These two distant lands are united in their desire to intimidate and harass women who have had abortions.
In Mato Grosso de Sul, a police raid of a clinic suspected of providing abortions resulted in the interrogation of nearly 10,000 women, whose records were found there, on suspicion of having abortions in 1999-2001. At this time, 36 women have been prosecuted; an additional 2,215 records have yet to be fully reviewed, but it is anticipated that approximately 1,000 women will ultimately be prosecuted and convicted. The official penalty for a woman who has willingly induced an abortion in Brazil is up to one to three years in prison. But the punishment meted out to the 36 women by the judge that ordered the investigation is community service at a local orphanage - just the kind of humiliation that should serve to shame them further.
This might seem unsurprising in a country where abortion is highly restricted, but a similar case has taken place in our own country. In Kansas, Women's Health Care Services, where Dr. George Tiller is a late term abortion provider, was ordered to turn over clinic records of about 2,000 women to police to determine if an illegal abortion procedure had occurred. Despite the considerable efforts of Kansans for Life and the invoking of a 19th century law, the clinic was able to block the subpoena and the grand jury refused to indict Dr. Tiller.
There is a key difference in the two situations: In Brazil, abortion is a criminal offense and is only permitted in cases of rape or to save the life of a woman whereas in the United States abortion is legal, though states have imposed restrictions. The criminalization of this very common procedure (1.3 million abortions take place in Brazil), results in the hospitalization of 250,000 Brazilian women with complications from unsafe abortion every year. In the United States the incidence of abortion is almost the same (in 2005, there were 1.2 million abortions in the United States), but complications and hospitalizations are extremely rare, largely because abortion is legal. But if opponents of women's rights have their way, how much longer will American women stay safe?
The harassment of abortion providers and the seizure of clinic records is simply another tactic to punish women for exercising their right to choose when and whether to be pregnant. Anyone who helps them on this path will be harassed and exposed.
It's clear from both of these cases that opponents of abortion are not simply concerned with a few restrictions here and there. They want to be sure that women and doctors alike are hauled into the public square and condemned openly for ensuring that women have control over their reproductive destinies. But research in Brazil, and elsewhere, shows that legal restrictions will not keep women from ending unwanted pregnancies. They will risk their lives to do it if safe, legal, respectful, high-quality care is not available. We know this. We also know that the easiest way to prevent deaths and injuries is to ensure that this care is available.
In Brazil, Ipas has created a campaign to get Brazilians thinking about the consequences of criminalized abortion, called "Think about it" ("Vai pensando aí," in Portuguese).
Perhaps we need to start a similar campaign in the United States. After all, what would the consequences for women be if those who drove the campaign to "out" women in the courts in Kansas were successful around the country? What if women knew that their doctor might be forced to hand over their private medical records to the courts for inspection, second guessing their medical judgment? We already have a situation where an abortion procedure is the only medical procedure ever to be adjudicated by the Supreme Court.
Are we willing to imprison women and their providers for abortion? Think about it.
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That's right. We said it. Abortion. For two days, participants openly discussed strategies for increasing access to safe abortion care for women everywhere. Not just in Europe or North America, but for all women no matter where they live or what their economic status.
Participants at the Global Safe Abortion Conference noted that there was an energy in the meeting that came from being free to be open about such a difficult topic. Presentations and discussions addressed access to safe abortion through the lenses of public health, human rights, gender equity and cost-effectiveness. Attendees examined strategies for promoting reform of restrictive laws, policies and practices concerning abortion, the promise of medical-abortion technologies, and ways to make safe abortion services, along with contraceptive counseling and methods to help couples prevent unwanted pregnancies, more widely accessible regardless of legal context.
Such a wide-ranging and open discussion about abortion is long overdue. Each year unsafe abortion claims 66,500 lives and injures 5 million more women and girls. Nearly all of these deaths occur in developing countries. New data from the World Health Organization (WHO) and the Guttmacher Institute show that while the number of abortions performed globally has fallen slightly in recent years, the number of unsafe abortions has actually increased slightly. In Africa--where restrictive laws from the colonial period are still on the books and women's access to contraception is most limited--the number of deaths from unsafe abortion rose significantly from 29,800 in 2000 to 36,000 in 2003.
Reproductive health advocates often find themselves on the defensive when it comes to abortion. Anti-abortion extremists, like those who protested the agenda at the Women Deliver conference last week, hysterically call "reproductive health," "family planning," or even (perversely) "safe motherhood" as euphemisms for "abortion on demand." They reinforce the sense of stigma that women often feel about abortion--whether she is a woman who feels she must end a pregnancy, or a healthcare expert trying to make the best services available.
Abortion is a common experience among women from all countries and at all income levels. In fact, the new research from Guttmacher shows that on average, during the course of a reproductive lifetime, there is nearly one abortion for every woman if current rates prevail. But whether or not an abortion is safe may depend on a woman's income; in high-income countries, almost all women who face unwanted pregnancies can obtain safe abortions one way or another, especially if they have money.
But poor women everywhere, and especially in low-income countries in Africa, Asia and Latin America, face multiple barriers to safe abortion care. Where abortion is legally restricted or inaccessible, or unaffordable where it is legally permitted, women instead resort to dangerous procedures, including trying to self-induce abortion and turning to untrained providers to end unwanted or unhealthy pregnancies.
Nearly 500 conference attendees signed a Global Call to Action for Women's Access to Safe Abortion, which, among other points, urged government authorities and donors to commit additional resources to make comprehensive sexual and reproductive health care - including safe abortion care - widely available.
The Global Safe Abortion Conference is just one step, but it has to be the first of many in an effort to ensure that ALL women, not just wealthy women, have access to this care.
]]>It's all politics and moralizing all the time.
The fact is that thousands of American women died before Roe. The fact is that thousands of women continue to die in the world today because access to safe abortion services is not available to them. And the fact is that countries have recognized this and are moving to reduce restrictions on abortions: since 1995, 16 countries in the last decade have reduced restrictions to abortion, countries that range from Colombia to Portugal to Ethiopia. Only six countries have gone the other way to increase restrictions, including the United States... right there with Nicaragua and El Salvador. Is this the company we wish to keep?
In Colombia, where it is estimated that 400,000 illegal abortions are performed every year, many under unsafe conditions, the Constitutional Court ruled that abortions will be permitted in cases of rape, fetal malformation, or when the life or health of the mother or fetus is in danger. Colombia has taken a step towards ensuring that women's lives are saved. In Portugal, where an estimated 15,000 women and girls seek unsafe abortions each year and some die from these procedures, the majority of voters in a national referendum cast ballots to broaden the circumstances in which abortion is permitted. In Ethiopia, where deaths and disabilities due to unsafe abortion are a public health crisis, the government dramatically broadened its law in an effort to save women's lives.
Not only does the U.S. Supreme Court's decision go against the global trend of lifting restrictions on abortion, it also runs counter to the direction taken in international law. Under the 1985 Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), governments are required to refrain from banning medical procedures only needed by women. The Inter-American Commission on Human Rights, the primary body that monitors human rights in the Americas, declared abortion a human rights issue in the case of Paulina, a 13-year old Mexican girl who was denied a legal abortion by the public health system after she was raped. In the case of KL v Peru in 2005, the U.N. Human Rights Committee ruled that the rights of a 17-year old Peruvian girl had been violated when health officials denied her a therapeutic abortion although her fetus carried a fatal abnormality. And only a few weeks ago, the European Court of Human Rights awarded damages to a 36-year old Polish woman; it called on Poland to establish clear guidelines to ensure access to legal abortion when pregnancy threatens a woman's health.
Activists for sexual and reproductive rights have often said that with policies like the global gag rule, the anti-prostitution oath and set-asides for abstinence-only AIDS education, the United States is out of step with the rest of the world. This ruling shows that the United States is not just out of step with the rest of the world on abortion; it is behind the rest of the world. By saying so clearly that American women's health and lives are not a priority, the Supreme Court sends a message to the rest of the world that America does not value its women. What, then, could the message be for the rest of the world's women?
]]>Anu Kumar is Executive Vice President for Ipas.
Last week, Andrea wrote an excellent post that pointed to the vulnerability of poor populations-particularly women-when natural disasters force them out of their homes. She reminded us not only to about the limp response of the international community that had just reached into their pockets for victims of the Asian tsunami and Hurricane Katrina. She also noted the hole in disaster relief: when communities around the world donate housing and supplies to the displaced, these "care packages" generally do not include reproductive health supplies.
I was particularly pleased to see this post because Ipas has just released the second issue of A-the abortion magazine, and our focus for this issue is reproductive health for refugees and displaced women.
]]>Anu Kumar is Executive Vice President for Ipas.
Last week, Andrea wrote an excellent post that pointed to the vulnerability of poor populations-particularly women-when natural disasters force them out of their homes. She reminded us not only to about the limp response of the international community that had just reached into their pockets for victims of the Asian tsunami and Hurricane Katrina. She also noted the hole in disaster relief: when communities around the world donate housing and supplies to the displaced, these "care packages" generally do not include reproductive health supplies.
I was particularly pleased to see this post because Ipas has just released the second issue of A ... the abortion magazine, and our focus for this issue is reproductive health for refugees and displaced women. There are currently as many as 33 million refugees and internally displaced people around the world, 80 percent of whom are women and children. Within this group, 20 to 25 percent of the women of childbearing age (aged 15-45) are pregnant at any given time, and at least 15 percent will suffer complications from pregnancy and childbirth. The U.N. Population Fund estimates that 25-50 percent of all maternal deaths in these situations are the result of unsafe abortion.
In addition to the need for food, shelter and clean water, reproductive health services are crucial to women's survival in a crisis setting. Women in these conditions are at great risk for obstetric complications, sexual assault and sexually transmitted infections, as well as unsafe abortion. In spite of this long list of dangers, it was not until 1994 that reproductive health was explicitly included in the basic health package used by many relief agencies.
In this issue of A, Ipas examines the similar challenges women face around the world, whether in Guatemala, Darfur or on the Gulf Coast: lack of access to health services; lack of personal security; health problems caused by flight; and lack of social support networks.
Yes, even in the United States, women are not immune from these challenges. Ipas spoke with medical staff from Planned Parenthood of Houston and Southeast Texas (PPHSET), who worked to ensure health care services for women displaced by the storm in Louisiana. In addition to getting health care centers back up and running, they were also fielding calls from relief agencies that didn't know how to deliver basic reproductive health care.
"They called asking for information about birth control, Pap smears, even [labor and] delivery," said PPHSET Clinical Services Director Dyann Santos.
That's right: if you are pregnant and fleeing a disaster in this country, you may well be on your own.
Click here to read more about how PPHSET responded, and how relief agencies around the world are meeting (or not) women's needs.
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