DEADLY RISK_Caravan Magazine_November 2017

DEADLY RISK

PHOTOGRAPHS BY LAIA ABRIL

DEADLY RISK Unsafe abortions through the ages PHOTO ESSAY / HEALTH PHOTOGRAPHS AND CAPTIONS BY LAIA ABRIL TEXT BY TANVI MISHRA

in an image captured by the Spanish artist Laia Abril, a white coat-hanger is pictured against a grey background.

While it might appear to be an innocuous household object, the coat-hanger is a frequently used symbol for selfinduced abortions, conducted by inserting the metal wire up the cervix and damaging the foetus.

For the first showing of Abril’s work On Abortion, in 2016, at a photography festival in Arles, France, she transformed the clinical two-dimensionality of this photograph into a disturbing multisensory experience. A dense pile of mangled coat-hangers lay in the centre of a room, assuming an almost sculpture-like quality. Viewers encountered the coat-hangers repeatedly while exploring the exhibition, their menacing pointed ends serving as a reminder of the danger that women face if they are forced to have unsafe abortions.

On Abortion, which examines the repercussions of this lack of access to safe and legal abortions, is the first chapter in Abril’s ongoing, long-term project A History of Misogyny. It includes video, photography, text and sound—she

described it as a “conceptual umbrella under which various chapters will be treated in a different manner.” Other series for the project explore similar issues relating to gender, sexuality and health: Menstruation Myths, which will lead into a chapter titled On Hysteria, examines how taboos surrounding menstruation influence young girls, and Las 17 focussed on 17 women serving sentences on charges of abortion and murder in El Salvador.

On Abortion expands the definition of the “image” in photographic work with its broad range of visual material.

Apart from Abril’s own photography, which alternates between studio stilllife, documentary reportage and constructed images, it includes found photographs, ultrasound images, posters of pro-life religious propaganda, copies of advertisements publicising abortion services, and US Federal Bureau of Investigation advertisements, from 1999 and 2001, for the arrest of antiabortion extremists. Abril moulded the form of her material according to the demands of publication spaces. For instance, in her exhibition, she included sound installations such as a voicemail recording of pro-life campaigners harassing employees at an abortion clinic in the United States. She also incorporated a staged confession of an abortion from the Extraordinary Jubilee of Mercy—a year-long period of prayer for Roman Catholics starting in 2015, when, according to Pope Francis, priests across the world had the “discretion to absolve of the sin of abortion” women who sought forgiveness for it. The confession was transcribed for the book version of Abril’s project,

which is due to be launched in November at the Paris Photo Fair.

Abril visited several countries, including El Salvador, Spain and the Netherlands, and interviewed women who had had unsafe abortions, although some of them did not want their identities revealed. She photographed one section of On Abortion at the Museum of Contraception and Abortion in Vienna, Austria, where she captured objects historically used for abortion and contraception against a plain background. The resulting collection is telling of the fact that the manifold dangers facing women who are denied safe abortions have been present throughout history. For Abril, demonstrating the passage of time was integral to the project, to show that though abortion methods may have changed, the degree of risk remains the same, and, in some cases, has worsened. There is little reassurance, she explained, in the thought that “what was before was worst, and we will be safe from here on.”

Recording acts—such as swallowing a pill—that do not lend themselves easily to being captured on a camera, because they are fleeting, or often done in secret, is a somewhat paradoxical excercise. Abril said that attempting to visualise the invisible—“invisible because it is hidden, or in the past, or taboo, or psychological”—is an undertaking common to many of her projects. She used various techniques of reconstruction to overcome the drawback of not being able to film certain events. For instance, she presented detailed case histories of women who have undergone illegal abortions as “photo novels.” She also created visual metaphors, such as an image of a bathtub with steaming water, which left viewers imagining the horrific method it represents—in this case, women bathing in scalding water, relying on the superstition that this induced miscarriages. Abril’s retrospective evocation of abortions, which recurs very

often in this series, also challenges the notion that only photographs of events that are captured in real time can serve as empirical evidence.

On Abortion covers a wide range of countries where abortion is illegal, such as Poland, El Salvador and Ireland, as well as those—such as the United States, Chile, Italy and India—where women face moral, religious, financial or social barriers to it. Although abortion was legalised in India in 1971, unsafe methods are still in use, and, according to an article in the Indian Express this September, are responsible for 10 percent of all maternal deaths in the country. Abril pointed specifically to the example of Italy, where she thinks that abortions should theoretically be easy to access. “But then, the hospitals are full of objectors of conscience,” she said. “Even Catholic or conservative women do it at home because of shame and repercussions.”

Abril said she had heard the phrase “If you do it at home, it’s not really an abortion,” from women who had starved themselves in attempted self-abortions.

Abril did not initially intend for On Abortion to be the first chapter of A History of Misogyny, but said she decided on it because of the urgency of the issue. “Human-rights, women’srights are always at stake, and especially in these moments of political insecurity, are the first to suffer the consequences,” she said. Her multidisciplinary project contributes to the ongoing, and often invisible, battle that women are fighting for the right to make informed decisions about their bodies. One of the most critical aspects of this struggle, Abril explained, is confronting pro-life groups campaigning to ban abortion. “It’s quite obvious that if at least 47,000 women die every year because of not having access to safe abortion, the solution of just illegalising it is not a real solution,” she said.

below: Around the world and across centuries, desperate pregnant women have been known to jab themselves with whalebone, turkey feathers, umbrella rods and—infamously—household items such as knitting needles and coat-hangers.

Using these items can cause infections, haemorrhage, sterility and death. Abortionrights advocates worldwide have long used the coat-hanger to symbolise dangerous abortion methods, whose existence has been avoided by the pro-life movement.

Risky do-it-yourself methods are now seeing a resurgence in the United States, with reduced access to safe and legal abortions.

73

below: Tools such as those in the assortment pictured here were used in illegal abortions throughout the twentieth century in Europe.

Among them are urinary catheters, a bottle with soap solution, a forceps and a speculum—the latter two continue to be used in routine gynecological examinations and operations to open the cervix.

During abortions conducted late into a pregnancy, sharp, pointed instruments such as urinary catheters and coat-hangers were used to poke the uterus.

These instruments are extremely dangerous, and the procedures risk puncturing the uterus, bladder or intestine. opposite page top: In Europe, the douche was one of the most common contraceptive methods of the nineteenth century, although it was extremely ineffective. It consisted of a hose and a cylindrical pump made from metal or porcelain, which would hold water, sometimes mixed with citric acid. A woman hoping to avoid pregnancy by using a douche would insert the tube into her vagina and turn on the tap, letting fluid rush in and eventually fall into a bucket on the floor—in theory taking sperm with it.

above: This photo was taken at the Museum of Contraception and Abortion in Vienna, Austria, which carries educational exhibits on birth control and the history of abortion. It shows a cross-section of a threedimensional model illustrating an attempted abortion with a knitting needle. This life-threatening procedure entails inducing early labour by pushing the needle, or another similar pointed instrument, through the cervix and into the embryonic sac. In places where abortion is illegal, women have been known to wait for 15 to 18 weeks—until the pregnancy becomes visible—before conducting such abortions.

below left: From the top, crocodile dung, a vinegar-soaked sponge and a halved lemon.

Crocodile dung was used as contraception in ancient Egypt; it was inserted into the vagina before intercourse. In ancient times, it was also thought that sperm died rapidly in acidic environments, and women occasionally used vinegar-soaked sponges and tissues before sex.

Casanova is credited with having discovered the use of lemons as a contraceptive in the eighteenth century. A lemon was halved and squeezed, and the rind was placed inside the vagina to block sperm during intercourse. All of these methods are ineffective and unsafe—such materials cannot be positioned precisely in front of the uterine entrance, nor are they likely to stay in place during intercourse. They can also be dangerous, particularly if they come into contact with the cervix or are pushed into the uterus. below right: Condoms made from fish bladder were among the earliest prophylactics to be invented in Europe. Both catfish and sturgeon bladders were commonly used. Other materials that were used include cleaned, split and dried lamb intestines. Since such materials are not very elastic, early condoms often had to be secured to the penis with a ribbon. They were also expensive, and would be washed after use, then dried, and rubbed with oil and bran to prevent cracking.

above: “I was lucky my mother is a feminist and I have a good network. But the only doctor we knew was in prison, so I did not know the people who actually performed my abortion.

The whole procedure turned out to be not very medical: You have to go alone and bring €500 in cash. You end up in someone’s house, where the nurse doesn’t dress like a nurse and her nails are painted. You never meet the ‘doctor’ beforehand. I remember huge statues of saints, and posters of Jim Morrison and Homer Simpson. They gave me tea with tons of sugar and contraception pills from the 1960s.”

above: Lucía, 37, Chile “It happened when I was 24. I had been sexually assaulted, and I found out I was pregnant after just four or five weeks. At that time, abortion in Chile was illegal under any circumstance. Getting it done was a hell of a process; I was afraid the so-called doctors who did it would botch the job or kill me and cut me into pieces. But in the end, everything went well and I threw a party to celebrate with the people who helped me.”

above: “I remember thinking that my foetus was the size of a plum stone, and wanting to cover my vagina with my hand for a couple of days after the surgery. Despite being stunned by sleeping pills and knowing that a stranger had reached into my body and taken something, I felt relieved and satisfied. But in an illegal situation, you never stop being vulnerable. Two months after my procedure, I recognised that same clinic on television; it was being dismantled by police. I prayed they wouldn’t find any information about me. I hadn’t just risked my life, but also my freedom.”

below: Marta, 29, Poland “On 2 January 2015, I travelled to Slovakia to have an abortion.

I was too scared to take DIY abortion pills alone. What if something went wrong? So I decided to get a surgical abortion in a clinic abroad. I felt upset about borrowing money for the procedure, and lonely and frustrated because I couldn’t tell anyone what was happening. The hardest part was facing my boyfriend, who opposes abortion. All the same, I felt stronger and more mature afterwards.”

above: “I got pregnant during Christmas, then I had to wait a few weeks before I could make the trip. I was so anxious to avoid the process and save the money, that I first tried to end the pregnancy myself. The night before departing, I took a bath in very hot water and swallowed many aspirin to induce miscarriage. I wanted to feel stronger than the law.

But I did not succeed because I was afraid of hurting myself.

When I packed for the 15-hour trip, I took only underwear, this nightdress that I hate and €445 to pay for the procedure (all the money I had at that time).”

above: “I was seven weeks pregnant when I finally made the trip. I waited at a gas station in Krakow, and then jumped into a van with two other pregnant girls. We drove about three hours into Slia , where there’s an abortion clinic that welcomes Polish women. I called my (now ex-) boyfriend from the road, and he begged me not to do it. When I mentioned the stuffiness and how packed it was with people, he answered, ‘That seems right, murderers should be treated like cattle.’”

below: In February 2015, a 19-year-old pregnant woman took abortion pills in SĂŁo Bernardo do Campo, Brazil, and later visited a hospital because of abdominal pain. After treating her, her doctor had her handcuffed to the bed, before calling the police and forcing her to confess that she had attempted an abortion. Denunciation by doctors is not uncommon in Brazil, Peru or El Salvador. Women who are reported for attempting abortion have sometimes been detained in hospitals for weeks or months. Doctors often claim that they are required to notify authorities when they suspect an abortion.

top: In February 2015, Purvi Patel was sentenced to 20 years in prison in Indiana, USA, after she confessed to leaving her stillborn foetus in a dumpster two years earlier. Patel had used abortion pills illegally ordered online from a pharmacy in Hong Kong. “My fam would kill me n him,” she texted a friend when she discovered her pregnancy. “I’m just not ready for it.”

Patel was released two years later, after an appeals court overturned her foeticide conviction. middle: In March 2011, Bei Bei Shuai attempted to commit suicide by eating rat poison in Indiana, USA. She was 33-weeks pregnant at the time. The 36-year-old survived and gave birth via caesarean section, but her baby died two days later.

Shuai spent a little over a year and two months in jail, charged with foetal murder and attempted foeticide. After a public outcry, state prosecutors eventually offered to drop her charges in exchange for a guilty plea to the misdemeanour of criminal recklessness. bottom: In September 2015, Anna Yocca attempted to give herself an abortion with a coat-hanger in Tennessee, USA. The 31-year-old was 24-weeks pregnant at the time. Worried about her heavy bleeding, Yocca and her boyfriend went to the hospital, where she gave birth to a 1.5 pound baby, who survived and was placed in foster care. In December 2015, Yocca was charged with attempted murder. The charge was eventually dismissed, but she was charged instead with three counts of felony: aggravated assault with a weapon (the coat-hanger), attempted procurement of a miscarriage and attempted criminal abortion. She pleaded guilty to the second charge in exchange for immediate release from jail.

left: The local plants pictured here, ruda and chipilin, were infused and prepared into a cocktail in a common abortion method used by some Salvadorian women during the first trimester. This is just one of a seemingly endless list of drugs and foods that were thought to induce miscarriage, including clover mixed with white wine, squirting cucumber, stinking iris, slippery elm, brewer’s yeast, melon, wild carrot, aloe, papaya, crushed ants, camel hair, lead, belladonna, quinine and pomegranate. Selfstarvation was another method. below: “Samita, a 35-year-old mother of two, lives near Calcutta,” Ninuk Widyantoro—the head of Indonesia’s Women’s Health Foundation, who has worked on abortion cases around the world—told me. “Since the birth of her first son ten years ago, she has taken extreme measures to self-induce abortion on three occasions, including once inserting a small grapevine stalk into her uterus, causing heavy bleeding and intense pain. She ended up in the hospital, where a doctor told her that delaying medical help for even one day more could have killed her.” India has some of Asia’s most progressive abortion laws. However, that does not guarantee access to safe or sanitary abortion services. A woman died every two hours due to an unsafe abortion in India in 2013.

below: For generations, a scalding bath has been associated with miscarriage and abortion. An eighth-century Sanskrit text recommends squatting over a boiling pot of onions, while Jewish women used a similar technique in Manhattan’s Lower East Side in the early 1900s. Pain and shock have long been thought to induce miscarriage. As late as 1870, some abortionists would pull out patients’ teeth without anaesthetic. The Roman and Greek authors Pliny the Elder, Dioscorides and Pseudo-Galen cite similarly ineffective “shock” abortion methods, including being bitten by a dog.

below: Neide Mota Machado’s family-planning clinic in Mato Grosso do Sul, Brazil, was revealed as an abortion provider by a television news exposé—of the thousands exposed in 2007. Reporters carrying a hidden camera had posed as a couple looking for an abortion service. Facing up to 79 years in prison, the clinic director later committed suicide in her car. In 2008, public prosecutors used the clinic’s files to find and punish past patients. The clinic had kept records of about 9,900 illegal abortions conducted over 20 years. opposite page left: According to a report published in April 2017 by the National Abortion Federation—an organisation of abortion providers in the United States—anti-abortion extremists have committed more than 350 acts of terror, including arson, bombings, and murders, in the United States since the country legalised abortion in 1973. Family-planning clinics have been picketed more than 252,470 times since 1977, and around 34,000 arrests have been made of pro-life protestors blocking clinic entrances. Abortion providers have reported more than 16,000 cases of hate mail or harassing phone calls, and 545 death threats. There have been at least 11 murders and 26 attempted murders related to anti-abortion extremism. “Wanted” posters made by anti-abortion extremists have revealed the personal information of suspected abortion providers and their families. In 2009, a doctor named George Tiller was accused of providing abortions in one such poster, and was later shot and killed while attending church in Wichita, Kansas. His murderer, Scott Roeder, eventually confessed. He was convicted of first-degree murder and aggravated assault.

above right: The US Federal Bureau of Investigation’s “Wanted” poster for James Kopp, a member of the antiabortion extremist group Lambs of Christ. In 2003, Kopp was convicted of murdering Dr Barnett Slepian at his home in Amherst, New York. He was later convicted at the federal level for violating the Freedom of Access to Clinic Entrances Act of 1994. Kopp received the maximum prison sentence of 25 years to life. right: The US Federal Bureau of Investigation’s “Wanted” poster for Clayton Waagner, a member of the anti-abortion extremist group Army of God. “It doesn’t matter to me if you’re a nurse, receptionist, book-keeper or janitor; if you work for the murderous abortionist, I’m going to kill you,” Waagner wrote in one message on the group’s website. After sending 554 letters containing fake anthrax, Waagner was convicted in 2003 of threatening use of a weapon of mass destruction, among other charges.

above: In November 2015, a 9-year-old girl named Inocencia gave birth to a boy in Nicaragua.

He was the son of her biological father, who had raped her repeatedly, starting when she was seven years old. Many countries, including Paraguay, Guatemala, Honduras, Venezuela, Somalia, Egypt, Iran and Lebanon, do not consider rape a legitimate reason to abort, and permit abortion only when the mother’s life is at risk. Stricter still, Nicaragua, El Salvador, the Dominican Republic, Malta and the Vatican are five nations that prohibit abortion under all circumstances. opposite page: This image, depicting Jesus crying over an aborted baby, is part of the iconography of the Eastern Orthodox Church, which believes that life begins at conception and that abortion is murder. However, if a woman whose life is at risk terminates her pregnancy, she will not be excommunicated for the sin, but she must confess and fulfil a penance.