On September 29th, during the 30th session of the Human Rights Council, we co-hosted a side event to discuss the importance of addressing unsafe abortion in order to eliminate preventable maternal mortality and morbidity.
The panel opened with a video from Ipas on the lack of access to safe and legal abortion in Rwanda.
Lucinda O’Hanian of the Office of the High Commissioner for Human Rights spoke about the human rights framework in regard to unsafe abortion and maternal mortality and morbidity.
- It is rooted in gender-based discrimination and harmful gender stereotypes. The problem arises from the lack of investment in protection of women’s health and the denial to recognize the need to relevantly address gender-specific services.
- There is generally also a lack of an holistic approach to sexual and reproductive health and rights.
- When abortion is legalised, it is still often not accessible due to countless barriers. There is a need for States to uplift or address these barriers, including spousal consent laws. Women should be able to make choices of when, who, how many children and with whom they want to have the children with.
- One main problem is only providing maternal education at a very late stage rather than understanding context and whether or not pregnancies are wanted in the first place.
- Programming in silos is ineffective. Human Rights mechanisms see unsafe abortion as broader than just a health issue.
- The maternal mortality and morbidity technical guidance takes a comprehensive human rights-based approach and has, in some cases, led to addressing issues around unsafe abortion.
- Lack of relevant actions that lead to deaths of women is a failure of institutional measures and an issue of accountability.
- States need to align laws with training institutions so as to enable medical personnel to understand the law and implement accordingly, where abortion is legal.
Rajat Khosla of the World Health Organization gave a brief yet comprehensive overview of data and statistics.
- There is no other medical service that would be controlled by the State to such an extent, even by criminal laws. Especially no “man-specific” procedure.
- Linkages between unsafe abortion and the socio-economic status of women in societies.
- It is critical that high levels of morbidity are addressed. The OHCHR report scheduled for 2016 should address this.
- Access to safe and legal abortion was a part of the SG’s revised global strategy on women, children and adolescent health, and critical to achieving the SDGs.
Karolina Wieckiewicz from Federation for Women and Family Planning and the SRI elaborated on the issue of using maternal and morbidity rates as an argument when discussing the issue of unsafe abortions and how sometimes it might not be relevant, especially for those States in which women do not die as a result of clandestine abortions.
- Stigma and restrictions around abortion harm individuals, communities and societies
- The current understanding should be expanded to include social well-being. She connected this with the WHO definition of health.
Question from the moderator: What Can be done at the Human Rights Council?
Karolina Wieckiewicz: States should pay more attention at UPRs to those States with abortion restrictions who do not have to face the most “severe” consequences of unsafe abortions and might therefore think that they do not have a problem with morbidity understood in the social meaning.
Rajat Khosla: Advances at the global and regional levels need to be reflected at the national and local levels.
Lucinda O’Hanlon: When specific UPR recommendations are made we see a difference, especially when CSOs, NHRIs and the UN system get involved and support in implementation. Recommendations from human rights mechanisms also help to improve the situation.
Interventions from the floor
Uruguay spoke about their national experience changing laws and policies using women’s rights and public health approaches, which drastically decreased maternal mortality and morbidity rates connected with unsafe abortion, and did not increase the number of abortions, contrary to some beliefs.
Norway suggested that the UPR may be the best platform to advance these issues.
Slovenia suggested that strong data and evidence exists on the issue of unsafe abortion and maternal mortality and morbity, which deserves serious attention.
UNFPA suggested that there should be more training of health professionals on post-abortion care, that legal barriers should be removed and access to quality services guaranteed, and pointed out importance of access to contraception and comprehensive sexuality education.
Final remarks from panelists
Karolina Wieckiewicz: human rights mechanisms should be promoted as a tool to better fulfill international obligations. States who do not see their role as supporting their actions and efforts tend to defend themselves rather than take advantage of the experts in developing laws, policies and practices. Restrictive laws in all countries must be eliminated and countries that have made advances should share their experiences with others.
Lucinda O’Hanlon: It is important to engage with treaty monitoring bodies and Special Procedures and to ensure sexual and reproductive health and rights in the implementation of the SDGs.
Rajat Khosla: Need to focus more on morbidity, provide services and realize rights in emergency and conflict settings, and focus on safe abortion and eliminating morbidity in the SG’s global strategy.