Turkey’s restriction on Caesarean births ‘reminds us that rights we take for granted can also be taken away’
‘SHE WAS my mother’s best friend,” the middle-aged woman told me over a cup of coffee in a trendy cafe overlooking the Bosphorus. “She died bleeding in a back alley because back then abortion was illegal. Every Ramadan my mother would pray for her soul and ask us children to do the same.”
Because abortion was only legalised in Turkey in 1983, there are many women who are old enough to have memories of the preceding period – and they have rather dark stories to tell today. The problem is, very few of these women are in parliament. Politics, both at the local and national level, remains a male-dominated arena.
It was the linking by prime minister Recep Tayyip Erdogan of abortion to murder in May that sparked off heated debates across the country about women’s bodies and reproduction. In the same speech in which he described termination as a crime, Erdogan declared he was against C-section births. Women’s groups mobilised swiftly, organising numerous rallies to protest against a possible abortion ban, while commentators and academics have come forward to voice concern. After weeks of tension and ambiguity, the government seems to have taken the reactions seriously and the subject of abortion has been dropped.
Meanwhile, the discussion on Caesarean births branched off in a completely different direction, and now Turkey has become the first country to make elective Caesarean sections punishable by law, threatening fines for doctors who persuade women to have the surgery, which is deemed unnecessary. Concern from civil society about this change has not been as strong and whatever discussions emerged petered out rather quickly, perhaps because the threat to abortion has receded. Also, it is recognised that Caesareans have been widely used in Turkey over the last few years.
In public hospitals last year, 40 per cent of all births were carried out in this way. In private hospitals, the total rocketed to 67 per cent. Of course, C-section births are more expensive, attracting the criticism that private hospitals make huge amounts of profit and are encouraging women who could have opted for natural births instead. Public hospitals have been getting financial support from the state for every C-section operation.
The optimal Caesarean rate given by the World Health Organisation is 15 per cent to 18 per cent, though this average has been surpassed in many western countries, including Switzerland and Italy.
The new law says Caesarean sections must be restricted to cases of medical necessity. In a recent interview the health minister, Recep Akdag, said that not only women with physical problems but also those who have a strong fear of natural birth will be regarded as having such a medical need. Claiming that children born through C-section were more prone to obesity, he said the government had felt the need to introduce the law because “doctors have been presenting C-section delivery as a normal alternative to natural birth”.
A reassessment of Caesarian rates was indeed necessary. What is difficult to understand, however, is the way women’s bodies, and women’s control over them, have been – or rather have not been – discussed in Turkey. There has been a strong, vibrant women’s movement in the country that dates back to the late Ottoman era. But it is only now that women are starting to realise the rights they have taken for granted can also one day be taken away. As the recent threats to abortion rights have shown, society remains highly polarised and there is little, if any, dialogue between opposing sides.
Secularists fear losing individual liberties and conservatives think they are being unfairly accused of retrogression. Between the women’s movement and the government, Kemalists and liberals, Kurds and Turks, Sunnis and Alevis, the distance is too wide at times to establish a constructive exchange. Where words are lost, and critical ideas cannot be freely and loudly exchanged, silences will be detrimental to democracy – and this is ultimately detrimental to women.
Elif Shafak is an award-winning Turkish novelist. Guardian News & Media