Fiona of the Re(al) Productive Health campaign, who have recently released their policy document, was gracious enough to answer a few question on the organisation for us.
What is Re(al)-Productive Health?
Re(al)-Productive Health is a working group, launched in October 2013, which actively campaigns around issues concerning reproductive care in Ireland. Our current campaign focuses on the availability of and access to over the counter emergency hormonal contraception.
In April 2011, Levonorgestrel (available in Ireland as HRA Pharma’s ‘NorLevo’) became available over the counter in Irish pharmacies. Our work intends to promote accessibility of the drug whilst mapping the implications for individuals seeking emergency contraception in Ireland in terms of this over the counter availability, and looking to tangibly improve accessibility.
We believe that the full availability and access to the morning after pill for those living in Ireland is hugely significant for securing those real reproductive rights which have often been overlooked.
Our website features details of our campaign to facilitate access to emergency hormonal contraception in pharmacies in terms of factors such as availability, cost and social stigma. For example, many people are unaware that a pharmacist may legally object to dispensing emergency hormonal contraception if it lies in contradiction with his/her ‘personal moral standards’. Such pharmacists may defer to the Pharmaceutical Society of Ireland (PSI) Code of Conduct on the dispensing of medication in general in order to ‘conscientiously object’ to a woman’s request. Though the pharmacist is required to refer individuals to another pharmacy this is often physically and financially impossible, not to mention quite possibly very shaming. Furthermore, despite being ‘safer than aspirin’, the consultation process that is presently mandatory to access over the counter medication is often a site of unnecessary, disrespectful and morally loaded questions. In addition, the cost of the drug is unregulated, ranging from prices such as €10 to €45.
The website features a platform from which individuals can upload their morning after pill experiences, in terms of location, availability and cost, onto a map of Ireland, helping others seeking the drug and building a better picture of collective experiences. Also featured are individual accounts of attempting to access the morning after pill, helpful tips on how to practically access the drug and what to expect. The social stigma which often surrounds issues of reproductive and sexual health is sought to be highlighted here, and as such, alongside other measures, reduced.
The research we have compiled on the issue represents input from those who have sought emergency contraception in Ireland, medical and academic literature concerning the subject, consultation with groups and organisations working within the realm of reproductive rights in Ireland and analysis of regulations governing emergency contraception in an international context. This research has informed our policy document ‘Emergency; Contraception in Ireland’ which offers proposals to the current Pharmaceutical Society of Ireland’s guidelines on the provision in pharmacies of NorLevo. The document reflects issues of inaccessibility to emergency contraception experienced in Ireland and the ways in which this inaccessibility may be addressed in order to provide for an equitable and efficient provision of this vital aspect of care within the Irish state.
How did the policy document come about?
The research and publication of this document was hugely supported by the groups and individuals who we consulted with since our launch – namely Leslie Sherlock of the IFPA, The Abortion Rights Campaign, ROSA, the Irish Feminist Network, The Union of Students in Ireland, The Y Factor and Doctors for Choice.
XminY, a fantastic organisation which helps to fund grassroots group to achieve social change very kindly funded the publication of our document. Since the launch of the campaign, we’ve received such fantastic and encouraging support from a host of grassroots groups, and from individuals who share our point of view.
The cornerstone of our work, however, is based upon the experiences of those who have sought to access or accessed the morning after pill in Ireland – the experts on every issue, amendment and proposal. The survey we carried out reflects the real impact of policies and a culture in which reproductive healthcare is not prioritised.
What’s the problem with reproductive health in Ireland?
In the 1880s, Elizabeth Cady Stanton of the US Women’s Rights Movement proclaimed, ‘The first great work to be accomplished for woman is to revolutionise the dogma that sex is a crime’. Over 130 years later, it’s quite clear that this, in Ireland, has yet to be accomplished. Why do we need to promote the accessibility of a drug that’s ‘safer than Aspirin’, that doesn’t render you infertile after you’ve taken it three times, that is not the ‘irresponsible’ choice?
The history of female sexuality in Ireland is one littered with examples of oppression and punishment, of shame and stigma. From the eighteenth to the late twentieth century we excluded ‘penitents’ and unmarried mothers from society. The very founding document of the Irish state presents women as one-dimensional and valuable only in terms of her adherence to strictly defined ideals.
But still today there exists the deviant woman, her supposed failings casting a shadow upon the moral vitality of the nation. We have the ‘slut‘ – shamed for having sex. We have the women who ‘take the boat’, forced, due to legislative cowardice and apathy, to travel overseas in order to avail of a reproductive right. It is clear that there exists within Irish society a continued exertion of punishment of women – women seeking to separate pleasure from procreation, sexuality from reproduction. Contraception represents the ultimate symbol of such decoupling of these concepts.
It wasn’t until 1979 that we saw the legalisation of contraception. It wasn’t until 1993 that condoms were available in vending machines. And it wasn’t until 2001 that emergency contraception became available in Ireland. It’s taken us a long time to get to where we are, but we still have far to go. With prices of emergency contraception ranging from €10 to €45, it is clear that contraception falls neatly within the remit of the free market. Our pharmacies are private. Free sexual and reproductive health clinics are few and far in between. Over the counter emergency contraception is not covered under the medical card. And good luck finding a pharmacy on a Sunday in rural Ireland!
We should refuse to accept our healthcare as a product, as a pawn in a game of chess which society as a whole can inherently never win. We can never claim to have achieved reproductive justice if reproductive justice is only for some.
Why is a feminist approach to healthcare so important?
Health care is not just a policy up for debate every budget season. It affects the ways in which we are able to make choices about our bodies, about ourselves and about our future. The interactions, access and treatment we receive is too often a reflection of a regressive, sexist and harmful politics which ever increasingly attempts to limit our autonomy and subjects us to the draconian moral autonomy of others. We can campaign, demand and even be granted more progressive policies surrounding heath but they are useless if their implementation requires a gatekeeper who may impede individual autonomy, backed by the power of bigotry to deny our choices which should be made by and for ourselves alone.
Healthcare should be autonomous – or in other words, we should be able to make our own decisions in this regard. However, and this is key – it should not be individualised. Experiences of women and general procedures of access are not isolated, but instead reflect the patriarchal society in which we live. This is why we have chosen to focus so keenly on experiences in their own words of, for example, pharmacist interaction and feelings of shame but also to analyse current policy-based barriers to access, to thoroughly analyse why they exist and what is necessary to remove them.
A recent case in Italy secured by the Council of Europe’s Committee on Social Rights rendered it the right of every woman to receive reproductive health care services, stating that conscious objection cannot stand in the way of a person’s reproductive autonomy. As commented by the director of International Planned Parenthood, our healthcare cannot be a ‘lucky dip’ dependent on the ‘luck’ of the patient, her ‘wealth’ or where we ‘live’.
This is what the reproductive movement in Ireland is fighting for; progressive, patient-led, autonomous and equal access to health care, removed from the ‘lucky-dip’ of the Dail or the ever deeper pockets of bigotry.
So what kind of changes do you want?
We demand that emergency contraception be something;
- For which the price is limited – that it is fully covered under the medical card.
- That we should be allowed to simply take off a pharmacy shelf and pay for it – no questions asked.
- For which pharmacists are properly trained to deal with.
- That is not subject to the private moral beliefs of individuals, of pharmacists.
- That any of us, in any town, village or city in Ireland should be able to reasonably access emergency contraception.
- That we should be able to keep a supply of emergency contraception in our medical cabinets like Paracetamol – just in case.
- That all of us, of all genders, sexes, sexual orientations and ages should have access to.
This is a time for solidarity, a celebration of how far we’ve come and taking collective stock of how far we have to go. No better was this represented than in the fantastic artwork we had on display at the launch of our policy document. So many individuals dedicated their time and energy to creating such wonderful and thought-provoking pieces on reproductive health in Ireland and what it meant to them. The time seems riper than ever, and the battle continues.
Take a look at Re(al)-Productive Health’s document, read through their proposals and check out their website. Find out how they do it in other countries and how they think it could work here.
Re(al) Productive Links