Women’s right to safe abortion: interview for London School of Hygiene & Tropical Medicine Online Course

Improving the Health of Women, Children and Adolescents: from Evidence to Action is a free online course of the London School of Hygiene & Tropical Medicine. I was interviewed on the subject of abortion for one of the sessions; this is what I said below. The course first ran in autumn 2015 and is due to be run again from 29 February – 8 April 2016. Find out more at: http://www.lshtm.ac.uk/study/freeonlinecourses/women-children-health/#sthash.tI7kCuOn.dpuf

1. Please introduce yourself

>>My name is Marge Berer. Since May 2015 I have been the Coordinator of the International Campaign for Women’s Right to Safe Abortion (www.safeabortionwomensright.org), which is a network of over 960 groups and individuals in 100 countries who are working for the right to safe abortion. From 1992 to 2015, I was the editor of the journal Reproductive Health Matters, which I founded with TK Sundari Ravindran. The International Campaign is important because abortion is still restricted by the criminal law in almost every country in the world, including countries where it is widely available, yet approximately one in five to one in three women globally will have an abortion in her lifetime. It is also important because the practice is under constant attack from a small but powerful minority of right-wing and conservative groups who believe women should be forced to carry every pregnancy to term whether they can cope with all the children that would result from this or not. We believe that universal access to safe abortion at a woman’s request is essential for women’s health and a necessary aspect of women’s right of autonomy over their bodies and lives.

2. Can you explain the human rights dilemma that affects access to safe abortion?

>> As a human rights issue, access to safe abortion is inextricably linked to the first principle of human rights, that is, the right to life. An estimated one million women have died from the complications of unsafe abortion in the past 20 years, and almost all their deaths would have been prevented had abortion been safe and legal in their countries. The anti-abortion movement claims that the right to life begins at conception. If this were accepted in human rights principles it would subsume a woman’s right to life to that of any pregnancy she was carrying, making her into a vessel, and would mean that no abortion would be permissible. In fact, every human rights body, from CEDAW to the Committee that interprets the Convention on the Rights of the Child, agrees that rights in general, including the right to life, begin at birth

3. What are some examples where the rights of the woman are violated?

>> There are unfortunately many examples of the ways in which the rights of women are violated, and one of them is when abortion is illegal. For example, let’s take 3 cases that were determined by Catholic health policy.

The first is the case of a woman who was 17 weeks pregnant, and began to miscarry. The miscarriage was inevitable, and the baby could not have survived no matter what was done because it was too early in the pregnancy. Because her cervix was open, the woman was highly susceptible to infection even though she was in hospital, and in fact she did develop a life-threatening uterine infection. Yet the hospital failed to provide the only treatment that would have saved her life before the infection became uncontrollable, that is, an abortion, because they waited until there was no longer a fetal heartbeat, even though the fetus was not viable. She was a young healthy woman and she died completely unnecessarily.

The second case is of another young woman who was an asylum seeker. She fled the conflict situation in her country of origin, where rape was being used as a weapon of war. She had been raped herself. After she arrived in the country that gave her asylum, she discovered she was pregnant as a result of the rape. She was unable to obtain a visa to travel for an abortion. She became suicidal and although the threat of suicide should have meant she had a legal right to an abortion, it was refused. Instead, she was locked up in a hospital, supposedly for her own protection, until her pregnancy was far enough advanced that the baby could survive independently and then she was forced to have a caesarean section.

Both these cases come from Ireland. Something similar happened to a ten-year-old child in Paraguay this year who had been sexually abused by her stepfather for two years. She too was locked up in a hospital and subjected to a caesarean section to save the baby, instead of an abortion.

These cases are horrific; they represent the worst sort of misogynistic treatment of girls and women. But there are thousands of cases every day in many countries, especially in the global South, where safe abortions are not available. Some 42 million women have an abortion every year. Half of those abortions are unsafe in the following ways:

Illegal or legally restricted
Dangerous method
Untrained/unskilled provider
Unsafe conditions
Self-induced without help or information
Incorrect usage of abortion pills through lack of information
Little or no access to treatment for complications
Stigma, fear and isolation
Violence, rejection (by family, school, work) and murder, both of women and of doctors providing abortion care
Threat of arrest, and prosecution and imprisonment.

Here is what a young girl who was put in prison in Rwanda at the age of 17 for having an abortion said:

“I am 20 years old and… have been in Karubanda prison since 2007 for committing abortion. I am the 3rd born in the family and the only girl. I was raised by my dad after my mum died when I was still young. I was in the 5th year of my secondary education when a teacher at my school started dating me. I needed school materials and since I could not afford them, I allowed to have sexual intercourse with this teacher at that tender age. With limited knowledge on contraceptive use, I got pregnant and had to drop out of school since it’s against school regulations. I decided to have an abortion and my elder brother out of fear reported me to the police. I am supposed to serve a period of 9 years of which I have so far completed 3 years.” Crying she says: “I have lost hope and this is the end of my life”. (Abortion and young people in Rwanda: a collection of personal stories about abortion. Family Planning Association of Rwanda (ARBEF), ARBEF Youth Action Movement Rwanda, Rutgers WPF

This young girl’s story is why I am devoting my time to campaigning for women’s right to safe abortion, along with thousands of others all over the world.

4. Do you see the situation changing? Are more women around the world being given the right to safe abortion?

>> The situation is improving in many ways in many places. Countries are reforming their abortion laws, for example, just this year Mozambique completed a change for the better in its law, and in Chile, Morocco and Malawi positive law reform is being proposed. At the same time, women who do not have access to safe abortion services are learning from other women through safe abortion information hotlines and from courageous health professionals in their countries about how to have a safe abortion with medical abortion pills on their own. They are accessing the pills from pharmacies and from trustworthy providers through the internet, and taking control of their lives in spite of the laws against abortion. This is not an ideal situation but deaths from unsafe abortion have been decreasing rapidly because of it and that can only be a good thing.

Let me close by saying that one in three women is a lot of women who will need an abortion in their lifetimes. It was me once, and it could be many of you who are listening today, or your partners. Safe sex is sex in which you and your partner protect yourselves and each other from unintended and unwanted pregnancy and from sexually transmitted infections. Protection can fail, however, and sometimes people fail to use it. We need our health systems to be there before and after to help us ‒ with contraception, condoms, emergency contraception, safe abortion, and treatment for HIV and other sexually transmitted infections. Each of these is part of a larger package of essential sexual and reproductive health care. I invite you to study how well your countries are doing in offering these services and get involved today to make the situation better for everyone, especially for young women, and also for yourself ‒ in case you may need it.