All States Should Provide Safe and Legal Abortion and Contraception, Says UN

The UN has just issued a report on "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health", with particular reference to "criminal laws and other legal restrictions relating to sexual and reproductive health and the right to health" in the areas of "abortion; conduct during pregnancy; contraception and family planning; and the provision of sexual and reproductive education and information".

The report concludes that "Realization of the right to health requires the removal of barriers that interfere with individual decision-making on health-related issues and with access to health services, education and information, in particular on health conditions that only affect women and girls."

Removing laws that criminalize abortion and various types of contraception could allow women access to safe sexual and reproductive healthcare and reduce the use of back street abortion clinics, which threaten the health and lives of women who use them. I say 'could' because it is doubtful if most women in low income countries, where use of such clinics is thought to be highest, have access to safe healthcare of any kind. But if abortion is no longer a criminal offense, the clinics should become less viable.

The need, or perceived need, for an abortion arises from sexual behavior involving males and females. Yet it is the subsequent behavior of the woman that is penalized. Denying women the right to make reproduction-related decisions and failing to provide the requisite health services is discriminatory. As the UN report says, the woman can suffer if she abides by the laws and be punished by law if she does not.

Unsafe abortions are estimated "to account for nearly 13 per cent of all maternal deaths globally." They also cause serious injuries to around 5 million women every year. The majority of these injuries and deaths occur in poor countries. In Tanzania, abortion complications are in the to 10 reasons for admission in many regions.

It's heartening to hear a UN agency calling for safe healthcare provision of any kind, not just for sexual and reproductive health. The report includes a call for creating all the conditions, trained personnel, equipment and supplies, etc, that will enable the provision of safe healthcare to those requiring abortion, contraception and other information and services.

The report cites evidence showing that access to family planning can reduce maternal deaths by between 25 and 40% and also reduces the number of unsafe abortions. They even cite the 98% effectiveness of condoms in preventing pregnancy, when used correctly and consistently. This is a figure most of the HIV industry avoid in order to stay in favor with donor country leaders, who need to at least appear to conform to whatever moral orthodoxy keeps them in the driving seat.

This report places welcome emphasis on the provision of accessible and safe health services. It also emphasizes the importance of access to information, the education to act on the information and the autonomy to make informed choices. Removal of criminal laws and legal restrictions is only the first step. I wonder if UNAIDS will read the report.