Supporters of employer-funded contraception rally in front of the Supreme Court. Photo: Getty
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The knitting needle age: this US verdict shows our abortion rights are always under threat

If you are a woman of my generation, you were born into an era of extraordinary good fortune, where you have the right to decide what happens to your body. But we mistook a truce in the war on women for a victory.

You don’t see it so much on pro-choice placards. It doesn’t have the recognisable profile of the coat hanger, but it’s the knitting needle’s shape that made it useful to women desperate to end their pregnancies. A simple household object, easily available when women’s work routinely included the creation of sweaters and socks for the family, pulling loop over loop; a fine metal spear with a pointed end that could be inserted into the uterus, in the hope of destroying the unwanted foetus and inducing miscarriage.

Not that useful, of course. Few women had the skilled knowledge of their anatomy that would let them navigate their internal organs successfully. The result might be nothing, or it might be worse: a self-inflicted puncture wound, infection, bleeding, death. Before abortion and contraception were made legally and widely available, physicians reported women being brought into hospital with knitting needles or similar objects trapped in their wombs. This was something normal, the bleak and gory price of a society that gave women no safe recourse when dealing with a pregnancy they could not continue.

Fitting, then, that the most recent assault on American women’s right to decide whether or not they get pregnant comes from one of that country’s largest purveyors of knitting needles. On Monday, craft store chain Hobby Lobby won a Supreme Court decision protecting it from paying for insurance for employees under the Affordable Care Act that covers certain forms of contraception which the company considered to be “abortifacients”, including the Mirena coil. This requirement, according to the judgement, would impose a “substantial burden” on the “religious freedom” of the company.

The fact that these contraceptives, by definition, prevent rather than end a pregnancy was apparently unimportant to the five judges who supported the majority verdict (all three female justices dissented, as did one of their male colleagues). Similarly, there was little effort to address what it means for a company to have “religious freedom” – maybe the Hobby Lobby stores really are all engaged in constant silent observance of the Holy Spirit, although it’s hard to tell, what with them being inanimate brick shells.

And what about the other burden here, on women who find their reproductive options shaped, not by their own wishes and needs and their doctor’s advice, but by their employers’ scruples? The judgement seems far more concerned by how heavy a Mirena might weigh on an employer’s conscience, than by the weight of living flesh on a woman’s body as an unwanted foetus multiplies cell by cell, becomes an embryo, a baby, a child, all the time unwanted, all the time living on the woman who didn’t want to be a mother.

The idea that women have a right to be something other than a resource for other life to consume is something I’ve been able to grow up taking for granted, but in truth it’s a phenomenal novelty. The 1967 Abortion Act in the UK, Roe vs Wade in the USA in 1973 – these and the other watersheds like them are all firmly within living memory. In Spain, abortion was wholly criminalised until 1985, and now the governing People’s Party is on the verge of outlawing abortion in all cases other than rape or medically certified risk to the life of the pregnant woman. Similar efforts to amend UK law have had little effect so far, but make no mistake: if you are a woman of my generation, you were born into an era of extraordinary good fortune. We mistook a truce on our bodies for a victory.

While we enjoyed the luxury of choice, the forces against women were finding new ways to attack. Advice aimed at giving women trying for a baby the best chance of a healthy child has been turned into injunctions that treat all fertile women as “pre-pregnant”, valuing the potential life that could inhabit her over the woman’s own life and decisions – whether she wants to be pregnant or not. The right of women to seek the medical treatment they need, and to do so in private, has been placed at odds with the freedom of speech of those who picket clinics. Niggling disputes about the exact point at which a foetus becomes “viable” have consumed our attention, and barely anyone thinks to mention that the woman herself is not merely “viable” but living, conscious and competent to decide her own best interests.

Anti-abortion protesters think that the world needs to have its face rubbed in the unpleasant truth of what abortion is. As if women seeking abortions didn’t know that a baby is, precisely, the thing they don’t want; as if we didn’t know that abortion, induced or otherwise, is a mess. These are not the things we need to be reminded of. What we have forgotten is what the world looks like outside our blissful bubble of choice. It looks like unmarried mothers imprisoned, and their babies left to die and given no resting place. It looks like being sexually assaulted and ripped off by the backstreet quacks you’re driven to. It looks like poverty and pain. It looks like a knitting needle stabbed into a cervix. Perhaps it is too hard to believe that such a world existed: but all we need to do is let things continue as they are, and we will see it again soon.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear