Right to safe abortion cannot be dislocated from human rights

Shobha Shukla *

Abortion is a human right. Yet, abortion-related stigma - rooted in patriarchy, misinformation, and control - continues to restrict access, fuel legal persecution, and force people into unsafe conditions in several countries. This Global Day of Action to Destigmatise Abortion, there is a stronger call for an end to criminalisation, medical gatekeeping, and harmful cultural narratives that shame and silence people who undergo abortions.

"To mark the Global Day of Action to Destigmatise Abortion (28th March), we call for stronger efforts to challenge harmful narratives, dismantle barriers, and demand stigma-free access to safe abortion everywhere in a rights-based manner," said the coordinator of SHE & Rights (Sexual Health with Equity & Rights) initiative.

Even though the right to abortion is part of promises made by our governments by endorsing Beijing Declaration 1995 and legally-binding CEDAW and other agreements and declarations, and are critical to deliver on UN Sustainable Development Goal-5 for gender equality and human rights, progress is not satisfactory.

“We are not on track to realise the right to health and gender equality. Despite committing to Agenda 2030 with a common vision and work plan, we are not doing well on delivering on the promises of UN Sustainable Development Goals,” said Dr Tlaleng Mofokeng, the United Nations Special Rapporteur on the Right to Health.

All people, including women and girls and gender diverse peoples, have a right to bodily autonomy- that is the right to make free and informed decisions about one’s own body, without coercion or violence. We see violations of bodily autonomy when a lack of choice and decision-making leads to unplanned pregnancy, or to unsafe abortion that is a leading yet totally preventable cause of maternal mortality and morbidity. Globally, six out of 10 unplanned pregnancies end in induced abortion, and around 45% of these abortions are unsafe.

Induced abortion is in fact very common – it is estimated that 73 million induced abortions occur worldwide annually. Around 61% (or 1 in 6) unintended pregnancies end in induced abortion – so these are pregnancies that were not planned – and 29% (or 3 in 10) of all pregnancies end in abortion globally. Thus quite a significant number of both- unintended and intended pregnancies- end in abortion around the world.

But what is most troubling is that globally 45% of induced abortions are unsafe. It is estimated that every year 29,000 pregnant women and girls die from unsafe abortion and 7 million are injured or disabled due to unsafe abortion worldwide. Unsafe abortion also leads to social and financial burdens for women, communities and health systems.

More than half of all unsafe abortions occur in Asia, most of them in south and central Asia. In Latin America and Africa, the majority (approximately 3 out of 4) of all abortions are unsafe. In Africa, nearly half of all abortions occurred under the least safe circumstances.

But what is perhaps more devastating is that deaths due to unsafe abortion are entirely preventable. It is lack of access to safe, timely, affordable and respectful abortion care that leads to these preventable maternal deaths.

Gender equality and right to health are fundamental human rights

“Violations of human rights are an early warning system. We need to use racial equity and anti-colonial frameworks to advance progress on right to health. Human rights unite all of us and not divide us. We should resist and push back harder on the (wrong) notion that human rights are divisive. Human rights are the actual basis of how we can move forward with something in common as humans. Protecting human right to health requires a constant analysis of power. None of us can imagine a future without a commitment to constantly analyse power, how it moves and shifts through us as individuals, and how it moves and shifts through our own organisations, and other multilateral systems,” added Dr Tlaleng.

“The idea that one can dislocate the right to health (which includes right to safe abortion) from other human rights is impossible. It is also good to remember that when we realise the right to health, we enable many other human rights. Therefore, by realising the human right to health, we can actually get to gender equality too,” added Tlaleng.

Crossroads: Will governments take the rights path?

“We are at the crossroads when it comes to gender equality and human right to health. The assault on the right to health (which includes right to abortion) is more than any other time. This is a time that we need to unite and make sure that everyone has the right to health regardless of gender, sexuality or where they are born. That is why the Global Center for Health Diplomacy and Inclusion (CeHDI) was established to raise the voice of the global south in global health negotiations,” said Dr Haileyesus Getahun, Chief Executive Officer of HeDPAC, an organisation dedicated to strengthening south-to-south partnerships in health development and founder of Global Center for Health Diplomacy and Inclusion (CeHDI).

Return on investing US$ 1 in family planning & maternal health in developing countries is US$ 8.40

“30 years ago, the International Conference on Population and Development (ICPD)’s Programme of Action of 1994 and the Beijing Declaration’s Platform for Action of 1995 were remarkable because they both placed gender equality and women’s empowerment at the heart of development. These conferences established that a woman's control over her fertility is fundamental to all her rights. The vision that also drives the 2030 Agenda and the call for universal sexual and reproductive health and rights is central to achieving SDG5 on gender equality and SDG3 on health and well-being,” said Dawn Minott, Advisor on Gender and gender-based violence, at United Nations Population Fund (UNFPA).

“Access to sexual and reproductive health empowers women and girls, leading to improved health, economic opportunities and her stronger agency. Also, an UNFPA estimation shows that the return on investing every dollar in family planning and maternal health in developing countries is US$ 8.40,” said Minott.

“I think the most significant step forward has been on SDG indicator 5.6.1 which measures a woman's ability to make her own decisions about her sexual and reproductive health. Initial analysis suggests that over half (56%) of the married or in union women are now in the driver's seat. However this means that 44% of partnered women still cannot make these essential decisions about their own healthcare, contraceptives, or their sexual decisions.”

Assault on multilateralism and global health institutions is challenging

“Fundamental human rights are under threat and particularly the right to health, and sexual and reproductive health, rights and justice (SRHRJ). Assault on multilateralism and global health institutions is one of the core challenges confronting us today. From funding cuts and political interference in technical bodies that are driving health and gender agenda, to attacking frameworks that we have been working on for years. These attacks undermine the very concrete agreements which gave us a human rights approach to population and development. These agreements deeply reflect the lived realities of women and the recognition that women have bodily autonomy and the recognition that women and girls and gender diverse peoples have a right to health and a right to sexual and reproductive health. Just this month we had a political declaration (at CSW69) but what is a political declaration without the recognition of sexual and reproductive health, rights and justice?” wonders Fadekemi Akinfaderin, Chief Global Advocacy Officer at Fòs Feminista.

“Anti-rights and anti-gender movements are trying to roll back the hard-fought gains and wins towards gender equality and human rights. It is alarming to recognise that anti-rights movements are using the similar-sounding frameworks that they seek to dismantle to advance their own (anti-gender and anti-rights) agenda. One such example is the (regressive) Geneva Consensus Declaration, which is not an internationally recognised instrument and not legally binding, that undermines gender equality and rights,” added Akinfaderin.

Agrees Dr Payal Shah, Director of Legal, Research, and Advocacy at Physicians for Human Rights: “I call for immediate action by global stakeholders to address critical attacks on gender equality and healthcare, including funding freezes and the growing criminalization of healthcare. We also have to demystify the concept of “reproductive violence” in conflict and crisis settings with a focus on devastating, systematic deprivation of reproductive autonomy (for example, in Gaza and Ethiopia).”

The world is not on track to deliver on SDG5 which promises gender equality by 2030 where no one is left behind. Whatever progress has happened towards this goal and the Beijing declaration of 1995 is threatened by the global anti-rights push that we are seeing today. The regressive Geneva Consensus Declaration, the Madrid commitment, and gag rule or Mexico City policy are only a few examples of this violent curtailment of rights and bodily autonomy of women and gender diverse peoples that we are seeing. It is necessary for our governments to act with urgency in order to protect bodily autonomy and ensure that gender inequity ends with us.

SHE & Rights (Sexual Health with Equity & Rights) is hosted by Global Center for Health Diplomacy and Inclusion (CeHDI), Asia Pacific Media Alliance for Health and Development (APCAT Media), Asian-Pacific Resource & Research Centre for Women (ARROW), International Planned Parenthood Federation (IPPF), Women's Global Network for Reproductive Rights (WGNRR), and CNS.