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Access to safe abortion is a woman's right
International Women's Health Coalition (IWHC)
February 04, 2008
http://iwhc.org/resources/safeabortion.cfm
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Safe abortion—the
termination of a pregnancy by trained health care providers using
correct, sanitary technique and proper equipment—is a simple,
lifesaving health service. Nonetheless, of the 42 million induced
abortions each year, an estimated 20 million are unsafe and 97%
of those occur in developing countries. Every year, nearly 70,000
women die unnecessarily from the complications of unsafe abortions,
and countless more suffer infections, infertility, and debilitating
injuries.
Abortion is
legal in almost all countries to save a woman's life, and approximately
30% of the world's women may seek abortions either to preserve their
physical or mental health or for socioeconomic reasons. Too often,
though, safe abortion services are not provided by public health
systems, are of poor quality, or are not accessible. This is true
even where abortion laws are liberal as in India. Evidence from
countries including the United States, Romania, and South Africa
demonstrates that abortion-related deaths and injuries can be virtually
eliminated with appropriate laws, policies, and services.
It is
a woman's right to determine whether to carry a pregnancy to term
A woman's ability to exercise her rights to control her body, to
self-determination, and to health depends, in part, on her right
to determine whether to carry a pregnancy to term.
Legal
restrictions do not reduce abortions
Women and girls who face punishment for having an abortion are not
less likely to attempt abortion—they are less likely to have
access to safe services. When abortion is restricted by law, trained
providers may be reluctant to perform abortions, even when legally
permissible, because they do not know the law, fear censure from
the community, or hold personal beliefs against abortion. This can
force women to seek unsafe abortions.
Funding
limitations jeopardize access
Restrictions
on foreign assistance that limit the availability of safe abortions,
such as the U.S. Global Gag Rule, have forced family planning clinics
to cut back their services, and in some instances, close.
Preventing
unwanted pregnancies reduces abortion
Reduction in the incidence of induced abortion is directly related
to contraceptive availability. Recent data from countries of the
former Soviet Union, for example, show that when contraception is
widely available, the incidence of unintended pregnancy and abortion
both decrease dramatically. In the developing world, more than 200
million women have an unmet need for contraceptives, including emergency
contraception.
Availablity
and accessibility are essential
Access
to good quality contraceptive services is essential but not sufficient.
Safe abortion services will always be necessary because contraceptives
are not universally available or affordable and are not always used
consistently to prevent pregnancy.
Abortion
should be part of a comprehensive approach
Safe
abortion care is part of comprehensive reproductive health services,
which should be accessible to and affordable for all women, married
or not. These services should also include:
- family planning
counseling and contraceptive supplies, including female and male
condoms
- antenatal,
delivery, and postpartum care
- access to
safe abortion services
- counseling
and care after all abortions, safe or unsafe, as well as miscarriages
- prevention,
care, and treatment for sexually transmitted infections (STIs),
including HIV-prevention methods such as microbicides when they
become available
- programs
that prevent violence against women and provide care and support.
Often, women
and girls cannot exercise their rights to make sexual and reproductive
health decisions. Comprehensive sexuality education for girls and
boys promotes the rights of women to determine when and if they
want to have children and their overall sexual health. Upholding
women's rights also requires that women's access to education, income
generation, and general health care is assured.
Sustained
and robust advocacy is crucial
- Reform laws
and policies - support is needed for the many advocates working
at local, national, and international levels to rescind or liberalize
restrictive laws and to implement and protect laws that enable
women to decide whether or not to end a pregnancy and to have
access to safe abortion services.
- Document
the consequences of limiting access to safe abortion. Research
undergirds policy changes that expand access to safe abortion
services and protect women's rights, health, and lives.
- Train and
equip health care providers. Governments, non-governmental organizations,
and women's health and rights advocates can educate and encourage
health care providers to perform abortions to the fullest extent
permissible under current law, retrain them when laws change or
new techniques become available, and support their care of women
who have unsafe abortions. In areas where there are few doctors,
mid-level health care providers can be trained to perform safe
abortions and refer women to higher levels of care when needed.
- Subsidize
services for poor women. Unsafe abortion rates are highest among
poor women and young women. Governments and international donors
need to understand that investing in contraception and safe abortion
services for poor women costs significantly less than paying for
the complications of unsafe abortions.
Acknowledgements:
We are grateful to reviewers Akinrinola Bankole (Guttmacher Institute),
Marianne Mollmann (Human Rights Watch), Maria Jose Rosado-Nunes (Catholics
for the Right to Decide-Brazil), and Maria Isabel Plata (PROFAMILIA).
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