Criminalized Abortion Overshadows Good News of Reduced Unsafe Abortion Deaths
“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” — Mahmoud Fathalla, Former President of the International Federation of Gynaecology and Obstetrics, 1997
Researchers at the World Health Organization have recently documented a substantial 48% decrease in the numbers of unsafe abortion deaths. In 2008, 47,000 women a year lost their lives from complications of unsafe abortion, compared to 70,000 in 2003. But the bad news is that unsafe abortions have not decreased and are still the predominant way that women end pregnancies in developing countries. Abortions appear to a bit less unsafe because more women are turning to safer medical abortion pills to induce their own abortion.
Unsafe abortion deaths are a direct consequence of antiquated and cruel laws against abortion. About 21.6 million unsafe abortions occurred worldwide in 2008, almost all in developing countries where abortion is illegal. (This compares to 19.7 million in 2003, with the rise due to the increasing number of women of childbearing age in the world.) Among women who survive unsafe abortion, an estimated 8.5 million suffer complications, with 1 in 4 needing medical attention.
In contrast, death from unsafe abortion has been virtually eliminated in western industrialized countries that have legalized abortion, and the complication rate is extremely low. When abortion is legalized in a country, there is typically a dramatic decline in maternal deaths and complications due to abortion. This pattern has been repeated numerous times since the 1950’s when abortion was first legalized in former Eastern Bloc countries.
Legal abortion saves women’s lives and improves their health because without it, women risk their safety by resorting to unsafe illegal abortion. The right to abortion also advances women’s equality, liberty, and other human rights, freeing women to pursue an education and career and to participate fully in public life. Access to abortion allows women to better plan and provide for their families, which benefits the entire community and society. Unplanned births of unwanted children can be very crippling to women and families, leading to higher rates of poverty and dysfunction, including child abuse. These factors make the provision of safe and legal abortion a vital public health interest that negates any justification for criminalizing the procedure.
Yet here we are, one decade into the 21st century, and almost every developing country in the world continues to enforce a near-total criminal ban on abortion. Abortion is illegal primarily in Africa, Latin America, and some parts of Asia, as well as a tiny handful of developed countries like Poland and Ireland. However, all countries with more liberal abortion laws still retain abortion as a criminal offence with exceptions, or have enacted further legal restrictions that make it difficult to access.
If the intent behind banning abortions is to stop or reduce them, it’s been a total failure. In 2007, the World Health Organization and the Guttmacher Institute found that overall abortion rates around the world are similar, regardless of whether or not abortion is illegal in a country. This is because countries with strict anti-abortion laws have well-developed black markets for abortion. The global average abortion rate for women of childbearing age (15-44) was 29 per 1,000 women in 2003, with the highest number of abortions occurring in countries where it’s highly restricted and in countries with poor access to contraception. Eastern Africa’s rate was 39 per 1,000 women, while South America’s rate was 33.
In countries with fewer restrictions where legal abortion is widely available, the rates are generally much lower, plus we see a decline in abortion rates as contraception use rises. Canada is the only democratic nation in the world with no abortion law or restrictions, but it has a low abortion rate of 14.1 abortions per 1,000 women of childbearing age. That compares favourably to western Europe’s rate of 12, the lowest abortion rate in the world and the region with the most liberal abortion laws. In contrast, the American rate is 19.4 (for 2005) and U.S. women must navigate through a thicket of abortion restrictions. There isn’t a shred of evidence that such restrictions are effective or helpful for women or society; instead, they create arbitrary obstacles and delays for women seeking abortion care.
Who should we blame for this global travesty of injustice and for the continuing suffering and deaths of women? The obvious culprits, of course, are the Vatican, conservative countries, various Catholic and fundamentalist religious organizations, and right-wing politicians. But perhaps a better question is: Why does the world allow these entities to inflict such a terrible toll on women’s lives and health, year after year? The most obvious culprit in this case would appear to be sexism and patriarchy, which are very much alive and well in our modern age, and still socially acceptable compared to racism. Traditional views on women’s motherhood role are the main reason that women’s rights and equality still lag far behind the rights of minorities and other vulnerable groups. Much of the world still clings to the deeply-held assumption that women’s dignity and humanity is tied to being a mother, even though this subordinates women to a biological function. Moreover, our male-dominated patriarchal societies still try to guarantee paternity by controlling women’s sexual and reproductive behaviour at the expense of their freedom and human rights.
The United Nations’ position on abortion reflects the world’s hostile attitude towards safe abortion as an essential part of women’s reproductive rights and the cornerstone of women’s health and survival. Although the UN’s purpose is in part to promote and encourage “respect for human rights and for fundamental freedoms for all without distinction as to race, sex, language, or religion,” the UN has essentially abandoned women who need abortions by caving to pressure from right-wing forces.