Monday, 24 February 2014

Abortions in Israel: Time to finally abort pregnancy-termination committees?

Last week, I published the second in my two-part miniseries for Israel's Haaretz newspaper on the politics of abortion in Israel. Below is the full article. 

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Abortions in Israel: Time to finally abort pregnancy-termination committees?

How Israel’s abortion law compares to other countries, and why the current political environment may be ripe for reform. Part two of a two-part series.

By  | Feb. 20, 2014 | 3:13 PM


As my previous blog on abortions in Israel showed, Israel's abortion law is not as liberal as some wishfully think. But the questions remain: how does Israel compare to other countries, and has the time come to change the status quo? As for whether Israel is more or less liberal, the answer, in short, is that Israel lies somewhere in the middle.


It is nowhere near as restrictive as the seven countries that ban abortion altogether, even when the life of the woman is at risk. Nor is it as restrictive as countries like Ireland that only allow abortion to save the woman’s life. Mara Klein Clarke, who directs the U.K.-based Abortion Support Network, told me Ireland is “pretty horrific, both North and South … women are seldom allowed to obtain abortions.” As a result, she says, “We’ve heard from women who have thrown themselves down flights of stairs, drunk bleach, chased packages of birth control pills down with bottles of vodka and gin. And this is in 2013/2014 in the supposedly developed world.”


Evidently the abortion situation in Israel could be much worse.

But, equally, it could be much better. In the United Kingdom (aside from Northern Ireland) abortion is free on the National Health Service and legal up to 24 weeks. Although there is a postcode lottery of provision and a paternalistic mandate that two doctors need to sign off on the abortion, this is largely a formality and certainly a far cry from Israel’s Orwellian three-person pregnancy-termination committee. Meanwhile, Canada has done away with restricting abortions altogether, and simply considers abortion a “medically necessary” service.


So Israel’s abortion provision sits between these two poles. “On the one hand, women really can’t make the choice for themselves here. They need to get approval from a committee. On the other hand, Israel is not one of those countries where there’s a complete ban on abortion,” explains Rivka Neumann of the Women's International Zionist Organization. Political scientist Yael Yishai categorizes Israel as an “intrusive” state that “limits individual discretion but is committed to implementing authorized (that is, legal), abortions.”

The question, then, is what accounts for Israel’s intrusion into women’s wombs?

My research (summarized here) suggests that Israel’s approach to abortion is the outcome of a complex interplay between various factors and actors. On the one hand there are those who have opposed abortion for either religio-moral or demographic reasons, while on the other hand have been those concerned about the implications for women’s health and welfare of restrictions on access to abortion, as well as feminists resisting attempts to render women’s wombs national vessels.

Historically, those opposed to abortion on demographic grounds feared that freer access would decrease the Jewish birth rate and in turn Israel’s Jewish majority. David Ben-Gurion was especially anxious about low Jewish fertility, and wrote in Haaretz in 1967, “The increase of the Jewish birthrate is not an imperialistic need, but rather an essential component of the survival of the [Jewish] people … Any woman who does not have four children as much as it depends on her is betraying the Jewish mission.” Linking abortion to the “demographic danger” became most vivid and vocal during the 1975 Knesset debate on abortion law reform. Feminist former MK Marcia Freedman recalls in her memoir that MKs opposing abortion shouted statements like, “tens of millions of Arabs, who are fruitful and multiply, surround our borders” and “Has Arafat given his consent to this law?”

Yet pro-natalist opposition to abortion has been resisted by those concerned with the negative repercussions for women of restrictions on access to abortion. Former MK Haviv Shimony, who submitted the successful abortion law reform bill in 1975, explained at the time that whilst the future of Israel depended on both immigration and natural increase, “these foundations are completed by the concern for the physical and emotional health of our people gathering in the country … Imposing the burden of a multitude of children on weak social groups from the financial, educational and mental points of view will only destroy the families and the society.” Others, like Freedman, went further, stressing the inalienable right of women to control their own bodies.

The outcome of these historic struggles – which I call a “war of the wombs” – is that abortion in Israel became widely available, yet legally restricted.

Has the time come to change the status quo? In order to answer that, we must first understand whether the power of the religious and nationalist forces opposed to liberalizing abortion has weakened enough to enable such a change.

Opinion on this is divided.

Some fear that religious and nationalist forces remain powerful within Israel, and worry that opening a new chapter in this war of the wombs could generate a counterproductive conservative backlash. The recent health-basket reform resulted in a funding victory, but before hastily moving onto the next stage of liberalizing abortion in Israel, they urge patience and caution. “We need to let things permeate,” Orly Hasson-Tsitsuashvilli, the Executive Director of Ladaat, a family planning education and counseling center in Jerusalem, told me. She says the health-basket reform “raised a storm and raised opposite opinions to the surface.” As such, she says ”We need a bit of time before we take the next big step.”

Others are more optimistic. Meretz chairwoman MK Zehava Gal-On has submitted a bill to the Knesset calling for the abolition of the termination committees. “The law should be changed and the committees should be stopped so that each woman can decide for herself if she would like to have an abortion or not … The bill that I have submitted will most definitely give the women control back over their lives and reproduction systems,” she told me. A recent editorial in Haaretz echoed Gal-On’s demands, stressing that “Lawmakers must act to change the abortion committees’ criteria and to ensure that Israeli policy matches that of most Western nations. Every woman must be given the freedom to choose.”

There are some indications that proposing such reforms could be successful. The health-basket committee unanimously supported expanding the funding of legal abortions, the Cabinet quickly approved their recommendation, and there are no ultra-Orthodox political parties in the current coalition to obstruct abortion reform. It is also doubtful that demographic fears linking access to abortion to the security of the Jewish majority are anywhere near as potent as in the past. Most encouragingly, during last week’s hearing on abolishing the termination committees, organized by the Knesset Committee on the Status of Women, consensus was reached that “until the 12th week, we don't need the committee,” according to Hasson-Tsistuashvilli, who attended the hearing. Even Dr Eli Schussheim, the Director of the anti-abortion organization Efrat, agrees, and has now argued in favor of abolishing the committees. Consequently, Gal-On told me that she is “very hopeful that we will be able to pass it (her bill) within the next parliamentary session.”

So perhaps this is an opportune moment to push for abortion law reform. After all, isn’t it high time to let women in Israel finally decide for themselves what to do with their own bodies?

In her last blog post, Dr. Rebecca Steinfeld explained that Israel’s recent health-basket reform may make abortions more affordable, but hardly more accessible. Steinfeld is a Visiting Scholar in the Department of History at Stanford University, and a BBC New Generation Thinker. She researches the history and politics of reproduction in Israel. She tweets @beccasteinfeld

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This article was originally published by Haaretz. For the full article, click here.

Thursday, 20 February 2014

Abortions in Israel: Time to finally abort pregnancy-termination committees?

Today, I published the second in my two-part miniseries for Israel's Haaretz newspaper on the politics of abortion in Israel. Below are the first 150 words, and in 48 hours I'll re-post the whole article. 

---------------------------------------------------------------------------------------------
Abortions in Israel: Time to finally abort pregnancy-termination committees?

How Israel’s abortion law compares to other countries, and why the current political environment may be ripe for reform. Part two of a two-part series.

By  | Feb. 20, 2014 | 3:13 PM

As my previous blog on abortions in Israel showed, Israel's abortion law is not as liberal as some wishfully think. But the questions remain: how does Israel compare to other countries, and has the time come to change the status quo? As for whether Israel is more or less liberal, the answer, in short, is that Israel lies somewhere in the middle.

It is nowhere near as restrictive as the seven countries that ban abortion altogether, even when the life of the woman is at risk. Nor is it as restrictive as counties like Ireland that only allow abortion to save the woman’s life. Mara Klein Clarke, who directs the U.K.-based Abortion Support Network, told me Ireland is “pretty horrific, both North and South … women are seldom allowed to obtain abortions.” As a result, she says, “We’ve heard from women who have thrown themselves down flights of stairs, drunk bleach, chased packages of birth control pills down with bottles of vodka and gin. And this is in 2013/2014 in the supposedly developed world.”

Evidently the abortion situation in Israel could be much worse.

But, equally, it could be much better. 
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This article was originally published by Haaretz. For the full article, click here.

Saturday, 15 February 2014

Abortions in Israel: Is the law as liberal as they claim?

Two days ago, I published my second blog as a Jewish thinker for Israel's Haaretz newspaper on the topic of abortion in Israel. Below is the full article: 
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Abortions in Israel: Is the law as liberal as they claim?

Israel’s recent health-basket reform may make abortions more affordable, but hardly more accessible. Part one of a two-part series.

By  Feb. 13, 2014 | 11:58 AM


Imagine you’re a woman in Israel facing an unwanted pregnancy. If you’re lucky and wealthy, you could pay for an illegal, private, no-questions-asked abortion, setting you back between NIS 2,099-2,912 ($600 and $830), depending on the stage you’re at and whether it’s a surgical or medical termination.

If you’re less well off, you could go the legal route. But then you’ll have to jump through a series of bureaucratic hoops, since abortion in Israel is only legal if you receive permission from a Pregnancy Termination Committee (consisting of two doctors and a social worker) and fulfill one of four criteria: you’re under-18 or over-40, pregnant as a result of criminal or extra-marital relations, your fetus is likely to have a physical or mental defect, or your pregnancy poses a danger to your life or could cause you physical or mental harm. If you don’t meet the criteria, you could lie - but this is risky.

All women in Israel - rich or poor, citizens or non-citizens - lack control over one of the most intimate decisions connected to their bodies: reproduction. Instead of having full reproductive autonomy, lawmakers, doctors and social workers decide who can and can’t end her pregnancy.

True, there have been a few positive steps of late: On Tuesday, a Knesset debate was to take place on abolishing Termination Committees; and last month, the Cabinet approved the health-basket committee’s decision to begin paying for legal abortions for women aged 20 to 33, regardless of circumstance.

As Prof. Jonathan Halevy, the head of the health-basket committee and director of Shaare Zedek Medical Center, explains, the women set to benefit from the expanded abortion benefits will be those who need it most: single women, young women unable to ask their parents for the funds, or those pregnant as a result of an extramarital affair but financially dependent on their husbands.

“This is a very important decision that we think opens a door for future progressive decisions regarding reproductive rights,” Orly Hasson-Tsitsuashvilli, the Executive Director of Ladaat, a family planning education and counseling center in Jerusalem, told me. “We, along with a coalition of women's feminist organizations, were among those who led and pushed for this change. I believe that financing this procedure allows every woman to realize her right for health.”

The changes also complement some other liberal aspects of abortion in Israel: A woman can undergo the procedure up to 40 weeks gestation, a minor does not require parental consent, doctors performing illegal abortions are very rarely prosecuted (despite half of all abortions reportedly taking place illegally), and the committees approve virtually all applications - 96.4 percent from 1990-2011, based on my calculations of Central Bureau of Statistics data.

Criteria, committees and campaigning

But while it appears Israel is heading in the right direction, we mustn’t get carried away. A recent Times of Israel article declared, “Israel’s abortion law now among world’s most liberal,” with a Haaretz article published Wednesday echoing the claim. Sadly, this is wishful thinking. Despite the positive elements, women in Israel must still surmount a series of obstacles to obtain legal abortions: criteria, committees, and campaigning anti-abortion organisations.

In order to fulfill the criteria, some women are forced to lie, especially married women, who must claim they’re mentally ill or pregnant due to extramarital sex. This can have dangerous repercussions given that religious authorities have exclusive jurisdiction over marriage and divorce in Israel. It’s not surprising that most women undergoing illegal abortions are thought to be married women aged 19 to 40. This goes to show that requiring women to fulfill certain criteria can compromise their honesty, further undermine their marital rights or risk their health.

The committee process also hinders access. It results in time delays, there is a lack of uniformity in how the committees function, and though all hospitals with gynecology departments are required to provide abortions, many do not, according to Jacqueline Portugese, who has written extensively about fertility policy in Israel. The approval rates are also misleading; since it’s likely those who don’t fit the criteria don’t apply. Hasson-Tsitsuashvilli believes “the way the committees work now is a burden on the system and on women.”

Facing an abortion committee can also be a shameful experience. Medical sociologist Yael Hashiloni-Dolev regards it as a “ceremony of shame and guilt” in which women have to “confess their sins or explain very intimate details about themselves to total strangers.” Health journalist Judy Seigel-Itzkovich told me in 2009 that she thinks 50 percent of abortions performed illegally are women seeking to avoid this embarrassment.

Another problem is the state’s toleration of the activities of anti-abortion organizations. One of these, Efrat, which offers funding and baby equipment to women considering terminations for financial reasons, has been accused of ambushing and manipulating vulnerable young women. Hasson-Tsitsuashvilli told me she thinks Efrat uses fear and guilt tactics to exploit pregnant women's vulnerabilities, uses their bodies for ideological purposes, gives out false information, and disappears from a woman's life about a year after the birth. She thinks “the work of organizations like Efrat is damaging to women as well as to society, from a human and feminist point of view.”

Efrat rejects these accusations as “false, unfounded and libelous,” and told me that in the almost four decades of its work it has “assisted over 56,000 new mothers” and has “never received a single complaint or notification that one of the people assisted had regretted having their new child.” Efrat also says it “gives support for up to two years” and refers women to other welfare organizations if additional assistance is needed.

Yet there remain reasons to be skeptical. The gender specialists L. Ariella Zeller and Elana Maryles Sztokman argue that “Efrat is an anti- abortion, anti-women’s-empowerment movement that wants to appear pro-choice and pro-woman.” And my research has suggested that there are other, demographic motivations that underpin Efrat’s work, and which may compromise their willingness or ability to help all women equally. Efrat’s 2012 billboards declared “Ultimately, the birth rate will determine our existence as a Jewish state,” and when I interviewed Efrat’s director, Dr Eli Schussheim, in 2009 for my doctoral research, he proudly told me, “This is the simplest way to make aliyah (Jewish immigration to Israel).” When I asked him whether Efrat would support non-Jewish women seeking terminations for financial reasons, he oscillated. First he said it would and does, and then he explained that as a constitutionally Jewish organization, Efrat is technically barred from doing so. But, “Barukh Hashem (Thank God),” he said, “we do not have any [such] cases.”

The upshot of these criteria, committees and campaigning anti-abortionist organizations is to undermine women’s reproductive rights in Israel. MK Zehava Gal-On told me “Women in Israel do not have any reproductive autonomy - the state robbed them of this right the moment it made abortions an illegal activity and decided to allow them only under very specific circumstances and only after passing a special committee for approval.”

Regrettably, the recent health basket reform does not address any of these problems. As Hasson-Tsitsuashvilli puts it, the reform “goes far, but not [far] enough."

So before we wax lyrical about how liberal Israel’s abortion law is, it’s worth considering what it’s really like to face an unwanted pregnancy in Israel and be confronted by the triumvirate of criteria, committees and campaigning anti-abortion organisations.

Is this really women’s liberation?

In her next blog post, Dr Rebecca Steinfeld will look at the historical context behind Israel’s restrictive abortion law, and ask whether the time has come to reform it.

Dr Rebecca Steinfeld is a Visiting Scholar in the Department of History at Stanford University, and a BBC New Generation Thinker. She researches the history and politics of reproduction in Israel. She tweets @beccasteinfeld

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This article was originally published by Haaretz. For the full article, click here.

Thursday, 13 February 2014

Abortions in Israel: Is the law as liberal as they claim?

Today, I published my second blog as a Jewish thinker for Israel's Haaretz newspaper on the topic of abortion in Israel. Below are the first 150 words, and in 48 hours I'll re-post the whole article. 

--------------------------------------------------------------------------------------------

Abortions in Israel: Is the law as liberal as they claim?

Israel’s recent health-basket reform may make abortions more affordable, but hardly more accessible. Part one of a two-part series.

By  Feb. 13, 2014 | 11:58 AM

Imagine you’re a woman in Israel facing an unwanted pregnancy. If you’re lucky and wealthy, you could pay for an illegal, private, no-questions-asked abortion, setting you back between NIS 2,099-2,912 ($600 and $830), depending on the stage you’re at and whether it’s a surgical or medical termination.

If you’re less well off, you could go the legal route. But then you’ll have to jump through a series of bureaucratic hoops, since abortion in Israel is only legal if you receive permission from a Pregnancy Termination Committee (consisting of two doctors and a social worker) and fulfill one of four criteria: you’re under-18 or over-40, pregnant as a result of criminal or extra-marital relations, your fetus is likely to have a physical or mental defect, or your pregnancy poses a danger to your life or could cause you physical or mental harm. If you don’t meet the criteria, you could lie - but this is risky.

This article was originally published by Haaretz. For the full article, click here.