Monique Rainford

The abortion debate is still a topical issue in the local news and there has been a vigorous debate in the United States of America for several years.

The supporters of abortion refer to themselves as pro-choice and, the opponents call themselves pro-life. However, the issue is clearly far more complex than people who oppose a woman's fundamental right to choose and people who do not respect a human being's right to life.

I have already mentioned in a previous article some of the early stages of the development of the pregnancy and I will reiterate them here. By about six weeks of pregnancy, the embryo (the name given to the developing baby between four to 10 weeks of pregnancy) has arm and leg buds and the heart begins to divide. Two weeks later the heart is fully formed and the embryo has fingers and toes. At 10 weeks, the developing baby is referred to as the foetus. By 12 weeks, the foetus is already moving and in just another two weeks the sex can be determined by an ultrasound.

When does life begin?

One of the controversial debates is about when life begins. While I certainly do not expect a consensus, if at six weeks the heart of the embryo is beating and legal abortion is allowed in most cases up to 12 weeks, there is certainly an argument that life has already begun by then.

The pro-choice people also argue that the pregnancy is a part of a woman's body. While the pregnancy is very much contained in and dependent on a woman's body, it is not a part of her body in the same way that her fingers, toes or womb are parts of her body. I would hazard a guess that if having an abortion involved losing one's womb or even a finger, fewer women would choose this approach. However, some women would still make this choice and some women place their lives at considerable risks to avoid unwanted children.

The changes of pregnancy

Pregnancy is by no means an easy time in a woman's life. Her body undergoes considerable and, in some aspects, permanent changes. The pregnancy itself could result in serious, sometimes fatal, illness. Pregnancy can be expensive and caring for the baby, which often falls on the mother's shoulder, is considered by many a lifetime commitment. If a women desires to place the child for adoption, there is no guarantee that her child will find a loving healthy household.

As an obstetrician and gynaecologist, I abide by the laws of the land and I regularly counsel my patients on the available methods of birth control to help them to avoid unwanted pregnancies but I must admit that I am not fully aware of all the available options for women who may want to continue their pregnancy but have no desire to raise a child.

The currently available contraceptive methods in Jamaica include the combined oral contraceptive pill, injectable contraception, the contraceptive patch and barrier methods such as the male and female condom. Medically abortions, although illegal in Jamaica, can be accomplished with minimal risks to the mother up to at least 12 weeks of pregnancy.

However, when all is said and done, who really has the right to determine that an embryo with a beating heart is not a life and can be sacrificed? Or who has the right to tell a woman that her body must support this embryo until it is able to survive on its own and who will then assume the responsibility of taking care of this new baby? I suspect the vigorous debate will continue until someone can begin to provide the answers to these questions.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.