I attended a hearing last week held by the Knesset Committee on the Status of Women. The hearing was organized by Committee Chair ML Aliza Lavie and Meretz Party Leader MK Zehava Galon, and focused on women’s access to abortion. MK Galon has been a champion of this issue for years now along with her excellent record on women’s rights, minority rights and human rights and MK Lavie has taken up this issue in her new role as chairperson. The room was packed and the conversation was serious. The issue at hand was not whether or not abortion should be legal in Israel, but whether the committees that are authorized to approve abortion should be abolished.
Despite not having separation of religion and state, in contrast with the U.S., Israel has some of the most liberal abortion policies in the world. Just to name a few: There is no parental consent policy for minors, there is no age of gestation limit, and abortion services are now covered for all women up to the age of 33 no matter the reason.
Minister of Health Yael German has recently created gender equality history by proposing that 50 percent of members of the committee that determines which medical services will be state subsidized must be women. The significance of this cannot be understated: this is the committee that determines coverage for the full range of health care services. How many American women and human rights activists would rejoice at such a government policy?
The primary issue at hand in this week’s hearing was the committees that review and approve access to abortion services. This process was established in 1977 with a well-meaning law that was created to protect women from illegal and black market abortions by providing abortion as a medical service in a hospital setting. The committees, in turn, were established to ensure that the women or girls seeking said services qualify under the criteria set out in the corresponding law.
The original criteria for approving abortion were: the woman is under the age of 17 or over the age of 40; the pregnancy is a result of forbidden relations such as rape or incest if she is unmarried (including divorced or widowed), or in the case of a married woman, the pregnancy is not her husband’s; the fetus has or is likely to be born with a physical or mental defect; continued pregnancy is life-threatening, or harmful physically or mentally to the mother or the child; or for socio-economic reasons.
What resulted from the establishment of the 1977 criteria was the first major battle around abortion rights in Israel. Not surprisingly, it was fought in a religious context. In 1979, the fifth criterion allowing for socio-economic reasons was withdrawn under pressure by the Orthodox religious parties. From that point on, an entire group of women who have reached the decision that now isn’t the right time for them to have a child have either not had access to abortion, or have had to lie to the committee.
During the hearing I was moved by the testimony provide by Prof. Moshe Ben Ami, chair of the Association of midwives and gynecologist and a member of many of the review committees. He related his discomfort watching the women who come before the committee squirm in their seats while lying about the reasons they need or want an abortion. The committee process has become a rubber stamp for 99 percent of the women who appear before it. And since 88 percent of the abortions approved are performed during the first trimester of pregnancy, it seems that the well-intentioned committee process has become not only a rubber stamp with huge, wasted amounts of time and money but a failed system where women lie and degrade themselves to the professional staff of doctors and social workers who in turn must degrade themselves by listening to the lies and approving them.
While public funds are used to prop up an administrative procedure that has no value or worse, birth control is relatively under funded. Only some HMOs subsidize birth control pills and only under certain conditions. (The army does provide free birth control for women soldiers as well.)
It is only logical to abolish the committee approval process for first trimester abortions. The money thus saved could be used to provide family planning and birth control instead. There are several NGOs operating in Israel that provide these services, such as the Open Door centers of the Israel Family Planning Association, but more are needed.
While there are 40 abortion committees around the country, access is limited for those who live in the periphery. By contrast, family planning services could be made available in community-based settings, such as health fund clinics or well-baby clinics, that are vastly more accessible and would serve the original rationale behind the 1977 law that was passed to provide solutions for unwanted or medically undesirable pregnancies. Birth control is significantly safer than medical procedure to terminate a pregnancy. Why not put the horse before the cart?