unborn baby’s Constitutional right to life and right to control over his/her body is violated by abortion.

  1. Comment on Definitions

2.1.             Section 1 (ix): We request that “Registered Midwife” not be changed to “Registered Nurse”. No nurses are suitable to perform abortions, as non-midwives are not sufficiently qualified to perform them safely.
2.2.             If the clause allowing abortion for a severe malformation is to remain in the CTOPA, then we request the addition of a more specific definition of severe malformation.
e.g. ‘ “Severe malformation” means a baby who is diagnosed as being anencephalic.’ (anencephalic means absence of a brain.)

There are many other malformations and anomalies that can occur, but children with these malformations have been known to live. Fetal and neonatal (newborn) surgery is now available and able to correct all sorts of fetal malformations, especially spina bifida (exposed spinal cord). Babies with hydrocephalus (water on the brain) can be cured, either in the womb or after live birth,  by the surgical insertion of a shunt; babies with microcephalus (small brain) have been known to survive; babies who develop phocomelia/amelia (deformed limbs or loss of a limb) are merely physically disabled; otherwise they are mentally intact and can thus adapt to enjoy a quality-filled life. All the other deformations or malformations merely hinder the child physically or mentally, but are not lethal, although some may have a shortened life-span, such as Cystic Fibrosis or Down’s syndrome.

Any condition is curable with God’s miraculous intervention including anencephaly. A pastor in Durban was born this way and healed after prayer by his parents.  Nevertheless, even if there was no cure, human life is still sacred.  The baby should be born and left to die peacefully.  This same logic would apply for example to care of AIDS babies – should they be killed if they are just going to die in a few days? The only exception is when killing is necessary to save another life (ie. to prevent the death of the mother) and the intent is still to try save both.

Therefore we advise that no malformed child is aborted, as they have a right to life and are entitled to the chance to exercise that right.
2.3.             We request the addition of a definition of trained counsellor.
e.g. “Trained counsellor” means a medical practitioner or registered midwife who has undergone a training course in pre- and post-abortion counselling.

  1. Comment on the circumstances in which and conditions under which pregnancy may be terminated

3.1.          “Section 2 (1) A pregnancy may be terminated-
(b) from the 13th up to and including the 20th week of the gestation period if a medical practitioner, after consultation with the pregnant woman, is of the opinion that-
the continued pregnancy would pose a risk of injury to the woman’s physical or mental health; …”

Effects of abortion on the physical and mental health of a woman:

1. Physical health:
Most arguments for legal abortion presuppose it to be beneficial to the mother and humane to the child. This is not true. Abortion unnaturally interrupts a pregnancy, destroying both the physical and emotional bond between mother and child. This often results in harmful physical and mental complications to the mother. Physical complications include haemmorrhage, rupture of the uterus, sepsis, and shock which is either neurogenic or due to the sepsis. These are all life-threatening medical conditions. These serious dangers of abortion are often obscured amongst media talk of ‘safe and legal abortion’, implying that legal abortions are safe. All abortions, whether legal or illegal, are dangerous.

2. Mental health:
As can be seen from above, abortion is not a safe procedure. It includes risks to the mental health of a woman. In reality, therefore, women who are granted abortions on psychiatric grounds are the very women whose mental condition is most likely to be aggravated by the abortion. They are the ones at the highest risk. ‘The more severely ill the psychiatric patient, the worse is her postabortion psychiatric state.’ (E. Sandberg, ‘Psychology of Abortion’, in Comprehensive Handbook of Psychiatry, 3rd Ed Kaplan and Friedman Publishers).

In an official statement of the World Health Organisation in 1970, it was stated: ‘Serious mental disorders arise more often in women with previous problems. Thus, the very women for whom legal abortion is considered justified on psychiatric grounds are the ones who have the highest risk of postabortion psychiatric disorders.’

‘The feeling of guilt is almost universal and some patients experience a form of postabortaldepression’ (“Contraception Science and Practice”, M. Filshie & J. Guillebaud. Butterworths Publishers, 1989, p268). The first very common reaction involves guilt, anxiety, depression, sense of loss, crying, deterioration of self-image, regret or remorse. The second, more serious reaction affects about one in a thousand aborted women and results in metal illnesses. The third, suicide, is rare, but considerably higher than for women who have not had abortions. (“Abortion: the crisis in morals and medicine”, NM de S Cameron & PF Sims, IVP, 1978, p65).

The following physiological effects were reported by women after having undergone an abortion: ‘Guilt; suicidal impulses; sense of loss; unfulfillment; mourning; regret and remorse; withdrawal; loss of confidence in decision making capability; lower self esteem; preoccupation with death; hostility; self destructive behaviour; anger/rage; despair; helplessness; desire to remember death date; preoccupation with “would be” due date or birth month; intense interest in babies; thwarted maternal instincts; hatred for anyone connected with abortion; desire to end relationship with partner; loss of interest in sex; inability to forgive self; feeling of dehumanisation; nightmares; seizures/tremors; frustration; feelings of being exploited; child abuse; decreased work capacity; crying; insomnia; loss of appetite; weight loss; nervousness; frigidity” (Before you make the decision’, Women Exploited By Abortion, pamphlet).

In a detailed study of post-abortion psychological effects in the American Journal of Psychiatry, it was reported that ‘Anxiety, which if present after an abortion is felt very keenly, was reported by 43%… Depression, one of the emotions likely to be felt with more than moderate strength, was reported by 31.9% of women surveyed… 18% felt no relief at or just a bit. They were overwhelmed by negative feelings. Even those women who were strongly supportive of the right to abort reacted with regret, anger, embarrassment, fear of disapproval and even shame.’ (‘Aborted Women: Silent No More’, David Reardon, Westchester Il: Crossway, 1987).

There have been many other studies done on the psychological after-effects of abortion, and to this end we have discovered that abortion does not improve a woman’s emotional and mental condition, it worsens it. Therefore, allowing abortion for mental health reasons is futile and thus we advise that this clause be removed.

The psychological distress experienced by some women  who have aborted is known as ‘Post Abortion Syndrome’ (PAS) and is often suppressed until it manifests many years after the abortion. Solutions to this condition are as follows:
a) Admit she was party to the killing of her own child;
b) Mourn over the loss
c) Seek and accept God’s forgiveness
d) Forgive herself
(“Abortion: Questions and Answers”, Dr & Mrs J Willke, p135)
3.2.             “Section 2 (1) A pregnancy may be terminated-
(b) from the 13th up to and including the 20th week of the gestation period if a medical practitioner, after consultation with the pregnant woman, is of the opinion that-
(iv) the continued pregnancy would significantly affect the social or economic circumstances of the woman; …”

In the majority of pregnancies in South Africa, which pregnancies do not significantly affect the social or economic circumstances of the woman? We feel that every pregnancy affects the social and economic standing of a woman, in whatever socio-economic group she finds herself in. Thus we reject this reason as grounds for a termination of pregnancy and advise that this clause be removed.
3.3.             Section 2 (1) A pregnancy may be terminated-
 (b) from the 13th up to and including the 20th week of the gestation period if a medical practitioner, after consultation with the pregnant woman, is of the opinion that-
(ii) there exists a substantial risk that the fetus would suffer from a severe physical or mental abnormality; …”

If this clause is to be kept, we request the addition of  a definition of “severe malformation”. Please refer to 2.2 above.
3.4.              “Section 2 (1) A pregnancy may be terminated-
(c) after the 20th week of the gestation period if a medical practitioner, after consultation with another medical practitioner or a registered midwife, is of the opinion that the continued pregnancy-
(ii) would result in a severe malformation of the fetus;…”

We feel that this clause makes no sense, as how can killing a child be preferable to it living even though it is malformed? Kindly refer to Appendix A, a letter written by three adults who were malformed from birth, speaking out against the abortion of babies whose mothers had taken Thalidomide.
We recommend that section 2 (1)(c)(ii) should be removed.
3.5.             “Section 2 (1) A pregnancy may be terminated-
(c) after the 20th week of the gestation period if a medical practitioner, after consultation with another medical practitioner or a registered midwife, is of the opinion that the continued pregnancy-
(iii) would pose a risk of injury to the fetus.”

There are a few conditions where continuing a pregnancy would risk the life of the baby. These conditions are rare and are emergencies of pregnancy, i.e. where a pregnancy has gone wrong. They are: trauma to the mother’s abdomen, abruptio placentae (the placenta tears away from the lining of the womb) or placental insufficiency. Surely if this were to happen, the child should be delivered (born) and given the chance to live outside the womb the best way he or she can. We feel that this clause makes no sense, as how can killing a child be preferable to it dying or being harmed by natural causes? Thus we recommend that section 2 (1)(c)(iii) should be removed.

  1. Comment on the Health Facilities approved for Abortion 

4.1.             Section 3 (4) is new.
”(4) Any public or private health facility that has a 24 hour maternity service, and which complies with the requirements and conditions contemplated in subsection (2), is exempted from requiring approval to terminate pregnancies of up to and including 12 weeks.”

we feel that these hospitals, even though they do comply with the requirements and conditions contemplated in subsection (2), should be up for review on a fairly regular basis, e.g. annually, in order to ensure that they do still comply with the regulations and are thus equipped with the correct equipment and personnel to perform abortions. This can be done by requesting that a form be filled in at the end of each year stating the facilities which are still present. This should be done to ensure that abortions are carried out in the safest environment and manner possible.

4.2.             Section 3 (5) is new.
“(5) The Member of Executive Council shall on an annual basis provide the Minister with statistics of approved facilities for that particular year.”

Because abortion is such an ethically delicate topic and one that has consequences for mothers, families and communities, we advise that these statistics be available every 6 months, not on an annual basis. This should be done to exercise greater control over the number of abortions being done countrywide.

  1. Counselling

    We advise that the following be added to the section (section 4) on counselling:The State shall ensure that:
    (1) Pre-abortion counselling takes place at least 48 hours prior to the scheduled termination of pregnancy;
    (2) Such counselling shall include an interview with a trained counsellor who shall be required to provide sufficient detailed medical information to enable the patient to make an informed choice regarding the desirability or otherwise of proceeding with the termination of that patient’s pregnancy.

    (3) Such counselling would include the provision of:
    (a)  information for the mother on alternatives (including voluntary counselling),
    (b)  the development of the baby, and
    (c)   the risks available to the mother.

    We advise the introduction of legislation requiring the use of a regulated booklet with colour photographs showing the stages of fetal development, so that mothers are thoroughly informed and educated. This, together with full pre-abortion counselling will ensure that she is able to make a fully informed decision and thus give her informed consent.
  1. Comment on Consent re: Mental Disability and Continuous Unconsciousness

    Section 5. (4) Subject to the provisions of subsection (5), in the case where a woman is-
    (a) severely mentally disabled to such an extent that she is completely incapable of understanding and appreciating the nature or consequences of a termination of her pregnancy; or
    (b) in a state of continuous unconsciousness and there is no reasonable prospect that she will regain consciousness in time to request and to consent to the termination of her pregnancy in terms of section 2, her pregnancy may be terminated during the first 12 weeks of the gestation period, or from the 13th up to and including the 20th week of the gestation period on the grounds set out in section 2(1)(b)-
    (i) upon the request of and with the consent of her natural guardian, spouse or legal guardian, as the case may be; or
    (ii) if such persons cannot be found, upon the request and with the consent of her curator personae:
    Provided that such pregnancy may not be terminated unless two medical practitioners or a medical practitioner and a registered midwife who has completed the prescribed training course consent thereto.”
    We advise the removal of clause (5). Clause 5 overrides the consent of the mother and of the spouse and natural guardian, leaving it solely up to the medical practitioners, this places an undue burden on the medical practitioners to decide on the fate of the fetus and therefore should be deleted. It also impinges on the rights of the mother and her spouse (or curator or guardian), if any, in that their wishes and desires can be overridden by the medical personnel concerned. The common law should apply in cases where consent cannot be obtained and the court can be approached on an urgent basis to supply the necessary consent and this would be more consistent with respect for the rights of all affected parties as the court can then take the responsibility for the decision which subsection (5) unfairly places on medical professionals concerned. This also eliminates the possibility of abuse of subsection (5).
  1. Comment on Information concerning Termination of Pregnancy“A woman who in terms of section 2(1) requests a termination of pregnancy from a medical practitioner or a registered midwife, as the case may be, shall be informed of her rights under this Act by the person concerned.”

    Kindly refer to our comments under 5 above.

  1. Addition of a Conscientious Objection Clause 

    We advise the addition of this clause to the CTOPA as section 10A:If a practitioner has a conscientious objection to abortion, he shall not be obliged to participate in any stage of the abortion process as far as he feels he should not become involved. This includes admitting, preparing for,  performing the abortion and caring for the patient after the abortion has taken place, as well as any administrative work attached to dealing with the patient, including prescribing medication, and attending to documentation thereto (such as filling in statistics forms and writing discharge letters).

     

  2. Addition of  a Protection of Students and Interns Clause 

    We advise the addition of this clause to the CTOPA as section 10B:Students and interns should not be asked to participate with abortions in any way. This includes admitting, preparing for,  performing the abortion and caring for the patient after the abortion has taken place, as well as any administrative work attached to dealing with the patient, including prescribing medication, and attending to documentation thereto (such as filling in statistics forms and writing discharge letters).

    This clause is necessary as students and interns are vulnerable to pressure from senior doctors.

 Appendix A

Letter on birth deformity

 In 1962, there was a great controversy in England over whether or not abortion should be permitted to destroy unborn children who had been handicapped by a drug taken by pregnant women to cure morning sickness. This drug caused the children to be born with stunted limbs. The following letter appeared in the Daily Telegraph (“The Right to Live, The Right to Die”, C.Everett Koop, Tyndale House Publishers, 1980 p63).

Trowbridge

Kent

December 8, 1962

Sirs

We were disabled from causes other than Thalidomide, the first of us having two useless arms and hands; the second, two useless legs; and the third, the use of neither arms nor legs.

We were fortunate…in having been allowed to live and we want to say with strong conviction how thankful we are that none took it upon themselves to destroy us as useless cripples. Here at the Delarue school of spastics, one of the schools of the National Spastic Society, we have found worthwhile and happy lives and we face our future with confidence. Despite our disability, life still has much to offer and we are anxious, if only metaphorically, to reach out to the future.

This, we hope, will give comfort and hope to the parents of Thalidomide babies, and at the same time serve to condemn those who would contemplate the destruction of even a limbless baby.

Yours faithfully,

Elane Duckett

Glynn Verdon

Caryl Hodges

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