Globally, Nationwide, Reproductive Health at Stake

Two new studies out today show little to cheer in women's health: a rising number of unsafe abortions worldwide and a growing number of attacks on reproductive rights in the U.S.

Reporting on the worldwide abortion trends study from The Lancet, the Globe and Mail reports:

As abortion declines dramatically in the developed world, it continues to remain common in the developing world. About a quarter of pregnancies end in abortions in the developed world today - down from 36 per cent in 1995 - yet the abortion rate in the developing world is essentially unchanged since 1995, with about a fifth of pregnancies still ending in abortion.

The study shows that the world is failing to tackle the epidemic of unsafe abortions, one of the most preventable causes of maternal deaths, and it suggests that the unavailability of contraception is a growing problem in much of the world, analysts said.

Unsafe abortion is one of the five major causes of the estimated 365,000 maternal deaths in the world every year. More than eight-million women need medical attention for complications caused by unsafe abortions annually, according to the U.S.-based Guttmacher Institute, which specializes in reproductive health issues.

The report shows a rising number of abortions worldwide. From The Lancet:

Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995.

The Lancet study concludes:

Measures to reduce the incidence of unintended pregnancy and unsafe abortion--including improving access to family planning services and the effectiveness of contraceptive use, and ensuring access to safe abortion services and post-abortion care--are crucial steps toward achieving the MDGs.

The Globe and Mail notes that the study shows "anti-abortion laws may be ineffective and even counter-productive." Yet, according to a new report from NARAL Pro-Choice America, state level attacks on reproductive rights are skyrocketing.

Among the key findings in Who Decides? The Status of Women's Reproductive Rights in the United States:

Total Anti-Choice Measures Enacted in 2011:

• 25 states enacted 67 anti-choice measures in 2011.
• Arizona, Florida, and Kansas enacted the most anti- choice legislation in 2011, with five measures each.
• Since 1995, states have enacted 711 anti-choice measures.

Anti-Choice Measures Enacted in 2011 Included:

• Alabama, Idaho, Indiana, Kansas, and Oklahoma enacted pre-viability bans on abortion care after 20 weeks. None of these laws includes an adequate exception to protect women's health or for cases in which the pregnancy was the result of rape or incest. These laws are clearly designed as a challenge to Roe v. Wade.

• Eight states - Florida, Idaho, Indiana, Kansas, Nebraska, Oklahoma, Utah, and Virginia - passed abortion-coverage bans. Some of these measures ban coverage of abortion in the state's health-insurance exchange; others prohibit abortion coverage in the state's entire private insurance market
• South Dakota passed a first-of-its-kind biased-counseling mandate. Of the law's many onerous provisions, it requires a woman seeking abortion care to submit to an in-person lecture at a so-called crisis pregnancy center, many of which are biased, anti-choice, anti- contraception facilities. The law also includes a precedent-setting 72-hour mandatory delay before care. This law has been temporarily enjoined pending the conclusion of ongoing litigation.

NARAL Pro-Choice America President Nancy Keenan stated:

The findings in this report should spur every American who values freedom and privacy into action. Last year, we predicted that our opponents would ignore the public's call to focus on the nation's immediate challenges, such as the economy. Sadly for women, our predictions came true at near-record levels. Lawmakers waged a War on Women, and as a result, women in many states will see more political interference in their personal, private medical decisions. In some cases, women could lose access to reproductive-health services they currently have.

Richard Horton, editor of the Lancet medical journal, discussed the problems faced when even writing about abortion. From The Guardian:

Cultural and religious opposition to abortion prevents the issues being properly discussed, let alone tackled, said Richard Horton, editor of the Lancet medical journal which published the report online. Yet the complications of abortion are responsible for 13% of maternal deaths and reducing those deaths is now a major global focus.

"The mere mention of the word 'abortion' in the journal leads to a phenomenal and visceral reaction against even discussing the issue," Horton told journalists.

"American representatives explicitly came to me and asked me to remove the word abortion from our draft," he said. "Even under an Obama administration, it is not possible to have an open discussion about abortion in international agencies and commissions. This stigmatisation, this censorship around the issue of abortion, is what is causing the enormous distortion of priorities in women's health today."