Abortion Law Reform Research Articles

Thorny entanglements: feminism, eugenics and the Abortion Law Reform Association's (ALRA) campaign for safe, accessible abortion in Britain, 1936-1967.

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women's social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists' campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act's eugenics clause, sometimes verbatim. This essay analyses ALRA's role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to 'voluntary motherhood' in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities.

The role of healthcare providers in expanding legal abortion: Qualitative insights from Argentina, Ireland, and South Korea.

Abortion laws are key in creating an enabling environment that facilitates the advancement of people's sexual and reproductive health and rights. Around 50 countries have liberalized their abortion laws in the last decades by adding new grounds allowing abortion. The road toward the expansion of legal abortion is a long, highly sensitive, and difficult process. The specific role of healthcare providers in influencing abortion law reforms has been scarcely studied. With the objective to better understand their (potential) roles, a qualitative study was conducted in 2021 focusing on three countries that had recently liberalized their abortion regulations: Argentina, South Korea, and Ireland. For each country, key informant interviews were conducted with actors in advocacy for legal change, the majority with healthcare providers. The study results indicate that healthcare providers can contribute to the expansion of legal abortion through their influence on public and legal debates. Healthcare providers were found to be scientifically credible and trustworthy. Their voice and argumentation counteracted anti-rights arguments and addressed information gaps, by providing specific clinical experiences and medical information. Healthcare providers amplified women's experiences through their testimonies and had entry points within governmental bodies, which facilitated their advocacy. These healthcare providers often functioned as individual operating obstetrician/gynecologists or general practitioners who were engaged in networks of health professionals or had previous advocacy experience. In a global context of social and political contention around abortion, extending the engagement of healthcare providers in law and policy deliberation on abortion appears to be useful. This requires recognizing the diversity of roles that healthcare providers can take up, creating a safe environment in which they can operate, equipping them with skills that go beyond the medical expert role and facilitating strategic partnerships that seek complementarity between multiple stakeholders, building on the uniqueness of each stakeholder's expertise.

Abortion Legal Reform and Neonatal Mortality in Mozambique.

Abortion law reforms have been hypothesized to influence reproductive, maternal, and neonatal health services and health outcomes, as well as social inequalities in health. In 2014, Mozambique legalized abortion in specific circumstances. However, due to challenges implementing the law, there is concern that it may have negatively influenced neonatal outcomes. Using a difference-in-differences design, we used birth history data collected via the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) between 2004 and 2018 to assemble a panel of 476 939 live births across 17 countries including Mozambique. We estimated the effect of the abortion reform on neonatal mortality by comparing Mozambique to a series of control countries that did not change their abortion policies. We also conducted stratified analyses to examine heterogeneity in effect estimates by household wealth, educational attainment, and rural/urban residence. The reform was associated with an additional 5.6 (95% CI = 1.3, 9.9) neonatal deaths per 1,000 live birth. There was evidence of a differential effect of the reform, with a negative effect of the reform on neonatal outcomes for socially disadvantaged women, including those with no schooling, in poorer households, and living in rural areas. Given the delay in implementation, our analyses suggest that abortion reform in Mozambique was associated with an initial increase in neonatal mortality particularly among socially disadvantaged women. This may be due to the delay in effective implementation, including the dissemination of clear guidelines and expansion of safe abortion services. Longer-term follow-up is needed to assess the impact of the reform after 2018, when services were expanded. Abortion legal reform without adequate implementation and enforcement is unlikely to be sufficient to improve abortion access and health outcomes.

Recent Abortion Law Reforms in India: Redefining Rape

Recent Abortion Law Reforms in India: Redefining Rape

The contribution of anti-abortion law on maternal mortality: A case study in Nigeria

Background: Abortion in Nigeria has been controversial, and both the proponents (protagonists) and opponents (antagonists) have good arguments. Proponents of the abortion prohibition law of Nigeria (the pro-life group) argue that human life is sacred and the right to life is basic; hence, on no account should one be deprived of that fundamental human right, not even the fetus in-utero. Objectives: This review aims to discuss the concepts of abortion and maternal mortality, analyze the Nigerian abortion laws, discuss issues and controversies with abortion in Nigeria as it relates to maternal mortality and morbidity; and discuss the contributions of this Law on maternal mortality and morbidity in Nigeria. Method: The relevant materials for this article were obtained from search engines such as PubMed and Google Scholar respectively. Conclusion: Reviewed literature reveals that many of the contributory factors to maternal mortality could be avoided if preventive measures were taken and adequate care was available. In view of this, efforts should be made by governments and policy makers towards the provision of safe, available and effective abortion care to Nigerian women at all levels of health care, most especially at the grass-root level, primary health care. The study also revealed a poor level of awareness of the Nigerian Abortion Law among women. It is therefore necessary to ensure the wide dissemination of the abortion law and its provisions to the Nigerian public in order to arm them with the necessary information to participate actively in campaigns on abortion law reforms.

International human rights law, devolution and democratic legitimacy: the case study of abortion reform in Northern Ireland

This article uses the case study of abortion law reform to critically assess what is required to secure democratic legitimacy in complying with international human rights law (IHRL) obligations. The case study exposes the inadequacy of the devolution arrangement. The article critiques the methodology through which the views, interests and priorities of the two systems are upheld and protected: a mere bifurcation of competence over law and decision-making. The devolution framework frames democratic legitimacy as requiring the representation of interests of only two governance systems to be balanced – the devolved people of Northern Ireland versus the collective interests of the United Kingdom (UK). Other systems of people with separate interests should be identified and represented. The article assesses the role and challenges that IHRL presents in securing democratic legitimacy. On the one hand, it feeds into an iterative process of ensuring that the voices of those most affected by the law at issue are at the forefront of the law-making process – it facilitates their engagement with the state apparatus. On the other hand, the incorporation of IHRL must be consistent with the aims of the devolution framework: to balance the democratic will of the people of Northern Ireland and the collective will of the UK. If we work from the premise that IHRL is democracy-enhancing in itself, then we need to prioritise inclusive processes for deciding the content of those norms and ensuring they are practically implemented. Devolution politics should not form a barrier to this overall goal.

‘The tabloid test’: a qualitative interview study on the function and purpose of termination of pregnancy review committees in Victoria, Australia

BackgroundTermination of pregnancy (TOP) is not an uncommon procedure. Availability varies greatly between jurisdictions; however, additional institutional processes beyond legislation can also impact care and service delivery. This study serves to examine the role institutional processes can play in the delivery of TOP services, in a jurisdiction where TOP is lawful at all gestations (Victoria, Australia). As per the Abortion Law Reform Act 2008, TOPs post-24 weeks require the approval of two medical practitioners. However, in Victoria, hospitals that offer post-24 week TOPs generally require these cases to additionally go before a termination review committee for assessment prior to the service being provided. These committees are not stipulated in legislation. Information about these committees and how they operate is scarce and there is minimal information available to the public.MethodsTo trace the history, function, and decision-making processes of these committees, we conducted a qualitative interview study. We interviewed 27 healthcare professionals involved with these committees. We used purposive sampling to gain perspectives from a range of professions across 10 hospitals. Interviews were transcribed verbatim, identifying details removed and inductive thematic analysis was performed.ResultsHere, we report the three main functions of the committees as described by participants. The functions were to protect: (1) outward appearances; (2) inward functionality; and/or, (3) service users. Function (1) could mean protecting the hospital’s reputation, with the “Herald Sun test”—whether the TOP would be acceptable to readers of the Herald Sun, a tabloid newspaper—used as a heuristic. Function (2) related to logistics within the hospital and protecting the psychological wellbeing and personal reputation of healthcare professionals. The final function (3) related to ensuring patients received a high standard of care.ConclusionsThe primary functions of these committees appear to be about protecting hospitals and clinicians within a context where these procedures are controversial and stigmatized. The results of this study provide further clarity on the processes involved in the provision of TOPs at later gestations from the perspectives of the healthcare professionals involved. Institutional processes beyond those required by legislation are put in place by hospitals. These findings highlight the additional challenges faced by patients and their providers when seeking TOP at later gestations.

Knowledge, Moral Attitude, and Practice of Nursing Students Toward Abortion.

In 2021, Thailand decriminalized abortions to allow for legal abortions on request up to 12 weeks' gestation and conditionally up to 20 weeks' gestation, or in the case of sexual assault, maternal mental or physical harm, or fetal abnormality. We intend to say that healthcare practitioners' positive attitudes toward abortion will destigmatize abortion for both themselves and their patients. We explored the knowledge, attitudes, and intended practices of nursing students toward safe abortion practices in light of the recent law reform. This was a cross-sectional study using a self-administered questionnaire. The questionnaire consisted of 4 parts: a demographic information questionnaire; and measures to assess their knowledge, moral attitudes, and intended practice regarding safe abortion care. Questionnaires were sent to 206 nursing students who had completed the Midwifery and Maternal-Newborn Nursing rotation in Bangkok, Thailand. The survey response rate was 90.8%. Mean (standard deviation) knowledge score was 6.72 (1.86) out of 10. Buddhist students were more likely to have a positive attitude toward abortions. Most students intended to practice safe abortions in pregnancies that affect maternal physical or mental health, or in pregnancies that resulted from unlawful sexual contact. Students were more ambivalent toward abortion practices for socioeconomic reasons. Better knowledge of abortion legislation was associated with a more positive attitude toward abortions and safe abortion practice intention. Approximately 1 year after the abortion law reform in Thailand, nursing students had incomplete knowledge of the amendment. Most students were inclined to provide abortion care services for certain conditions.

The Womb Monologues: Toward A Mizrahi Feminist Theory of Israeli Law

Abstract Israeli legal feminists have largely overlooked the constitutive theoretical developments that introduced the “third wave” to global feminism. Drawing on the critical insights of black and postcolonial feminist discourse, this Article introduces Mizrahi feminism to Israeli jurisprudence. It aims to lay the groundwork for a new theoretical school of critical legal scholarship in Israel and expose the multidimensional oppression endured by Mizrahi women in Israeli law and history. To this end, the Article focuses on a particular slice of the legal history of the Israeli abortion law reform of the 1970s. Analyzing extensive parliamentary protocols and institutional archival records, the Article pioneers the deconstructive toolbox of Mizrahi feminism in order to extract the subversive ethno-class narrative that has been left invisible in the feminist story of Israeli abortion law—a sorely neglected history of a separatist, quality-control regulatory mechanism that restrains the Mizrahi womb and Orientalizes its female carrier as “unqualified” vis-à-vis the “dignified” Ashkenazi womb. This intellectual exercise in legal historical study does more than unveil the complex dynamics behind the regulation of the female body in Israel. It also gives a voice to an intra-Jewish ethnic female minority that otherwise remains a transparent and denied gender category in the sociolegal literature.

What skills do New Zealand clinicians have to provide first trimester abortion in primary care and are they willing?

ObjectiveTo determine the skills and intentions of health practitioners in New Zealand to provide first trimester abortion care.New Zealand achieved abortion law reform in 2020, changing how abortion could be delivered and experienced by pregnant people. However, little has changed in the way abortion care is provided.Study design: This survey, which was deployed to a range of health practitioners via regulatory bodies and professional groups, used an online free text and tick box survey. Questions included demographics, scope of practice, abortion care experience, philosophical perspective on abortion, and skills transferable to abortion care. Data was analysed using descriptive statistics and deductive and inductive thematic analysis. Results128 respondents included doctors, nurses, midwives, counsellors, and social workers from a range of practice settings, the majority from primary health (51%). Most respondents indicated competency or proficiency in clinical skills relevant to provision of early medical abortion. However, practitioners were more likely to indicate “I do not have this skill” or “support required” for: calculating gestational age by bimanual examination (42%), LARC (implant and IUC) insertion (36%), undertake a pregnancy related consultation using tikanga best practice guidelines (19%).Analysis of qualitative data showed three main themes; (1) support for abortion access and for abortion provision in primary care (2) levels of intention to provide abortion (3) critical components for an action plan for abortion in primary care. ConclusionAbortion care in the community has support from health practitioners. They identified needs including development of clinical skills, funding, and wider sector support.

P003“We are completely captured”: The influence of us foreign policy through the global gag rule on malawi's sexual and reproductive health and rights landscape

<h3>Objectives</h3> Though existing literature discusses the impacts of the global gag rule (GGR) since President Reagan enacted the policy in 1984, limited research documents its influence in countries reliant on US global health assistance, particularly when the policy is revoked. We partnered with Fòs Feminista, a leader in GGR research on this policy, to analyze how the GGR influenced Malawi's sexual and reproductive health and rights (SRHR) landscape from 2017 to 2021. <h3>Methods</h3> We conducted 17 semi-structured interviews with current and past recipients of US global health assistance in Malawi and civil society organizations working in SRHR. We recruited participants via purposive and snowball sampling and thematically analyzed interview transcripts in MAXQDA using inductive and deductive codes. <h3>Results</h3> The GGR stalled the passage of a liberalized abortion law, cemented conservative anti-abortion attitudes, and damaged national sovereignty in Malawi. In some cases, mis-implementation of the policy restricted legal access to post-abortion and contraceptive care. The revocation signaled increased freedom for SRHR, but did not reverse the fueling of anti-abortion sentiment. Participants noted that the threat of the GGR being reinstated by a future US president caused continued fear and hesitation about investing in SRHR programs and advocacy, and contributed to a weakening of national sovereignty. <h3>Conclusions</h3> The US GGR disrupted abortion law reform in Malawi from an advocacy and policy perspective, prevented organizations from providing safe abortion care, and reinforced stigmatizing norms about abortion. Importantly, these impacts endured even after its revocation. The US government should permanently repeal the GGR, to remain accountable to its goal of protecting SRHR for all.

The Reform of Abortion Law in India: A Critique

After six consecutive years of discourse, India has finally passed the amendment to its Medical Termination of Pregnancy (MTP) Act of 1971. This paper addresses the problems that the 2021 Amendment may prove to be inadequate to resolve, considering the existing practical lacunae between the vision of the legislation and the implementation of the law. It analyses and conducts a study on the numerous socio-economic factors that relates to the nuances of unlawful abortions, the extent to which this amendment has been able to address such problems, and how effectively has the Judiciary been able to provide appropriate remedies in accordance with the jurisprudence of the law of abortion. The paper also deliberates on the viability of the prescribed specialised Medical Board in the present infirm medical infrastructure of the country. Furthermore, several crucial elements of the concerned legislation have been left to be addressed by the MTP Rules that is yet to be enacted. This paper, in order to provide suggestive measures for such voids, attempts to strike a balance between the right to personal liberty and the right to life of an unborn, placing reliance on a comparative evaluation of the laws regarding abortion above the gestation period in other jurisdictions. In conclusion, the paper appreciates the gradual progression of abortion law in India while establishing a nexus with the recent relevant legislative developments and the socio-political role of the debate between pro-choice and pro-life in the judicial decision-making.

The factors influencing the trajectory of Danish abortion law: From progressive to 50 years of stagnation

In 1973, Denmark broke new ground when it introduced abortion as a legal right. We explore the drivers of Danish abortion law reform and demonstrate that liberalization was effectuated as the answer to a number of societal concerns. In observing the absence of autonomy as a winning argument for abortion law reform, we find that the Danish case is in alignment with the existing literature. Moreover, this article contributes to the understanding of how the historical drivers affect modern-day issues in abortion, including the fact that expansive autonomy for women is still not prioritized. Thus, we argue that liberalizing abortion regulation for reasons other than achieving reproductive autonomy comes at a price: downstream, it becomes difficult to achieve full autonomy in health law regulation because the initial reasoning behind liberalization continues to provide a certain framing even for present-day abortion issues. This observation can be of importance for those working in other jurisdictions to implement expansive autonomy in reproductive rights.

Beyond Criminalisation: Abortion Law Reform in Aotearoa New Zealand.

With the enactment of the Abortion Legislation Act 2020, New Zealand radically transformed its approach to abortion. Abortion is no longer a crime, and is instead regulated under general health law, adopting a gestational model. Whilst some claim that reform was overdue, critics have described the new legislation as the 'world's most extreme abortion law'. This article investigates these claims through the lens of reproductive justice, a movement that emerged alongside the global campaign for recognition of reproductive rights. First, it outlines the tenets of reproductive justice, before critiquing New Zealand's previous law, and considering arguments for its modernisation. It then describes how a growing number of jurisdictions have decriminalised abortion, with increasing pressure on other countries, including England and Wales, to similarly undertake law reform. Finally, it examines the main provisions of New Zealand's law. It concludes that, to the extent that the new law enables access to timely, equitable, and publicly funded abortion services, it is consistent with the tenets of reproductive justice. By placing women at the centre of the law, it improves the welfare of women, but particularly marginalised women. However, it suggests that the current 20-week gestational test is arbitrary, with the originally proposed 22-week threshold preferable.

The unmet need for abortion law reforms and modern contraceptive uptake in Nigeria, Kenya, Ghana and Ethiopia: A systematic review

Background: It is estimated that about 68,000-70,000 deaths occur from unsafe abortions annually, with 97% of this occurring in developing countries. The reality that almost 35% of these worldwide deaths occur in sub-Saharan Africa Countries alone is a lot to think about.Aim of Article: This article seeks to bring to better lamplight the direct and indirect proportional relationship between contraceptive uptake, unwanted pregnancies, abortion laws and unsafe abortions. To suggest for better abortion law reforms to reduce maternal mortalities from unsafe abortions.Discussion/Conclusion: Comprehensive male sex education, modern methods of pregnancy prevention and Reformed laws on Therapeutic Safe Abortion Care are key paths that should be taken more seriously in the quest to end the menace of unwanted pregnancies and unsafe abortions in Sub-Saharan Africa.Restrictive abortion laws only further fuel the pathology of unsafe abortion in sub-Saharan Africa. We need to legalize safe abortion care and in fact, illegalize unsafe abortion services and/or procurement.

Leaps ahead in law but not in practice: Why we need to train in second trimester abortion care.

Abortion care has always been controversial, with health professionals worldwide continually working to offer well-rounded safe services. Key improvements in New Zealand since abortion law reform include the ability to self-refer, no formal certification under 20weeks gestation, and change to the indications for abortion after 20weeks. Nationally, we know that the second trimester abortion incidence is stable, and will therefore require an ongoing workforce to sustain the service. To document the current second trimester workforce for medical and surgical abortion in New Zealand, and examine their training and practice. Anonymous non-discriminatory snowball survey covering the domains of demographics, barriers to abortion care, abortion training, abortion provision and procedure specifics using Qualtrics software. Eleven practitioners currently perform dilation and evacuation, and 33 wish to. Current providers have between zero and three other colleagues to assist them in service provision. Most learned by an informal apprenticeship model and operate relatively infrequently. There is variance in the cervical preparation and evacuation procedure as well as skillset and/or willingness for later gestations. Fifty-nine practitioners' units currently provide medical abortion, and 62 wish to. There is more coherence in the regime of medical abortion, although the availability of this is affected by gestation and location. For most women requesting second trimester abortions, additional time, cost and stress is still very much the status quo. District Health Boards need to prioritise training and workforce planning to ensure the availability of this essential service.

Impact of abortion law reforms on women\u2019s health services and outcomes: a systematic review protocol

BackgroundA country’s abortion law is a key component in determining the enabling environment for safe abortion. While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, with the majority of them moving away from an absolute ban. However, the implications of these reforms on women’s access to and use of health services, as well as their health outcomes, is uncertain. First, there are methodological challenges to the evaluation of abortion laws, since these changes are not exogenous. Second, extant evaluations may be limited in terms of their generalizability, given variation in reforms across the abortion legality spectrum and differences in levels of implementation and enforcement cross-nationally. This systematic review aims to address this gap. Our aim is to systematically collect, evaluate, and synthesize empirical research evidence concerning the impact of abortion law reforms on women’s health services and outcomes in LMICs.MethodsWe will conduct a systematic review of the peer-reviewed literature on changes in abortion laws and women’s health services and outcomes in LMICs. We will search Medline, Embase, CINAHL, and Web of Science databases, as well as grey literature and reference lists of included studies for further relevant literature. As our goal is to draw inference on the impact of abortion law reforms, we will include quasi-experimental studies examining the impact of change in abortion laws on at least one of our outcomes of interest. We will assess the methodological quality of studies using the quasi-experimental study designs series checklist. Due to anticipated heterogeneity in policy changes, outcomes, and study designs, we will synthesize results through a narrative description.DiscussionThis review will systematically appraise and synthesize the research evidence on the impact of abortion law reforms on women’s health services and outcomes in LMICs. We will examine the effect of legislative reforms and investigate the conditions that might contribute to heterogeneous effects, including whether specific groups of women are differentially affected by abortion law reforms. We will discuss gaps and future directions for research. Findings from this review could provide evidence on emerging strategies to influence policy reforms, implement abortion services and scale up accessibility.Systematic review registrationPROSPERO CRD42019126927

Impact of abortion law reforms on health services and health outcomes in low- and middle-income countries: a systematic review.

While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, expanding the grounds on which abortion can be performed legally. However, the implications of these reforms on women's access to and use of health services, as well as their health outcomes, are uncertain. This systematic review aimed to evaluate and synthesize empirical research evidence concerning the effects of abortion law reforms on women's health services and health outcomes in LMICs. We searched Medline, Embase, CINAHL and Web of Science databases, as well as grey literature and reference lists of included studies. We included pre-post and quasi-experimental studies that aimed to estimate the causal effect of a change in abortion law on at least one of four outcomes: (1) use of and access to abortion services, (2) fertility rates, (3) maternal and/or neonatal morbidity and mortality and (4) contraceptive use. We assessed the quality of studies using the quasi-experimental study design series checklist and synthesized evidence through a narrative description. Of the 2796 records identified by our search, we included 13 studies in the review, which covered reforms occurring in Uruguay, Ethiopia, Mexico, Nepal, Chile, Romania, India and Ghana. Studies employed pre-post, interrupted time series, difference-in-differences and synthetic control designs. Legislative reforms from highly restrictive to relatively liberal were associated with reductions in fertility, particularly among women from 20 to 34 years of age, as well as lower maternal mortality. Evidence regarding the impact of abortion reforms on other outcomes, as well as whether effects vary by socioeconomic status, is limited. Further research is required to strengthen the evidence base for informing abortion legislation in LMICs. This review explicitly points to the need for rigorous quasi-experimental studies with sensitivity analyses to assess underlying assumptions. The systematic review was registered in PROSPERO database CRD42019126927.

Identifying data for the empirical assessment of law (IDEAL): a realist approach to research gaps on the health effects of abortion law

Reproductive rights have been the focus of United Nations consensus documents, a priority for agencies like the WHO, and the subject of judgments issued by national and international courts. Human...

Early abortion care during the COVID-19 public health emergency in Ireland: Implications for law, policy, and service delivery.

Early abortion care became available in Ireland in January 2019. Service delivery involves two consultations with a medical practitioner, separated by a mandatory 3‐day waiting period. The Model of Care for termination of pregnancy initially required in‐person visits. The onset of the COVID‐19 pandemic necessitated significant reductions in in‐person interactions in healthcare. A revised Model of Care for termination of pregnancy, issued for the duration of the pandemic, permits delivery of early abortion care by remote consultation. Significantly, this was introduced without amending the 2018 abortion law. The pandemic precipitated a rapid development in the delivery of abortion care that was not anticipated at the time of abortion law reform only 18 months earlier. We outline the work undertaken to maintain access to abortion care in early pregnancy through the lens of a single community‐level provider and explore what these developments may mean for abortion law, policy, and service delivery.