Too many women are dying from unsafe abortions, and it is fact that these premature deaths and related morbidities can be prevented. Access to safe abortion is a human right, and governments should be protecting women and their sexual and reproductive health choices. As such, restrictive abortion policies around what is undoubtedly a gendered health service must be redressed to safeguard women’s health and well-being and uphold their individual autonomy.
September 28th is International Safe Abortion Day, an important recognition that abortion is a yet-achieved right for all women and that further advocacy is needed to expand access to this vital health service. Restrictions and absolute bans on abortion force women to seek alternative means, which too often are unsafe and lead to high rates of mortality and morbidity. Even when governments are invested in ensuring these rights are realized, there are limited statistics and significant challenges in collecting data around abortion. Reported numbers are often underestimates, caused by systemic barriers such as restricted education and information access; few safe abortion providers and provider judgment; risk of criminal charges, stigma and other methods of marginalization and oppression. Further research could greatly enhance advocacy efforts to uphold women’s right to choose.
One year ago, a study in The Lancet reported that between 2010 and 2014, approximately 25 million unsafe abortions occurred annually. Additionally, an estimated 7 million hospitalizations due to unsafe abortions take place in developing nations alone. Furthermore, about 220 deaths per 100,000 unsafe abortions occur in developing countries, compared to 30 deaths per 100,000 unsafe abortions in developed nations. Deaths per 100,000 unsafe abortions leap to 520 when looking at sub-Saharan Africa. These figures are unsettling—but once again, they do not capture the full extent of the unsafe abortion problem. Limited safe services and spaces, misinformation and restricted knowledge, the potential for disrepute and reproach force many women to seek unregulated care, increasing risk of complications. While not all clandestine abortions result in poor outcomes, there are inherent challenges in collecting data around necessarily veiled care. Women and providers are unlikely to record or report illegal abortions in places where the service is restricted or banned. Increased availability and accessibility of safe abortion services will not only save millions, but it will enable women to control their sexual and reproductive health and the course of their lives.
Globally, it is imperative that policies pertinent to safe abortion access are legalized, decriminalized and liberalized. There have been some positive trends: in 2017, Chile revised its complete ban on abortion with a new law that allows the procedure in cases of risk to a pregnant woman’s life, a pregnancy resulting from rape or if the fetus will not survive. And while these changes do not fulfill women’s right to complete bodily autonomy, they are encouraging signs of progress. Ireland’s vote in May of this year to legalize abortion was signed into law last week, and there are plans to offer abortion services free of charge—which would further increase their accessibility for more women. These successes speak to the hard work of women’s reproductive rights advocates around the world and can serve as a beacon for other countries to reform their policies.
Unfortunately, the move toward liberalization and decriminalization of abortion is not universal. Last month, Argentina’s Senate rejected a bill to legalize abortion. While the slim voting margin was analyzed by some as a positive sign of social change in the conservative region, it is more significant that the result was a blow to women’s reproductive health rights after decades of activism. Guatemala’s government is also debating a proposed “Law for the Protection of Life and Family” that orders further restrictions on abortions except to save a woman’s or girl’s life and the criminalization of miscarriages, among many other rights restrictions. Finally, at the global level, policies such as the Global Gag Rule threaten to undo international progress on increasing access to safe abortion services and reducing maternal mortality.
Sexual and reproductive health and bodily autonomy are among the inalienable human rights that all governments bear the duty to respect, protect and fulfill. Policies that restrict lifesaving health care such as abortion are a means of institutionalizing discrimination and violence against women. A more enabling environment is imperative to uplifting and protecting women, and this global day of action is intended to raise our collective voices in this fight. Let’s continue to highlight International Safe Abortion Day as a tool to take the global temperature on abortion rights, a reminder of what is at stake, and motivation to continue championing women’s rights. Abortions will continue to happen, so let’s make them safe.