Further Evidence of the Necessity of Safe Reproductive Health Services

Reproductive health, which includes access to safe abortions and contraception, is a controversial issue everywhere in the world. It is controversial in Uganda. It is controversial in the US. It is controversial in politics, made more contentious by religion, and I very much doubt that it will cease to be a controversial issue in my lifetime. It is therefore safe to assume that some of you reading this may find this post controversial.

A few weeks, ago a young woman came to the clinic miscarrying in her 4th month. After the fetus was delivered one of the midwives inspected him and noted that the skull was damaged, though she chalked it up to a fetal-development issue, perhaps related to the miscarriage.

Later in the afternoon, the woman was transferred to the local health unit in the center of Atiak where she died the following morning. An autopsy revealed that she had not miscarried, but that she had performed her own abortion – succeeding in terminating her pregnancy, but also in taking her own life.

This is an unfortunate and upsetting story no matter which side of the abortion debate one is on, but I will not keep quiet about my politics. Access to abortion is an essential resource for women across the globe. A young woman’s life would have been saved if she lived in country where abortions were legal and accessible across all economic classes and this is a large-scale reality. If a woman is desperate enough for an abortion, you damn well better believe she will find a way to get one in spite of the illegality. This was also the case in the US prior to the legalization of abortion in the 1970s and remains the case in areas of the US where woman simply cannot afford a legal abortion. It is estimated that an average of 1.2 million back-alley abortions were performed annually before the Supreme Court ruled on Roe v. Wade in 1973. Many of the women who received those abortions died as a result of complications or were otherwise gravely impacted by the procedure (http://www.prochoice.org/about_abortion/history_abortion.html).

This is the current case in places like Uganda. Criminalization is NOT a deterrent against abortion, particularly in communities entrenched in poverty and with a permeating history of war and rape. When a pregnant mother of multiple children has been abandoned by her husband who has been deeply traumatized by war; when a woman cannot get work because in rural Uganda the only work is to farm her own land; when a woman must fend for her children and herself on literally no income; when a woman has been repeatedly raped, forced to marry a rebel leader, and impregnated; when a woman can only afford to eat once every other day; when a woman is out of reasonable options; when a woman feels for whatever reason that she cannot give continue with a pregnancy- no government, no society, and no religion should blame or attempt to stop her from considering and seeking a termination to the pregnancy. She will find a way to end the pregnancy regardless and the likelihood that it will end without further incident is low.

The World Health Organization estimates that 21.6 million women seek illegal or unsafe abortions each year – 98% of them occurring in resource-limited settings. These women need options. They need access to and education about contraception. They need people to help them work towards developing a society that gives women more power over their sexuality and their relationships with men. In societies where men refuse to use condoms for cultural (or any) reasons and where women do not have the option to say no, these women need to find hope somewhere else. If that hope comes from knowing that she does not need to worry about feeding another child or reliving the pain of her rape or abandonment by delivering a child who is a product of that experience, that must be respected.

I understand that abortion is controversial, but abortion happens whether it is illegal or not. Please understand that societies that ban abortions take far more lives than they save. To consider oneself pro-life in the face of that fact is hypocritical.

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One thought on “Further Evidence of the Necessity of Safe Reproductive Health Services

  1. I agree 100%. In my village, women would intentionally overdose in hopes of terminating the pregnancy, but more often it would just leave mother and baby permanently damaged. Another option is greater emphasis on family planning, including depo provera or other forms of contraception that require no male participation and can be done without a husband/boyfriend knowing or approving. For most women, abstaining from sex simply isn’t an option.

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