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: 

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


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