A note on language:
[This article will use ‘disability-first’ phrasing as opposed to ‘person-first’ phrasing, as many disability rights campaigners, including myself, prefer it because our disabilities are not secondary to who we are, but a fundamental part of ourselves.
I also will be using ‘women’ in reference to people affected by the Eighth Amendment for the sake of brevity, though I acknowledge that nonbinary people and trans men are also directly impacted by the Eighth Amendment.]
I joined the movement to repeal the Eighth Amendment for many reasons, but the one which I return time and again to is this: as a disabled woman, the fight for bodily autonomy is one I have been fighting my entire life, and will likely spend the rest of my life fighting for.
Disabled women face a triple-bind when it comes to our reproductive and sexual healthcare: we are burdened by ableist prejudices which lead to the depressingly pervasive idea that we don’t have sexualities, by the health issues we might have as a result of our disabilities, and finally by the daily struggle of navigating a world built largely without us or our needs in. These three, with an added dash of good old Irish misogyny, make for a hell of a cocktail.
The idea that disabled people either cannot, or do not, have sex is an extremely common stereotype, and one that has an overwhelmingly negative impact on disabled people, particularly women. Disabled women in particular are frequently seen as ‘eternal children’i, innocents who neither desire sex nor ought to.
This prejudice became starkly obvious to me personally when I first began to use a cane on a daily basis at the age of nineteen. Previously to that, I had barely had a GP’s appointment since the age of fourteen or so wherein I wasn’t asked whether I was sexually active, or told about the pill. In the almost four years since I started to use my cane, I have been asked exactly once whether I was sexually active, and in that instance I was asked by a consultant OB-GYN. (Apparently, a mobility device is more of a barrier to my having a sex life than being a nerdy teenager who never went ou,t ever was.)
Any sexual or reproductive health information I have needed since using my cane, I have had to seek out myself – it is more than a little bit humiliating to have to do this, knowing that the only reason the information is no longer being offered to me as it was before is because it doesn’t occur to many medical professionals that I might need it. It is much documented that the less information given to people about reproductive health, the more likely they are to experience crisis pregnancies – there is no reason, other than the assumption that we do not have sex, that this does not apply to disabled people as well.
The risks inherent in an unplanned pregnancy will also tend to be greater when the woman is disabled or chronically ill. Many of us will be taking medications to manage our symptoms which may not be healthy for the developing foetus – but abruptly stopping medication once a pregnancy is confirmed can also be disastrous for a woman’s health, both mental and physical. And of course, many women may not even be aware that they are pregnant for weeks or even months – particularly if they have a chronic health condition which leads to irregular periods. By the time a pregnancy is detected, damage may well already have been done to the developing foetus.
There are also many health conditions which are made worse by pregnancy. In my own case, I have Ehlers-Danlos Syndrome; this is a rare, genetically inherited connective tissue disorder which means that all of the collagen in my body is malformed. This causes constant joint pain, poor healing from injuries, excessive bleeding from cuts, and near-daily joint dislocations.
If I were to become pregnant, my hips – which already dislocate every second day on average – would likely each dislocate multiple times daily from very early pregnancy. My pain levels, already high, would become nearly unbearable, and I would probably need to use a wheelchair. I would also probably have to quit my medications cold turkey for the health of the pregnancy, which would cause intense withdrawal and almost definite relapse of my mental health conditions.
I very much want to have children, but it is no exaggeration to say I would be unlikely to survive a pregnancy. But I have absolutely no idea whether, under the current vague constitutional definition of ‘threat to the life of the mother’, I would be considered to be in enough danger to access a legal abortion in this country. I, and other disabled women – including my partner, who has the same genetic condition as me – should not have to live in fear of becoming pregnant, and of the potentially disastrous results to our health that this may have.
When planning our families, we should not have to factor in the costs of travel or the obtainability of illegal medication just in case something goes wrong. The Eighth Amendment casts a shadow over our family lives and relationships; unless it is repealed, the uncertainty and doubt it casts over our lives will remain.
The increased availability of the medical abortion pills, misoprostol and mifepristone, have made abortion care more accessible to disabled women in Ireland, who often face even more barriers to travel than abled women do. However, as long as the Eighth Amendment remains in place, and women cannot access abortion care at home, there will be women who need to travel.
Many disabled women, particularly those of us with complex or rare medical conditions, are already familiar with having our healthcare needs exported to the UK.
This does not make the journey any easier. The experience of travelling abroad to access an abortion is a miserable one for anyone – imagine, then, how much that misery is compounded for those of us with ‘specific access needs’. Not only the isolation of sitting in an airport terminal alone, but perhaps also of needing to lie to the wheelchair porter about her reason for travel.
That is, if she could somehow, on the maximum Disability Allowance rate of €198 a week, actually scrape together the money for the trip at all. Or find a clinic with doctors who had any knowledge of her disability, or access to her medical history. Or, if she were a wheelchair user, if she could find a clinic she could actually get into the door of, actually get onto the surgery table of. And that isn’t even touching on the difficulties of accessing adequate aftercare if complications do occur: which they are far more likely to if the patient has pre-existing conditions.
The reality of the Eighth Amendment is this: it does not protect women, and it does not protect disabled people.
There have been claims by some defenders of the Eighth Amendment that a liberalisation of Ireland’s abortion laws will lead to women en masse deciding to have abortions when they receive diagnoses of foetal disabilities; this is not a point that I want to address, but I feel it is one that I must. This argument, to my mind, is rooted solely in ableism; in the appalling assertion that women will only knowingly give birth to disabled children if they do not have a choice in the matter. It is simply ableism couched in paternalism: disabled people need protecting, and we only exist because of a moralistic control of women’s reproductive choices.
As a disabled woman, I reject this utterly, and I say this: if we are to protect disabled people, we must repeal the Eighth Amendment, and allow disabled women to have control over our reproductive choices and appropriate continuity of care when we access abortion care. We must remove barriers to sexual and reproductive health education, not only for abled but for disabled people, taking our differing needs into account. We must accept that reproductive healthcare, including abortion care, is as much of a healthcare right as any other, and we must strive to make it free, safe, legal and accessible to disabled women.
Article by: Aisling Kenny
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