(May 31, 2019)
Maritza Crespo Balderrama, M.A. and Diego Tapia Figueroa, Ph.D.
“All pains can be assumed if we put them in a story or tell a story about them”.
Isak Dinesen
A few days ago, at the Faculty of Psychological Sciences of the Central University of Ecuador (UCE), a debate was held on abortion, and they asked (Maritza) to talk about its psychological consequences. This edited and expanded article is part of that paper.
In our South American region and Ecuador in particular, there is no major academic research on the psychological implications on women who voluntarily decide to have an abortion. Although abortion should be treated as a public health issue because of the implications it has on women who perform it (for whatever reasons) and their families, communities, and society in general, it must be addressed, also from the perspective of the effects and consequences that this decision has on people, but also from the very process of making this difficult decision.
Ecuador is the second country in Latin America with the highest rate of child and adolescent pregnancies; between seven and eight girls under the age of 14 are forced to give birth in all maternity wards in the country every day. The most numerous cases of these pregnancies in the country are due to rape, especially incest (data reported by the national press, this month). Crimes, which remain in impunity. Girls and adolescents who have been abused and forced to give birth and prevented by the State, the law, society, and patriarchal culture from their right to have an abortion.
It is relatively easy to define some elements that arise, from research carried out in the world, on the relational-emotional effects of the practice of voluntary abortion, many of them show that there are elements that predispose women to problems related to depression or postabortion anxiety, including social sanction, cultural factors, exposure to contexts of clandestinity and insecurity, and, of course, the impact of the couple in decision-making.
These factors contrast with what can be observed in contexts where voluntary abortion is done legally and safely. Research conducted, for example, in the United States (1990) shows that the majority of women (76%) felt relief in being able to carry out abortion and that, having access to abortion in adequate conditions, well informed and without external pressures, there are little negative consequences in the subsequent period. Rather, the opposite.
It must be valued and recognized that in Ibero-American contexts the reforms that expanded the possibility of legal abortion or that achieved the decriminalization of abortion are achievements of feminist struggles; however, abortion is not a feminist issue: it is an issue, it is a responsibility of the whole society.
“Women’s rights are human rights”
The only way to guarantee the exercise of the set of rights that are included under the label of sexual and reproductive rights is, first of all, through the decriminalization of abortion. Also guaranteeing women’s access to safe abortions, through information and orientation programs for women who want to have an abortion, trained health services in good conditions, etc. By criminalizing abortion, all this cannot be guaranteed, and with it, the State double violates women’s rights- that is- by criminalizing women who have sexual and reproductive rights not recognized by the State and by not providing health services that guarantee the exercise of those rights in conditions of hygiene and safety. This is morally wrong.
(https://www.elsevier.es/es-revista-debate-feminista-378-articulo-etica-feminista-etica-femenina-aborto-S0188947816300044)
With this background, it is essential to start from a comprehensive analysis when we talk about the right to abortion in which we can -in addition- approach not only the individual psychological perspective, of the woman who decides to carry out an abortion in conditions, such as those of our country, of illegality (it is decriminalized only in two situations), lack of protection and insecurity; but also to the relational perspective -which is a fundamental issue for psychology- that this problem implies, taking into account that both women and men live-in relationship and we build ourselves, daily, in the relationships, in the dialogues that we are developing.
The “human psyche” is built on the bond with the other. Since we are born, the relationship with our parents and the people who make up our immediate environment will be fundamental for our subsequent way of understanding the world, our contexts, and for decision-making; also, for our self-perception, as women and men who live in society, in relationship; we do with others, in relation to others.
The cultural and social aspects, which are analyzed in this dialogue proposed by psychology students, make up the scenario or “the court” where the game of our life is developing. The norms, rules, parameters, and guidelines of this game are previously delimited, have been established in our contexts, before our birth, and are lived by all the people with whom we are linked throughout life, with more or less the same perspectives, positions, beliefs.
We are not individual beings, we are people who conform in the relationship and are precisely, the relationships that we are living and building over time, those that fill our thoughts with “content”, and also, our decisions.
When we speak, then, of being a woman, we are forced to understand femininity in relational contexts framed in a specific culture and in a temporal historical moment (that is, the framework of our historical time).
It is not the same to be a woman, for example, in the eighteenth century, when the first feminists questioned themselves about social hierarchies and the right for the education of women, or to be so today, when, in theory -and we emphasize IN THEORY- women have been able to claim our situation of equality in front of the world of work and family.
When we talk about being a woman -today, in 2019- we cannot ignore, then, the fact that, despite all the advances and achievements that have been given by the persistence and struggle of the women of the world, in many of our contexts, at least in our region and country, still the right to decide on our own body is strongly questioned by the cultural hegemonic discourse, patriarchal.
In the end, what this political struggle around abortion once again highlights is that sexist power remains untouched: the men who hold ecclesiastical power continue to resist women being subjects with rights over their lives. Men who exercise political power do not risk confrontation with the Church, privileging electoral reasons over those of social justice and public health. The cost of such indecision is paid by women, especially those of poorer sectors… What equality, if women abort and men do not, but they decide about it? (Marta Lamas, 1992-2017)
Our individual being, once again, is shaped in relational and cultural contexts where women (and men) are, at the very least, in principle “property” of our parents. To exemplify this, it is enough to listen to the contents that the consultants bring to the psychotherapeutic space about “their” (language is decisive) sons and daughters and how they are considered as extensions of them and they (of the parents): “my daughter must follow in the footsteps of her mother”, “it is my right to punish my children so that they are good men and women …”, etc. All kinds of cruel, unjust, abusive, and often criminal practices of adults with children and adolescents.
The growth in abortion figures also reveals the failure and limits of sex education that is being carried out in our country. Scarce, de facto forbidden in many places and oriented almost exclusively to biological and contraceptive information. It is not aimed at recognizing the diversity of expressions of human sexuality, nor at promoting in sexuality the same values that we consider essential in other areas of interpersonal and social relationships, such as equality, autonomy -understood as having capacity, knowing how to decide and being responsible with the decisions that are adopted- the care of ourselves and that of others… Despite those who see nothing but misery in human sexuality, it is a source of pleasure, joy, and satisfaction. We need more sex education and many changes in the approach with which it is currently carried out. Sex education should not only occur in formal education but also campaigns aimed at society as a whole and, in particular, at the sectors in situations of greatest vulnerability. Campaigns that not only inform, but that reinforce values, that allow progress respecting the diversity of ways of living sexuality and also in respect for the diversity of options and behaviors in the face of an unplanned pregnancy.
(http://www.pensamientocritico.org/primera-epoca/otrvoc0409.html)
Needless to say, deciding on the woman we want to be is forbidden or, at least, we achieve it with a lot of “rebellion” in between. Being a woman and deciding on what we want implies, from the beginning and in general terms, a confrontation in which dialogue and listening give space to the imposition of ideas, criteria, and censorship of those who understand that we are not able to decide on anything, positively and autonomously.
Over the years, most women in our socio-cultural contexts went from being the possession of our parents to being the possession of “the man on duty”. The most dangerous relationship for the physical and psychological integrity of Ecuadorian women is (statistics indicate conclusively) the one we have with our partners. Although gender violence or femicide is not the subject of this article (see in this same blog, the article of Friday, January 25, 2019), it is closely linked to the issue of abortion and the idea -generalized although not admitted in most cases- that we are not able to decide, that they “must decide for ourselves” to do it well.
Deciding on what kind of relationships we want to maintain, on what is good and positive for us, is not part of the plan of a society and a culture in which we are infantilized and subordinated. Responsible decision-making, as psychology professionals know, is one of the strongest pieces of evidence that our evolutionary psychic development has led us to be adults; however, socially, it is not recognized in our condition as a woman: our father/mother decides for us until we have a partner who decides for us, not to mention the turn that over time occurs towards the fact that children (almost always boys) decide for their elderly mothers.
In all this, the issue of voluntary abortion seems to be lost. Undoubtedly, an 11-year-old girl, pregnant by her abuser (there is no pregnancy without abuse at that age), will need support that recognizes her as a person to decide to end her pregnancy; this implies a health, educational and legal system that understands her as a human being (not as an object of satisfaction of another), who has a voice (her own, not that of her abuser or her parents), who has a future (which she and no one else will have to assume) and who has rights (which she must fully exercise, without restrictions) which must be guaranteed by society and the State.
However, it is less complex to have a position in the face of a crime in which the victim is a pregnant girl. It is more difficult to locate ourselves, because of our culture and our way of relating, when the one who wants and must decide to abort is an adult woman (young or old). There, the relationships that society weaves within the framework of culture, become a fundamental and preponderant piece for decision-making and the psychic situation of women. An additional burden that is difficult to carry, but that, many times (from professional experience: most of the time), is carried in solitude and with guilt.
Psychologists and psychotherapists are familiar with the psychic and relational consequences of guilt imposed -once again- by our patriarchal belief system and by cultural-historical contexts. A guilt that has led women to nullify their voice and, what is worse, to introject into their psyche the voice of the dominant convention that speaks of our incompetence to decide on anything and less on our body.
In Ecuador, in addition to being exposed to a complex decision such as opting for abortion, the culture imposes guilt, punishment, and criminalization on women who choose to decide (as is their right) about their body and their lives.
Finally, it is essential that as psychologists, we ask ourselves about our role in front of women who are forced into this situation. What do we do in our listening and clinical care spaces? What are our own relational and cultural contexts and how do they influence the care we give to our consultants who are wanting to decide or who have already decided and come to ask for help? Do we see women as responsible people with rights over their own body or as the property or extension of someone else? The answers to this type of questions will mark the path of psychotherapeutic processes and the well-being of these women.
Not only “society” in the abstract must continue and deepen the dialogue on the issue of abortion as a right that, fortunately, women are currently raising; we, psychologists and professionals who work in processes of accompaniment, of reflective dialogues with people, must ask ourselves and question our practice and cultural beliefs. We are co-responsible, not only for the changes that may be generated in people from the individual perspective and their family context, but we have a fundamental role in the changes of cultural and social paradigms. As filmmaker Barbara Miller (2019) points out, “… patriarchy is the great global religion. The woman is oppressed and asked to be cute. The important thing is that the man is happy”.
We must propose new ways of relating, in which we recognize the other, the other, as a valid interlocutor, as a person who can decide and promote that adult position of responsible decision-making. Abortion, therefore, is a decision that must be taken autonomously and independently by the woman, who is the sole owner of her own body, without the criminalization of a decision that must be respected by her support networks, so that she can go through this crisis, without prejudice, hypocrisies, legal, moral sanctions and social stupidity; without exclusions or marginalizations.
Abortion is an alternative, an option, and a decision from which it is unnecessary to blame women, without trivializing the experience, freeing them from the tyranny of an oppressive cultural duty. It is obvious that we must also rebel and not cover up or be accomplices of those situations in which (due to prejudices or as part of the culture of control and social oppression) adult women who do not want to do so are abusively forced to abort.
Voluntary abortion is a path that accounts for the autonomy and independence of women (their right to take care of themselves, protect themselves, take responsibility for themselves, their body, their integrity) and does not require a plebiscite every time to receive permission forgiven of the dominant culture, nor patriarchal condescension; it is a courageous and dignified action, which deserves respect, understanding, and solidarity from the whole society.
Abortion, in Ecuadorian society, is a reality, which by not having adequate legislation that guarantees its practice in medical conditions that ensure the life of women (a responsibility of which the State and public institutions avoid with cynicism and hypocrisy), exposes them to serious dangers to their physical integrity, emotional and psychological.
Abortion, therefore, must cease to be a pending right and we are all responsible for it becoming a human right exercised in freedom.
https://iryse.org/aborto-complejidades-para-reflexionar-valentia-y-dignidad-de-las-mujeres/
English translation of Bruno Tapia Naranjo