‘Why Are You Still Wearing That?’ Reflections on Reproductive Healthcare (in Ireland) on the Anniversary of the ‘Repeal’ Referendum.
Aideen O’Shaughnessy, May 2019
“Why are you still wearing that? my brother asks, pointing to my now-very-tatty Repeal jumper. “It’s over isn’t it?”. His question makes me pause. I examine my beloved jumper with its fraying sleeves, and white letters against a now grey (once black) background. It’s seen a lot of places and a lot of faces over the past two years, been privy to innumerable conversations in airports, on doorsteps and through car windows. This jumper always gave me strength; probably because it helped me feel connected to all the others, having difficult conversations in supermarkets and living rooms, up and down the country. In that sense, this jumper has given me something to draw on, in the inevitable moments when my own strength wains. Catching my own reflection, passing another jumper on the street, it is a gentle nudge to keep going; a reminder that this is for all of us. This week marks the one-year anniversary since Ireland voted to repeal the 8th amendment paving the way for abortion access in the Republic. I haven’t stopped wearing my Repeal jumper, and I’d like to talk about why.
Last Saturday, I logged into my Facebook profile to see my newsfeed awash with commentary on a segment of The Late Late Show – a popular Irish late-night talk show – which had aired the previous evening. The segment featured ‘Lucina’, a ‘birthing robot’, accompanied by the Master of the Rotunda hospital and a doctor and medical student from the Royal College of Surgeons, Ireland. The apparent purpose of the segment was to demonstrate how ‘Lucina’ – a ‘simulated birthing mannequin’ - is being utilized in a training capacity to build medical students ‘clinical and communication skills’ in the area of childbirth. With Lucina flat on her back, plastic genitals exposed, the medical practitioners proceed to coach Lucina and in one fell swoop, deliver the robotic child; all the while praising the ‘lifelike’ technology which, according to them, allows a ‘realistic’ recreation of ‘what goes on in a labour ward’. Within hours of the show airing, the Association for Improvement of Maternity Services (AIMS) Ireland, released a statement criticizing the segment which, in their view, had “the concept of vessel written all over it.” The training scenario depicted, AIMS argues, reinforces the idea that “birth is done to women” and that “they are not active participants” in their birth experience.
In a country which, only one year ago, voted to repeal an amendment of our constitution which removed women and pregnant people’s bodily autonomy in pregnancy and childbirth; there seems to me to be something deeply unsettling in our collective objectifying gaze upon this dummy-birthing-woman, and something even more insensitive about the fact that this demonstration was construed as having some sort of ‘entertainment’ value (as was suggested from the audience’s stifled laughs). The Late Late Show controversy comes only weeks after Joe Duffy’s Liveline radio programme was inundated with calls from women recounting their various traumatic experiences within the Irish maternity services. The Health Service Executive in Ireland (HSE) later released a statement apologizing to the women, who shared stories about pain suffered during childbirth, injuries accrued and how they felt scolded or ignored by medical staff. The ‘highly medicalised’ and ‘paternalistic’ nature of the Irish maternity services has long been the subject of criticism from health practitioners, maternal health advocates and academics alike; it is one of the reasons I am still wearing my jumper.
I wore my jumper too on a recent trip to the hospital, where I underwent a colposcopy. My best friend met me outside, smiling as she came around the corner. “Did you wear that on purpose?” she asked, gesturing to my jumper. She knows this jumper gives me strength, that I always wear it on days like today, when I need a helping hand. That day, my jumper had a dual purpose: I wore it to fortify myself and although I was undergoing my procedure in the U.K. (where my jumper has less cultural relevance), I felt compelled to wear it during that procedure, as my own personal protest towards the horrendous failures in the Irish cervical screening programme, which came to public attention a little over a year ago. In April 2018, just weeks before the referendum on the 8th amendment, the story broke in the Irish media: CervicalCheck – the national cervical screening programme which offers smear tests to women in Ireland between 25 and 60 years of age – had misread the smear samples of over 200 women who later went on to receive cervical cancer diagnoses. A programme audit in 2014 revealed that over 200 women had received ‘false negative’ pap smear results since 2010 but were not informed of the error until several years later. When the government opened up an official investigation into the CervicalCheck scandal in 2018, 17 of the women affected had already died. As of last October, that number sits at 20.
Published last September, the Scally Report - the scoping inquiry initiated by the government into the CervicalCheck programme - found “serious gaps in the governance and expertise of the programme”. Amongst the 50 recommendations made by Dr. Gabriel Scally, who headed the enquiry, he suggested “a specification for a new and more robust quality assurance procedure” with regards to contracts for testing smear samples, that the HSE should revise their document management policies, and finally, Dr. Scally advised that the Minister for Health “should give consideration to how women’s health issues can be given more consistent, expert and committed attention within the health system.” I remember reading an article in the Irish Independent the week after the CervicalCheck news broke – the women of Ireland are “begging for our lives”, it read. It’s a sentiment that many of us shared I believe, particularly in the run of to the 8th amendment referendum, and it’s a sentiment that has stuck with me ever since. How grossly unjust it was, I thought, that those of us campaigning for Repeal were begging the public to ‘trust women’; but who can women themselves trust, I wondered, when it comes to their reproductive health? I’m still wearing my Repeal jumper for the women affected by the CervicalCheck scandal; because women in Ireland are still begging to be listened to, still begging for their lives to be valued.
In his studies on chronic illness, Simon Williams argues that when individuals attempt to make sense of and create meaning from chronic illness – that is, when they attempt to transition from what he calls a dys-embodied to a re-embodied state – a large amount of ‘biographical work’ is required which “fundamentally transforms previous concepts of body, self and society” (Williams 1996, 24). Whilst Williams’ work relates to individual embodied trajectories, I think his thesis could also be useful in analysing macro-level embodied transitions. What if we were to think about the ‘dysembodied’ or ‘reembodied’ state as a geopolitical context? How then should we think of this ‘biographical work’? And how might this be useful for us in understanding the complexities, and apparent contradictions in how we continue to relate to maternity and reproduction, in Ireland, post-Repeal? It seems an understatement to say that social norms are changing in Ireland, specifically in relation to sexuality. Whilst the results of last year’s referendum were hailed as signalling the beginning of a new era of a more kind, compassionate and caring society, much remains to be done it seems with regards to how the healthcare system treats women and pregnant people and in relation to general cultural attitudes towards childbearing.
At the annual conference of the Coalition to Repeal the Eighth Amendment, held in Dublin on April 13th, panels of doctors, lawyers and activists spoke about the work which needs to be done following the introduction of abortion services, to ensure free, safe, legal and accessible reproductive healthcare provision in Ireland. The key issues identified were inequalities in access to services - citing that rural women, disabled women and migrant women continue to face additional logistical and financial barriers; as well as the 3-day waiting period, currently required between initial contact with a G.P. and accessing abortion services, which many argue is not medically necessary. The panellists spoke about the importance of solidarity and normalisation of abortion provision; it is this ‘normalisation’, I believe, which may now constitute our most abstract and consequently, our most difficult work. For 35 years, the 8th amendment was a toxic cultural keystone in Ireland; disallowing women and pregnant people autonomy over their bodies and lives. Whilst removing the 8th amendment has paved the way for (re)inserting bodily autonomy into legislation and into medical policy, it is less clear how we might go about reinserting bodily autonomy into our collective cultural imaginary.
Whilst reproductive ‘rights’ are legally, medically and symbolically pivotal, our activist work must extend beyond a rights agenda. Not only because having ‘rights’, being in a position to exercise one’s rights, and having one’s rights recognised are very different things; but because ensuring respect and just treatment for women and pregnant people in the medical system and society at large requires a much more comprehensive transformation in how we relate to our bodies/selves, and to the bodies/selves of women and pregnant people. Moreover, as the news from Georgia and Alabama – where legislators passed restrictive abortion bans last week - reminds us, ‘rights’ can all too easily be taken away. So, I continue to wear my Repeal jumper, one year on – for Georgia, for Alabama, for Malta, for Argentina, for Northern Ireland (amongst others) – and for Ireland, in the hope that our reembodied state will be one which listens to women and pregnant people, which actively accounts for their embodied experience, and which offers them the dignified and respectful healthcare which they so heartedly deserve.
 Kelly, A. 2019. “’What in the mother of God are we watching?’ Late Late Show airs its first birth thanks to birthing simulator Lucina” Irish Independent, May 11th, 2019, accessed May 13th, 2019 @ https://www.independent.ie/entertainment/television/tv-news/what-in-the-mother-of-god-are-we-watching-late-late-show-airs-its-first-birth-thanks-to-birthing-simulator-lucina-38101410.html
 AIMS Ireland, 2019. ‘Women Don’t Give Birth Like Robots’, May 11th, 2019, accessed May 13th, 2019 @ http://aimsireland.ie/real-women-dont-give-birth-like-robots/
 Finn, C. 2019. “HSE Apologises to Women Callers to Joe Duffy’s Liveline who shared their Traumatic Childbirth Experiences” thejournal.ie April 11th, 2019, accessed May 13th, 2019 @ https://www.thejournal.ie/childbirth-joe-duffy-4585612-Apr2019/
 See Edwards, N. Mander, R. & Murphy-Lawless, J. (eds.) 2018 Untangling the Maternity Crisis, London: Routledge
 Bowers, F. 2018, “What is the CervicalCheck Controversy about?” RTE, October 16th, 2018, accessed May 13th, 2019 @ https://www.rte.ie/news/analysis-and-comment/2018/0427/958788-cervical-cancer-q-a/
 O’Loughlin, E. 2018. “Ireland Investigates Cervical Cancer Screening Scandal.” New York Times, April 30th, 2018, accessed May 13th, 2019 @ https://www.nytimes.com/2018/04/30/world/europe/ireland-cervical-cancer-screening-scandal.html
 O’Regan, E. 2018. “Death Toll in CervicalCheck Scandal now sits at 20.” Irish Independent, October 9th, 2018, accessed May 13th, 2019 @ https://www.independent.ie/irish-news/health/death-toll-in-cervicalcheck-scandal-now-sits-at-20-37398692.html
 RTE. “The 50 Recommendations of the Scally Review.” September 12th, 2018 accessed May 13th, 2019 @ https://www.rte.ie/news/2018/0912/993308-scally-review-recommendations/
 Sutton, J. 2018. “Comment: There is Something Happening to Women in Ireland Right Now: We’re at Breaking Point.” Irish Independent, May 3rd, 2018, accessed May 13th, 2019 @ https://www.independent.ie/life/comment-there-is-something-happening-to-women-in-ireland-right-now-were-at-breaking-point-36869371.html
 See Williams, S. 1996. “The Vicissitudes of Embodiment Across the Chronic Illness Trajectory.” Body & Society, Vol. 2, Issue. 2
 Leahy, P. & Carswell, S. 2018. “Harris Rules Out Change to Three-Day Wait for Abortions.” The Irish Times, September 20th, 2018, accessed May 13th, 2019 @ https://www.irishtimes.com/news/politics/harris-rules-out-change-to-three-day-wait-for-abortions-1.3634952
 See Luna, Z. & Luker, K. 2013. “Reproductive Justice.” Annual Review of Law and Social Science, Vol. 9; 327-352.
 The New York Times, 2019. “How to Help Protect Abortion Rights in Alabama and Georgia.” May 15th, 2019 accessed May 17th, 2019 @ https://www.nytimes.com/2019/05/15/opinion/abortion-alabama-law.html