Roe v. Wade ruling on future of abortion in US could impact Cayman

The upcoming decision by the US Supreme Court potentially to reverse constitutionally protected rights to obtain an abortion could have a knock-on effect on women in Cayman, leading to unsafe efforts to terminate unwanted pregnancies, advocates for women’s rights and healthcare in Cayman are warning.

It is illegal to perform or get an abortion in the Cayman Islands, unless it is done to save a pregnant woman’s life.

While the subject of abortion often hits the headlines in the US, and especially now with a Supreme Court decision on the Roe v. Wade case expected soon, it’s not a topic that is frequently publicly aired in the Cayman Islands.

The issue was tackled at a roundtable discussion on 10 May, prompted by the results of a survey of local women carried out by University College of the Cayman Islands social work student Estefanie Barnett as part of a paper she is preparing on the subject, which found that more than 90% of the 252 female respondents supported the legalisation of abortion in Cayman.

Barnett told the gathering of about 15 people at the talk, “Criminalising abortion only pushes women to engage in unsafe behaviours in order to procure an abortion, sometimes with fatal consequences. … My paper argues that the restrictive abortion law does not reflect the opinions of women across the island.”

She added, “Restrictive abortion laws and regulations do not prevent abortion. It only pushes women to engage in self-induced, unsafe and clandestine abortions.”

Barnett noted that after Barbados legalised abortion in 1983 – the first Caribbean country to do so – the rate of maternity mortality fell by 53% over the next 25 years.

In Cayman, if a woman wants to get an abortion, she must either fly overseas to get one, or buy an abortion pill illegally here on island.

Barnett said it costs $400 to get such a pill, with no guarantee of its effectiveness and no medical supervision; and about $2,000 to fly to Miami to undergo an abortion – money not easily available to many young women who become pregnant.

Law Reform Commission examining abortion laws

The abortion issue has also recently been addressed by Cayman’s Law Reform Commission; in December last year, it invited the public to weigh in on the subject of legalising abortion as, at the request of Attorney General Samuel Bulgin, it began examining sections of the Penal Code that need to be updated to bring them into line with the Bill of Rights.

While the Penal Code has been revised with the introduction of new offences and amended for the type and length of punishment for other offences, the commission noted it has not undergone a comprehensive review since its introduction in 1975 to determine if any of the provisions are now outdated because of social change.

The Law Reform Commission said in its discussion paper, “International human rights legal instruments and authoritative interpretations of those instruments support the claim that the right to access safe abortion services is a human right and compel the conclusion that women have a right to decide independently in all matters related to reproduction, including the issue of abortion.”

It added, “Where abortion is illegal and unsafe, women are forced to carry unwanted pregnancies to term or suffer serious health consequences and even death.”
Approximately 13% of maternal deaths worldwide are attributable to unsafe abortions, it said.

Survey results

Barnett, as a part of her study, surveyed members of the Women in Cayman Facebook group, which is made up of a cross-section of Caymanians and expats living the Cayman Islands, in a bid to gauge the thoughts of females of reproductive age on the subject.

She pointed out that her research shows few surveys had been done on the issue – the most recent she could find was a study by government into adolescent health and sexuality in 2013, which surveyed teens aged 16 to 19. The findings of that survey showed that, of 202 female teens who responded, 9.1% of the 15-to-16 year olds, and 8.5% of the 17-to-19 year olds, said they had had an abortion. Four of those girls said they had had two or more abortions.

Barnett’s results indicated that nearly one-third of those who responded to her survey, which involved females aged 16 and over, said they had obtained an abortion. Of those, 39 had travelled off island for the procedure, 14 had taken abortion pills on island, and 25 had terminated their pregnancies in their home countries before moving to Cayman.

Asked if women should have the right to legal and safe abortion methods in the Cayman Islands, 90.4% agreed.

The survey also asked, if abortion were to be legalised, should it be covered by health insurance. 78.6% believed it should.

More than 80% of the respondents also said they would find it hard to reveal to their friends or family members that they had had an abortion.

An overwhelming majority (96%) said they did not think schools were providing enough sex education to high school students, and 99.2% agreed that a more in-depth curriculum regarding female sexual and reproductive life and health should be available in secondary schools across the Cayman Islands.

Unsafe termination efforts putting women at risk

Another speaker at the 10 May roundtable discussion, part of the Studio Notes series of talks at Parcel 110 in George Town, was Carolina Ferreira, who heads the Red Cross’s child protection and sexuality education programmes.

Ferreira, who said she had been working with young people in Cayman for almost 20 years, told of horror stories involving girls trying to end their pregnancies, from throwing themselves downstairs to inserting tampons soaked in bleach into themselves or drinking noxious teas and brews to make themselves ill – methods that don’t work to end a pregnancy but can greatly injure the mother.

“So, that’s a lot of harm that young girls, that women, do to themselves when they’re trying to resolve a situation that can’t be resolved legally, by appropriate medical means,” she said.

If the Roe v. Wade decision is reversed, it will likely limit the number of states in the US where a woman can obtain an abortion, which Ferreira said would probably increase the cost for a woman from Cayman travelling to get an abortion. Currently, it appears many women who do travel to the US for a termination go to Miami.

Even before the Supreme Court makes a final decision on Roe v. Wade, Florida’s legislature has indicated it is in favour of restricting abortions – it has already passed a law that bans abortions after 15 weeks, replacing the current 24-week limit. That amended law comes into effect on 1 July.

Barnett estimated, if it becomes more difficult to get an abortion in Miami, the $2,000 cost for someone in Cayman to obtain one legally in the US could potentially double.

She worries that, once it becomes harder to get an abortion in the US, “it will cause more illegal abortions here. They’re going to try to buy pills, or find teas or fall down the stairs, or punch themselves in the stomach, or use hangers on themselves. It’s going to be worse for women here. Abortions will be even less accessible than they are now.”

The roundtable discussion was moderated by Emily DeCou, a former political candidate, who pointed out that with doctors in Cayman restricted to only terminating pregnancies that put a mother’s life at risk, “there are no provisions for underage girls who may be victims of incest, women who have been raped, or in relation to foetal abnormality. These women need to travel to another country.”

Roe v. Wade

According to a draft opinion, leaked to Politico journalists, the US Supreme Court has voted to strike down the landmark 1973 Roe v. Wade decision, which guarantees federal constitutional protections of abortion rights, as well as a subsequent 1992 decision – Planned Parenthood v. Casey – that cemented that protection.

The final ruling is expected in July.

If the judges’ decision outlined in the leaked document is accurate, it will mean that a nationwide legalisation of abortion in the US would end, and each state would instead decide whether to allow, restrict or entirely ban abortions.