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May 28, 2012, Monday

Courting controversy

Prime Minister Recep Tayyip Erdoğan was deliberately courting controversy when he recently issued blunt statements against abortion and Caesarean sections, which makes me hesitant to wade into the debate.

In his speech, he linked two issues that have little to do with each other, apart from the fact that they both concern women. Comparing abortion to the Uludere massacre, for which his government has yet to provide satisfactory answers, was offensive and only added insult to injury. Yet, like many other members of the media, I’ll rise to the bait and comment on his remarks because the matters he raised are of serious concern for all women in this country.

Prime Minister Erdoğan’s opposition to abortion came as no great surprise. Religious conservatives all over the world are opposed to terminations. The issue weighs heavily on the US presidential campaign and, only recently, anti-abortion campaigners in the UK borrowed from their American counterparts’ stylebook and started picketing clinics just as the country marked the anniversary of the implementation of the 1967 Abortion Act.

It was just a matter of time until the polemic engulfed Turkey, where abortion is legal until 10 weeks into a pregnancy. The topic hasn’t been discussed much so far, but after the prime minister issued what sounded like a decree, a heated debate can be expected, followed perhaps by attempts to amend legislation in Parliament. As for Mr. Erdoğan’s populist claim that abortion is part of a sneaky international attempt to erase the Turkish nation from the world stage, it speaks for itself.

Bringing up children involves a lot more than just professing to love them, as the prime minister does when he encourages families to produce at least three offspring. Yes, love and affection are crucial ingredients, but financial resources and hard work, which Mr. Erdoğan seems to underestimate, are also needed in large quantities. Only recently he described how easy mothering had become thanks to disposable diapers. At the same time, when he talks about motherhood, words like pain, sacrifice and compassion naturally pour out of his mouth.

No woman makes the decision lightly to terminate a pregnancy, but she should have the right to do so if she feels she cannot adequately care for a child. The best way to prevent unwanted pregnancies, of course, is to provide young people with information about contraception and to make it easily accessible, no questions asked.

As for C-sections, it is as absurd to say “I’m against Caesarean-section births” without qualifying this remark, as it would be to state “I’m against heart surgery.” Birth complications, even in our modern age, are not rare, and Caesarean sections can, and do, save the lives of mothers and babies.

The prime minister could have avoided a lot of the backlash if he had expressed himself in a more nuanced way, and pointed out that Turkey currently has the highest rate of C-sections in the Organization for Economic Cooperation and Development (OECD) at 42.7 percent (“OECD Health at a Glance 2011”) and that favoring what amounts to a serious surgical intervention when a normal delivery is not only possible but desirable places undue strain on public health resources.

C-sections are on the rise worldwide for a multiplicity of reasons. Some women fear natural childbirth or find it easier to show up at a hospital at an appointed time rather than risk a mad rush to the maternity when their waters break in the middle of the night. For doctors, too, scheduled deliveries can be more convenient as well as more lucrative. In some countries, the risk of litigation that medical practitioners face if something goes wrong can also tip the balance toward a C-section if there is any risk of complications.

The World Health Organization (WHO) believes that in developed countries, where mothers tend to be well-fed, healthy and followed by doctors throughout their pregnancies, C-sections should not amount for more than 15 percent of births. In fact, OECD data suggest that in all member states rates have been creeping up steadily in the past couple of decades and, by 2009, only in the Netherlands did they remain below the recommended level.

When it comes to childbirth, as I discovered when my daughters were born, even the most carefully made plans can go awry and a Caesarean can become the safest option. Encouraging expectant women and doctors to opt for a normal delivery whenever possible is a goal worth pursuing, but it won’t be reached by issuing blanket condemnations of surgical deliveries.

Unfortunately, the prime minister’s use of polemic to score political points fosters deep divides in society and prevents legitimate issues from being publicly debated in a healthy atmosphere. With Turkey still lagging toward the bottom of global gender equality tables, it would be more useful if he directed his determination to improving the status of women or if he spoke out forcefully against domestic violence. And, of course, mothers and fathers in Uludere are still waiting to find out exactly why their children died and who is responsible.

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