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Worldwide there are approximately 80 million unwanted pregnancies each year. Half of those pregnancies end in abortion, and half of those abortions, an estimated 20 million, are unsafe abortions. These unsafe abortions result in nearly 70,000 maternal deaths each year, and tens of thousands of additional complications and injuries.1

In many cases, even where abortion is legal, there are barriers to safe abortion care, such as a shortage of skilled health care providers, a shortage of equipment or medications, the cost of paying for abortion, lack of information, distance to health centers, or stigma around seeking abortion. In developing countries receiving US Foreign assistance, these barriers, particularly shortages in supplies and training, have been exacerbated in the past by the Global Gag Rule and continue to be exacerbated by the Helms Amendment. Read more about these two detrimental pieces of legislation in my previous blog posts about the Global Gag Rule, here, and about the Helms Amendment, here, to find out what you can do about it.

However, in countries where abortion is still illegal, the situation for women is even more dire. Read the rest of this entry »

Yesterday I wrote about the Global Gag Rule and its effects on abortion rights and services around the world. What I didn’t write about was the Helms Amendment,  which has been in effect since 1973 – it followed right on the heels of Roe v. Wade as a conservative backlash to the legalization of abortion in the US.  The Helms Amendment prohibits the use of US foreign assistance funds to pay for “abortion as a method of family planning, or to motivate or coerce any person to practice abortion.” Although this amendment is slightly less far-reaching than the Gag Rule, it also has a huge detrimental effect on the availability of safe abortion services to women around the world. Currently, approximately 67,000 women worldwide die each year as a result of unsafe abortions, and millions more are seriously injured. Check out this article by IPAS to get a better idea of how the Helms Amendment violates human rights and inhibits other nations’ efforts to provide abortion services in their own countries.

The Helms Amendment is the Foreign Policy equivalent of the Hyde Amendment,  a domestic policy which prohibits federal funding from being used to pay for abortion. Read the rest of this entry »

Here in the US, abortion has been a contentious issue for decades. Clinics where abortion services are provided often have protesters in front showing gruesome and inaccurate pictures of aborted fetuses.  Pro-choice activists are sometimes labeled as murderers; once, when I mentioned that I was working at Planned Parenthood, I was told by a med student that she was studying to “be able to save babies, not kill them.” And yet here in the United States women do have the right to choose when and if to have children, and whether pregnancy is right for us. Of course, preventative contraception methods are always preferable, but accidents happen. What sexually active girl hasn’t had a pregnancy scare at some point?  Birth control is not a guarantee. Abstinence only campaigns have been proven over and over again to be ineffective – sexuality is a part of our humanity. As American women, we are privileged to have access to that basic human right, the right to have control over our own bodies.

In many developing countries, that is not the case, and this is hugely affected by U.S. international policies. The Mexico City Policy, better known as the Global Gag Rule, prohibited any organization abroad that receives federal US funding from performing abortions, or even counseling or referring patients for abortion. This is even if the organization was doing so using outside funding.  Or, as laid out by USAID on its website:

“The Mexico City Policy required foreign nongovernmental organizations to certify that they will not perform or   actively promote abortion as a method of family planning using funds generated from any source as a condition for receiving USAID family planning assistance.”

This means that a US policy can determine what an individual doctor, who works for a US funded organization, can say to his or her individual patient halfway around the world. Read the rest of this entry »

abortion-lawsIf you want to decrease the number of women who seek induced abortions each year, then you should promote the decriminalization of abortion laws in countries where the procedure is illegal and encourage increased access to comprehensive contraceptive choices. Abortion is a highly controversial subject and I am not here to make an argument either way about how the issue relates to religion, when life begins or the other common morality debates that arise when the topic is discussed. Instead, I’ll just present a few facts and what those facts mean to me.

Just because abortion is illegal in a country doesn’t mean that abortions are not performed there. While some may find this paradoxical abortion rates are similar, if not higher, in countries where the procedure is illegal. For example, abortion is prohibited almost entirely in the majority of countries in South America, yet the average abortion rate is 31 per 1000 women on the continent, and only 21 per 1000 in North America (excluding Mexico). Countries like Peru and Uganda – where abortion is prohibited – have abortion rates six times those of Germany and the Netherlands, where abortion is legal and readily accessible.

The medical risk of an abortion varies greatly between regions where the procedure is legal and where it is illegal. Guttmacher Institute estimates that each year 67,000 women die and five million women are hospitalized due to complications of unsafe abortions. On the other hand, the risk of dying from a safe and early abortion is actually significantly less than the chance of dying from pregnancy and childbirth.

Prohibiting access to proper medical care and services is a violation of inherent human rights. Women will seek out abortions whether the law allows them to or not, and when they do society must protect those women by allowing them to obtain safe procedures.

The key to preventing abortions is reducing the number of unwanted pregnancies and giving people contraceptive choices so that they can limit or space pregnancies. The general rule is, as you increase access to contraceptives, abortion rates go down. After the fall of the Soviet Union, former Soviet Union countries were able to obtain a wide range of contraceptive options that were not available before. As a result, the abortion rates in Eastern Europe have decreased by half since 1995.

I think both sides of the abortion argument can agree that the goal should be to reduce the total number of abortions performed each year. We need to make sure that the means to this end protect the lives and health of women and girls everywhere.

Now that some of the excitement has died down after Barack Obama was elected president last Tuesday, much attention has turned to what he will actually do once he gets into office. Amid all the news about his transition team, and those he is planning to surround himself with, an important piece of news came out this week that is getting the global health community REALLY excited: President-elect Barack Obama is expected to make an executive order to remove the “Global Gag Rule” which essentially prevents any family planning organization abroad to receive US funds if they do anything relating to abortion, which includes even mentioning abortion, providing post-abortion services or counseling, or performing abortions, even in places where they are legal. This policy, also know as the “Mexico City Policy” has come and gone numerous times now. It was created under Reagan, but repealed by Clinton when he took office in 1993, then reinstated when Bush came into the White House in 2000, and hopefully will be removed once and for all this January as soon as President Obama is officially inaugurated.

This is a huge step in the right direction for Barack Obama and brings to mind words like HOPE and CHANGE (pardon their overuse- I think it’s justified in this case) when thinking about all the possibilities in store for the next four years not only in the global health realm, but also in development, aid, and foreign policy realms. Let us hope that with a new administration will also come many new policies to benefit not only Americans and the United States as a country (yes, we do need it), but also the rest of the world.

Check out this article from the Washington Post, which outlines some of the other goodies in store starting January 20th, 2009. Until then, let’s hope Obama continues to make plans for what the next four to eight years will look like.

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