Abortion access versus abortion rights: Envisioning a way forward for abortion programming by understanding SRH in context of resource and health service availability
ESC Congress Library. Gural D. May 28, 2014; 50424; A-006
Dr. Demet Gural
Dr. Demet Gural
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In 2008, 43.8 million abortions are estimated to have occurred, nearly half of which were unsafe. To advance our capacity to bring meaningful change in this area, we have conducted an inquiry to better understand the best use of abortion programming funds, to inform donors and policy makers. Our assumption is that development programs must go beyond promotion of safe abortion services if they are to generate sustainable value for women.


We conducted a desk review collecting articles published in the last five years regarding abortion, SRH, and countries' social and economic characteristics. We analyzed data from Population Reference Bureau comparing gross domestic product with maternal deaths, abortion policies, and sexual and reproductive health indicators including unmet need, fertility rates, and CPR as proxies for women's achievement of SRHR.


Results suggest a positive association between countries where abortion is legal and lower risk for maternal death, as well as a correlation between high income countries and less restrictive abortion policy. This is a perverse portrait of how poverty and poor health outcomes generate and are generated by inequality. In developing countries, 97% of abortions are unsafe and virtually all abortion-related deaths happen in Africa. One third of these abortions occur among young women aged 15-24. Desk review findings suggest that economic and social factors are correlated with poor abortion and SRH outcomes.


Abortion advocacy arguments are typically articulated via the number of abortions per year and deaths related to unsafe abortion, yet this type of analysis may miss the point. By arguing for abortion through the lens of maternal death, advocacy efforts may extirpate abortion from global human rights advancement efforts by suggesting that the measure of \"\"success\"\" in abortion programming is reduced mortality, thereby divorcing abortion programs from efforts to challenge conservative legal frameworks and political agendas and address economic and social factors that forge women's inequality (efforts which are otherwise present in human rights work). Instead, this approach leaves intact the very inequalities that drive women and girls' poor SRHR outcomes. We propose a more intentional rights-based abortion programming platform to tackle social determinants, reinforce women's autonomy, and uphold their right to bodily integrity and self-determination. Based on review findings, this platform proposes an evidence-based means of supporting women to overcome the structural violence that perpetuates poor outcomes, and sustain this change into the future.

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