Waking the abortion tiger

Abortion. It is Israel’s little secret and it has been until recently, through a pact of silence between the women’s organizations and the religious parties around the don’t ask, don’t tell idea. Just as a reminder – despite not having separation of religion and state, in contrast with the US, 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 more or less now covered for all women up to the age of 33.

What’s the catch? The catch is that abortions are disallowed unless approved by a committee of health providers. The pregnant woman does not get to decide.

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 criteria for committee approval for an abortion include a pregnancy being the result of rape or incest; a woman being unmarried (including divorced or widowed); if the woman is married and the pregnancy is not her husband’s; if the fetus has or is likely to be born with a physical or mental defect; and if continued pregnancy is life-threatening or harmful physically or mentally to the mother or the child.

The social-economic reason in the original law was removed in 1979 under pressure from the Orthodox religious parties. Still, the law is a very liberal one, and given the relationship between religion and state in Israel, it is surprisingly liberal. And yet, since it is does not rely on a woman’s right to choose, in most Western countries, the law would be considered archaic. The liberalization of abortion policies in Europe, for example, has brought the “dangerous abortion” rate to six percent, whereas in Latin America, where abortion is not legal, the rate is 30 percent.

Just as criminalizing abortion does not prevent it, requiring the approval of a committee will not reduce abortions. Women who need or want to abort will seek to do so and at all risks. And so this past week, an historic union within the women’s movement, legislators, politicians, the medical profession, and academia announced new legislation to be introduced in the current Knesset. The legislation’s most important points include, first, the elimination of the committee review for the first 15 weeks gestation period when over 90 percent of the abortions in Israel take place. During that period the woman can decide on her own what to do. Second, free counseling is to be provided in the form of education and prevention, not finger-wagging or scare tactics. And third, free sex education and contraceptives are to be included as national ‘basket’ of health services provided to girls and women.

There are many reasons why this liberalization effort is happening now. First, we have a window of opportunity with this Knesset – there are no religious parties in the coalition, although in 2006 when reform of the abortion laws was introduced to a similar coalition government without religious parties, it was rejected by a wide margin. But since then, more importantly, an influx of women in the public sphere has allowed a breach in the pact of silence. Minister of Health Yael Gelman is insisting that 50 percent of the committee that determines which medical services will be state- subsidized must be women.

The significance of this policy cannot be understated. With more women involved in decision making on a national level, the issues of women, their bodies, and their health will become part of the mainstream dialogue. Abortion, one could argue, is many things – a health issue, a moral issue, a political issue – but most importantly, it is a woman’s issue. The decision to end a pregnancy or continue it should not be decided by committee. It should be decided by the woman. Committees can counsel, committees can guide, but women must be the sole decision makers. No other medical procedure or health issue is scrutinized or determined by committee under Israeli law. Women have the right to make these decisions for themselves as they do with tonsillectomies, chemotherapy, or any other medical procedure. A committee of health practitioners can counsel but should not dictate.

Let’s wake the sleeping tiger. Let’s allow the bill to be introduced in the Knesset and let’s have the conversation that needs to be had on abortion and reproductive choice in Israel.