Young Women, Unwanted Pregnancy and Abortion: Are We Achieving Global Goals?

Maria de Bruyn

Young women are the most vulnerable to maternal morbidity and mortality. A panel at the UN Commission on the Status of Women examines the reasons.

The Commission on the Status of Women is a body of the United Nations Economic and Social Council (ECOSOC), dedicated exclusively to gender equality and advancement of women. It is the principal global policy-making body on these issues and meets every year at United Nations Headquarters in New York to evaluate progress on gender equality, identify challenges, set global standards and formulate concrete policies to promote gender equality and advancement of women worldwide. The CSW is now in session in New York and this is one of a series of posts from side panels and open discussions being held concurrently with the formal proceedings.

The UN member states are devoting the 54th meeting of the Commission on the Status of Women (CSW)  to a review of the Beijing Platform for Action (BPFA), adopted in 1995 at the Fourth World Conference on Women. So on the first day of the CSW, taking place starting this week in New York City, the government of The Netherlands partnered with Ipas and International Planned Parenthood Federation (IPPF) to host a session on the unmet needs of young women in relation to preventing unwanted pregnancy and, when neceesary, accessing safe abortion services. The topic was of obvious interest as the 170-person room was filled to capacity.

The BPFA acknowledged that young women are even more vulnerable than older women to maternal morbidity and mortality. Arushi Singh of IPPF  pointed out that young women face a number of restrictions on their right to choose, even in decisions concerning the most fundamental aspects of their lives.

“What does the right to choose mean for the four out of five young women whose parents never consulted them on the timing of their marriage and the two out of three married young people who reported that they had met their spouse for the first time on their wedding day?” asked Singh.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

She pointed out that in 1995, the rate of unsafe abortion in India was 12 per 1000 women; in 2003, the rate was almost the same at 11 per 1000 women. Even in countries with more liberal laws, young women’s access to safe abortions remains curtailed. They lack awareness of the fact that abortion is legal and don’t know where to go for safe services. Often, they don’t recognize the early signs of pregnancy and when they do realize they’re having an unwanted pregnancy, they face negative attitudes from healthcare providers, especially if they are unmarried.

The situation can change. For example, young women in rural Nepal who were trained on sexual and reproductive health are now members of village youth forums that organize regular dialogues between young people and parents on sexual and reproductive health. In Bangladesh, a school headmaster persuaded the community to provide free board and lodging so that girls can remain in school, leading one girl to remark: “If I were married today, what would I lose? My independence, my vision, my dreams.” Singh commented that such progress should inspire us to continue our endeavors in protecting the right to choose and creating enabling environments that take us as close to free choice for young women as possible. The evolving capacities of adolescents mean that young women must be enabled to make their own decisions, including about marriage, pregnancy and abortion.

Marie Khudzani Banda, of the International Community of Women Living with HIV/AIDS (ICW) in Malawi, spoke about a project with grassroots women in which ICW facilitators organized community dialogues about contraception, unwanted pregnancy and abortion. Since pregnancy termination is only allowed to save a woman’s life, almost everyone believes abortion is totally illegal and that it cannot be done safely; the subject is also taboo and rarely discussed openly.

With support from important policy-makers, such as representatives of the Ministry of Health, the national Commission on Human Rights and the National Nurses Council, ICW members offered women in villages information and the chance to share their own and family members’ experiences with unwanted pregnancies and abortion care. Many women talked about unsafe procedures, one woman describing how a 14-year-old girl lost her uterus and subsequent chances of marriage, and another telling about her 15-year-old cousin who lost her life due to an unsafe abortion.

By the end of the dialogue series, the women were expressing opinions about changes needed, both at their own individual level and the wider community and societal levels. They acknowledged a need for parents to talk with young people, especially young women, about sexuality and reproductive health matters. They felt that community members should be sensitized and educated about emergency contraception, especially young girls and boys, and that more community dialogue and education sessions should be held on topics like safer sex, pregnancy, contraception and abortion, including sessions at schools.

And as one participant said:

“HIV-positive mothers who become pregnant are making a responsible choice for the children they already have if they end the new [unwanted] pregnancy early and in a safe way.”

The ICW members want to see more women receiving information and education about the differences between unsafe and safe abortion care.  Participants said that safe abortion should be legalized in Malawi so that girls, their mothers and other women can freely request this service. They also would like hospitals to ensure that they have a client-friendly atmosphere so that girls and women feel comfortable asking for reproductive health services. As a result of the project, ICW has produced a booklet with women’s testimonies and policy recommendations and they are starting to collaborate with other civil society groups on advocacy around women’s sexual and reproductive health and rights.

Alexis Hernández, of Ipas Mexico and the MenEngage Alliance, noted that it is women who experience pregnancy and abortion in their bodies. They face the health consequences and most of the emotional, material and other burdens of an unwanted pregnancy. It is mostly women who receive legal punishment where abortion is illegal and it is women who are denied the right to decide due to restrictive abortion laws. He added that it is women who die and suffer the consequences of unsafe abortions and  young and poor women who are most at risk.

As a nurse and youth activist, Hernández commented:

“We men, both young and adult, should take responsibility for our own sexuality and reproduction. Why do we leave most responsibility to women? What would we men do if we became pregnant? Women do not make themselves pregnant.”

He said that some men would like to protect their partners and wish they could have the abortion instead of the woman. But they can’t and then feel fear, worry, stress and guilt. However, men don’t often have this sympathy with women before it gets to the point of pregnancy termination. So organizations that work with men in Latin America are using experiential exercises to build empathy in men about reproduction. They use a story called “It is the last, my dear, the last”. The story tells of a man who originally refuses to use contraception, but who is transformed when he witnesses his partner giving birth.

Hernández said that health-care providers in Mexico have seen the emotional impact on men when they witness an event like insertion of an IUD, childbirth, abortion or pregnancy. For example, when men are invited to cut the cord at delivery, they can feel excitement, shock, fear, nervousness, or sometimes even cry or faint. Health workers report that more men are interested in this kind of participation in reproductive health events and in caring for and raising children.

We must acknowledge that men are frequently involved in abortion-related decisions and care, said Hernández, and this can be positive or negative for the women involved. It is negative when men pressure women to have or not have an abortion. This pressure shows itself in different ways: intimidation, violence against women, abandonment, refusing financial aid or other support, or denial of paternity so that the woman thinks abortion is her only option.

We need to make men allies, he avowed, in order to increase women’s access to safe abortion. To involve young men, we must put aside some of our ideas about youth and keep an open mind because gender relations and sexual and reproductive health may be different for young people than what we assume. Generally, men are not welcome in abortion clinics. Providers think they are there to hold the woman’s coat, drive, or pay for the procedure. One study in the United States showed that 73 percent of men wanted to go with the woman to the clinic, but only 23 percent of the clinics allowed this.

Hernández remarked that the BPFA said that men are “necessary allies for change.” He said that members of the MenEngage Alliance know the importance of the women’s movement in creating possibilities for men to be more just and caring human beings. He ended his presentation by inviting adult men, young men, and boys to embrace healthy models of masculinity and non-violence and to take responsibility for working alongside women and girls to achieve gender justice:

“Now we men must unite to say: No more deaths and complications from unsafe abortions. No more abuse and denials in health services. No more women identified, stigmatized, and imprisoned for deciding to terminate a pregnancy.”

Ariana Childs Graham, of SIECUS, spoke to session participants about why young people should care about the work being done by conservatives opposed to choice in sexual and reproductive health. She noted that these groups work on many issues, including opposition to comprehensive sexuality education, opposition to young people’s access to contraception, preserving the “traditional family” (which means a heterosexual couple with children rather than allowing other forms of families), and opposition to rights for people of various sexual orientations in addition to condemning abortion.

She noted that conservatives often speak “on behalf of” constituencies, claiming that they represent all families, parents or faith-based groups. Progressive youth advocates need to indicate that they, too, speak on behalf of peers and on behalf of poor and marginalized young people who have specific needs. Young people can emphasize the complexity of decision-making involved in sexual and reproductive health issues, as well as the diversity of women’s experiences, which means that decisions cannot always be simple and the same for everyone.

Childs Graham pointed out that youth advocates should stay informed about the claims of conservative groups so that myths which stand in the way of sexual and reproductive rights can be debunked. For example, some groups say that having an abortion significantly increases a woman’s chances of developing breast cancer. The U.S. National Cancer Institute, however, convened a meeting of over 100 world experts who study pregnancy and breast cancer risks and they concluded that research shows that having an abortion or a miscarriage does not increase a woman’s subsequent risk of breast cancer.

Childs Graham concluded by urging young people who work for sexual and reproductive rights to learn about critical issues so that they can present evidence and factual information, to speak out about their experiences and those of family and friends, to adopt positive and pro-active strategies, and to assume leadership roles in educating key stakeholders, including parents, community and religious leaders, and policymakers.

During the discussion period, the young panelists addressed important questions raised by audience members. Childs Graham said that promoting comprehensive sexuality education means young people must have the opportunity to build skills in an ongoing and age-appropriate manner. Education cannot comprise only a three-hour session for 13 year olds, for example. Rather, education should begin at younger ages, always adjusted to the students’ cognitive levels, and then progress through adolescence until young adulthood. It is also critical to garner support from policy-makers to promote such a cumulative process by addressing concerns with evidence. For example, studies show that teaching younger adolescents about sexuality does not result in their engaging in sexual behavior at an earlier age.

When asked by a teen pregnancy program manager how one can identify the maturity of young people, Singh stated that it is not so difficult to gauge the evolving capacity of an adolescent: if she is able to approach a healthcare provider and request a service in clear terms, she has developed the capacity to understand and deal with the situation involved. Singh also said that healthcare providers must actively seek ways to help young women avoid unsafe abortions and protect their health and lives in any legal setting.

A Kenyan member of Parliament attending the session thanked the panelists for what she called their “brilliant presentations”, commenting that they had caused her to perform a “self-audit” about how she had educated her 24-year-old daughter and 22-year-old son. She had to acknowledge that it was mostly in terms of “the don’ts” rather than giving them the space to talk about their needs. She said that adults must consider how they can make today’s situation in sexual and reproductive health better than it was when they were young themselves and this can be partly accomplished by connecting with young people.

Wieke Vink, a member of the Youth Coalition who co-moderated the session, concluded that all the panelists were “pro-life”, but pro-life also for those who are already living. She said we must acknowledge the wide range of perspectives and opinions among young people on sexual and reproductive health issues and give youth have the opportunity to express them rather than restrict their freedom of expression and choice.

Carlien Scheele, head of The Netherlands’ CSW delegation this week and a representative of the Dutch Ministry of Education, Science and Culture, emphasized that the Dutch government will continue to support comprehensive sexuality education and sexual and reproductive health services for young people. Her words were echoed by the former Dutch Minister of Development Cooperation, Bert Koenders, who addressed the session participants in a short video message.

News Politics

Democratic Party Platform: Repeal Bans on Federal Funding for Abortion Care

Ally Boguhn

When asked this month about the platform’s opposition to Hyde, Hillary Clinton’s running mate Sen. Tim Kaine (D-VA) said that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde Amendment.”

Democrats voted on their party platform Monday, codifying for the first time the party’s stated commitment to repealing restrictions on federal funding for abortion care.

The platform includes a call to repeal the Hyde Amendment, an appropriations ban on federal funding for abortion reimplemented on a yearly basis. The amendment disproportionately affects people of color and those with low incomes.

“We believe unequivocally, like the majority of Americans, that every woman should have access to quality reproductive health care services, including safe and legal abortion—regardless of where she lives, how much money she makes, or how she is insured,” states the Democratic Party platform. “We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment.”

The platform also calls for an end to the Helms Amendment, which ensures that “no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning.”

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Though Helms allows funding for abortion care in cases of rape, incest, and life endangerment, the Obama administration has failed to enforce those guarantees.

Despite the platform’s opposition to the restrictions on abortion care funding, it makes no mention of how the anti-choice measures would be rolled back.

Both presumptive Democratic nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) have promised to address Hyde and Helms if elected. Clinton has said she would “fix the Helms Amendment.”

Speaking at the Iowa Brown and Black Presidential Forum in January, Clinton said that the Hyde Amendment “is just hard to justify because … certainly the full range of reproductive health rights that women should have includes access to safe and legal abortion.” In 2008, Clinton’s campaign told Rewire that she “does not support the Hyde amendment.”

When asked this month about the platform’s opposition to Hyde, Clinton’s running mate Sen. Tim Kaine (D-VA) said in an interview with the Weekly Standard that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde amendment.”

“The Hyde amendment and Helms amendment have prevented countless low-income women from being able to make their own decisions about health, family, and future,” NARAL President Ilyse Hogue said in a statement, addressing an early draft of the platform. “These amendments have ensured that a woman’s right to a safe and legal abortion is a right that’s easier to access if you have the resources to afford it. That’s wrong and stands directly in contrast with the Democratic Party’s principles, and we applaud the Party for reaffirming this in the platform.”

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.