Fetal Discourses and the Politics of the Womb

Author(s): Michael Lim Tan

Source: Reproductive Health Matters, Vol. 12, No. 24, Supplement: Abortion Law, Policy and
Practice in Transition (Nov., 2004), pp. 157-166
Published by: Reproductive Health Matters
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 ? 2004 Reproductive
HealthMatters.All rightsreserved. REPRODUCTIVE
HealthMatters2004;12(24Supplement):
Reproductive 157-166 HEALTH
0968-8080/04$ - see frontmatter matters
ELSEVIER PII:S0968-8080(04)24013-7
www.rhm-elsevier.com ISBN 0-9531210-2-X www.rhmjoural.org.uk

andthe Politicsof the Womb

FetalDiscourses
MichaelLimTan
Chairperson,Department of Anthropology,
Collegeof SocialSciencesand Philosophy,
of the Philippines,
University E-mail:
QuezonCity,Philippines. mtan@packard.org

Abstract: Discourseon abortionrightsinevitablycentres on the fetus, and is often framedaround

the dichotomyof "pro-life"vs. "pro-choice"positions.Thisdichotomyis not, however,the only
frameworkto discussabortion;concernsabout the fetus have foundvariedexpressionin theological,
legal and medicalconstructs.Thisarticleexaminesdiscourseson the fetus fromthe Philippines,Iran
and the UnitedStates, to show how complex they can be. It examineslaws punishingabortion
comparedto laws punishingthe murderof children,and also looks at the effects of ultrasound,
amniocentesisand stem cell researchon anti-abortiondiscourse.Althoughthe fetus figures
prominentlyin much legal discourse,it actually figuresless prominentlyin populardiscourse,at
least in the Englishand Philippinelanguages,wheretermslike "child"and "baby"are used far more
often. Finally,the article highlightsthe need to examine the experiencesand narrativesof women
who have had abortions,and the implicationsfor publicpolicies and advocacy.It is importantto
expose the way anti-abortiongroups manipulatepopularcultureand women'sexperience,driving
home their messages throughfear and guilt, and to show that pregnantwomen often decide
on abortionin orderto defend their family'sright to survive.? 2004 ReproductiveHealthMatters.
All rights reserved.

Keywords:abortionrights,contraceptionand unwantedpregnancy,anti-abortiongroups,religion,
reproductiverights,Iran,Philippines,UnitedStates

M UCH of the discourse in western coun-
tries around abortion rights, in the
United States (US) in particular, has
revolved around the dichotomy of "pro-life"
and "pro-choice" positions. In this configura-
tion, support for abortion rights is mainly
equated with the idea that abortion is a
woman's right to choose, a right closely tied
to their rights over their bodies. Anti-abortion
groups, on the other hand, proclaim themselves
as "pro-life" in an effort to project the other
side as being "anti-life", life here referringonly
to that of the fetus.
While this pro-life vs. pro-choice framework
is an important one, there are other discourses*
around abortion rights, shaped by different
social and historical circumstances. This article
reviews the pro-life vs. pro-choice frameworkas
developed in the US and compares it with other
discourses and frameworksfrom the Philippines
and Iran, to show how these have evolved and
had an impact on abortion rights. The US was
chosen because this is where the pro-life vs. pro-
choice framework remains the strongest, even
though as an argumentit is fraying at the edges.
It is important to look at how old frameworks
are being questioned, even as they are re-
appropriatedthrough new labels such as "pro-
choice conservatives".1
*"Discourse" in this articlerefersnot just to what is said
or printed- what some researcherswould call "text" -
but also to the whole range of images that are created,
invoked and evoked by different stakeholdersin the
increasingly complex debates around abortion. These
images are found throughout popular culture, from
folklore to advertising,as well as in more formal and
codifiedforms,such as laws and publicpolicies.

157
 MLTan/ReproductiveHealthMatters2004;12(24 Supplement):157-166
The Philippines was chosen because of its
peculiar colonial history, having been under
Spain from the 16th to the 19th century, during
which Catholicismwas introduced. Catholicism
remains the professed religion of about 85%
of the population and church leaders continue
to wield tremendous political clout, especially
in relation to issues of sexuality. Following
the Spanish colonial period, the Philippines was
occupiedby the US from 1898 to 1946. American
influence also remains strong in terms of politi-
cal institutions and processes. In the area of
sexuality, it is curious that the American Reli-
gious Right, mainly identified with evangelical
Protestants, have found allies among Filipino
Catholic conservatives. Their impact on the dis-
course and policies on abortionin the Philippines
is also describedin this article.
Iran is included to offer a counterpoint in
relation to the interactions between the legal
system and a powerful Islamic tradition in the
framing of abortion discourses and the law on
abortion. This provides a basis for comparison
with the zeal of the Religious Right with
regard to abortion in both the Philippines and
the US.
Fetalrights,children'srights
This article is based on a newspaper article I
wrote for the Philippine Daily Inquirer.1It was
inspired by the work of Iranian lawyer and
human rights activist ShirinEbadi,who received
the 2003 Nobel Peace Prize for her efforts to
reform her country's laws. A large part of
Ebadi's activism has been to expose the con-
tradictions in Iran's family laws. Her work pro-
vides activists in many countries with an
important model for analysing laws to decon-
structculture,to bring out its problematicaspects
and propose alternatives.
Ebadihas examined laws to do with the fetus,
which she then contrasts with those relating to
children. In a 1997 article entitled "On the legal
punishment for murdering one's child", Ebadi
wrote: "Ifa man helps a woman have an abortion
which would result in the death of the embryo,
he will be sentenced to three to six months'
imprisonment; on the other hand, if that very
same embryo is not killed and lives to become
a 14-year-old boy or girl, and the father kills
him or her intentionally, that brutal father will
158
receive a less severe punishment" of blood
money with discretionarypunishment that can
be as light as one lash of a whip.2
If a woman causes an abortion in herself, she
has to pay blood money but is not imprisoned,
which Ebadi describes as a more compassionate
attitude.The blood money to be paid depends on
the stage of pregnancy:
* a fertilisedspermplaced in the womb: 20 din-
nars
* a fertilised egg which has blood: 40 dinnars
* an early embryo: 60 dinnars
* a fetus which has grown bones but not mus-
cular tissue: 80 dinnars
* a fetus whose bone and muscular tissue has
fully developed but lacks a soul: 100 dinnars
Ebadi does not explain how "ensoulment"is
determined but apparently, if the fetus is con-
sidered to have acquired a soul, then the blood
money to be paid is equivalent to that paid for
an adult. As with adults, however, the embryo's
value is gender-based - female embryos, like
adult women, only deservehalf the blood money
paid for males.
Thus,the laws of Irangive moreprotectionto the
embryoor fetus than to childrenalreadyborn.
In a 2002 forum on children'srights, Ebadi is
quoted as saying: "Under the penal code, if a
girl of nine and a boy of fifteen commit a crime,
they are punished as adults... If the same boy or
girl participates in a children's painting com-
petition and wins, they would need to obtain
their father'spermissionto receive a passportfor
travel... At the same time, we see that the same
boy or girl cannot participate in elections as a
voter. On the other hand, a lady at the age of 40,
who is, for example, a university professor and
wants to marry for the first time, needs her
father's permission to do so:"3
Such inequities in the law are certainly not
limited to Iran. Similar inconsistencies can be
found, for example, in the Philippines, around
definitionsand penaltiesfor abortionand murder.
Articles 256 to 259 of the Philippine Penal
Code4have detailed provisions on penalties for
abortion as severe as imprisonment from 12 to
20 years for someone who uses violence to induce
an abortionin a woman.
UnderPhilippinelaw, Article 246 of the Penal
Code provides that a person who kills his or her
own child will be tried for parricide,which can
 MLTan/ ReproductiveHealthMatters2004;12(24 Supplement):157-166
be punished with life imprisonment.Yet Article
247 makes an exception if the death or physical
injury is inflicted under "exceptional circum-
stances" with destierro* prescribed as punish-
ment for a parent who kills a daughter (though
not a son) if she is below the age of 18, living
with her parents and is caught having sexual
intercourse.The same lighter sentence applies if
the parent kills the daughter's "seducer" after
catching them having intercourse.
The contradictions in such laws merely reflect
social norms,the origins of which may have been
obscured by time. For example, Iran's graded
penalties for abortion, depending on the stage
of fetal development, are drawn from Islamic
theological speculation about ensoulment, a dis-
course which finds parallels in Christiantheol-
ogy, and which date even furtherback to classical
Greek philosophy. Thomas Aquinas and early
Christiantheologians took the Aristotelean view
that a fetus first acquired a vegetable soul, fol-
lowed by an animal soul and finally, a rational
soul. Abortion before rational ensoulment was
not considered murder. Christian theologians
adopted the Aristotelean view that animation,
somewhat akin to ensoulment, did not take place
until 40 days after the conception of a male fetus
and 80 days for a female fetus.6'7
The contrast between the elaborate legal pro-
tection of fetuses and the anaemic provisions
for child murder highlight the powerful ideol-
ogies that govern social relations, particularly
in terms of the authority of men over women.
These ideologies are expressed more specifically
in terms of the authority of the father over his
children, especially daughters, and the need to
protect female chastity and family honour, even
at the cost of killing an erring daughter.
Given the heavy legal sanctions for abortion
in relation to other laws, and especially in the
absence of heavy punishment for murdering
children, such abortion laws seem to be linked
more to upholding male honour and authority
over women and the family, rather than to the
protection of the fetus itself.
*Destierro(a Spanishterm)is definedin Article87 of the
Penal Code as a form of banishmentor exile. In effect,
destierrois an exemption from punishmentdue to the
enormousprovocationconsideredto be involved.5
Fromthe fetus to the unborn
Although the fetus figures prominently in much
legal discourse, it actually figures less promi-
nently in popular discourse, at least in the
English and Philippine languages. Terms like
"child" and "baby" are used far more often,
together with their emotion-laden connotations.
Anti-abortion groups are aware of the power of
these words so it should not be surprising that
they pass out keychains with a fetus attached,
sometimes given names such as Joshua. The
message is clear: do you want to kill Joshua?
To be pro-choice then is not just to be anti-life
but in an even more terrifying sense, to be anti-
baby and anti-child. This imagery is easily
linked to other sensitive social issues, as shown
in this excerpt from a posting on the Pro-Life
Philippines website:
"Thepeople who cryfor more family reduction/
culling/eliminate the 3rd, 4th and 5th child
masquerading as planning', more 'sex mis-
education', more 'I hate all men, I hate child-
birth, I hate children'feminism, are either in the
business of selling contraceptives,misinformed,
racist (they see the Filipino people as an inferior
race), class oppressors (they see poor people as
inferior and do not deserve to multiply), or blind
followers of the dogma of overpopulation."8
Pro-LifePhilippineslinks the imageryof the fetus
to many other social issues, including that of
women's bodies. Members of Pro-Life Philip-
pines regularly write to newspapers with dire
warings about the risks of cancer and other side
effects from contraception itself. Such warnings
are especially serious given that family planning
surveys often show that the fear of contracep-
tive side effects tops the reasons for non-use and
discontinuationof use.9Researchthat I and Health
Action InformationNetwork,a non-government
organisation(NGO),have carriedout in the Philip-
pines on perceptions of contraceptionhave con-
sistently shown how strong these fears are, and
that they are picked up from stories told by
Catholic church workers.10,11
Not surprisingly, when mifepristone was
approved as a medical abortion drug in the US,
Philippine groups expressed their outrage
through graphic referencesto the womb and the
fetus. Francisco Tatad, a Philippine Senator,
described the drug as "the equivalent of a
159
 MLTan/ReproductiveHealthMatters2004;12(24 Supplement):157-166
miniature chemical bomb detonated inside a
mother's womb. It is guaranteed to kill the
fetus instantly."12
Thus, anti-abortion rhetoric invokes not just
the fetus but also the womb. Moreover, the
Catholic anti-abortion movement, especially in
the Philippines,goes furtherand lumps abortion
and family planning together as being anti-
family. In January 2003, the Philippines hosted
a World Congress on Families, which allowed
anti-abortion groups to maximise their own
media exposure using imagery of fetuses, babies
and children.In one striking example, the orga-
nisers of the congress announced that they were
giving delegate status to 42 babies and toddlers,
one as young as 10 months old. Manila's Aux-
iliary Bishop Socrates Villegas described these
children as "the secret powerhouse of the con-
gress", and said they were there "to dramatise
the Church'sstrong stance against abortion and
artificial contraception".He is also quoted as
saying: "It takes a sick mind to get bothered by
the sight of a baby.The normal mind gets excited
and thrilledto see a baby because every baby is a
blessing... Thereis no baby who entersthe world
from the womb of the mother as a curse."This
same bishop lamented that people sometimes
"deposit aborted babies" at the EDSA Shrine, a
church under his care.13*
The imagery of fetuses and babies is not con-
fined to representationsin the media, however.
In several cities, Pro-Life Philippines has been
able to convince local government officials to
put up monuments to abortedfetuses. In front of
the Quiapochurch,in a centraldistrictin Manila,
there is a "Shrineto the Unborn"showing a fetus
on an outstretched palm with a crucifixion
wound, presumably that of Jesus Christ. On
Shaw Boulevard, a busy street in Metro Manila,
there is a five-story building that on one wall
facing the street has a painting of Jesus carrying
what seems to be a fetus but could also be an
infant. A caption under the mural reads: "Thisis
a child, not a choice."
One could argue that images are only images,
and perhaps that they have little impact on
people's actual lives, but these larger-than-
*Itis quitecommonforpeopleto leaveaborted fetusesat
theshrine.I suspectthisis donebecauseit is as closeto a
Christian burialas theycanget.
160
life representations are only part of a larger
campaign by Pro-Life Philippines that has suc-
ceeded in adversely affecting policies on family
planning by describing modem contraceptives
as abortifacients.
In 1995, the Philippines devolved authority
over health services and health policies to local
government, opening up new possibilities for
the Religious Right. The result has been disas-
trous for family planning. Whenever a pro-life
city mayor or provincial governor comes to
power, he (they have always been men) usually
prohibits"artificialcontraception"in local health
units. Invariably,the argument, mainly put for-
ward in TV interviews, is that the pill and other
"artificial"methods are all abortifacients.
In another instance, Abay-Pamilya, an anti-
abortiongroup affiliated to Pro-LifePhilippines,
was able to pressure the Health Departmentto
withdraw Postinor, an emergency contraceptive
pill. The move was made without public hear-
ings and was based on the argument that the
drug was an abortifacient.In reality, emergency
contraception works within the first 72 hours
after unprotected intercourse, a time when fer-
tilisation may or may not have taken place. The
anti-abortion groups argued that because there
was a chance fertilisation had taken place, the
drugwould then work as an abortifacient.Health
NGOs came forward demanding the return of
emergency contraception,invoking the medical
definition of pregnancyas startingat the time of
implantation rather than fertilisation.The legal
hearings, a debate on the status of the zygote
and the embryo,have continued and are unlikely
to be resolvedin the near future.
Since 2002, still another term, "the unborn",
has come into wider usage, with Philippine
President Arroyo declaring 25 March 2004 as
the "Day of the Unborn".The choice of date is
tied to the Catholic feast of the Annunciation,
when angels were said to have announced to the
Virgin Mary that she was pregnant with Jesus.
The President said the day was a way of
promoting a "cultureof defending life from the
moment of conception",t and was intended to
tThis is an obvious referenceto the Philippines 1987
Constitution14 which states, in Section 12, Article II:
"TheStateshallequallyprotectthe life of the motherand
the life of the unbornfrom conception'"
 MLTan/ReproductiveHealthMatters2004;12(24 Supplement):157-166
focus attention on "babiesthat died during their
mother's pregnancy", with a rather cryptic
reference to the fact that "3% of fetal deaths
recorded were due to ill-health of pregnant
women and socio-behavioural factors".15
On the surface, this could be seen as concern
for maternal health. But shortly after Arroyo
declared the "Day of the Unborn", Conrado
Limcaoco, her advisor on ecclesiastical and
media affairs (the combination of the two
functions is itself revealing), told newspaper
reportersthat he had read about similar events
in other countries on Zenit, a conservative
Catholic media service. Limcaoco's own ration-
ale for the event was: "As the Philippines is the
only Roman Catholic country in Asia, it is
important that we make a clear stand for the
dignity of life and the protection of the unborn
who are unable to protect themselves.'15*
Not surprisingly, Arroyo's "Day of the Un-
born" has appearedon the Internetsites of anti-
abortion groups, e.g. the Canadian Campaign
Life Coalition hailed the declaration of the day
as another example of defending the unborn.16
Manila's Mayor Jose Atienza, running for re-
election, chose to start his campaign on that day,
which he dubbedthe "Day of the Unborn Child".
This mayor has been outspoken in his views
against abortion and family planning. He has
banned artificial contraception from all city
health offices, and created a Haven for Angels,
which he described in a BBC documentary, Sex
and the Holy City, as containing "fetus babies
we find in the streets, garbage...".
The unborn have also taken centre stage in the
US where, on 2 April 2004, PresidentBush signed
the Unborn Victims of Violence Act. This new
federal law prescribesthat a person who inflicts
violence on a pregnant woman and who then
harms the mother and the fetus can be tried for
two separate crimes, in effect giving the fetus
legal status. With rhetoric similar to Arroyo's,
*Inpublicdebateson moralissues,rangingfromabortion
to nudityin movies,conservativesoften claimthe Philip-
pines is the "only"Catholicor Christiancountryin Asia
as a reason for the importanceof it defending certain
values. The claim is false. East Timor has a Catholic
majorityin its population,while many otherAsian coun-
tries have large Christianpopulations,e.g. SouthKorea.
Bush gave the following rationale for the
new law:
"With this action, we widen the circle of
compassion and inclusion in our society, and
we reaffirmthat the United States of America is
building a culture of life."17
Medicine,embryosand fetuses
The discourse of the womb and the fetus is not
new, as seen in the specific Iranian penal pro-
visions relating to the fetus and its stage of
development. In recent years, advances in medi-
cal research,particularlyin fetal and reproduc-
tive medicine as well as in biotechnology, have
led to new and powerful imagery of the fetus.
The 9 June 2003 American edition of News-
week had a cover showing a fetus. The cover
story's theme was "Should a fetus have rights?
How science is changing the debate".An article
inside entitled "Treating the tiniest patients"
describedvarious medical procedures,including
surgery, that can now be performedon fetuses.
The article notes: "Twenty-fiveyears ago scien-
tists knew little about the molecular and genetic
journey from embryo to full-term fetus. Today,
thanks to the biomedical revolution, they are
gaining vast new insights into development,
even envisioning a day when gene therapy will
fix defects in the womb."Author Claudia Kalb
believes that "medicine has already granted
unborn babies a unique form of personhood -
as patients".18Kalb focuses on fetal surgery
because she believes this raises the stakes around
political, moral and ethical debates:
"The very same tools - amniocentesis and
ultrasound - that have made it possible to
diagnose deformities early enough to terminate
a pregnancy are now helping doctors in their
quest to save lives. While fetal surgery is still
rare and experimental, the possibility that a
fetus that might have died or been aborted ten
years ago might now be saved strikes at the core
of the abortiondebate.And these operationsalso
raise afundamental question: whose life is more
important - the mother's or the child's."'1
It is not surprising that the bioethical debate
around abortion is rapidly changing. As fetal
surgery can be performed in the womb, and
more premature babies are being kept alive,
161
 ML Tan / Reproductive Health Matters 2004;12(24
anti-abortionists argue that fetal viability is
occurring earlier in pregnancy, and calling for
a reduction in the number of weeks of preg-
nancy that abortion should be permitted.The US
Supreme Court in fact recently handed down
an opinion that states could prohibit abortion
after viability, which was defined in that judge-
ment at 24 weeks of pregnancy.19 However,
the scientific evidence is that up to 24 weeks
the survival rate is below 10% and more than
half of the few infants that survive show evi-
dence of more or less severe physical problems
and learning difficulties. It is only beyond
26 weeks that survival chances rapidly increase
above 500/0 and the rate of handicap among
survivors drops below 500/.20
These debates have become even more heated
in relation to stem-cell research,in which human
embryos are being used to develop cell lines that
can be used to treat diseases such as juvenile
diabetes, Alzheimer's and Parkinson's disease.
US President Bush is vehemently opposed to
such research and has banned the use of fed-
eral money for research on stem cell lines, an
obviously political move which drew praise
from groups such as Focus on the Family,whose
president James Dobson hailed Bush as having
"courageously upheld his promise to protect
unborn children".21The attempt to link unborn
children and stem cells may seem overdone but
it is only one example of how overarching
themes from culture, medicine and politics
come together to challenge advocates for abor-
tion rights and, to borrow from Newsweek, the
entire "politics of the womb".
Kalb's article on fetal rights in the US begins
with the story of TracyMarciniak,who five days
before her expected delivery,was punched in the
stomach by her estranged husband. When Mar-
ciniak had herself checked that night in a
hospital, doctors could not detect any fetal
heartbeat. Marciniak'shusband was eventually
convicted of reckless injury and sentenced to
12 years in prison. He could not be charged
with homicide because the existing laws apply
only to "born persons". Marciniak eventually
became a key figure in the campaign to pass the
Unborn Victims of Violence Act. The groups
supporting the Unborn Victims of Violence Act
have been mainly anti-abortion groups, yet
Marciniak, at least until her husband's assault,
was a supporterof abortion rights.l8
162
Supplement):157-166
Kalb also interviewed a couple, Pieter and
Monica Coenradds,describedas devout Catholics
who are strongly opposed to abortion. Yet
because one of their daughters was diagnosed
with a debilitating neurological disorder called
Rettsyndrome,the Coenraddssupportembryonic
stem-cell research, which they hope will yield
therapy for their daughter's illness. The News-
week article summarisesthe paradox:
"Whenabortionfoesare willingto destroyembryos
for life-saving medical research and abortion
rights supportersare willing to define a fetus as
a murdervictim, the black-and-whiterhetoricof
the 1970s' abortionwars no longerapplies."18
Moreover, use of the Internet is a particularly
intriguing development, especially in the way it
can draw information from the ancient past to
help stimulatenew perspectivesto addresspresent-
day realities.For example, there is now a website
calledAnsweringIslam,with a whole section that
analyses advances in reproductivemedicine,par-
ticularly embryology, using interpretationsfrom
the Qu'ran, the Hadith (sayings attributed to
Mohammed)and medicalresearch.
Talking to the fetus
This article has centered on the discourse gen-
eratedin medicine and law and the way terms are
picked up, particularlyby anti-abortion groups,
to shape public opinion. People process these
messages and images in different contexts. For
example, Americans use both medical terminol-
ogy (fetus, embryo) as well as popular terms like
baby and child when talking about a pregnancy.
There is a tension in these terms, affected by
aspects of researchin fetal medicine seeping into
popular consciousness.
In the Philippines, the linguistic distinctions
are different, reflecting a different epistemology
regarding pregnancy. Fetus and embryo are
terms familiar only to those who use English
as a first language, who are a minority. In pop-
ular culture, a pregnancy is described quite
differently. Dugo (blood) is used to refer to the
fetus during the first few weeks of pregnancy.
During this stage, medicinal plants as well as
western pharmaceuticals such as misoprostol
are described as pampabalik ng regal (restoring
menstruation).This whole phase, too, is referred
to as paglilihi, a protractedperiod of conceiving.
 MLTan/ ReproductiveHealthMatters2004;12(24 Supplement):
After the first trimester of pregnancy, women
will referto the fetus as bata (child),anak (child)
or sanggol (baby).
The use of these terms is not exactly the same
as in the US or other societies, and this is why it is
importantto conduct researchto understandthe
full context of the uses of these terms.Tothis end,
Likhaan,a FilipinoNGOinvolved in reproductive
health care, recently released preliminaryresults
from interviews with women who had had abor-
tions.22They note widespreadpersonification of
the fetus, where women say they actually talk to
their bata, anak or sanggol as they try to decide
whether they will abort or not. The women's
stories are quite moving, as they try to explain to
the fetus why they have to choose abortion.
Strikingin their stories is the way the fetuses are
personifiedon one hand, but also often described
as sagabal (obstacles).Another account, recorded
in 1998 during a researchprojectin the southern
Philippines,was of a motherwho describedapo-
logising to the fetus: "I'msorry,but I have to do
this so your brothersand sisters can live."
A nationwide study conductedby the Univer-
sity of the PhilippinesPopulationInstitute23found
that economic hardshipwas cited most often as
the reason for abortion. Likhaan's interviews
showed that while economic factorswere also the
most important, there were other important
reasons for abortion too: not being able to finish
school, abandonmentby the husband or partner,
rape, domestic violence and, yes, pregnancies
that are too many, too soon. The women's stories
show it is impossible to identify one reason for
an abortion. An unmarried secondary school
student will be driven to abort by a mixture of
fear and shame. A batteredwife talks about how
she is beaten up, but finally explains it is the
husband'sdependencyon alcohol and drugsthat
makes her decide on the abortion, because he is
unable to help support the family.
The decision to abort is not a moment in
time. Women talk with other women, with their
partners and with the embryo/fetus. They go to
church as well, praying for a sign, to have or not
to have the abortion.Onewoman claims she won
P8000 (about US$200 at the time of the inter-
view) in a lottery after praying for a sign, money
which paid for her abortion.
Likhaanreportsaccounts of how hospital staff
would harass women seeking help for abortion
complications, including threats of legal action
157-166
or worse. One woman in the Likhaaninterviews
describeda woman physician who told her,when
she was wheeled in bleeding: "You may still be
alive, but your soul is now burning in hell." If
abortion is successful, the woman still has to
prepare alibis to use upon her return to the
community, since neighbours are often aware of
a pregnancy. And long after the abortion,
memories and stories will persist, including the
many events that led to the abortion, and the
times when women talkedto the fetus, sometimes
right after the abortion.
The paradox here is that while fetuses are
personified in many cultures, there is a dearth
of cultural mechanisms to deal with this per-
sonification of the fetus. A notable exception is
Japan,where temples offer mizuko kuyo (memo-
rial services for water babies), with women
returning year after year offering incense and
prayers for aborted, miscarried and stillborn
fetuses. In sharp contrast, the Roman Catholic
church, despite its strident anti-abortion stand,
has no officially prescribedprayersor rituals for
fetuses, whether abortedor miscarried.It should
not be surprisingthat Likhaan'sresearchshowed
so much agonising in relation to unwanted
pregnancies and the tortuous decision-making
processes for an abortion.
Implicationsfor advocacy:listeningto
women'svoices
Deconstructing the imagery around abortion,
and understandingits social and historical con-
text, are important for strengthening advocacy
and reproductivehealth services. This is not to
suggest that abortion rights groups ape the
tactics of the anti-abortionists, exploiting pop-
ular images and associated emotions around
fetuses and babies. Instead, advocacy efforts
should draw on women's own descriptions of
their reproductivelives, their pregnancies and
the circumstancesand concerns that lead to a
decision to have an abortion.Likhaan,for exam-
ple, drawingon their interviews,produceda play
called Aming Buhay (OurLives).The play shows
how abortion takes on different meanings and
tensions for a young unmarriedgirl as compared
to a middle-aged mother of five. The most
powerfulstoryis that of a young, unmarried,preg-
nant girl facing the fury of her father,who goes on
about having lost theirfamily'shonour.When the
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 ML Tan / Reproductive Health Matters 2004;12(24 Supplement): 157-166

girl's mothercomes to her daughter'sdefence,the
fathershifts his wrathto his wife, who had had an
abortionmany years before."Anakko 'yan"("That
was my child"), he bellows, dramatising the
patriarchalconstructionof the fetus.
Likhaanhas producedseveral postersthat they
hope will encourage a more open and less judge-
mental discussion of abortion. One poster reads:
"It could be (your) mother, your older sister, a
cousin or a classmate among the 400,000 women
who have abortionseach year."In anotherpartof
the poster are the stark words: Libongaborsyon.
Libong dahilan (Thousandsof abortions. Thou-
sands of reasons.)
Drawing on women's experiences can and
should include images of the fetus, recognising
that in popular culture women do grapple with
what the fetus means as part of what abortion
means, and this helps to get aroundthe pro-lifevs.
pro-choice dichotomy. Some feminists have in
fact argued against the idea that the fetus is
completely devoid of value, as this does not

Likhaanposter: 'You don't know because it's not talked about. It can
be your mother, an elder sister, a cousin, a classmate... Thousandsof
abortions,thousands of reasons. Know.Understand.Don'tjudge.

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 MLTan/ReproductiveHealthMatters2004;12(24 Supplement):157-166

representmany women's experienceof unwanted
pregnancy and that "fetal value can vary and
increase as pregnancy progresses".24
Whether abortion is legal or not, discourse
around this issue is pervasive, found in popular
culture as well as in legal and medical texts. A
focus on women's experiences does not mean
moving away from the politics of the womb. In
fact, a focus on the fetus allows an interrogation
of the so-called pro-life rhetoric, asking anti-
contraception bishops and mayors if they have
ever linked the abortedbabies that end up in their
garbage cans or their churches to their own pro-
hibition of contraceptive use. The lack of access
here includes the absence of contraceptive ser-
vices, not only in cases where such services have
been banned, but also social inaccessibility- the
fear of contraception fanned by anti-abortion
groupsthat preventswomen from using it.
In places like the Philippines,where abortionis
illegal, women tell horrendousstories about the
pain from catheters inserted in the uterus, pain
from massage by traditionalbirth attendantsand
harassment by hospital staff, and speak of feel-
ings of fear,guilt and shame, and the consequent
need for social support.22Anti-abortion groups
distortthese needs as post-abortiontrauma.Thus,
it is important to expose the way anti-abortion
groups manipulatepopular culture and women's
experience, driving home their messages through
fear and guilt and showing how the invocation of
termslike baby,child and unborn can be manipu-
lative and callous, insensitive to the circum-
stances surroundingthe need for abortion.
William Saletan, in his book Bearing Right,25
points out that even the rhetoric of American
pro-choice groups, with its emphasis on privacy
and individual rights, has been effectively co-
opted by anti-abortion groups, who now argue
against abortion as excessive government inter-
ferencein mattersthat should be kept privateand
within the family. This argumenthas been used,
for example, to argue for parental notification
before a minor's abortion, and is an example of
how concepts of confidentiality and privacy can
be distorted to ends which are the opposite of
what the concepts themselves stand for.
The article began by referringto the contra-
dictions in the laws of Iran and the Philippines,
and the way they seem to be skewed towards
protectionof the embryoand fetus while neglect-
ing the rights and needs of living childrenand of
women. This wider analysis of law and policy,
and of the discourse surroundingabortion, must
be developed further for an environment that
will allow progressive abortion law reformto be
created and the chances of achieving reproduc-
tive rights are to change for the better.
Acknowledgements
Thecore ideasfor this article werefirst developed
in an opinion-editorial column entitled "Fetal
rights, children's rights" in the Philippine Daily
Inquirer, 16 December2003.

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Resume
Le discours sur le droit a l'avortement se centre
inevitablement sur le foetus et s'inscrit souvent
autour de la dichotomie des positions ? pour *
ou ccontre * l'avortement. Cette dichotomie
n'est cependant pas le seul cadre de discussion
de l'avortement ; les preoccupations pour le
foetus ont trouve diverses expressions dans des
argumentations theologiques, juridiques et
medicales. Cet article etudie le discours sur le
foetusaux Philippines,en Iran et aux Etats-Unis,
pour montrer sa complexite. I1 compare les lois
qui sanctionnent l'avortement avec les lois
punissant le meurtre d'enfants, et s'int6resse
aussi aux consequences sur le discours anti-
avortement de 'techographie,l'amniocentese et
la recherchesur les cellules souches. Si le foetus
figure au centre de beaucoupde textes juridiques,
sa place est moindre dans le discours populaire,
au moins en anglais et en philippin, oi les
termes enfant et be'be sont utilises
beaucoup plus frequemment. Enfin, l'article
souligne la necessite d'examinerles experiences
des femmes qui ont avorte, et les consequences
sur les politiques publiques et le plaidoyer. I1
faut expliquer comment les groupes anti-
avortement manipulent la culture populaire et
l'experience des femmes pour vehiculer leurs
messages par la peur et la culpabilite,et montrer
que les femmes decident souvent d'avorterpour
defendrele droit de leur famille a survivre.
Resumen
La disertaci6n sobre los derechos de aborto
inevitablemente se centra en el feto y suele
enmarcarseen tomo a la dicotomia "pro-vida"
contraposiciones"pro-libreeleccion".Sinembargo,
esta dicotomiano es el iunicomarcoparaanalizarel
temadel aborto;las inquietudesrespectoal feto han
encontradodiversasexpresionesen las estructuras
teol6gicas,juridicasy medicas.En este articulose
examina la disertaci6nsobre el feto en Filipinas,
Irany EstadosUnidos,paramostrarcuan compleja
puede ser. Se analizan las leyes que castigan el
abortocomparadocon las que castiganel asesinato
de ninios,y ademas se estudian los efectos de la
ecografia,amniocentesise investigaci6nen celulas
madreen la disertacionanti-aborto.Aunqueel feto
se destacaen gran partede la disertacionjuridica,
en realidadno se menciona tan a menudo en la
disertacionpopular,por lo menos en ingles y en
filipino, donde terminoscomo "nino"y "bebe"se
utilizan con mayor frecuencia. Por iltimo, el
articulo resalta la necesidad de examinar las
experienciasy lo referidopor las mujeresque han
abortado,y las implicacionespara la gestoria y
defensa y las politicas.Es importanteexponer la
formaen que los gruposanti-abortomanipulanla
cultura populary la experiencia de las mujeres,
recalcandosus mensajes mediante el temor y la
culpa, y mostrarque las mujeresembarazadasa
menudooptanporinterrumpir su embarazoa fin de
defenderel derechode su familiaa la supervivencia.

166