“When we empower women, we empower communities, nations and the entire human family” – Ban Ki-moon, former UN Secretary General
Today marks International Safe Abortion Day of action for access to safe and legal abortion. Access to safe, legal and compassionate abortion care saves the lives of girls and women. Yet, it is estimated that 25 million of all abortions are unsafe. Around 13% of maternal deaths can be attributed to unsafe abortion and 7 million women are admitted to hospitals as a result of unsafe abortions. More than half of all estimated unsafe abortions occur in Asia, although the risk of dying from an unsafe abortion is the highest in Africa.
Almost every death and disability from an unsafe abortion could be prevented through comprehensive relationship and sex education, access to high quality family planning, including effective contraception, and safe, legal, and timely abortion care. But in many countries across the world, girls and women meet barriers that make these crucial healthcare services non-existent or difficult to access. These barriers include restrictive laws, poor availability of these essential services, stigma, and conscientious objection of healthcare professionals.
In countries where abortion care is banned or allowed only to save a woman’s life or her physical health, only one in four abortions are safe. Meanwhile, in countries where abortion is legal on broader grounds, almost nine in 10 abortions are safe. Abortion rates are similar in countries where it is legal and countries where it is banned.
The Royal College of Obstetricians and Gynaecologists – a charity dedicated to the improvement of women’s health worldwide – is committed to improving access to abortion services and family planning. In 2015, the College launched Leading Safe Choices, a programme aimed at expanding contraceptive choice and improving access to safe abortion services in South Africa and Tanzania. It does this by strengthening the competence of, and raising the standing of family planning professionals.
More than 140 healthcare workers have been trained in abortion care and more than 1,000 in postpartum family planning and family planning counselling. As part of the two year implantation phase of Leading Safe Choices in Tanzania, more than 10,000 women received postpartum family planning.
Yet, despite such inspiring and important efforts, a major challenge blocking access to family planning programmes across the world, particularly in developing countries, has been the reinstatement of the Mexico City policy by the Trump administration in the United States. This policy, also known as the Global Gag Rule, blocks US federal funding for non-government organisations that offer or provide information about abortions. This has seriously damaged family planning programmes and increased the risk of unintended pregnancies and unsafe abortions. Reinstating the policy has affected 880million women in over 37 countries.
The Mexico City policy has particularly affected family planning in developing countries where abortion is often unsafe. It does not prevent abortions, but rather reduces access to high-quality contraceptive services and therefore increases the likelihood of abortion.
Improving access to comprehensive sexual and reproductive health care protects the health and wellbeing of girls and women, their families and society as a whole. Access to these basic health care services protects their basic human rights and dignity, and is critical to achieving the United Nations’ Sustainable Development Goal 5 of achieving gender equality and empowering all girls and women by 2030.
Eliminating unsafe abortion remains an urgent public health problem that must be addressed. Girls and women across the world should have timely access to safe, high quality family planning, contraception, abortion and post-abortion services and healthcare professionals must be supported to provide these crucial women’s healthcare services.