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Women's Health

A Call for Universal Access to Safe, Legal Abortion

Women march against the Dominican Republic's anti-abortion law in 2009. Credit: Elizabeth Eames Roebling/IPS

WASHINGTON, Mar 26 2014 (IPS) - Lawmakers and civil society leaders from over 30 countries are calling for universal access to safe, legal abortion.

The declaration, released in Washington on Wednesday, comes in the context of a 20-year review by the United Nations of the 1994 International Conference on Population and Development (ICPD) in Cairo. That landmark conference called for safe access to abortions in countries where the procedure was legal, while Wednesday’s declaration calls for the decriminalisation of abortion in all countries.

“What we know now is that law changes social attitudes.” -- Nepali MP Arzu Rana Deuba

The declaration also anticipates the post-2015 development agenda. Advocates are calling to expand the discussion on women’s health to include abortion rights when determining the next round of global development goals, following the expiration of the Millenium Development Goals (MDGs).

“True gender equality cannot be achieved without access to safe, legal abortion,” it says. “In the last two decades, roughly 1 million women and girls have died and more than 100 million have suffered injuries – many of them lifelong – due to complications from unsafe abortion.”

One of the MDGs, number five, does aim to reduce by three-quarters the maternal mortality ratio and to achieve universal access to reproductive health. However, it does not include access to safe abortions in its definition of access to reproductive health.

Advocates are now planning to formally offer these recommendations at a 20-year anniversary summit of the original ICPD. That event will take place in Addis Ababa next month.

“Looking ahead to ICPD+20 and the review of the Millennium Development Goals, the one goal they would not take was reproductive and sexual health for all,” Nafis Sadik, the special advisor to the executive director of UNAIDS and the former executive director of the United Nations Population Fund, told IPS.

The new declaration targets not just the international development agenda but also U.S. policymakers.

Four-decade-old legislation here has restricted foreign assistance programmes from funding abortion-related procedures. Critics say the result is a disconnect between the work done by USAID, the country’s main foreign assistance arm, and the women’s health services offered.

“Regarding the problem of U.S. policy – it’s not just the financial support, but the moral leadership,” Sadik says. “It makes a big difference if the U.S. becomes restrictive in areas of support, if they restrict funding for any NGO that provides abortion.”

Cost-effective and feasible

The Airlie Declaration was composed following a two-day conference near Washington. It was written by representatives from over 30 countries, including health ministers, members of parliament, and medical leaders as well as advocates from the United Nations lawmakers and civil society.

“Our goal is to bring this message forward and build a broader coalition,” Elizabeth Maguire, the president of Ipas, an international NGO dedicated to ending preventable deaths and disabilities from unsafe abortions, told IPS. “Every participant is committed to pursuing action.”

Maguire led the recent conference as convenor.

One such participant is John Paul Bagala, president of the Federation of African Medical Students’ Associations. Bagala works in a hospital in northern Uganda that treated 480 women from cases of unsafe abortions in 2011-12 and another 500 in 2012-13.

According to Bagala, providing access to safe abortion is cost-effective. Treating injuries resulting from an illegal abortion in Uganda can cost more than 100 dollars, he says, while the cost of a safe abortion would be less than 10 dollars.

“As a medical student in Africa, we are taking a stand to disseminate the declaration in our respective institutions,” Bagala told IPS.

“To drive [out] stigma from our health workers when they are still in the training system, to ensure that the women, when they come for service, get the best service they need in terms of safety and quality. We are driving towards integrating the aspects of this declaration in terms of reproductive health rights into the curriculum of training health workers in Africa.”

Ipas’s Maguire likewise emphasises that providing universal access to reproductive health care is not just critical but “feasible.” In the case of Nepal, for instance, decriminalising abortion greatly increased women’s health and maternal mortality ratio.

“Nepal is one of the few countries that will be meeting MDG 5, and what the experts say is that it’s increased access to family planning, emergency obstetric care, and increased access to emergency abortion care,” Arzu Rana Deuba, a member of the Nepali Parliament, told IPS.

Deuba recounted the story of a young girl in Nepal who was jailed for 12 years after she was raped and unsuccessfully attempted an illegal abortion. The girl’s story gained international attention, and Nepal eventually decriminalised abortion in 2002.

“It’s a story of hope,” said Deuba. “After 2004, we had 1,500 skilled providers and 75 hospitals doing medical abortion services. As of 2014, 500,000 women have access to safe abortions, and that’s quite a lot for we are not a big country.”

She says Nepal’s success comes not just in the growth of medical services but in the country’s changing cultural attitudes toward abortion.

“What we know now is that law changes social attitudes,” Deuba said.

“I work at the community level and workers tell me there is no more stigma, that abortion is seen as part of women’s rights, that women are more vocal about abortion … it’s seen as part of the continuum of care. Now women don’t have to die anymore and there is a feeling of confidence and security among women.”

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  • Dwain

    A bunch of murderers!! If abortion is OK then what is the difference if I kill someone I do not want around??Both are murder!! With the birth control available today it is their own fault if they get pregnant and am sick of women using abortion for birth control!!

  • Janet

    Thank you for finally addressing the issue of ensuring women’s rights, not only in the developing world, but also in the U.S. This is truly a global fight to decrease maternal mortality and to improve women and children’s health. With one hand, the U.S. government empowers USAID to implement family planning and MCH programs across the developing world. With the other hand, U.S. domestic policy enables more and more states to pass restrictive abortion laws and to limit access to family planning services and birth control. All women have the right to govern their own health. It is necessary not just for women, but for all of society. The numbers of women dying and suffering do not lie. Statistical evidence demonstrates countries that ensure access to safe abortions actually have LESS incidents of abortions. I am pro the life of women.

  • Vestias

    Thank You Lawmakers and civil society liberty the right legal abortion womens

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