Fertility rates

Restrictions on abortions and closure of clinics increase attempts at self-induced abortions, suggests a study by the Texas Policy Evaluation Project, University of Texas:

"To determine the prevalence of self-induced abortions in Texas, investigators surveyed women and asked them whether they had ever tried to end a pregnancy outside a clinical setting, or if their best friend had," reports Amanda Holpuch for the Guardian. "The best-friend measure was included because women tend to under-report abortions in studies."

Surveys are less than reliable, but methods for tallying such incidents are simply not available. As described in Allure of Deceit, a few women could be successful in terminating their own pregancy. Others fail and go on to deliver a child. The study suggests that between 100,000 and 240,000 women in the state of 27 million tried to induce an abortion at home.

Allure of Deceit, set in a fictional remote village in Afghanistan, takes an unconventional look at the topic.

The little girl was plump, content, alert. Before finding Shareen, Zahira had once believed that abortion was kinder than adoption. A mother could never trust a stranger with her child, and thoughts of Shareen with another woman were abhorrent. 

Zahira had rescued the  child not once, but twice. Their relationship was exceptional, though it was ironic how much Zahira sounded like the women who opposed abortion for others but vehemently justified their own.

The suspense novel begins at a lavish charity event and a Texas woman's hope to secure funding for a charity designed to introduce natural family planning in Afghanistan. The director of the largest foundation in the world uses such activities to investigate the death of her only son. His fortune led to the foundation's creation.

The US total fertility rate, the average number of children born to women during child-bearing years, has been in decline since the 2007-2008 recession, going from 2.09 children per woman in 2006 and 2007 to 2.01 in 2014, suggests CIA World Factbook and Mundi. Texas, at 2.07,  ranks among the 10 US states with highest fertility rates.

Afghanistan's fertility rate stands at 4.9 for 2013 down from its height of 7.9 around 2000 when the Taliban controlled the country, notes World Bank data. The CIA puts the country's fertility rate estimate at 5.33 children per women. Countries that have higher fertility rates than Afghanistan: Niber, Burundi, Mali, Somalia, Uganda, Burkina Faso, Zambia, Malawi, Angola. Texas's rate at 2.07 is less than rates for France and Guyana, higher than those in Grenada or Libya.

Places with higher fertility rates have younger populations and, with a median age of 33.6, Texas is the second youngest after Utah, according to the US Census.

The median age for the US is 37.8. For Afghanistan it is 18.4 - meaning half of Afghan people are children, according to CIA estimates. The Texas median age compares with Chile's, Greenland's, North Korea, Palau and Saint Lucia.
 
Fertility rates influence a society's environmental, security and economic conditions. Good governance requires monitoring demographics for long-term policy planning, and problems including waves of immigration, when young populations do not receive adequate education, health care and other services.

Photo of children in Afghanistan following a patrol by coalition forces and a provincial reconstruction team  in Laghman Province 2011, courtesy of Staff Sgt. Ryan Crane and Wikimedia Commons. Fear of Beauty is the story of a provincial reconstruction team in Helmand and an Afghan woman desperate to learn how to read after the death of her son on the night before he is supposed to leave for school.

Hills

During heated arguments, some individuals keep their opinions to themselves, especially for the topics on which agreement is impossible.

On such topics, writers may strive for ambiguity by allowing - even encouraging - readers to reach their own conclusions. Abortion is one such topic.

The short story "Hills Like White Elephants," by Ernest Hemingway influenced the approach taken on abortion in Allure of Deceit. In either story, readers may not be sure about where exactly the writer stands on the topic. But one theme runs true - the urge for individuals to take control of another's life. Such quests are common even though men and women, too, often do not respect what they can readily control. For resolution of such stories, so much depends on a reader's own experiences and opinion.

"Hills" is about a couple engaging in what seems like a tired argument while waiting in a station bar for arrival of an express train to Madrid. The word "abortion" is not mentioned in the story, but the man exerts mild pressure, urging the woman to undergo a procedure, suggesting that it's "awfully simple" and "really an operation at all." The pregnancy, again not specified, looms over the relationship and, like it or not, will set the direction for its future course. The male character may recognize the decision is not his to make and demonstrates little responsibility for the outcome either way.

The story emerges through dialogue rather than characters' observations and description. "Hemingway's accurate ear for speech patterns duplicates the gender-linked miscommunications which exist between man and women in the real world," wrote Pamela Smiley for The Hemingway Review in 1998. As a result of these differences, there are two Jigs: the nurturing, creative, and affectionate Jig of female language, and the manipulative, shallow, and hysterical Jig of male language." Smiliey goes on to suggest there are also two sides to the male who is referred to as the American: "in the female language he is a cold, hypocritical and powerful oppressor; in the male language he is stoic, sensitive and intelligent victim."

Yet, the gender distinctions and who holds power may not be so clear-cut.

Another essential element of the dialogue in "Hills" are the questions and how they signal character transformation during the course of the story. There are 26 question marks in all. At first, most come from the female character, and they are shallow and needy, asking the man what they should drink, what the print says on a beaded curtain says, and whether her observation that the nearby hills look like white elephants is "bright."

Midway through the story, the man asks questions, too, as he nervously reaches understanding that Jig does not necessarily agree with him that the pregnancy should be terminated. Her questions continue, but they become more challenging, taking on the tone of orders: "What makes you think so?" "And if I do it you'll be happy and things will be like they were and you'll love me?" and "Can't we maybe stop talking?"

Toward the end, the man relies on questions to change the topic. Jig wants to nail down a description of the nearby hills, which she describes as "white elephants," and "lovely" and "with skin." The man interrupts by asking if she wants another drink.

In the end, the male character is left posing the final question, returning after re-positioning their luggage for the incoming train. He also stops for a drink alone in the bar, another sign that alcohol and time alone are methods for masking or dwelling on discontent. Upon his return, he asks if she feels better, hinting at the state of  hysteria described by Smiley. Jig's response, "There's nothing wrong with me. I feel fine," suggests her emotions run true. The female is not ill or damaged or fearful, and the pregnancy is not a leading problem for her.

The story is about a man pressing a woman who is initially uncertain about a course of action, and subtly demonstrates how the pressure strengthens her resolve. That could involve going ahead with the procedure or going ahead with the pregnancy and birth. Either way, Jig likely contemplates ending a relationship with the man who offers annoying lectures, as indicated by her plea for him to stop talking, accentuated by the word "please" used seven times.

The lack of trust and distance in the short exchange of dialogue is intense. Jig seeks reassurance that the couple can be happy again and resume their carefree ways. The male character's early confidence only increases her doubt about his role in her happiness. He focuses on immediate concerns, loving her "now" while insisting they cannot have "the whole world."

The male character presses her to take steps that will preserve their wandering ways, summed up in another pointed, judgmental question by Jig: "That's all we do, isn't it - look at things and try new drinks?" She is unsatisfied and yearns for more than an aimless life with a manipulative partner.

The story and dialogue take a sharp and ambiguous turn, as suggested in the long exchange without attribution toward the end when Jig talks about having the whole world and "everything." The man argues with her. By paragraph breaks and orderly dialogue progression, the line "We can go everywhere" should be Jig's and the line "once they take it away, you never get it back" belongs to the man. Yet someone speaks out of turn as the breaks do not show an even back or forth. The reader can only be certain about who is speaking again when the man urges the woman to "Come back in the shade" and chides that she "mustn't feel that way." If the dialogue had been orderly, that line should have been Jig's turn to respond. One character had two lines in a row, and this reader suspects it was the man toward the end of exchange.

The confusion is momentary as the characters speak in circles to the point of going into role reversal, seemingly for the sake of argument. Still, Jig's side of the dialogue offers keen recognition that, regardless of the decision, there is no going back.

Conservatives and liberals could embrace this story and yet neither can be exactly certain that the set of words will sway other readers to their way of thinking - and that is the story's power. Hemingway may have been undecided, too. He gives his readers the power to take their own stance.

~~~

The context for abortion in Allure of Deceit may be more manipulative - a tale about another procedure, supposed to be so easy and simple. Yet the attempt to exert control over another human does not work out as planned, sending out repercussions for others well into the future. Characters cannot control the feelings of others, unless of course those other characters want to be controlled.

Photo of the Ebro River in Spain courtesy of Nicola and Wikimedia Commons.

Uncertainty

The UN secretary-general urges that physicians not refuse to do abortions on women who report being raped in the camps serving refugees from Iraq and Syria. 

""The Secretary-general’s comments are part of an ongoing dispute between nations and the UN bureaucracy on how best to end rape and sexual violence in conflict," reports Susan Yoshihara for the Catholic Family and Human Rights Institute and LifeNews.com. "Like the work of the [UN Security] Council, major political initiatives in the last few years have emphasized ending impunity for perpetrators and making reparations to survivors of violence.... UN staff, however, have promoted a feminist agenda which views deconstructing traditional social relationships and abortion rights as necessary steps to ending discrimination and violence."

The secretary-general suggests that his recommendation is in line with UN Security Council Resolution 2122, adopted in 2013. The resolution does not specify abortion, but does recognize "the importance of Member States and United Nations entities seeking to ensure humanitarian aid and funding includes provision for the full range of medical, legal, psychosocial and livelihood services to women affected by armed conflict and post-conflict situations, and noting the need for access to the full range of sexual and reproductive health services, including regarding pregnancies resulting from rape, without discrimination...."  

The resolution also points out that women are especially vulnerable in armed conflict with "forced displacement," "unequal citizen rights," "gender-biased application of asylum laws," and "increased risk of violence." It also urges participation of women and consideration of gender-related issues. 

Syria and Iraq are "red" countries on the World Abortion Laws map from the Center for Reproductive Rights: In Syria, abortion is explicitly permitted to save a woman's life, but spousal authorization and parental notification are required. In Iraq, the law is not explicit on exceptions on saving a woman's life. 

Permanent members of the UN Security Council - United States, China, France, Russia and the United Kingdom - are "green" countries, where abortion is generally permitted for most women without restriction on reason. Non-permanent members are a mixed bag: Chile and Nigeria are red which allow for saving a woman's life or are prohibited; Argentina (allows for cases of rape), Chad (allows for fetal impairment), Jordan, Republic of Korea (allowed for incest and rape; spousal authorization required) and Rwanda (allowed for incest and rape) are orange, allowed for various health puproses; Australia, Lithuania, Luxembourg are green. 

"According to the United Nations High Commissioner for Refugees (UNHCR), over 3 million have fled to Syria's immediate neighbours Turkey, Lebanon, Jordan and Iraq. 6.5 million are internally displaced within Syria," reports the Migration Policy Centre at the European University Institute in Florence, Italy, also noting that "the influx of refugees has been an enormous challenge for Syria’s neighbours, with strong implications for the stability of the entire region." 

As of July, 22 countries, most in Europe, have agreed to help resettle more than 34,000 Syrian refugees who have fled to a second country. The United States, Kuwait, European Commission, United Kingdom, Canada and Japan lead in pledging funds to support UN appeals to assist Syrian refugees, reported the UN Tribune. 

The camps are bleak places offering little in the way of education for children or work for parents. More than 30 million children worldwide cannot attend school because of violent conflicts, reports UNICEF. 

Allure of Deceit, to be released in February 2015, is a mystery novel about post-war Afghanistan and the small village of Laashekoh. The novel explores how charitable giving can come with a hidden agenda and upend incentives. Children run away to an orphanage. A caregiver accepts donor funds for women's health care, but lacks patients. A Michigan foundation director pursues programs for the purpose of solving the murder of her wealthy son. Lying is a means of self-defense. 

Contact the publisher for review copies. 

July 2013 photo of Za'atri camp for Syrian refugees is from the US State Department and Wikimedia Commons. 

Life imitates art

Authorities arrested 13 people in a Greater Manchester trafficking ring run by a gang, reports the BBC News. A 20-year-old woman from Slovakia was tricked into thinking she was traveling to visit a sister:

"She was met by a man who claimed to be her sister's friend and was taken to an address in Failsworth, Oldham before being sold to another man. In July, she was married under Sharia law in Rochdale. The woman was later taken to hospital for an appointment by a woman who acted as an interpreter and told staff she wanted an abortion."

An interpreter at the hospital uncovered the plot. Some gangs suggest that a pregnant wife is useful for securing immigration status in the UK.

Imagine the vulnerability of young women in a country where the CIA World Factbook reports the overall literacy rate is 28 percent,  12.6 percent for women; where the child labor rate is 25 percent; where more than 60 percent of the population is under the age of 24; the unemployment rate is estimated as high as 35 percent; and one third of the population lives below the poverty line.  Imagine a land where there is one physician for every 5000 people, one nurse or midwife for every 10,000 and one hospital bed for every 2000 people, as reported by the World Bank, with rates much lower for rural areas. The rates for Afghanistan are but a fraction of what's available in the developed nations like the United Kingdom.

Allure of Deceit is set in Afghanistan. No one should suggest that the tale of a sham abortion that haunts one caregiver, ruining the lives of many, is unrealistic.

Photo by Todd Huffman and from Wikimedia Commons under the Creative Commons Attribution 2.0 generic license. He writes: "A woman in conservative parts of the country without male support can do nothing but beg to survive."