Ensuring the Human Right to Survive Pregnancy in Southeast Asia

Ramona Vijeyarasa

To combat maternal mortality rates in Southeast Asia far higher than Millennium Development Goal targets, governments must ensure women's right to safe abortion.

Like child mortality in many countries around Asia, maternal
mortality rates remain staggeringly high, despite the global commitment
of reducing maternal mortality
ratios by three-quarters
With progress one-fifth of what it needs to be, ActionAid reports that maternal mortality is
the Millennium Development
on which the
least progress has been made. Not only does it appear that women’s right
to survival is a neglected concern around the globe, but apparently
it is also forgotten amongst the other millennium targets. 

On September
24, 2008, world leaders will meet at a High-Level Event on the Millennium Development Goals
to discuss progress to date and what programs need to be implemented
to bridge the MDG gap as we rapidly approach 2015. This meeting presents
a decisive opportunity to ensure that the limited progress on maternal
mortality is at the center of the dialogue. Interestingly, Africa features significantly amongst the
partnership events being organized in conjunction with the High-Level
Event. Yet many of the counties in South-East Asia have similarly seen
little improvement in their maternal morality ratios. With the World Health Organization
stating that
maternal mortality in South-East Asia contributes to 40% of global deaths,
maternal mortality in the region needs to be put back on the discussion
table. 2005 maternal mortality ratio estimates released by WHO were as high as 540 maternal deaths
per 100,000 lives births for Cambodia, 420 for Indonesia and 230 for
the Philippines as compared to 14 for the Republic of Korea or 11 for
the United States. 

On World Population
Day in July of this year, UNFPA noted that three basic interventions
are necessary if the world is to improve maternal health: skilled birth
attendants, access to emergency obstetric care and family planning.
On this occasion, the Secretary-General reiterated the global commitments
made in Cairo in 1994 at the International Conference
on Population and Development

on access to family planning information and noted its relationship
to combating maternal mortality. Yet, years after the right to decide
the number and spacing of one’s children has become a standard call-cry
for reproductive rights activists, many countries in Asia continue to
fail to guarantee access to all forms of modern contraceptives.  

The interrelationship
between unwanted pregnancies that result from lack of family planning,
unsafe abortion and high rates of maternal death is unquestionable. It is estimated that unsafe abortion,
what has been deemed by WHO as the silent, but preventable,
, contributes
to 19% of maternal deaths in South-East Asia in any one year.
In the Philippines, where abortion is illegal and remains a taboo subject,
it is estimated that up to 800 women die each
as a result
of unsafe abortions, not to mention abortion-related complications and
their impact on women, their families and the country’s health system.
In many countries in the region where abortion remains illegal, such
as Indonesia, Laos and Myanmar, activists continue to advocate for abortion
reform, to improve access to safe abortion, particularly for marginalized
or poor women. 

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A change in
abortion laws alone is not the solution. In Cambodia, despite the legalization
of abortion in 1997 on broad grounds, many women remain unaware of the change in law and still undergo
terminations carried out by unskilled providers. Education and awareness
raising is a key element to addressing misconceptions about the law,
misconceptions that make women vulnerable to bad care, bribery and corruption,
or no care at all. This is particularly true for adolescents and other unmarried women, where cultural
barriers and taboos about sex outside of marriage exacerbate this vulnerability
to seeking clandestine abortions. The need to address this gap in knowledge
about the legality of abortion should be considered by other legally
permissive countries in the region like China, DPR Korea, Japan, Mongolia
and Vietnam.

The importance
of concerted efforts by countries to stop preventable maternal deaths
has clearly been endorsed by the world community through the MDGs. Whether
abortion is currently legal or illegal, governments must develop an
effective strategy to ensure women’s right to access legal abortion
procedures by skilled individuals under safe conditions. Such much needed
change will move many of the countries in the region much closer to
reaching their MDG target and tackling their maternal death pandemics.
Such progress would also reflect a revaluing of women’s lives and their
human right to survive pregnancy.

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