Can Obama Change the Lives of Women in East Timor?

Much faith has been invested in President Obama from women's groups, and Obama's repeal of the global gag is indeed a win for those who are pro-choice. However, we should not narrowly conceive what this momentous decision means for women's health and lives around the globe. It is not simply that foreign organizations who were previously prevented can now provide legal abortions and abortion advice. It is also about the hundreds of thousands of women around the globe who may no longer need to seek an unsafe abortion as a means of last resort, risking their health and lives to do so. 

The choice of Hillary Clinton as Secretary of State also raises hope about the benefits to the global south of President Obama's entire administration. According to the United Nations Population Fund, the $34 million funding cut for family planning under the Bush administration could have prevented 2 million unwanted pregnancies; nearly 800,000 induced abortions; 4,700 maternal deaths; nearly 60,000 cases of serious maternal illness; and over 77,000 infant and child deaths in one year, let alone in the seven years that the funds were blocked. Recognizing these harms, President Obama has resumed this funding. Clinton, reflecting on a statement she made at Beijing in 1995, added, "Rather than limiting women's ability to receive reproductive health services, we should be supporting programs that help women and their partners make decisions to ensure their health and the health of their families."

According to the World Health Organization, of the 45 million abortions that take place worldwide every year, 19 million are performed under unsafe conditions, causing at least 68,000 deaths. Several months ago I advocated that the right of a woman to survive pregnancy is a human right. The difference in the experiences of women in the global south and north are stark. In the Asia region alone, unsafe abortion contributes to 19 per cent of maternal deaths. A woman in the global south is at least 100 times more likely to die of an unsafe abortion than a woman in the global north, a statistic that will hopefully change over time as NGOs with the repeal of the global gag rule.  

Chares Darwin University's researcher, Dr Suzanne Belton, has recently completed the first study on unwanted pregnancy in East Timor: Maternal Mortality, Unplanned Pregnancy and Unsafe Abortion in Timor-Leste: A Situational Analysis. A research associate with CDU's Graduate School for Health Practice, Dr Belton's research shows maternal deaths in East Timor continued to be very high. The research, which was commissioned by UNFPA, shows that a startling forty per cent of all emergency obstetric care involves managing and treating complications from early pregnancy losses.  

A key problem in East Timor is the reluctance shown by doctors and midwives when it comes to speaking with women about induced abortions. Last November, the Ministry of Justice circulated the latest draft of the Timorese Penal Code, which would decriminalize abortion in certain cases, including for the physical or mental health of the mother. However, the current law remains complex and health professionals are often influenced by both the Timorese Government and Catholic Church who do not endorse abortion. 

At the start of the Obama administration, five former directors of USAID's Population and Reproductive Health Program came together in a report released in January 2009 on family planning funding, Making the Case for U.S. International Family Planning Assistance. The report calls on the Obama administration to act and restore the US' position as a leader in global family planning. The report also hopes to act as a wake-up call for other governments and donors to address the world's unmet need for family planning, advocating that it is not just a matter of reducing unintended pregnancies and saving millions of lives, but also of making progress toward anti-poverty and development goals.  

In fact, Australia, East Timor's near neighbor, has been said to follow the lead of the US on the issue of family planning, with Australia's funding contributions having drastically declined over the past 10 years. Funds for family planning in 2005 were around two-thirds of their 1996 level and in the 2006-2007 budget accounted for only 0.07 percent of total aid. With Australia's ban on using Australian aid funds for activities that involve abortion training or services still in place, the call has already been made for Australia's Prime Minister Kevin Rudd to follow President Obama's lead and increase funding for sexual and reproductive health in the region. Having promised "a fresh conversation on family planning" it seems that these first steps of the Obama Presidency will indeed positively impact the lives of women as far away as East Timor.