Abortion Rights Are Human Rights, Part One

Marcy Bloom

Over the years, I have come to appreciate the reproductive health and justice movement as an international feminist and human rights struggle. There are a myriad of connections and lessons. We can all learn from each other.

The public health statistics of abortion restriction and illegal abortion in the world are grim. But we can use these numbers—which represent real flesh-and-blood women—to inspire us to make changes.

Over the years, I have come to appreciate the reproductive health and justice movement as an international feminist and human rights struggle. There are a myriad of connections and lessons. We can all learn from each other.

The public health statistics of abortion restriction and illegal abortion in the world are grim. But we can use these numbers—which represent real flesh-and-blood women—to inspire us to make changes.

Currently, more than 61% of the world's people live in countries where induced abortion is permitted for a wide range of reasons. In contrast, 26%—more than ¼—of all people reside in the 72 countries where abortion is prohibited, and where women are stigmatized, treated as criminals, often prosecuted, and thrown in jail. According to the World Health Organization, an estimated 80 million women worldwide have unintended or unwanted pregnancies each year, and 46 million of these end in abortion. Almost half of these 46 million abortions—twenty million—are unsafe; this means that eight women die every hour because of the horrific complications that occur. That further translates to 68,000 women a year who die due to unsafe, illegal abortions, and 85% of such deaths occur in sub-Saharan Africa and South Central Asia. Nearly 75% of the world-wide 500,000 pregnancy-related deaths annually occur because of unsafe abortion and unsafe childbirth practices that could be prevented.

The basis for the international legal support that has begun to interpret a woman's right to safe and legal abortion as a universal human right can be found in numerous international treaties (such as the Universal Declaration of Human Rights), various human rights commissions (such as the European Commission on Human Rights), and in conference documents from the United Nations International Conference on Population and Development of 1994 in Cairo, Egypt and the Fourth World Conference on Women in Beijing, China in 1995. A year before that, the 2004 United Nations World Health Assembly had adopted the first global strategy designed to demand government responsibility and accountability on a broad spectrum of reproductive rights issues and based their strategy on a human rights framework.

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So just what is that framework?

The denial of a pregnant woman's right to make an independent and non-coerced decision regarding abortion violates a wide range of human rights. Women's reproductive rights under international human rights law are a composite of a number of separate human rights:

  1. the right to health, reproductive health, and family planning
  2. the right to decide the number and spacing of children
  3. the right to marry and found a family
  4. the right to life, liberty, and security
  5. the right to be free from gender discrimination
  6. the right to be free from sexual assault and exploitation
  7. the right to not be subjected to torture or other cruel, inhuman, or degrading treatment or punishment
  8. the right to modify customs that discriminate against women
  9. the right to privacy
  10. the right to enjoy scientific progress and to consent to experimentation

In my next post, I will explore in more detail how four of these human rights specifically apply to safe and legal abortion.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

Analysis Politics

Timeline: Donald Trump’s Shifting Position on Abortion Rights

Ally Boguhn

Trump’s murky position on abortion has caused an uproar this election season as conservatives grapple with a Republican nominee whose stance on the issue has varied over time. Join Rewire for a look back at the business mogul's changing views on abortion.

For much of the 2016 election cycle, Donald Trump’s seemingly ever-changing position on reproductive health care and abortion rights has continued to draw scrutiny.

Trump was “totally pro-choice” in 1999, but “pro-life” by 2011. He wanted to shut down the government to defund Planned Parenthood in August 2015, but claimed “you can’t go around and say that” about such measures two months later. He thinks Planned Parenthood does “very good work” but wants to see it lose all of its funding as long as it offers abortion care. And, perhaps most notoriously, in late March of this year Trump took multiple stances over the course of just a few hours on whether those who have abortions should be punished if it became illegal.

With the hesitancy of anti-choice groups to fully embrace Trump—and with pro-choice organizations like Planned Parenthood, NARAL, and EMILY’s List all backing his opponent, Democratic nominee Hillary Clinton—it is likely his stance on abortion will remain a key election issue moving into November.

Join Rewire for a look back at the business mogul’s changing views on abortion.

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