On September 28, activists around the world will mark International Safe Abortion Day, an opportunity to mourn those who have died because of oppressive anti-abortion laws. But this day is also about spreading a message on behalf of Elizabeth and other women like her: Abortion, while in many countries a political wedge issue, is simply a fact of life.
Each year, 25% of all pregnancies – about 56 million – are terminated. Abortions occur in every country and within every socioeconomic class. In the United States, 61% of abortion patients are in their 20s, 59% are already mothers, and nearly two-thirds identify with an organized religion. But abortion is most common in developing countries, where access to family-planning services is often limited. In fact, a staggering 88% of the world’s abortions occur in the Global South.
Abortion is a safe procedure that becomes hazardous wherever it is legally restricted. Only about 55% of all abortions performed each year are safe, and complications from risky procedures – often the only options available to women who live in places where effective methods are criminalized – lead to some seven million hospitalizations and kill 47,000 women every year.
The struggle for safe abortion is centuries old. While the methods varied, abortion was a normal – and often accepted – practice in ancient China, Egypt, Greece, and Rome. It was only in the nineteenth century that Catholic and colonial elites propagated anti-abortion laws to control women’s sexuality, bodies, and lives.
But, contrary to popular opinion, criminalization does not reduce the number of abortions; it only makes having one more dangerous. In Latin America and the Caribbean, where the procedure is banned or restricted, rates of abortion – and resulting complications – are among the highest in the world. By contrast, in North America and Western Europe, where abortion is legal and widely accessible, rates of abortion are comparatively low and safety is high.
Moreover, when abortion is decriminalized, death rates fall and maternal injuries vanish almost overnight. For example, a year after Romania decriminalized abortion in 1990, maternal deaths fell by half, while in South Africa, deaths plummeted 91% in the first four years after passage of the 1996 Choice on Termination of Pregnancy Act. Simply put, there is no medical reason why any woman should have to risk her life to end an unwanted pregnancy.
Buoyed by these statistics, rights activists around the world are demanding changes to national abortion laws, and since 2000, more than 30 countries have liberalized their approach. In May, voters in Ireland repealed the country’s abortion ban, a significant victory in a society so deeply influenced by its Catholic faith. Even in Argentina, hope remains high. Opinion polls show strong support for abortion rights, and the bill that could have saved Elizabeth’s life failed by only seven votes.
Still, the fight is far from over. Globally, Internet searches for misoprostol, a drug that women use to induce abortion safely, are surging. In South Africa, only about 5% of public clinics and hospitals offer abortions, and a third of women still do not even know that abortion is legal. In Morocco, meanwhile, women who campaign for abortion rights are arrested and harassed. And in the US, activists are preparing for a rollback of reproductive freedom if Supreme Court nominee Brett Kavanaugh is confirmed.
The fiercest opposition to abortion rights originates with the Catholic Church and other conservative forces, and it has direct consequences both for women and for their countries’ health-care systems. Recent research conducted by my organization, the International Women’s Health Coalition, found that in more than 70 jurisdictions worldwide – including 45 US states – health-care providers can deny abortion services to patients based simply on doctors’ personal beliefs.
These restrictions are unconscionable. Abortion is part of women’s lives. It is time for governments to listen to the millions of women who are demanding reproductive justice and bodily autonomy. Laws must recognize and guarantee a woman’s right to sexual and reproductive care. Services must be made financially and medically accessible. And women everywhere – regardless of age, race, ethnicity, sexual orientation, or religious affiliation – must have access to safe abortion services.
Elizabeth never had these opportunities, and millions of women around the world are in the same position. Unless and until that changes, every one of them is a potential tragedy.
Françoise Girard is President of the International Women’s Health Coalition