Sexuality and Honour Abuse: Challenges in Reproductive Healthcare

Honour violence is a complex system of abuse that has attracted a lot of media attention over the last few years, not least because of the deeply vicious nature of murders carried out by family and close members of the victims’ community. The tragic stories of women like Shafilea Ahmed, Banaz Mahmoud and many others  are at the extreme end of a scale of abuse unique in character and quite different to domestic violence or murder, mainly because of the level of community collusion involved.

In these communities a family’s status is judged by its ability to control its women and children, and must ensure their adherence to a strict code of behaviour. Swift punishment is expected for any deviance from this. Physical violence, stalking, forced marriage, rape, incest, imprisonment, domestic/sexual exploitation and forced immigration have all been carried out in the name of ‘honour’, although these and other abuses such as genital mutilation can occur without any such ‘breach of behaviour’.

Reproductive health practitioners face a number of specific challenges in supporting victims of honour abuse, as the range of apparent offences that can provoke it mostly involve expressions of sexuality or discovery of sexual activity. There is a particularly high risk of unplanned pregnancy due to lack of contraceptive awareness or unwillingness to use contraception that may interfere with menstrual cycles.  In abusive households periods may be monitored by female members, most often the mother, to deduce readiness for marriage and to ensure that the hymen, a mistaken indicator of virginity, is kept intact. It can also safely be said that the life of most victims who present with pregnancy at a reproductive health clinic is at risk, and this should never be underestimated. Women have either become pregnant as a result of the abuse, or they have been sexually active in a ‘forbidden’ relationship i.e. with someone from the ‘wrong’ race or even the ‘wrong’ caste.

Mental health issues may also impair victims’ capacity to make important decisions about their health. As this study demonstrates, depression, self-harm and suicide can all affect South Asian women 2-3 times more than the national average, and stigma around mental illness in this community is well documented.  Where sexual abuse and incest occur, it is most often with the knowledge of other family members who are complicit in the abuse due to active participation, inaction and/or fear of reprisal. Seeking help for any kind of personal family issue is heavily frowned upon and can constitute a loss of honour in itself.

Although measures are beginning to be taken to address the problem, there continues to be a deep lack of general awareness around the issue. If you would like to find out more about honour abuse, organisations like Karma Nirvana, the Iranian & Kurdish Women’s Rights Organisation (IKWRO) and the Southall Black Sisters have a range of useful resources available. Information can also be found online at HBV Awareness and in publications such as Rana Husseini’s ‘Murder in the Name of Honour’ and Lynne Welchman/Sara Hossain’s ‘Honour: Crimes, Paradigms and Violence against Women’.

The impact of anti-abortion protestors on our clinic staff

The first thing anyone at bpas will say if asked how protestors make them feel is ‘Oh I’m OK – it’s the women I worry about.’ Our staff are passionate about their work and hate to see the impact of groups like ‘40 Days for Life’ or ‘Abort67’ when a woman is already feeling vulnerable. Helping women and their escorts deal with protestors will always be our top priority so the impact on the doctors, nurses and support staff who work in clinics is usually at the back of our minds, but it is worth taking a moment to explain what it is like for us during that time.

The general feeling among staff in the clinics affected by major protests (primarily Central London, Brighton and increasingly Milton Keynes) is that while it is unpleasant it is manageable. Support of the local police goes a long way to reassure staff that they are protected from any extreme behaviour by, increasingly entirely male, groups that stand outside clinics. The outpouring of support from our neighbours and local people has also been a comforting reminder that the protestors are a tiny minority.

Imagine every day when you get to work there is a strange man standing by the front door either glaring at you or trying to ‘befriend’ you depending on his mood. When you step outside the door during the course of the day, depending on what you look like, you may be hassled by protestors asking if you’re pregnant, face a dozen people who start praying loudly when they see you or have leaflets aggressively thrust at you. At the end of the day when the clinic is closed you lock up the building there is a large man is standing by the door, this time with no pretence about ‘helping women’ – he is just there to intimidate you as you leave alone at night.

That is an average day – manageable but unpleasant. The occasions where staff are followed on their lunch breaks, filmed coming in and out of the clinic or called ‘murderer’ while on a fire drill are thankfully infrequent.

Ultimately everyone at bpas feels this is unimportant when compared to the distress protestors cause women and their escorts, but that’s not to say the deliberation creation of a hostile environment outside clinics is meaningless to staff. Our staff should not suffer a form of daily harassment that the protestors would find reprehensible should the women in their own lives were subjected to it.

40 Days for Life, anti-abortion protests and their impact on women

At the end of another 40 Days for Life, we want to share some comments from women attending our clinics who have faced protestors. These comments reflect experiences with 40 Days for Life and the group Abort 67. We really hope that before protestors start their next “vigil” they consider the impact they have on women.

“I’ve felt harassed by one of the ladies asking me constantly if I was sure of my decision and offering me her help giving me her phone number. I found that like an intrusion in my private life and not making easier such a difficult decision like the one I had to make.”

“They kept staring at me and made me feel uncomfortable and upset.”

“I was very nervous about coming to my appointment and felt very intimidated by the 5 or 6 women standing on the street. Not knowing the area I did not know another route to avoid them and due to feeling extremely distressed by their presence, I turned around and went home.” This woman subsequently came for another appointment.

“She told me they could help; that I was going to hurt terribly emotionally after today and it wasn’t too late to walk away. I was running a few minutes late as I’d travelled quite far and she suggested I was late for a reason.”

“I was harassed and intimidated. I was told to read the leaflets they were trying to give out. Then they went up to my daughter and tried giving her the leaflets.”

 “I am extremely angry at the presence of the protestors. Me and my girlfriend are upset enough but have made our decision and I believe confronting people on their way into the building is sickening.”

“Please remove the protestors. It’s fine to offer a leaflet but chasing me down the street is not.”