Now obviously this would not be possible in a system where abortion is illegal.

So it appears that the Group was not being mandated to study and make recommendations on

legal; but rather to advise on how legalized abortions could be made safe and accessiblefor all

and would be legalized.

Based on imposed tunnel vision, this report is proposing the use of a medical procedure,

induced abortion, to help solve what is essentially a social problem – unwanted pregnancy.

The wider landscape of interpersonal attitudes and conduct, sexual education and behavior,

family life, moral, ethical, religious and social issues has not been carefully surveyed and

included for deliberation.

the group into using obviously inadequate data to make a case and support their

recommendations.

2.

The data presented from the Victoria Jubilee Hospital of some 641 admissions to Ward 5 over a

six month period in 2005 give the impression that these were all cases of induced abortion but

that only 7% of these patients confessed to deliberate interference. This is extremely misleading

as cases admitted to this ward include all cases of bleeding in pregnancy – i.e. spontaneous

abortions (miscarriages), or where bleeding in pregnancy indicates that the pregnancy is in

danger of being lost (threatened abortion), as well as cases of deliberate (induced) abortion.

The report was that during this period no patient died (i.e. zero mortality) but that morbidity (i.e.

the complication rate) was “high”; however no morbidity data were provided to support this.

That observation was no doubt factual. But the same demographics would likely be true of

patients in other wards of the same hospital being treated for fibroids or cervical cancer; or in the

KPH suffering from diabetes, or heart disease, or appendicitis.

The fact is that the complications of abortion are found among patients of all social and

economic strata in both public and private hospitals.

Complications related to abortion are not limited to the home-style methods or the “back street

practioner”, but occur also, and not infrequently, in cases performed by trained medical

personnel.

In Canada, where abortions are performed by trained persons in proper facilities, early physical

complications are reported at 10% - and this does not include later physical complications or

psycho-emotional problems which are alarmingly prevalent.

The point must be made and stressed that legal abortion does not equate to safe abortion!

Qualitatively similar criticisms can be made of the data offered from Cornwall Regional Hospital.

Since then, not only has the number of legal abortions dropped considerably,

from 59,417 in 1990 to 151 in 1999 (these were for rape, problems with the

fetus, or threats to the mother's life or health), but so has maternal and

infant mortality. Maternal mortality, recorded at 15.2 per 100,000 live

births in 1990, dropped to 7.3 per 100,000 by 1999. Infant mortality also

showed a steady decline, from 18.1 in 1991 to just 8.9 in 1999 (and dropped

again to 8.1 in 2000).

that reported the lowest maternal mortality rates for 1988 - - some three

and a half times lower than that reported for the British.

At least in these two countries, mothers appear to be safer in the country where abortion

Is not legal.

While the number of abortion-related maternal deaths did decline in the time

of a larger, longer downward trend in maternal mortality. This decline began

in the 1940s with the introduction of sulfa drugs and penicillin and

continued through the 1950s and 1960s with the advent of better surgical and

anesthetic techniques and instruments. Overall maternal mortality declined

during the same time frame by roughly the same margin, a further indication

that these innovations, not abortion's legalization, were driving the

mortality figures down.

On the other hand, it is well known that improving quality of health care including ante-natal care

does make a significant impact on maternal morbidity and mortality - properly equipped

hospitals, clinics and health centres, adequate numbers of trained medical staff, availability of

drugs, blood and blood products, etc.

Within the terms of reference with which it was provided, the APRAG probably saw no

alternative but to advise that the law be amended to make abortion legal in Jamaica.

The report then proceeds to define the circumstances under which abortions should be legally

performed. These are outlined on what on my copy is page 6 of the APRAG report.

Based on these recommendations, the draft bill “Termination of Pregnancy Act of 2007” states

the locations where and the personnel by whom abortions may be performed in the different

stages of pregnancy.

4.

The stated indications for abortion include :

(a) Cases of rape, incest, carnal abuse. In every such case counselling as provided under

Section3 shall take place before a decision is made to terminate a pregnancy and to continue

after the termination.

(b) When continuation of the pregnancy would involve risk to the life of the patient or risk of

great injury to her physical or mental health.

Under these indications, any woman with a pregnancy which is causing her distress – physical,

mental, emotional, financial, or social – qualifies for an abortion; and this applies whether the

stress factors are actual or foreseeable!

Even after 22 weeks, at a stage of potential fetal viability, it is proposed that abortion be allowed

if an authorized medical practitioner (i.e. one doctor) deems some “special” but undefined

indication to be present.

Now a woman does not request an abortion unless it is causing her some sort of significant

distress. She requests an abortion when the pregnancy is causing her distress; and the draft bill

proposes in effect that if she is distressed she should be allowed to have an abortion.

What is the message here to our people : “If you get pregnant and you don’t want it, you may

have an abortion”.

In our local parlance : “Dash it wey!”

5.

Both the report and the draft bill speak to the need for counseling before and after abortion.

The reported experience from countries which have implemented this approach is that in many

cases this either does not happen at all or is offered in a perfunctory, cold or routine manner to

fulfill the letter of the law. Very often, what is called counseling is in reality the application of

pressure to have an abortion.

Let us accept the uncomfortable fact that those involved in the medical assessment of the

patient and in offering advice and counsel are often those who themselves stand to gain

financially from a decision to abort the pregnancy.

The inclusion of a recommendation for counseling in no way guarantees the caring assistance

needed by a woman with an unwanted pregnancy.

The draft bill also proposes that a mentally competent minor would not be required to obtain

consent for an abortion from parent or guardian or to notify them. This would seem to contradict

the existing law regarding parental consent for a medical procedure.

The draft bill proposes that

How does this square with

i) my duty as a doctor to provide my patient with what in my opinion is the best medical advice,

and

ii) my right to conscientious disagreement and objection

6.

The APRAG report and the draft bill propose the provision of legal abortion on request as a tool

designed primarily to reduce maternal morbidity and mortality and help achieve compliance with

Millennium Development Goals.

Little or no attention is paid to other means by which these objectives could be achieved.

And little or no consideration is paid to the facts that:

Abortion involves the taking of a human life

Abortion carries real dangers to the woman, whether done legally or illegally – potential

serious threats to her physical, mental and emotional well-being, both in the short term and the

long term.

Abortion carries dangers for the society.

Already our society is struggling with problems like disrespect for each other, violence,

exploitation and abuse of women and minors, and disregard for life and property.

Do we think that legalizing abortion, which to be accurate is the killing of unborn babies, will help

to lift us up as a people?

Is it congruous with our desire for wisdom, justice and truth?

Is it the enactment of a nation’s prayer learn true respect for all?

Maternal health is precious and must be fought for and guarded.

So too must the soul of our nation – the things we believe are right and wrong, the principles we

hold and the way we live.

Surely we can find a better way than what is mapped out for us in this report and the proposed

bill.