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Abortion: We Said It

Anu Kumar

For two days, participants at the Global Safe Abortion Conference openly discussed strategies for increasing access to safe abortion care for women everywhere.

Earlier this week in London, more than 700 public health experts, government representatives and activists from nearly 60 countries came together for a landmark Global Safe Abortion Conference, sponsored by Marie Stopes International, in association with Ipas and Abortion Rights.

That's right. We said it. Abortion. For two days, participants openly discussed strategies for increasing access to safe abortion care for women everywhere. Not just in Europe or North America, but for all women no matter where they live or what their economic status.

Participants at the Global Safe Abortion Conference noted that there was an energy in the meeting that came from being free to be open about such a difficult topic. Presentations and discussions addressed access to safe abortion through the lenses of public health, human rights, gender equity and cost-effectiveness. Attendees examined strategies for promoting reform of restrictive laws, policies and practices concerning abortion, the promise of medical-abortion technologies, and ways to make safe abortion services, along with contraceptive counseling and methods to help couples prevent unwanted pregnancies, more widely accessible regardless of legal context.

Such a wide-ranging and open discussion about abortion is long overdue. Each year unsafe abortion claims 66,500 lives and injures 5 million more women and girls. Nearly all of these deaths occur in developing countries. New data from the World Health Organization (WHO) and the Guttmacher Institute show that while the number of abortions performed globally has fallen slightly in recent years, the number of unsafe abortions has actually increased slightly. In Africa–where restrictive laws from the colonial period are still on the books and women's access to contraception is most limited–the number of deaths from unsafe abortion rose significantly from 29,800 in 2000 to 36,000 in 2003.

Sex. Abortion. Parenthood. Power.

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Reproductive health advocates often find themselves on the defensive when it comes to abortion. Anti-abortion extremists, like those who protested the agenda at the Women Deliver conference last week, hysterically call "reproductive health," "family planning," or even (perversely) "safe motherhood" as euphemisms for "abortion on demand." They reinforce the sense of stigma that women often feel about abortion–whether she is a woman who feels she must end a pregnancy, or a healthcare expert trying to make the best services available.

Abortion is a common experience among women from all countries and at all income levels. In fact, the new research from Guttmacher shows that on average, during the course of a reproductive lifetime, there is nearly one abortion for every woman if current rates prevail. But whether or not an abortion is safe may depend on a woman's income; in high-income countries, almost all women who face unwanted pregnancies can obtain safe abortions one way or another, especially if they have money.

But poor women everywhere, and especially in low-income countries in Africa, Asia and Latin America, face multiple barriers to safe abortion care. Where abortion is legally restricted or inaccessible, or unaffordable where it is legally permitted, women instead resort to dangerous procedures, including trying to self-induce abortion and turning to untrained providers to end unwanted or unhealthy pregnancies.

Nearly 500 conference attendees signed a Global Call to Action for Women's Access to Safe Abortion, which, among other points, urged government authorities and donors to commit additional resources to make comprehensive sexual and reproductive health care – including safe abortion care – widely available.

The Global Safe Abortion Conference is just one step, but it has to be the first of many in an effort to ensure that ALL women, not just wealthy women, have access to this care.