Preventing injury and death from pregnancy-related complications is the big thing in world development circles these days, for a couple of reasons. One reason is that a lot of these problems are simple to prevent with inexpensive interventions during childbirth, like childbirth kits and prenatal care. But another reason is that the image of smiling mothers cradling babies is a fundraising behemoth, a surefire way to get rich do-gooders to open their wallets. All of which would be great, except, as Jill Filipovic reports for Al Jazeera America, it means that the issue of safe abortion access is being ignored, even though unsafe abortion is one of the three leading causes of maternal mortality around the world.
The importance of safe abortion access in preventing unnecessary injuries and deaths isn’t particularly controversial in the reality-based world, as Filipovic explains:
Unsafe abortion is the third leading cause of maternal mortality worldwide. The World Health Organization identifies safe abortion care as one of seven necessary interventions to ensure quality reproductive, maternal and child health care. Ending death and injury from unsafe abortion is also one of the easiest goals to achieve — early-term abortion is a simple procedure and, when done by a trained provider, remarkably safe. The rate of death from unsafe abortion could conceivably get very close to zero.
The problem is that the stigma around abortion, particularly in the United States, means that the development efforts around maternal mortality largely ignore the issue. Most maternal health NGOs avoid the topic of abortion. Lobbyists and donors prefer to focus their efforts on women who are going forward with their pregnancies, even though a woman having a baby today might be the woman needing an abortion tomorrow. Because of confusing and ever-changing laws, U.S.-based government-funded agencies are often unaware that they are free to discuss abortion options with women. Under the Obama administration, discussing abortion is allowed, but it was not under the Bush administration. Privately funded enterprise often prefers to stick to topics that they believe won't attract controversy.
It doesn’t have to be this way. The Gates Foundation, which was initially reluctant to address the importance of contraception in improving maternal health outcomes, has in recent years made contraception central to their health care efforts. (They’ve even started to emphasize sexual pleasure as an important part of encouraging condom use.) The foundation should build on that success by taking up the cause of abortion, arguing globally that women have value beyond their ability to reproduce and working to ensure that women are able to choose whether to continue a pregnancy without imperiling their health. Melinda Gates, however, is on the record saying that the foundation is not planning to take safe abortion on as a cause.
As Filipovic notes, even as a bunch of American NGOs continue to pretend that unsafe abortion isn’t a women's health care issue, there has been some forward movement. Nepal liberalized its abortion laws and cut the percentage of abortion complications at essential obstetric facilities almost in half. And in late March, “leaders from more than 30 countries called for the decriminalization of abortion and a renewed commitment to the provision of safe abortion services,” Filipovic writes. These people are willing to fight maternal mortality even when powerful forces, particularly religious ones, are aligned against them. Pushing back against anti-choicers isn’t easy, but saving the lives of tens of thousands of women a year is worth it.