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Breaking the Cycle of Unwanted Pregnancy and Unsafe Abortion: A Call to Action

1:31 pm in Uncategorized by RH Reality Check

Written by Elizabeth Maguire for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

This article is adapted from remarks made at the International Conference on Family Planning, Dakar, Senegal.

Millions of women in Africa and the developing world suffer and die needlessly from unwanted pregnancy and unsafe abortion. As we know, 215 million women want to space their births but do not have access to contraception, or contraception may fail – but for a variety of reasons, women are do not have access to the care that they need.

Actions to break this cycle are a major focus at the International Conference on Family Planning now underway in Dakar, Senegal, and we are pleased that participants will be sharing successful strategies for giving women ready access to contraceptive information and services and to life-saving treatment for complications of unsafe abortion. Thanks to many organizations and governments represented at here, we have seen major progress in both these important areas.

But much remains to be done and a much more comprehensive approach is needed. Even the best contraceptive and postabortion services are not enough to prevent women from suffering and dying from unsafe abortion. A third component that is often stigmatized and neglected even in the context of reproductive health programs is safe, legal abortion.

Unsafe abortion is a major – and entirely preventable — public health crisis. But eliminating it requires a comprehensive, holistic approach addressing all three of these components.

African women are at particularly high risk of unwanted pregnancy and unsafe abortion, because unmet need for family planning is higher here than in other regions of the world. An estimated 47 million women in sub-Saharan Africa want to limit or space births but cannot obtain the information and care they need to do so.  Each year, over 6 million women risk their lives with unsafe abortion because they have no other option; of this number, 29,000 die needlessly, or in other words, hundreds of thousands in the space of a decade.  Africa accounts for more than half of all abortion-related deaths in the world.

These statistics – and the human stories that lie behind every number – are simply intolerable. Evidence tells us that abortion is one of the safest of all medical procedures when performed by trained health care providers in sanitary conditions and, with medical abortion pills, an early abortion is safe in the hands of women themselves with medical back-up nearby.

Globally, all but a handful of countries have at least one indication for legal abortion. In Africa, every country permits abortion at least to save a woman’s life, and, in more than 40 percent of African countries, in cases of rape, incest and fetal impairment.

But safe services, even to the extent of the law, are unavailable or inaccessible in most parts of Africa.

Today, we call on the global family planning and health community to take three steps that are completely feasible to help break this cycle. 

  • First, stop avoiding discussion of abortion. It is part of many women’s lives and always has been. Not talking about it will not make it go away.  We are glad this conference has made the space to talk about abortion. This must be the beginning of a greatly expanded dialogue on this critical issue.
  • Second, do a better job of ensuring that every woman who has an abortion or is treated for complications is offered contraceptive counseling and a choice of methods – on site and ideally by the same health workers who provided the abortion or postabortion treatment.
  • But we cannot simply hide behind postabortion care as if the job is done.  A third and most important step within the power of family planning programs and providers is to ensure that each woman experiencing an unwanted pregnancy receives counseling, and, if she wishes to terminate the pregnancy, is referred for a safe, legal abortion in the same or a nearby facility.  Currently, few programs require or train family planning providers to offer such counseling or referral.

In summary, the family planning community – and the wider global health community – must honestly confront the realities of unwanted pregnancy if we claim to value women’s lives and well-being and if we truly respect their rights. We must ensure that women everywhere have access to a full continuum of care:  contraceptives, postabortion care and safe induced abortion. 

House Committee Votes to Reinstate Global Gag Rule (Again) and Other Misogynistic Amendments

8:23 am in Uncategorized by RH Reality Check

Written by Editor-in-Chief Jodi Jacobson for RHRealityCheck.org. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

A central motto of today’s GOP and Tea Parties appears to be: Never let evidence get in the way of efforts to pass a law undermining women’s access to healthcare.

An addendum to this motto appears to be: Never let an opportunity pass to deny funding to or politicize services providing care to the poorest and least-enfranchised women in the world, most particularly those who suffer high rates of maternal death due to lack of access to family planning services and high rates of complications of pregnancy and unsafe abortion.

In keeping with this, just weeks after publication of a major report underscoring the benefits of robust U.S. investment in family planning worldwide, the GOP-controlled House Foreign Affairs Committee voted in the early hours of the morning today to reinstate the Global Gag Rule (GGR) as part of the draft Fiscal Year 2012 State Department Authorizations Act, except this time with broader and more damaging implications than ever before.

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For More Than 200 Million Women, A World Without Options

7:23 am in Uncategorized by RH Reality Check

Written by John Skibiak for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Today, there are over 200 million women in the developing world who want to prevent or delay pregnancy, but are not using any means of modern contraception. This is, without a doubt, a horrifying figure. But the greatest tragedy for us—those of us who have dedicated our professional lives to ensuring global access to family planning—is that this figure has not budged in nearly two decades.

The gap was 200 million in the 1990s; it was 200 million in at the beginning of this decade; and it remains roughly 200 million today. Yes, contraceptive prevalence around the world is increasing — as is the number of new family planning users. But each step forward is more than matched by comparable increases in demand in new users. Therefore, despite our best efforts, we are caught in a deadlock.

We need to find a way to meet the family planning needs of a growing number of women so can we see these numbers fall.

By the year 2020, an estimated $424 million will be required in commodity support to satisfy total demand for contraceptives in donor-dependent countries. If donor funding were to remain at or near current levels, the shortfall would be almost $200 million annually, with a cumulative shortfall of about $1.4 billion over the 2008 to 2020 period. Data on other essential reproductive health (RH) commodities are less available, but it is clear that the need and demand for sexually transmitted infection diagnosis and treatment—as well as antenatal and emergency obstetric supplies—are also rapidly increasing.

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