By Liz Yarrow and Kara Apland, Coram Children's Legal Centre's International Team
Access to sexual and reproductive health is crucial for the fulfilment of women and girls' most basic rights, from the right to health and education, to the right to be protected from violence and abuse.
Yet there is no country where women possess the unequivocal right to make choices in relation to their own reproductive and sexual health. In fact, female sexuality and reproduction is a matter that is heavily controlled, regulated, restricted - even criminalised - in law in every state around the world.
In the UK we often assume that such restrictions do not apply to us. We think of our legal framework as relatively progressive: made up of laws which protect the sexual and reproductive rights of women and girls and promote their empowerment. Abortion is legal in the UK, we have free and relatively access to a range of different forms of birth control, and most of us receive sexual and reproductive health education in school - we may say. We might juxtapose ourselves to places like the US where women's access to sexual and reproductive health is deeply politicised; where legal battles around public funding for services are constantly waged, and voters choose which candidate to support according to their position on abortion.
We - the authors - work with a team of researchers from Coram International and have recently conducted several studies on how law regulates young people's sexual and reproductive health, in partnership with the International Planned Parenthood Federation and the UN Population Fund. Our research took us to 10 jurisdictions across the world, including England, Wales and Northern Ireland. We found that laws governing women and girls' sexual and reproductive rights share a number of restrictive characteristics across both the developed and developing world and in countries with diverse cultural and religious traditions. In short, we found that the law does impact on women's reproductive freedom and health, often with devastating effects.
The most extreme example of this can be found in El Salvador - a case study country in our research - where there is an absolute legal prohibition on abortion: even if abortion is necessary to save the life of the mother, and/ or if the foetus is not viable. In several cases, women have been prosecuted after suffering miscarriage; accused of 'murder' and sentenced to lengthy jail terms. The prosecution of miscarriage has been termed a 'by product' of the law criminalising abortion; yet it is arguably the direct consequence of a law which does not recognise women and girls as humans with inalienable rights over their own bodies and health, but treats women and girls as vessels for protecting and preserving foetuses, and criminalises women and girls who fail in this duty assigned to them in law.
El Salvador may seem like an exceptional case, yet in every state in the world abortion is legally restricted and depends either on the question of whether the pregnancy was 'deserved' (was the woman to blame for getting pregnant?), or on a balance, which negotiates the legal rights to life and health of a woman against dominant social and religious norms.
In many states, such as Senegal, abortion may only be allowed if a woman's life is at risk. Other states, such as Indonesia, permit abortion when a pregnancy results from rape. India has a particularly telling provision: legalising abortion in the first 12 weeks of pregnancy for women who are married and on birth control. The law passes judgment on the actions and decision making of the woman concerned - was she taking precautionary measure to prevent pregnancy? Was she behaving in a morally responsible way, or was she having sex outside of marriage?
In England and Wales it is often assumed that abortion is legal and available to women 'on demand'. In fact, the law- introduces contingencies. For a woman to access an abortion two doctors must agree that a continuation of the pregnancy would be a greater risk to her physical and mental health - or (interestingly) to that of her children - than a termination, and termination must occur within the first 24 weeks of gestation.
In practice the law on abortion in the UK is flexibly and liberally applied, but we cannot take access to sexual and reproductive health services for granted. The recent debate regarding legislation to make SRE mandatory in schools demonstrates that legal protection for sexual and reproductive rights remains a politically contested space and that legal protections are far from guaranteed.
Reports for our latest study, conducted in partnership with the International Planned Parenthood Federation and the United Nations Population Fund in India, Sri Lanka and Indonesia, will be published later this year.
Further information about the international work of Coram Children's Legal Centre can be found herehttwww.childrenslegalcentre.com/index.php?page=international_programmes