Thursday 21 November 2019

Women still powerless over their own bodies

As Angelina Jolie tells women to 'take control', Carol Hunt argues it may not be an option for the women of Ireland

Angelina Jolie
Angelina Jolie
Carol Hunt

Carol Hunt

The irrepressible Katie Hopkins has engineered another media storm. In the wake of Angelina Jolie's editorial in The New York Times detailing her latest preventative surgeries, Hopkins tweeted: "Angelina Jolie. Smug doesn't even come close. Curating her organs to maximise life expectancy. What's next, fag ash lil? Your lungs?"

Yes, it's typically Hopkins nasty. And yes, it is, of course, more than a bit disgusting to call a woman who has already had a preventative double mastectomy and has now undergone more surgeries to remove her fallopian tubes and ovaries, forcing her into premature menopause at the age of 39, "smug". (Jolie had previously been tested positive for a mutation in the BRCA1 gene that gave her an estimated 87pc risk of breast cancer and a 50pc risk of ovarian cancer.)

All the other reactions to Jolie's exhortation for women to "seek advice, learn about the options and make choices that are right for you" have been uniformly positive, praising her undoubted courage, honesty and the dignity with which she has dealt with what must be very tough choices.

And yet when I read Jolie's strong and well researched editorial asking women to take control of their bodies, which ended: "Knowledge is power", I couldn't help guiltily thinking, "it's alright for you to say that, Angie, but in the real world you also need money, prestige and power.

Living in a country where women are entitled to make informed decisions about their own bodies would help too.

Jolie's openness about her experience is laudable - and certainly helpful for many women - but her assumption that every woman can also avail of the top-level and, most likely, exorbitantly expensive medical care that she can command seems, well not quite smug, but definitely naive.

It's certainly not the norm in the US where millions of women continue to go without healthcare and the fate of the Affordable Care Act continues to be a political football. Meanwhile, back here in Ireland, the idea of women taking control of their own bodies is, quite frankly, as much of a fantasy to us as being beautiful, talented, wealthy and married to Brad Pitt.

Last month, I talked to a woman who was recovering from breast cancer. She knew her own body and told me that before she was diagnosed, she "knew that there was something wrong". The medical experts disagreed, however, despite her taking herself off to them twice to tell them of her suspicions.

Eventually she was diagnosed with aggressive breast cancer - during a pregnancy - and had to have immediate surgery. She was lucky. She is doing well. But her experience of her concerns not being taken seriously by doctors is one echoed by many other women.

Last Monday, Mark Kelly, executive director of the Irish Council for Civil Liberties, wrote (in the Irish Examiner) that Ireland is not a State "where the autonomy and bodily integrity of women is respected". This is not news to many Irish women. Ask any teenager who has been refused the morning-after pill by a disapproving doctor - or one of the many thousands of women who head off to the UK every year to avail of services denied them in their home state, and they will agree.

It's often been said that Ireland is no place for pregnant women - despite the fact that some still make the untrue claim that "it is one of the safest places in the world to have a baby". Tell that to Savita Halappanavar's family.

Tell it to Michael Kivlehan and Sean Rowlette whose wives died in childbirth at Sligo Regional Hospital. Tell it to Warren and Lorraine Reilly who lost two of their babies at Portiuncla Hospital in Ballinasloe. Tell that to the parents of children who died in Portlaoise hospital, where over 250 findings of adverse care were discovered and where currently we are witness to an unedifying legal dispute between the HSE and HIQA.

Because, of course, no one wants to be held responsible for the continuing, appalling failures in our care of women and their babies.

In 2001, the national health strategy - 'Quality and Fairness: A Health System for You' - promised "a new model of maternity care" that is "woman-centred, equitable, safe, accessible, and accountable". We are about as far off achieving this as we are of landing Dustin the Turkey on Jupiter.

There is a chronic shortage of midwives in Irish maternity hospitals. The Association for Improvement of Maternity Services in Ireland (AIMS) has described the shortage as "grossly inadequate and unsafe".

Why is this? Perhaps it's because the medical system we follow in Ireland is not "woman-centred" and never has been. And why should it be? Women have always been treated as second-class citizens in this country. Many women who have been through the obstetrician-led Maternity and Infant Care Scheme (Mics) which has operated in Irish hospitals since 1954 know that the wishes and wants of the staff or the ideology of (our many) religious hospitals take precedence over what she feels or knows is best for her or her child.

The 'What Matters to You?' survey released by AIMS Ireland last month, revealed: "52pc of those surveyed did not receive information on potential implications to have or not have tests, procedures, treatments to assist with their decisions, and only 50pc felt able to make an informed refusal during their labour and baby's birth".

This is the sort of power imbalance that led to women having their pelvis's broken during childbirth without their knowledge or consent. Sure, what did they know about anything to do with their health?

Get any group of mothers together and some of them will, no doubt, be able to regale you with horror stories of things that happened to them during their pregnancies; of indignities suffered, information denied and the casual infantilisation of them by the system.

We seem to assume that women of childbearing age lose the right to autonomy over their own bodies as a matter of course. Or the ability to make informed decisions for themselves.

So while Angelina may tell us that the most important thing is to "choose what is right for us personally" we know that unless things radically change in this country that just isn't an option for many women.


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