Ipas > “I have full trust in these women to decide”

“I have full trust in these women to decide”

June 16, 2005

A gifted visionary and eloquent leader, Dr. Fathalla is acknowledged to be the author of the concept of woman-centered reproductive health.

Photo courtesy of Valerie Holbert

Dr. Mahmoud Fathalla, Professor of Obstetrics and Gynecology at Assiut University in Egypt, addressed a reception in his honor at a recent meeting of the Ipas Board of Directors. A gifted visionary and eloquent leader from a conservative Muslim country, Dr. Fathalla is acknowledged to be the author of the concept of woman-centered reproductive health and one of its greatest champions. The following is an excerpted transcript of his remarks.

…as a physician, in a very long professional career, I have seen many women risk their health and life in order to get an abortion in a country where abortion is against the law. But in this long professional career, I've also seen women risk their health and life in order to have a baby. And when I reflect on it and think about what differences are there between these two types of women I find they are the same, they are the same women, the same types of women, making different decisions when they are faced with different circumstances in their life. In some cases they have been even the same woman, making this decision at one time and the other decision at the other time.

Another reflection as a physician, I have cared for pregnant women for many years, and I cannot accept that anyone, anyone, can care about the embryo and the fetus the woman is carrying more than the women herself. I know what pregnancy means to a woman. But as a physician also, I have the privilege to practice in a part of our country where people are poor and where women are the poorest of the poor. And I have always been impressed by the ability of these poor women, who are mostly illiterate, the ability to make sound correct decisions about their lives and the lives of their families, when they are allowed to make those decisions. I have full trust in the ability of these women to decide. They are even more correct because they have a relatively much narrower safety margin for error in their positions.

So these are some of my reflections as a physician. I am also a scientist. I have followed a guide of science and one of the things which I would say is that science should not be used to justify or rationalize moral prejudices. […]

When I was with the World Health Organization, one day a letter was referred to me to answer. The letter was an inquiry, a short letter: Dear World Health Organization, When does life begin? […] My answer was short, two sentences: Life began millions of years ago. Since that time, life has been a continuation.

I'm not sure that this scientific answer pleased the person who asked the question, but it is correct, life is a continuation. If someone wants to throw an arbitrary line, they can do it, but don't try to use the cloak of science on it.

Another thing which I know from science is that abortion will never be eliminated. The need for abortion will never be eliminated. Abortion will never be eliminated because there's no power, be it the U.S. Congress and Senate or Supreme Court or any super power, there is no power that can control the most efficient pro-choice activist in the world, which is our dear Mother Nature. Nature, our Mother Nature, is the most active terminator of pregnancies. The majority of human conceptions are aborted by Mother Nature every day, efficiently. Mother Nature does not give us reason, any reasons for most of them, but keeps on doing it and apparently with no moral misgivings about it.

But not only that, the need for abortion will never be eliminated, there is no human community or society in the past or on the present, throughout human history, where women did not feel the need for abortion, and did not try to get an abortion with whatever means were available to them at that time. […]

Contraception may decrease the need for abortion, but contraception will never eliminate the need for abortion. …[W]ith the current levels of use effectiveness of contraceptive methods there is a very simple mathematical model that every year there will be between 10 and 20 million unwanted pregnancies among contraceptive users. […] And the real social choice is not between abortion and no abortion, but will for practical purpose be to have it under the law or against the law, to have it safe or to have it unsafe.

Now let me come to my role as a woman's health advocate. […] Women's health will not be improved by medical services and scientific developments alone because women's health needs social action that has been overdue. I believe that the prescription which most women need for their health is not a prescription which can be dispensed in a pharmacy, nor can be provided in a hospital. It is a prescription for power. What women need is power because powerlessness of women is probably the most serious health hazards for women's health. […]

I also believe that asking the question “is abortion moral or immoral?” is asking the wrong question. The right question is can women be trusted to make moral judgments on their own or are women morally incompetent to make these decisions and they need men in robes or elderly men to make these decisions for them.

Thank you.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258