In a statement, the independent experts, who cover areas of health, law, discrimination, human rights and extrajudicial killings, urged “all States to end the criminalization of abortion and to ensure that all women are able to access all necessary health services, including sexual and reproductive health care, in a manner that is safe, affordable and consistent with their human rights.”

The experts rightly denounced the denial of essential health services caused by criminalization and stigma as a violation of women’s human rights.

“Millions of women and girls still face deeply entrenched legal, cultural and economic barriers to safe abortion, and are subjected to other people’s moral or religious beliefs when they seek that vital medical service,” said Françoise Girard, President of IWHC. “We commend the Special Rapporteurs for standing with the millions of women who are forced to resort to illegal or unsafe abortions, resulting in  dire physical and mental suffering, including death.”

To mark International Safe Abortion Day on September 28, IWHC has joined a global call to action on access to safe abortion as a human right. In 2016, organizations and advocates in 55 countries organized activities to observe the day.

Nearly 7 million women, mostly in developing countries, are treated for complications from unsafe abortion annually. Policymakers and family planning programs continue to turn a blind eye on the need for safe and legal abortion. As noted by the UN experts, abortion should be included as an essential component of the sexual and reproductive health services available to women and girls.

IWHC works with grantee partners in ten countries in Africa, Asia, Eastern Europe, Latin America, and the Middle East to promote sexual and reproductive health and rights and fight restrictive abortion laws. For a snapshot of the current state of abortion laws globally, click here.

The UN experts who issued the statement are: Kamala Chandrakirana, Chair-Rapporteur of the Working Group on the issue of discrimination against women in law and in practice; Dubravka Simonovic, Special Rapporteur on violence against women, its causes and consequences; Dainius Pûras, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Ms. Agnes Callamard, Special Rapporteur on extrajudicial, summary or arbitrary executions.

Contact: media@iwhc.org, (+1) 917-498-3346

Photo: OHCHR

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Last month, nearly 50 champions of women’s health and rights gathered in Montevideo, Uruguay, for the first global convening to explore the rising trend of conscientious objection to abortion. Activists, legal experts, health care providers, academics, and policymakers from 20 countries met to develop strategies to safeguard abortion access in the face of the mounting use of conscientious objection to abortion by health care providers. The three-day meeting, co-hosted by Mujer y Salud en Uruguay (MYSU) and the International Women’s Health Coalition (IWHC), resulted in recommendations that advocates can use to tackle this growing phenomenon. In a forthcoming IWHC and MYSU report, we will capture practical strategies discussed at the convening.

Research shows that conscientious objection to abortion is a global phenomenon: currently, seventy countries allow conscientious objection in health care, according to the newly launched Global Abortion Policies Database. In Italy, for example, abortion has been legal since 1978, yet it is nearly inaccessible for most women; approximately 70 percent of Italian gynecologists (the number is higher in some regions) have registered as conscientious objectors who refuse to provide abortion services. Similarly, Uruguay passed a landmark law that expanded the right to abortion in 2012. But the law allows for conscientious objection, and in some areas of the country, up to 80 percent of providers object to providing abortion services.

Conscientious objection in the context of health care has been used by providers to exempt themselves from delivering services by invoking their rights to freedom of thought, conscience, and religion. This results in the denial of patients’ right to health care. While international human rights standards uphold an individual’s right to conscience, no international bodies recognize the right to conscientious objection in the health care context. Throughout the meeting, we heard the consistent refrain—including from many in medical and research fields—that health professionals had a moral and ethical duty to put the lives and health of their patients first.

“There should be no place for health workers to refuse abortion,” a South African doctor said. But he further explained the complexities of the issue and the complicated medical environment he has seen firsthand: even when health providers do not object to providing abortion, they might not have the necessary skills or support from management to offer it. And, they may face stigma if they do provide the service. In some cases, health providers use conscientious objection as an excuse to exempt themselves from providing a service that they don’t know how to deliver or that they find stigmatizing.

Convening participants developed practical strategies that would address these challenges and mitigate the harms of conscientious objection. These include advocating for health professionals to receive pre-service training, continuing education, and ongoing professional and psychosocial support and networking.

Everyone unwaveringly agreed that efforts to tackle conscientious objection to abortion must be based on the experiences of women and girls who are disproportionately affected, as well as those courageous providers who ensure that women and girls can access the services they need and are entitled to. One of the most compelling messages we heard throughout the meeting was the need to reclaim “conscience” from the religious anti-choice movement. An attention to conscience as a decision-making tool for practitioners can also mean placing emphasis on providing abortion services as a professional obligation, and as a way to uphold women’s rights.

With attacks on reproductive rights increasing, we must become better equipped to not only understand and anticipate the evolving strategies of those opposed to abortion, but also to expose and counter the effects of their attacks.

“We must call in our colleagues,” said another doctor from South Africa. “And we must call out administrators, policies, and structures that don’t prioritize the right to abortion.”

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After more than 20 years of struggle, reproductive rights advocates rejoiced last month when Chile relaxed the ban, passing a law that permits abortion in some circumstances. The victory is one of several examples of reproductive rights advances taking place in Latin American countries, and a trend in the liberalization of abortion laws in the region over two decades. While existing laws in the Dominican Republic, El Salvador, and elsewhere in Latin America still result in horrific injustices—such as the recent case of a young rape victim in El Salvador sentenced to 30 years of prison for murder after having a stillborn child—Latin America can, and should, celebrate its successes.

In 2006, human rights attorneys argued successfully to Colombia’s Constitutional Court that the country’s total ban on abortion was unconstitutional. In a landmark decision, the Court ruled that abortion should not be criminalized in cases of rape, incest, fatal fetal impairments, and health or life endangerment of the mother. Since then, the country has been a pioneer in leading regional efforts to interpret “health,” including mental health, as liberally as possible, and working to ensure that women and girls can access abortion to the fullest extent of the law.

In 2007, Mexico City passed legislation decriminalizing elective abortion in the first 12 weeks of pregnancy for all residents of the city. Five years later, Uruguay became the first country in South America to legalize abortion for any reason (up to 12 weeks). That same year, in Argentina, activists declared victory when the country’s Supreme Court issued a landmark ruling known as “Caso F.A.L.,” which established that abortion in cases of rape is not punishable by law. In Peru, even though therapeutic abortion has been legal since 1924, the government finally released protocols for this service in 2014, giving health professionals much needed guidance to provide this service.

These laws, policies, and protocols are an integral part of ensuring high-quality abortion care for all, but alone are not enough. Feminist activists from Mexico City to Montevideo work day and night to hold their governments accountable to these commitments, and civil society groups are essential to the fight. In Argentina, for example, IWHC grantee CEDES supports hospital staff to collect data, enabling them to track legal abortions. Without this data, the government might not be held accountable for its obligations to train providers or buy equipment. Promsex, one of our grantee partners in Peru, played a key role in pushing the government to release the protocols for therapeutic abortion. The group now works with a network of public sector abortion providers in Lima’s maternity hospitals to put these policies into action, ensuring that women can obtain lifesaving services. In Uruguay, a woman can legally obtain an abortion, but research from our grantee partner Mujer y Salud en Uruguay (MYSU) suggests that are there are still barriers limiting women’s access, including health professionals increasingly citing conscientious objection to abortion. This is a growing trend not limited to Uruguay.

The liberalization of Chile’s abortion law is a historic shift in the right direction, but we know that work to implement the law is just getting started. Gynecologists in Chile will not necessarily line up to be trained. Health authorities will not rush to allocate funds to buy medical abortion pills. Research institutions will not necessarily design studies to monitor how, and if, the law is being implemented. Feminist organizations and activists must ensure these actions are taken and that women’s rights are fully realized.

Advocates must pressure Ministries of Health to register medical abortion drugs on essential drug lists, create codes for abortion in medical records, and update medical school curricula so that students receive comprehensive abortion care training. Most importantly, we must continue to advocate for the complete decriminalization of abortion on all grounds.

Victories like the one in Chile are important steps, but only partial ones. The relaxing of the law still means that value judgments are placed on a woman’s choice to have an abortion, and that some women are told that their reasons for seeking an abortion are less valid than others. As a result, they are denied the ultimate right to control their bodies and their lives. El Salvador, Nicaragua, Malta, and Dominican Republic still have outright bans on abortion. Every woman, everywhere, should be able to get an abortion—no matter the reason or circumstance.

Photo: Revista Intemporie

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Below is a quick glance at some of the most dangerous places in the world to access an abortion. Yet, even where abortion isn’t criminalized, a host of restrictions can limit women’s and girls’ access to safe abortion. And in many countries—including the United States—conservative groups are working to limit access further.

For example, in Poland last year, the ruling Law and Justice Party proposed a near ban on abortion, which could have potentially imprisoned women who sought abortions and doctors who provided them. Tens of thousands of women took to the streets over many days in protest, forcing the government to withdraw the bill. While that bill is dead, for now, the push by Poland’s government for more restrictive laws is not.

The Philippines is one of the few countries in the world to criminalize abortion in all circumstances with no clear exceptions. Of course, this does not mean that women do not get abortions. Instead, they go to providers who are not trained or equipped, and often perform the procedure in unsanitary conditions. As a result, every two in three women in the country who undergo an abortion experience a complication.

Ireland only permits abortion when there is a “real and substantial risk” to the pregnant woman’s life. In all other circumstances, abortion is criminalized and carries a 14-year prison sentence for women who have them. As a result, every year thousands of women travel to England to access abortion. In June, the United Nations Human Rights Committee ruled for the second time that Ireland’s abortion laws had subjected a woman to cruel, inhumane, and degrading treatment in denying her the right to abort a fetus with fatal abnormalities.

El Salvador has one of the world’s most restrictive abortion laws. Until 1998, abortion had been permitted in cases where the pregnancy posed a risk to a woman’s life, in cases involving sex with a minor or rape, and cases of serious fetal deformities. But in 1998 a new penal code took effect banning abortion in all circumstances, and in January of 1999, the Constitution was amended to recognize life as starting from the moment of conception, bolstering the law even further. Since then, more than 150 women and girls—some as young as 12 years old—have been prosecuted.

While the above countries—and others—criminalize abortion to varying degrees, many other countries have liberalized their laws on abortion. Despite many battles still to fight, the global trend is moving in this direction.

The International Conference on Population and Development in 1994 affirmed reproductive health as a human right, changing the conversation and compelling many governments to modify their laws and policies. But, implementation of these laws is often weak and inconsistent. To improve reproductive health policies and ensure that existing progressive laws are put into effect, IWHC works with grantee partners in ten countries in Africa, Asia, Eastern Europe, Latin America, and the Middle East that are working to promote sexual and reproductive health and rights and fight restrictive abortion laws. These grassroots organizations are critical to holding governments accountable to their commitments to ensure all women and girls everywhere can make their own choices about their bodies and realize their human rights.

Learn more about the laws in specific countries here.

Photo: Beth Wilson

The post Where Are We Now? A Snapshot of Some of the World’s Most Egregious Abortion Laws appeared first on International Women's Health Coalition.

Through its Rapid Response funding stream, IWHC was able to get much needed resources to some of these groups to carry out this essential work. Recently, IWHC’s Jessie Clyde and Shena Cavallo of our Strengthening International Partnerships team, held a virtual discussion to highlight the importance of donations to the Rapid Response Fund and to share the achievements of our local grantee partners, who were able to counter an urgent threat.

WATCH: The Impact of Rapid Response Funding to Women’s Groups in Brazil

Here are some excerpts from the conversation:

“The Zika epidemic disproportionately affected black and indigenous communities. It was very important to ensure that the women most affected were also the women leading the interventions.”

“While our partners were actually working on the ground, providing information, services, and the kind of support that communities really needed, the Brazilian National Congress was working on a bill that would have increased penalties for women who thought they had Zika and sought an abortion. Feminists had to mobilize very quickly to ensure that Brazilian women were not being punished any more than they were already being punished.”

“This crisis demonstrated the strength of the women’s movement in the country. In many ways the women’s movement was able to respond more quickly and more comprehensively than the government.”

Photo: Daniele Rodrigues for IWHC

Read More:

Brazil Declares Zika Crisis Over, But Is It?

• By Shena Cavallo
• •
• May 19, 2017

Brazil recently declared the Zika emergency over, but for those living in the most at-risk areas, the virus is a constant threat.

Life After Zika: Stories from Brazil

• June 23, 2016

On Thursday, June 2, Friends of IWHC watched Zika, the incredibly moving documentary about five young Brazilian women and the health care professionals struggling to serve them in the middle of the Zika epidemic.

The post Life After Zika: Stories from Brazil appeared first on International Women's Health Coalition.

Advocates working with the National Coalition for Reproductive Justice sing these bold words in communities across Lagos, Nigeria. Their catchy rhythms and lyrics educate other women on reproductive health and their rights, including accessing safe abortion and postpartum hemorrhage and postabortion care. IWHC’s newest grantee partner, Generation Initiative for Women and Youth Network (GIWYN), supports the National Coalition and trains its members to raise awareness in communities where access to sexual and reproductive information and services are hard to find.

Abortion is criminalized in Nigeria except when the life of a woman is at risk. In some northern regions of the country, where sharia law is widespread and Boko Haram is active, abortion services are not accessible at all. Administrative barriers, coupled with widespread patriarchal beliefs and practices, make access to abortion extremely limited for women, and even more out of reach for girls. To procure a legal abortion, a woman must obtain permission from a physician and a gynecologist, and many times providers demand consent from her husband too. Unmarried women or those who fail to gain their husband’s consent are often left with no safe options. The country has one of the highest maternal mortality rates in the world, due in large part to unsafe abortion.

GIWYN runs a hotline called “Ms. Rosy,” which provides accurate and nonjudgmental reproductive health and rights information to callers, including information on abortion. Since its launch in 2014, the hotline has received approximately 135,000 calls from across Nigeria. Because abortion is so severely restricted in Nigeria, GIWYN uses a harm reduction model. Trained professionals provide callers with accurate information on how to use misoprostol, which is available over-the-counter and can be used to terminate pregnancies. For women who face innumerable barriers to accessing abortion services, using misoprostol is safer than the methods these women may resort to otherwise.

I met Sybil, GIWYN’s Executive Director, and Amarachi, Hotline Manager, in 2016 at a feminist roundtable in Lagos. I was immediately struck by their unabashed approach to women’s sexual and reproductive rights, especially since the women’s movement in Nigeria seems to have divergent approaches to abortion. Some activists incorporate abortion rights into their work, while many do not; they would rather stick to more broadly accepted issues, such as economic empowerment and political participation. GIWYN is going against the grain and is committed to working on one of the most important, yet controversial, women’s rights issues. Our partnership is timely as we anticipate a potential chilling effect as the Trump Administration’s policies on international reproductive health are implemented.

IWHC has supported work in Nigeria since 1988, providing close to $5 million to women’s rights organizations. We have seen many of our local partners become visionary leaders on sexual and reproductive health and rights at the national, regional, and global levels. This new partnership presents IWHC and GIWYN with the opportunity to expand access to safe abortion across the country. IWHC has three other grantee partners in Nigeria: Education as a Vaccine; International Center for Reproductive Health and Sexual Rights; and Action Health Incorporated.

We welcome GIWYN into the IWHC family and are thrilled to be working alongside its fierce advocates!

WATCH: Advocates in Nigeria Sing Safe Abortion Anthem

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Brought together by Mujer y Salud en Uruguay (MYSU) and the International Women’s Health Coalition (IWHC), approximately 50 policymakers, academics, health professionals, and activists from around the world will discuss the rise of conscientious objection as a significant hurdle to safe and legal abortion. They will examine how health providers are denying women their right to abortion, even in places where it is legal.

Documentation of conscientious objection is limited, but the existing evidence indicates that doctors, nurses, and other health care staff are increasingly citing it. Recent research shows that in Italy alone, 7 out of 10 Italian gynecologists have objected to carrying out abortions. As a result, women, especially those who are marginalized, are denied safe abortion services.

Participants of the convening will review current research about the scope of conscientious objection globally, its effects, and their own experiences. They will explore a strategic response to its use and misuse by health care professionals. By the end of the three-day meeting, they aim to develop recommendations on how to guarantee that women’s rights are protected, including the use of law, protocols, ethical guidelines, training, and education to limit or mitigate the exercise of conscientious objection.

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Monica Oguttu is the Executive Director of the Kisumu Medical and Education Trust (KMET), an IWHC grantee partner in Kenya. KMET provides and advocates for comprehensive reproductive health services throughout Kenya, and especially in rural and under-served communities. From 2017 to 2021, KMET was slated to receive approximately 56 percent of its budget from the US government. In this video, Ms. Oguttu explains the deadly impact of Trump’s expanded version of the Gag Rule in Kenya.

The post The Human Cost of the Global Gag Rule: A Kenyan Story appeared first on International Women's Health Coalition.

Grupo Curumim, a long-time IWHC partner based in Recife, in hard-hit northeastern Brazil, has been working for the past year to educate communities, health providers, and activists about the risk of Zika and other mosquito-borne diseases. While the symptoms of Zika are often mild, the implications for pregnant women are far more severe. Fetuses infected with the virus can develop “congenital Zika syndrome,” a series of birth defects including microcephaly—underdevelopment of the brain—as well as vision and hearing problems. Most recently, Curumim has reached out to female employees of local fisheries to inform the women about the associated risks of the Zika virus and ways to prevent infection.

In response to the epidemic, the Brazilian government launched mosquito eradication programs in 2016, but activists say that the focus has been almost entirely on the mosquito, and not on the people most likely to be infected. These efforts also failed to address long standing inequalities, and the burden of prevention was placed almost entirely on women and girls. In the northeast of the country, poor sanitation, irregular access to water, and the region’s tropical climate are conducive to the spread of the virus, which is transmitted sexually as well. Meanwhile, Brazil’s ultra-conservative government continues to chip away at programs and policies on sexual and reproductive health so women and girls who want to delay pregnancy often lack the necessary information and means to do so.

The Zika crisis coincided with Brazil’s recent political and economic turmoil and the impeachment of President Dilma Rousseff. Rather than focusing on policies and programs to address long-standing inequalities, her successor, President Michel Temer, prioritized harsh austerity measures, including freezing public spending on health and education for the next 20 years. This is extremely worrying for those who have babies with congenital Zika syndrome. The existing meager social benefits don’t make up for the fact that many mothers and caregivers have had to give up working outside the home to care for these babies.

In such a challenging context, local organizations are trying various strategies to change harmful policies. Curumim is advocating with local policymakers for greater access to long-acting contraception, such as IUDs, which many women have been demanding in light of the epidemic.

In August 2016, the Brazilian National Association of Public Defenders (ANADEP), in coordination with Anis-Institute of Bioethics, Human Rights and Gender, another IWHC grantee partner, filed a petition before the Brazilian Supreme Court demanding the protection of women, families, and children affected by Zika. In addition to calling for information, contraception, and access to legal abortion in light of the virus, the petition also calls for expanded social benefits for families with children who have congenital Zika syndrome.

It’s clear the impact of Zika lives on. As Debora Diniz, IWHC Vice Chair and lead researcher at ANIS, recently said, “Brazil’s declaration of an end to the Zika emergency sends a message that there is no more urgency in protecting these women and children. But the risk did not end; we only forgot about these women again.”

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The Trump Administration’s version of the Global Gag Rule bans all foreign nongovernmental (NGO) organizations who receive any US health funding from providing abortion services, counselling, or referrals, or advocating for the liberalization of abortion laws, even with their own non-US funds. Under previous Republican administrations, this policy has only applied to US family planning funding. But the Trump Administration has made a bad policy even worse by extending it to all US global health spending—meaning that it will apply to organizations working on maternal and child health, nutrition, HIV/AIDS, malaria, tuberculosis, and other health issues. US-based organizations receiving funding will be responsible for enforcing the Gag Rule on their foreign NGO partners.

The Human Cost of the Global Gag Rule: A Kenyan Story

The policy does have some limits. It does not apply to funding given to foreign governments or to multilateral organizations, including Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria. It does not extend to humanitarian aid, including disaster relief, migration, and refugee-assistance activities. Further, it allows foreign NGOs receiving US health funding to provide abortion services, counseling, and referrals in cases of rape, life endangerment, or incest, and it allows them to provide post-abortion care. These exceptions notwithstanding, this policy will undermine global development and put women’s lives at risk.

The Global Gag Rule runs counter to global efforts to achieve sustainable, people-centered development. Over the past decade, countries of the Global South have made significant progress integrating essential health services and overcoming the barriers that put quality health care out of reach for many. The Global Gag Rule threatens to reverse that progress. It will cut off funding to some of the most effective organizations in the Global South, many of whom are the only organizations providing quality health care services in remote or isolated communities. It will force others to stop offering a comprehensive spectrum of care in order to sustain funding for other critical services. In an era of diminishing aid, it will hinder the cost-effectiveness and impact of US development dollars.

Most devastating, however, is the impact it will have on the lives of women, girls, and their communities. Because of this policy, clinics will close. Health services—reproductive health care, but also HIV prevention and treatment, maternal health care, and other services—will be increasingly scarce. Unintended pregnancies will rise, along with unsafe abortions. Women and girls, particularly the most marginalized, will have less ability to make decisions about their own bodies, health, and lives. Simply put, women will die because of this policy.

With today’s announcement of how the Global Gag Rule will be implemented, the Trump Administration shows, once again, that it is all too willing to put religious ideology and politics over evidence.

Photo: Pierre Holtz for UNICEF

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