UN guidance affirms safe abortion as essential for human rights
Friday, December 14, 2012
Policymakers, governments and reproductive health advocates around the world have a new tool in the fight to prevent maternal deaths and injuries: technical guidance from the Office of the United Nations High Commissioner for Human Rights (OHCHR) that promotes a human rights-based approach to eliminating the 287,000 maternal deaths that occur globally each year.
The new guidance is the product of a multi-disciplinary process and collaboration that began in 2009, when the UN Human Rights Council adopted a resolution recognizing, for the first time ever, the human rights aspects of solving the maternal mortality crisis.
Navi Pillay, the UN High Commissioner for Human Rights, made that link clear when announcing the new guidance: “Maternal mortality and morbidity are not simply issues of public health, but the consequence of lack of fulfillment of multiple rights…The scale of maternal mortality and morbidity is a stark reminder of the inequality and discrimination women in all parts of the world experience in their lifetimes.”
The guidance is comprehensive in outlining the measures needed to ensure that women’s human rights to sexual and reproductive health are fulfilled. It specifically calls for “authoritative public health guidelines” and national plans to ensure universal access to: “family planning services; prevention and management of sexually transmitted infections, including HIV; management of unintended pregnancies, including access to safe abortion services, wherever legal, and post-abortion care; appropriate antenatal care; detection of domestic violence; management of pre-labour rupture of membranes and preterm labour; induction of labour for prolonged pregnancy; prevention and management of post-partum haemorrhage; caesarean sections; and appropriate post-partum care.”
The guidance further states: “If abortion laws are overly restrictive, responses by providers, police and other actors can discourage care-seeking behaviour.”
Noting that adolescent girls suffer disproportionately higher rates of maternal death and injuries, the guidance says that there are many contributing factors— such as early marriage, high levels of sexual violence, a lack of youth-friendly health services and high rates of self-induced abortion—that must be addressed in order to fully ensure the human rights of girls and young women.
Aimed primarily at policymakers, but with wide potential for use by ministries of health and other stakeholders alarmed by the slow rate of progress in reducing maternal deaths and injuries, the guidance is based on several key principles, including:
- A recognition that women must be empowered to claim their rights—not merely to avoid maternal death or morbidity
- The need to pay special attention to groups of women who are vulnerable to higher rates of maternal mortality and morbidity, including women who are young, disabled, living with HIV or residing in underserved areas
- The need to address structural factors which perpetuate discrimination against women, such as the power differential between men and women that exists in many countries
- The importance of making accountability “not just an afterthought,” but an essential component of all plans and strategies for reducing maternal deaths and injuries.
In June 2012, Ipas Ethiopia Program Director Saba Kidanemariam participated in a panel discussion at the Human Rights Council on “Criminal Laws and Women’s Right to Health,” held in conjunction with preparation of the guidance. She noted that Ethiopia had begun to implement a relatively liberal abortion law in 2006 and that, in the years since, Ipas and other partners have worked with government officials to ensure that safe, legal abortion services are integrated in the public and private health systems. “Despite many challenges,” she told the gathering, “we are seeing that even in a low-resource country like Ethiopia, women’s lives can be saved and their human rights protected.”
Ipas Mexico Country Director Dr. Raffaela Schiavon is among the many other reproductive rights advocates welcoming the new guidelines. “They will be very helpful,” says Schiavon, who also heads the Committee for the Promotion of Safe Motherhood in Mexico. As the committee marks its 20th anniversary in 2013, she says, “We will disseminate the guidelines and will encourage the government and others to use them as a framework for change. This gives us an umbrella under which we can launch new initiatives and strategies.”