African Union (AU) health ministers gathered in Mozambique this month to adopt a continental policy on reproductive health and rights. Though some participants wanted to include abortion in a range of issues, they were defeated. The African states, most of which prohibit or strictly limit abortion, raised the issue of including abortion, but participants could not reach a consensus.
The draft version of the document had attempted to include “unsafe” abortion in tackling the issue of maternal mortality. The draft had called on member states to “provide safe abortion services to the fullest extent of the law,” to provide for the training of “service providers in the provision of comprehensive safe abortion care services where national law allows,” and to “refurbish and equip facilities for provision of comprehensive abortion care services.” AU member states failed to reach an agreement on a unified policy to address unsafe abortion and opted instead to take up the matter individually.
The African document did call on Member States to seek action on “sexual and reproductive health.” At the international level, the term “sexual and reproductive health” has caused heated debate over the past many years though it looks like the General Assembly (GA) is becoming less concerned with the term. UN delegates told the Friday Fax that they are less concerned because they are confident that it does not include abortion. While conservative UN experts note that the AU decision reaffirms the GA position, they remain concerned because UN agencies, radical NGOs and human rights treaty bodies continually misinterpret the term, and then use it to pressure states to liberalize their abortion laws.
Abortion proponents have long argued that a right to abortion should be guaranteed by international law because restricting abortion leads to high maternal mortality. However, UN reports such as the 1991 World Health Organization (WHO) report Maternal Mortality, A Global Factbook, conclude that decreased maternal mortality rates in the developed world, “coincided with the development of obstetric techniques and improvements in the general health status of women.” Subsequent WHO reports have identified low social and economic status, unskilled birthing attendants, and poor nutrition as underlying causes of maternal mortality. They also identify anemia and malaria as primary indirect causes of maternal deaths in Africa.
Of the 53 member states of the AU, 25 prohibit abortion altogether. An additional 12 members allow abortion for the protection of the health of the mother. Only 3 African countries allow abortion on demand. Conservatives are concerned that some will use the issue of “unsafe abortion” under the guise of reducing maternal mortality to pressure African countries to liberalize laws and restrictions on abortion.
In a paper published by Ipas entitled Access to Safe Abortion: An Essential Strategy for Achieving the Millennium Development Goals to Improve Maternal Health, Promote Gender Equality and Reduce Poverty, authors Barbara Crane and Charlotte Smith argue, “While making abortion safe where 'not against the law' is a very significant positive step, many women still have no access to abortion and are even subject to criminal prosecution and punishment. In this context, it is not ethically justifiable for leaders in the international community to continue to maintain such a neutral position on abortion laws and policies.”
