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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Junior doctors’ strikes: the greatest union failure in a generation

The first wave of junior doctor contract impositions began this week. Here’s how the BMA union failed junior doctors.

In Robert Tressell’s novel, The Ragged-Trousered Philanthropists, the author ridicules the notion of work as a virtuous end per se:

“And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of the gasometers, you will all fall upon him in the name of law and order.”

Tressell’s characters are subdued and eroded by the daily disgraces of working life; casualised labour, poor working conditions, debt and poverty.

Although the Junior Doctors’ dispute is a far cry from the Edwardian working-poor, the eruption of fervour from Junior Doctors during the dispute channelled similar overtones of dire working standards, systemic abuse, and a spiralling accrual of discontent at the notion of “noble” work as a reward in itself. 

While the days of union activity precipitating governmental collapse are long over, the BMA (British Medical Association) mandate for industrial action occurred in a favourable context that the trade union movement has not witnessed in decades. 

Not only did members vote overwhelmingly for industrial action with the confidence of a wider public, but as a representative of an ostensibly middle-class profession with an irreplaceable skillset, the BMA had the necessary cultural capital to make its case regularly in media print and TV – a privilege routinely denied to almost all other striking workers.

Even the Labour party, which displays parliamentary reluctance in supporting outright strike action, had key members of the leadership join protests in a spectacle inconceivable just a few years earlier under the leadership of “Red Ed”.

Despite these advantageous circumstances, the first wave of contract impositions began this week. The great failures of the BMA are entirely self-inflicted: its deference to conservative narratives, an overestimation of its own method, and woeful ignorance of the difference between a trade dispute and moralising conundrums.

These right-wing discourses have assumed various metamorphoses, but at their core rest charges of immorality and betrayal – to themselves, to the profession, and ultimately to the country. These narratives have been successfully deployed since as far back as the First World War to delegitimise strikes as immoral and “un-British” – something that has remarkably haunted mainstream left-wing and union politics for over 100 years.

Unfortunately, the BMA has inherited this doubt and suspicion. Tellingly, a direct missive from the state machinery that the BMA was “trying to topple the government” helped reinforce the same historic fears of betrayal and unpatriotic behaviour that somehow crossed a sentient threshold.

Often this led to abstract and cynical theorising such as whether doctors would return to work in the face of fantastical terrorist attacks, distracting the BMA from the trade dispute at hand.

In time, with much complicity from the BMA, direct action is slowly substituted for direct inaction with no real purpose and focus ever-shifting from the contract. The health service is superficially lamented as under-resourced and underfunded, yes, but certainly no serious plan or comment on how political factors and ideologies have contributed to its present condition.

There is little to be said by the BMA for how responsibility for welfare provision lay with government rather than individual doctors; virtually nothing on the role of austerity policies; and total silence on how neoliberal policies act as a system of corporate welfare, eliciting government action when in the direct interests of corporatism.

In place of safeguards demanded by the grassroots, there are instead vague quick-fixes. Indeed, there can be no protections for whistleblowers without recourse to definable and tested legal safeguards. There are limited incentives for compliance by employers because of atomised union representation and there can be no exposure of a failing system when workers are treated as passive objects requiring ever-greater regulation.

In many ways, the BMA exists as the archetypal “union for a union’s sake”, whose material and functional interest is largely self-intuitive. The preservation of the union as an entity is an end in itself.

Addressing conflict in a manner consistent with corporate and business frameworks, there remains at all times overarching emphasis on stability (“the BMA is the only union for doctors”), controlled compromise (“this is the best deal we can get”) and appeasement to “greater” interests (“think of the patients”). These are reiterated even when diametrically opposed to its own members or irrelevant to the trade dispute.

With great chutzpah, the BMA often moves from one impasse to the next, framing defeats as somehow in the interests of the membership. Channels of communication between hierarchy and members remain opaque, allowing decisions such as revocation of the democratic mandate for industrial action to be made with frightening informality.

Pointedly, although the BMA often appears to be doing nothing, the hierarchy is in fact continually defining the scope of choice available to members – silence equals facilitation and de facto acceptance of imposition. You don’t get a sense of cumulative unionism ready to inspire its members towards a swift and decisive victory.

The BMA has woefully wasted the potential for direct action. It has encouraged a passive and pessimistic malaise among its remaining membership and presided over the most spectacular failure of union representation in a generation.

Ahmed Wakas Khan is a junior doctor, freelance journalist and editorials lead at The Platform. He tweets @SireAhmed.