Friday, March 18, 2011

Let's Talk About Abortion in Taiwan

I intended to include this in a longer post about National Health Insurance, but that was far too big a topic to bite off in one post and I'll instead cover it in several, with a focus on women's health, but discussing the system as a whole (summary: it's a great system, certainly better than the "system" - heh - in the USA, but still needs some work and has flaws that ought to be addressed. That said, it's one of the best in the world).

I'm covering abortion first because I have more concrete information - I'm still looking into other aspects of women's health including contraception, health treatments and preventative medicine.

Anyway, abortion in Taiwan. No, not for me! I'm writing about this because it's a women's issue in Taiwan and it deserves some more recent coverage - most of the discussions and articles I found on the issue were severely dated and, honestly, didn't delve into the topic in nearly enough depth - the exception being a paper I found by David Sho-Chao Hung - a law student who may well have graduated by now - that discusses abortion law in Taiwan compared to the USA. The paper is not dated, however. Only Hung's paper discusses the moral, cultural and feminist issues surrounding the abortion issue, as well.



It is amazing how much misinformation there is among the general public in Taiwan. As I've mentioned before, my work brings me into the offices of many pharmaceutical companies, some government offices and other people whose positions could lend a general assumption that they are familiar with how abortion law works in Taiwan.

Sadly, that is not true. I've never been so shocked by public misconception of abortion in Taiwan since I started asking people about it.

The general idea seems to be that in Taiwan, abortion is "illegal", except in cases of medical danger to the mother or the child, but that it is quite common for women with healthy pregnancies to get abortions at "illegal" clinics or through legal clinics willing to engage in ethically gray practices - or through pills purchased illegally at dispensaries. One person I know described it as an "abortion wave" at the end of every summer, where young women go to clinics for abortions despite them being technically "illegal" (as I'll show later, they're not actually "illegal", just very highly regulated with a lot of workaround room, though not nearly enough), to doctors found through a social network or by distraught parents, often paid for by parents who want to make the problem go away.

A problem that could be greatly ameliorated if there was better sex ed in Taiwan in the first place. The solution to the "abortion wave" at the end of every summer is not to make abortions easier to get (even though I do support the freedom of choice) but to educate tweens and teens about safe sexual practices...I'd like to see the abortion rate go down to zero, but not at the expense of women's rights - but I digress.

This shocking misconception can be somewhat explained by different interpretations of the law, although that doesn't entirely excuse it.

The law in Taiwan is, in summary, that abortions are legal for:

1.) medical reasons - danger to the mother or fetus including deformities and defects - this includes psychological trauma to the mother
2.) rape or incest (which must, apparently, be "proven")
3.) "seduction" - meant to cover statutory rape but can technically be used as a reason by a woman of any age
4.) mental/psychological issues of the parent(s) that could be passed on to the child

...but are not a guaranteed right for all women, are not constitutionally protected, and are meant to be performed only in the extreme cases above.

That's where the misinterpretation may come in: women seeking abortions quickly learn that they are available - if you're single, it's fairly easy to claim "seduction" (it was meant to cover statutory rape but there is nothing stopping a grown woman from claiming it) or "psychological stress" due to inability to properly care for or raise the baby, or even claim an onset of depression (which is very morally gray).

It's harder for married women, even though there might be ways to slither around the provision.

I could see how someone who is not seeking an abortion and will never (or may never) seek an abortion (such as a man, or woman beyond childbearing age or a woman who would carry an unexpected pregnancy to term rather than terminate it) might interpret the above is "it's illegal unless it's a medical issue or rape/incest issue" - it wouldn't necessarily occur to them to claim "psychological stress" or "seduction" because they're not in that position, and so their view is more literal. I could see how making such claims could be interpreted as "illegal" under the spirit, though not the letter, of the law (I'd argue that the spirit of the law is sexist and wrong, so it's OK).

I'd go so far as to say that there is nothing wrong with claiming "psychological stress": I do trust that any woman making the drastic decision to have an abortion is a mature person - even if she may have been forced to become mature very quickly - who has agonized and considered every aspect of this decision before making her final choice. Abortion is serious business, and I do believe that any woman considering it knows this. Therefore, if she decides in the end to terminate her pregnancy, then she would know better than anyone that carrying it to term would cause her undue psychological stress.

Single women can get an abortion for any of the above reasons, mentally handicapped women need the consent of a guardian, an underage girl needs the consent of her parents and - most disturbingly - a married woman needs (or needed) the consent of her husband.

I say "needs or needed" because it's unclear: Mr. Hung's paper and other discussions online have mentioned that a married woman needs to obtain her husband's consent, and yet this Taipei Times article from 2006 mentions specifically that a husband's consent is not required (though he must be informed).

And yet in this 2009 article, it states that spousal consent is, in fact, required and that the age after which a young woman doesn't need parental consent is 20 (20!! Really! So we're all adults at 18, except for women, who are still children at 20).

That's almost - but not quite - worse. It's not even clear from a few hours' worth of Internet research whether or not a married woman can seek an abortion independently. How could that NOT be readily available information? What kind of oversight is that?

The information - at least in English - doesn't appear to be available, and yet it is something that every woman in Taiwan has a right to know.

If it is true, then argh. I don't know how it could get more sexist, patriarchal and paternalistic than that. You are free to disagree with me, and I respect that people have different views, but that's my opinion. It's of paramount importance to protect the autonomy and rights of a woman over her own body.

The possibility that - as mentioned in the Forumosa discussion linked above and below - any man could show up and sign a consent paper and nobody will check to see if it's truly the husband/assumed father doesn't really make it better. It does provide married women in abusive marriages with an option. By the way, I count any marriage in which the woman's autonomy is compromised and controlled by a "head of the household" as abusive. That doesn't include women who enter freely and purposely into marriages in which their husband takes charge, because presumably if she had a problem later on and the marriage were healthy, she would still have autonomy to deal with it. That said, the fact that the signature of a man - potentially any random man (I have no idea if the Forumosa discussion is based in truth or not) - is more important than the decision of the pregnant woman is unconscionable. I...I just....I 受不了!NO! NOT OK. How is that NOT sexist?

There are so many reasons for my views on this (I'm tempted to say it's not even my views, it's just true whether you like it or not) which are very well-addressed in Mr. Hung's paper - if I were to elaborate, I'd be basically parroting his excellent reasoning.

If it is not true, then the government has done a shockingly poor job of disseminating valuable information on women's rights. Also NOT ACCEPTABLE.

Don't even get me started on the fact that you have to "prove" rape or incest (pregnancy by anyone with whom marriage would be deemed illegal - which basically means incest) in order to get an abortion on those grounds. How traumatic! How heartless! How completely soulless and sick! Forcing a woman to produce evidence (what evidence, exactly, is what I'd like to know) of such a thing is like taking the trauma sticking in her heart like a poisonous arrow and plunging it deeper. It completely de-humanizes the woman and displays an unacceptable lack of empathy for women in such a situation. It makes my blood boil and my hands shake.

Taiwanese society has changed a lot since the law was enacted in 1985. There is still a lot of sexism and there are still patriarchal attitudes in the culture, but things have evened out considerably, to the point where I'd say that Taiwan is the most female and feminism friendly country in Asia. It's the most egalitarian regarding gender issues and is ages ahead of Korea, Japan, China or really any other country in Asia. A lot of the attitudes about husbands making decisions that impact their wives in such a cutting manner have been eradicated, and women are generally accorded respect, rights and a general assumption that they can make their own decisions and run a household as well as a man (at least in urban areas - the countryside is surely different). This is a generalization, of course, and there are certainly still lawmakers and citizens of urban Taiwan who still cling to outdated beliefs about a woman's place, but I'm conjuring the generalization because it is generally true.

There is, as a result, no reason for this law to continue in the manner in which it has. Attitudes are changing and the societal notions that helped frame the legalization of abortion in 1985 are no longer quite so valid. The law, therefore, needs to change alongside these cultural sea changes.

And yet, problems continue - as late as 2006, lawmakers wanted to add waiting periods and mandatory counseling to the abortion law for any woman seeking an abortion (I found a lot of news regarding the proposal and none regarding whether or not it was passed - if someone has info on that please let me know but I can hopefully assume that the proposal did not pass).

Give women in Taiwan true freedom of choice - allow them to seek an abortion without having to put up a weak claim to a medical reason, and clarify, publicly, whether married women require spousal consent. If they do, change the law - give them the ability to choose for themselves.

I do realize that abortion is not the hot topic of debate in Taiwan that it is in the USA. The deep conservative/liberal divide we have back home doesn't exist as such here. That said, it surprises me, as well, that more women's groups haven't been taking up this issue - the public misconceptions, the lack of accurate information and the ridiculous strictness of the law are all begging to be fought tooth-and-nail by feminists and women's rights advocates in this country.

Oh yes, and abortions are not covered under National Health Insurance, as far as I could find (again, the information is not clear

Here are some links for you, organized into one place from the spatter of linkings above:

PubMed

I want to finish by saying that yes, I am pro-choice, and I have many reasons for that, which I don't feel I need to justify as that's not the point. I do respect that other people have other views and am not trying to force my opinion on them - someone who is pro-life is just as able to fight for his/her beliefs as I am for mine. As someone who believes that there are more gray areas in the moral and ethical realm than black-and-whites (though there are some of those, too), I do realize that my opinion is not the only one. I welcome your comments and civil debate.

Note: More thoughts in the comments section.

5 comments:

Anonymous said...

I read a bit about this in "Women's Movements in Twentieth Century Taiwan." What I remember from the book is that it took a concerted effort from the feminist movement to make abortion legal at all, especially since it was still during the martial law era. Eventually, in order the people in power, the feminists had to put less emphasis on women's rights, and more emphasis on population control. According to the book, if a woman has an abortion because a) of medical reasons b) of rape/incest c) the unborn child has a disability (which is ableist, but that's a different issue) and I think there is a d) somewhere, she does not need permission from anyone, not even her husband if married. It is only if she gets an abortion because having a child would cause too much stress that she would need her husband's permission. The feminists made sure that the "too much stress" clause was in there because it was the closest they could get to "get an abortion for any reason", and the people in power knew this, which is why they required husband's permission for that reason alone. If you haven't read the book yet, you really should, since you're so interested in Taiwan and women's issues.

On a different note, I think mandating waiting periods is cruel to both mother and fetus. While I would love to live in a world where nobody got an abortion because everyone used contra-conception and they cured eclampsia and other pregnancy-related illnesses, I think that if an abortion must happen, the sooner the better, preferably before the fetus has a sufficiently developed nervous system to feel pain.

-MSK

Jenna said...

I haven't read the book (someday when I'm off my "not paying full price for books" kick I will buy it and read it) but it is fairly clear that that's how abortion got legalized at all.

Yes, it's infuriating that as late as 1985, the Taiwanese government had no sympathy or sense of women's rights, but this isn't 1985.

Society has changed, perception of women's rights has largely changed, the powers-that-be are more receptive to women's issues...

...so it's time for the law to change.

It seems that the husband-consent law is still on the books and the three-day waiting period proposal would have (possibly) done away with it. I, too, am against three-day waiting periods.

Basically, I figure by the time a woman approaches a clinic for an abortion, we can trust that she is enough of an adult to have taken the time she needs to contemplate what she is going to do and what her choices are - mandating more waiting time is infantilizing women and assuming that if Big Brother didn't make them take time to mull it over, that they'd just terminate pregnancies without thinking. That's **offensive**.

But if the law would have done away with the husband-consent provision, I am not sure why women's groups attacked it with such vigor. Lesser of two evils, I'd say. A waiting period is an assumption that a woman can't think for herself, but even worse than that is the assumption that her husband gets the final decision over matters pertaining to her body - assuming that not only can't she think for herself, but she shouldn't have to or be allowed to.

Like I said, times have changed in Taiwan and it's time to change the law, or at the very least, for the sake of women in abusive, controlling marriages get rid of the husband-consent clause when a woman claims "psychological stress". They should also do away with the need to prove rape/incest.

I'd like to see them do away with the need to justify an abortion to the powers that be: if a society values women as mature and equal adults, then that society needs to trust that a woman who seeks an abortion has come to a valid reason for it. Anything less is patriarchy, chauvinism, paternalism and sexism. NOT ACCEPTABLE.

I am surprised that women's groups don't seem to be working on it. Maybe they are and it's just not publicized...

And I, of course, would also like to see the abortion rate be at zero. Nobody - NOBODY - likes the idea of abortion. It is undeniably true, though, that abortion rates do not go down when abortion is illegal - they simply go underground to seedy clinics that often do more harm than good to women with no options.

I'd like the end of abortion to be due to better education and use of contraception, and sex ed that teaches not only the value of abstinence when you're not ready, but also the value of safety when you are ready, and the value of being conservative about your choice/number of partners. I'd like it to be about reducing the rates of abuse and rape (both within marriage and out) through public education and effort and greater services and empathy for women in those situations.

Anonymous said...

I would think that there would be a library that carries the book ... even though it's in English, I'd expect the libraries would be interested in just about any book about Taiwan. But I know very little about Taiwanese libraries.

-MSK

Anonymous said...

"I'd like to see them do away with the need to justify an abortion to the powers that be: if a society values women as mature and equal adults, then that society needs to trust that a woman who seeks an abortion has come to a valid reason for it. Anything less is patriarchy, chauvinism, paternalism and sexism. NOT ACCEPTABLE."

As if men are not stuck in the system too.

Equality also demands equal reproductive rights for men. Which means if a woman gets pregnant, her choice is hers and his choice is his. That is, if she chooses to keep the child he can choose not to be obligated to support it.

Many women like the idea of equality when they are in line to receive benefits. But then they remain quiet about collecting the corresponding responsibilities.

Must be nice to be able to wear so many different hats, men only get to wear one.

Jenna Cody said...

Well, for pretty much every other thing in history, men have gotten to wear many hats and women have gotten to wear one (men could pursue various careers or take various life directions - women could do two things: get married and have babies or try to, or become a nun. So I don't feel terribly sorry that women get the better end of abortion rights than men. You're not going to win my sympathy there.

Also, it's the woman's body that carries the baby, so I actually feel it's right that she has more say in whether to keep it or not. This evens the playing field in that in many cases, even when abortion was not legal/not available, men have often chosen to ignore the hard truths of pregnant sex partners and refused to recognize or support their offspring - leaving women with the entire burden of possible consequences of premarital sex.

Considering how much women have been kept down or dealt with societies that either have withheld rights or, despite legal rights, practiced rampant social sexism, I just don't feel bad that in this case, women have more reproductive choices than men. Just as, through history, if women didn't want to face dire consequences (which, once upon a time, could have meant being disowned by family or even killed) they had to keep their legs shut. If men don't want to face it today, then they can keep it in their pants or be willing partners in protection (I'm a fan of birth control pills AND a condom, personally. It'd take the next Messiah to get through that).

So, yes, saying a woman has the right to terminate a pregnancy or not, but if she does not the man has an obligation to support the child (not her - the child) might seem unfair, but I don't think it is.

You can reply if you want - I may even publish it. But you're not going to change my mind. One one side, anonymous commenter, on the other side the burden of history and collective consciousness as a woman...sorry, you lose.