Unsafe abortions killing women

There are no people for abortion, there are just those against unsafe abortion.

That was the take-home message by Professor Anibal Faúndes, chair for the FIGO Working Group on Prevention of Unsafe Abortion at a press conference presented at the 19th FIGO World Congress of Gynaecology and Obstetrics underway in Cape Town.

“It does not help to criminalise abortion – it only makes an already difficult process even more difficult for women who do not want to have a child,” says Faúndes.

Every year some 19 million women around the world undergo induced abortions in unsafe conditions, leading to an estimated 68 000 women dying annually. Unsafe abortions account for 13% of annual global maternal deaths, while hundreds of thousands of women suffer long-term complications.

Stigma
There is a lot of social and religious stigma surrounding abortion, and in some communities women who go for abortions are even considered criminals.

“A woman who shows up at hospital with complications due to unsafe abortion is not a criminal – she is there because society has failed her,” says Faúndes. “Society failed her by not providing her with sexual education, contraception or access to a safe abortion.”

In a lot of developing countries, including South Africa, a lot of women do not have control over their sexuality, according Dr Eunice Brookman-Amissah from Ipas Africa Alliance.

“In some communities, rape is very common and women are often forced to have sex, even in marriage,” says Brookman-Amissah.

Preventing unsafe abortions
Considering the toll on women from unsafe abortions, including death, the International Federation of Gynaecologists and Obstetricians (FIGO) is advocating for global interventions to reduce the suffering caused by unsafe abortion.

FIGO developed a working group to address challenges facing safe abortions on a country-to-country basis.

A very important tool in the fight against unsafe abortions are access to contraceptives, which will help women control pregnancy.

Unfortunately there is still stigma around the use of contraception in many communities and there is a great need for education on this topic. Another great challenge is the lack of access to contraception.

“In Africa and also South Africa, only about 15% of women in need of contraception have access to it,” says Brookman-Amissah. This figure only accounts for married women and unmarried girls are not even accounted for in this 15%.

Education on sexual health and access to safe abortions are other main strategies in the fight against unsafe abortions.

Medical abortion
Abortion was also in the spotlight in other presentation at the FIGO congress.

Africa has the highest number of deaths due to unsafe abortion in the world, but the affordable and uncomplicated method of medical abortion is not available in most countries.

Medical abortion, which involves administering pills rather than invasive medical procedure, can save many women’s lives, especially in developing countries like South Africa.

This is according to recent studies from Nepal, India and Mexico City, presented at the 19th FIGO World Congress of Gynaecology and Obstetrics underway in Cape Town.

“These studies show how effective medical abortion is in low resource settings,” says Mosotho Gabriel, director of Ipas Africa Alliance based in Nairobi, Kenya.

“Because medical abortion means that the patient does not have to be admitted to hospital, it is cheaper technology that makes abortion more accessible to poor and rural women, as these studies show.”

In South Africa, medical abortion is not yet available in the public sector. The policy guidelines have been developed and progress is being made with preparing regulations.

“But,” says Gabriel, “it is being used in the private sector where its success shows that it will reduce maternal mortality, which is what we are concerned about.”

While women’s right to choose termination of pregnancy is violated in most African countries, “there is usually one indication where abortion can be provided, which is to save a woman’s life,” Gabriel explains. Rape and incest are other instances where medical abortion can be of help.

(Wilma Stassen, Health24, October 2009)

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