NICOLE POPE

Handling it wrong, consistently

Faced with strong opposition from women’s groups, the government appears to »»

Faced with strong opposition from women’s groups, the government appears to have quietly shelved its plans to ban, or strictly limit, abortion, at least through legislation. It does, however, plan to bring in regulations that will make it harder for women to terminate a pregnancy. Quite how it will achieve this goal remains unclear, but the state’s interventionist approach to women and their reproductive rights, deeply flawed, continues to generate outrage.

The Habertürk daily has just highlighted the case of a young unmarried woman who recently underwent a pregnancy test. The results were communicated by the Ministry of Health to her father, who received a text message on his cell phone congratulating him on his daughter’s pregnancy. Notifying male relatives of a woman’s pregnancy violates all rules of patient confidentiality and it is a blatant invasion of privacy. It also, once again, underlines that the government views women not as individuals, but as possessions of their male relatives.

Media reports suggest that laboratories were asked six months ago to pass on the results of pregnancy tests and contact details to the ministry. Officially, the aim is to allow family doctors to follow up on their pregnant patients and ensure they undergo regular check-ups. Reminding pregnant mothers to see the doctor regularly is not in itself a bad idea. In fact, the practice is not unusual; in the UK, general practitioners often recall patients for health checks, or remind them that they have an upcoming appointment by SMS. But they only contact the patients themselves, and never their relatives.

Even if a pregnant woman is thrilled to be expecting a baby, she should be the one who imparts the momentous news to her partner. It is not the state’s role. But in Turkey’s traditional context, alerting male relatives to a pregnancy could even put a woman’s life at risk, particularly if she is unmarried. As we know, women are still regularly killed to protect the so-called “family honor.”

Given the government’s poor track record on women’s rights, feminists are also rightly concerned that the information could be used to pressure women into keeping an unwanted baby, by letting their relatives know that they are considering a termination. Feminist lawyer Hülya Gülbahar recently complained that the government was keeping tabs on pregnant women, a claim denied by the Ministry of Health.

The prime minister’s hostile attitude toward women’s groups and patronizing statements on the part of officials have generated such mistrust that even policies that have positive aspects generate negative reactions and are viewed suspiciously by women’s groups. Flawed implementation, poor communication and a determination on the part of the Justice and Development Party (AKP) to move quickly on controversial policies, rather than seek advice, only compound the problem.

For instance, Parliament is expected shortly to approve new legislation that would impose fines on doctors who deliver babies by Caesarean section when there is no emergency warranting surgical intervention.

Trying to lower the number of Caesarean sections, which has skyrocketed in recent years in Turkey and is well above international averages, is a valid goal, but it is not one that can be achieved overnight through sanctions. The government’s clumsy interference not only denies women the right to control their own bodies, but its determination to rush through new regulations, without first ensuring that the proper infrastructure is in place, could actually place mothers and babies at risk.

I spoke to Nazan Karahan, the head of the Turkish Midwives’ Association, who told me that not enough emphasis is placed on the role of midwives in Turkey, which partly accounts for the rise in C-sections. There are 48,000 midwives in Turkey, but in a hospital environment, most of them are employed as nurses, even though they have the skills and are legally allowed to deliver babies. But they have been largely sidelined by doctors, who have control over deliveries.

She did have some good news, however. Even before the prime minister launched his rhetorical attack on abortion and C-sections, the government had started work to boost the role of midwives. In cooperation with the Turkish Midwives’ Association, the Ministry of Health is studying systems in place in developed countries, where midwives provide support to women throughout their labor, often perform the deliveries -- with doctors on stand-by in case complications arise -- and continue to follow up with new mothers after the birth.

While work is under way, at this point no formal steps have been taken toward setting up this new infrastructure, and it seems premature for the government to seek to limit C-sections without first ensuring that hospitals have enough personnel and the right infrastructure to handle more natural deliveries.

2012-06-25

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Columnist:: NICOLE POPE