Abortion - a matter of human rights and social justice

 

Access to safe abortion and legalization of abortion can prevent unnecessary suffering and death of women.

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Abortion incidence

  • As of 2010–2014, an estimated 36 abortions occur each year per 1,000 women aged 15–44 in developing regions, compared with 27 in developed regions. The abortion rate declined significantly in developed regions since 1990–1994; however, no significant change occurred in developing regions.
  • Abortions occur as frequently in the two most-restrictive categories of countries (banned outright or allowed only to save the woman’s life) as in the least-restrictive category (allowed without restriction as to reason)—37 and 34 per 1,000 women, respectively.

Abortion law

  • Laws fall along a continuum from outright prohibition to allowing abortion without restriction as to reason. As of 2017, 42% of women of reproductive age live in the 125 countries where abortion is highly restricted (prohibited altogether, or allowed only to save a woman’s life or protect her health).

Abortion safety

  • In highly restrictive contexts, clandestine abortions are now safer because fewer occur by dangerous and invasive methods. Women increasingly use medication abortion methods—primarily the drug misoprostol alone, as it is typically more available in these contexts than the method of mifepristone and misoprostol combined.
  • Of all abortions, an estimated 55% are safe (i.e., done using a recommended method and by an appropriately trained provider); 31% are less safe (meet either method or provider criterion); and 14% are least safe (meet neither criterion). The more restrictive the legal setting, the higher the proportion of abortions that are least safe—ranging from less than 1% in the least-restrictive countries to 31% in the most-restrictive countries.
  • Unsafe abortions occur overwhelmingly in developing regions, where countries that highly restrict abortion are concentrated.
  • In 14 developing countries where unsafe abortion is prevalent, 40% of women who have an abortion develop complications that require medical attention. In all developing regions combined (except Eastern Asia), an estimated 6.9 million women are treated annually for such complications; however, many more who need treatment do not get timely care.

For more information please see https://www.guttmacher.org/report/abortion-worldwide-2017

 

By restricting access to safe abortion countries violate women’s rights especially Article 25 of the United Nations' Universal Declaration of Human Rights states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services."

The World Health Organization’s definition of health is: “Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. (http://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1)

The WHO listed the abortion medicines mifepristone and misoprostol as essential medicines since 2005. (http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf)

Access to essential medicines as part of the right to the highest attainable standard of health ("the right to health") is well-founded in numerous international human rights treaties, such as: the Universal Declaration of Human Rights: Article 25.1 in 1948; the International Convention on the Elimination of All Forms of Racial Discrimination; Article 5 (e) (iv) in 1965; the International Covenant on Economic, Social and Cultural Rights: Article 12.1 in 1966; the Convention on the Elimination of All Forms of Discrimination against Women; Articles 11 (1) (f), 12 and 14 (2) (b) in 1979; the 1989 Convention on the Rights of the Child; Article 24; the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families; Articles 28, 43 (e) and 45 (c) in 1990, and the Convention on the Rights of Persons with Disabilities: Article 25 in 2006.

In October 2011, Anand Grover, the UN Special Rapporteur on the Right to Health, submitted a report to the UN General Assembly which stated, “Criminal laws penalising and restricting induced abortion are the paradigmatic examples of impermissible barriers to the realisation of women's right to health and must be eliminated. These laws infringe women's dignity and autonomy by severely restricting decision-making by women in respect of their sexual and reproductive health” (https://www.un.org/press/en/2011/gashc4018.doc.htm)

General comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights) states that, “Essential medicines should also be available, including a wide range of contraceptive methods, such as condoms and emergency contraception, medicines for abortion and for post-abortion care, and medicines, including generic medicines, for the prevention and treatment of sexually transmitted infections and HIV.” (http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=17168&LangID=E#sthash.MfGe1y5D.XSS87v3P.dpuf)

In 2013 the Committee on the Rights of the Child General comment No. 15 ( 2013) on the right of the child to the enjoyment of the highest attainable standard of health (art. 24) stated: The Committee recommends that States ensure access to safe abortion and post-abortion care services, irrespective of whether abortion itself is legal.

(http://www.refworld.org/docid/51ef9e134.html)

On 6 December 2016, the Committee on the Rights of the Child General comment No. 20 (2016) on the implementation of the rights of the child during adolescence stated:“The Committee urges States to decriminalize abortion to ensure that girls have access to safe abortion and postabortion services, review legislation with a view to guaranteeing the best interests of pregnant adolescents and ensure that their views are always heard and respected in abortion related decisions.”

(http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CRC/C/GC/20&Lang=en)

On April 4 April 2016 the Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” stated:” In connection to sexual and reproductive health rights, the Special Rapporteur recommends that Governments: (b) Decriminalize abortion and guarantee all adolescents access to confidential, adolescent-responsive and non-discriminatory sexual and reproductive health information, services and goods, including on family planning, counselling, pre- conception care, maternal care, sexually transmitted infections, diagnosis and treatment, as well as modern forms of contraception, including emergency contraception, and safe abortion and post-abortion services; (https://www.right-docs.org/doc/a-hrc-32-32)

In 2008 The Parliamentary Assembly of the Council of Europe, resolution 1607 stated:The Assembly invites the member states of the Council of Europe to:

7.1. decriminalise abortion within reasonable gestational limits, if they have not already done so;

7.2. guarantee women’s effective exercise of their right of access to a safe and legal abortion;

7.3. allow women freedom of choice and offer the conditions for a free and enlightened choice without specifically promoting abortion;

7.4. lift restrictions which hinder, de jure or de facto, access to safe abortion, and, in particular, take the necessary steps to create the appropriate conditions for health, medical and psychological care and offer suitable financial cover;

(http://assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=17638&lang=en)

 

States have a responsibility to refrain from limiting access to health and to refrain from enacting, laws and policies that create barriers in access to sexual and reproductive health services:

The General Comment of the Committee on Economic Social and Cultural Rights on the right to the highest attainable standard of health in the International Covenant on Economic, Social and Cultural Rights paragraph 42 stated: “While only States are parties to the Covenant and thus ultimately accountable for compliance with it, all members of society - individuals, including health professionals, families, local communities, intergovernmental and non-governmental organizations, civil society organizations, as well as the private business sector - have responsibilities regarding the realization of the right to health. State parties should therefore provide an environment which facilitates the discharge of these responsibilities. 

The authoritative General Comment 14 (2000) also applies the principles of accessibility, availability, appropriateness and assured quality to goods and services, which include essential medicines "as defined by the WHO Action Programme on Essential Drugs". (http://www.who.int/medicines/areas/human_rights/en/)

General comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights) states that: “Also essential medicines should be available, including a wide range of contraceptive methods, such as condoms and emergency contraception, medicines for abortion and for post-abortion care, and medicines, including generic medicines, for the prevention and treatment of sexually transmitted infections and HIV.”

And

39. States parties have an obligation to respect, protect and fulfill the right of everyone to sexual and reproductive health.

40. The obligation to respect requires States to refrain from directly or indirectly interfering with individuals’ exercise of the right to sexual and reproductive health.

41. The obligation to respect also requires States to repeal, and refrain from enacting, laws and policies that create barriers in access to sexual and reproductive health services.

(https://www.escr-net.org/resources/general-comment-no-22-2016-right-sexual-and-reproductive-health)