A major attack on human rights with global impacts

The Maternal Adolescent Reproductive & Child Health (MARCH) Centre and the Health in Humanitarian Crises Centre (HHCC) at the London School of Hygiene & Tropical Medicine (LSHTM) are gravely concerned about developments in the US that remove abortion rights for millions of women and risk having a catastrophic effect on reproductive rights around the world.

Along with hundreds of other healthcare organisations across the world, MARCH and HHCC have signed a global statement which emphasises that access to safe abortion is a recognised part of essential healthcare and must be protected as a human right.

The statement says: "Attacks against reproductive freedom are attacks on democracy and international human rights standards, on individual freedoms and the right to privacy, and they set back progress towards gender equality.”

Our Centres stand in solidarity with women, girls and pregnant people around the world whose basic right to bodily autonomy and reproductive freedom is now at risk.

US actions affect rights globally

The Supreme Court decision signals that safe abortion is not only not a healthcare priority but that these services are criminal. This retrograde ruling has significant implications for the rest of the world as a colleague from Ghana highlights: “The reversal of Roe vs Wade is likely to erode the gains made in promoting women’s rights and access to reproductive health services in most African countries and traditional societies, where women’s ability to say “no” to their spouses/partners can have dire consequences such as sexual violence, resulting in unwanted pregnancies.”

A colleague from Uganda highlights that criminalising abortion will lead to more unsafe abortions, which are a major cause of maternal mortality worldwide: “The ruling makes it even harder to decriminalise or liberalise abortion in countries like Uganda where abortion is still illegal or criminalised. The inevitable outcome is that women will continue using unsafe abortion methods.”

In humanitarian emergencies, where increasing access to safe abortion is vital, the US decision may affect existing policies. This decision would "embolden these anti-choice groups and have a strong impact on policymakers and on government itself" Demeke Desta, the Ethiopia country director at Ipas, commented. 

Médecins Sans Frontières (MSF) also highlights how the US ruling goes against more positive actions globally: “It is shocking to see the US moving backward just as many other countries are moving forward to expand access to safe abortion care. Safe abortion care should be accessible to everyone everywhere.”

Criminalising abortion removes essential healthcare, killing women

Millions of women and girls in the US now face the prospect of being forced to carry a pregnancy they do not want, including children who have been raped and adults whose pregnancies cannot end in live births and might kill them, for example ectopic pregnancies. This is effectively a death sentence for people whose pregnancies are life-threatening, showing complete disregard for their right to life.

In countries where abortion is illegal, women are incarcerated for miscarriages and stillbirths, even in the face of international campaigns to free them.  When Romania criminalised abortion and made and access to contraception severely restricted (between 1967-1990), women died in huge numbers.

In the UK, where abortion is still criminalised despite being widely available, women and girls have endured being investigated by the police after miscarriages and stillbirths.

Abortion is not only essential for the bodily autonomy of anyone who can become pregnant – it is essential healthcare and should not be criminalised. Withdrawing essential healthcare from a huge portion of the population is irresponsible and unethical. Medical providers and others who try to help people end pregnancies where abortion is illegal risk losing their jobs or being imprisoned.

Many of the impacts of criminalising abortion are disproportionately felt by marginalised groups, or those living in poverty, or in humanitarian settings. These groups often face increased risk of sexual violence and may not be able to travel for abortion care to states or countries where the services are legal, or may not have the funds or contacts to obtain services, including medication for early abortion which can be safely used at home.

Each year 47,000 women in the world die as a result of unsafe abortion and an estimated five million women are hospitalised for the treatment of serious complications such as bleeding or infection as the result of an unsafe abortion.

Every injury and death from unsafe abortion is preventable by providing timely, quality and safe abortion or post-abortion care.

MARCH and HHCC join the call on governments to act now

Joining the hundreds of healthcare organisations globally who have signed the FIGO-led statement, we urge all governments to take immediate action to:  

• Create and protect legal and regulatory environments that support healthcare professionals to provide access to safe and affordable abortion care. Access to abortion care should be protected and supported as an inalienable reproductive right.
• Decriminalise abortion care and regulate it like any other healthcare provision. Decriminalising abortion refers to the removal of specific criminal and/or civil sanctions against abortion from the law, so that no one is punished for having, providing or supporting access to abortion. 
• Utilise the full benefit of the safety and efficacy of abortion medication, as well as the advancement of technology, to allow telemedicine and self-management access to abortion, as recommended by the WHO Abortion Care Guideline.
• Invest in robust health systems that are human rights-centred for abortion care information, counselling and services.
• Prioritise training on abortion care as an essential part of professional development for health care professionals – integrate it into lifelong learning to ensure health services are universally available. Such approaches should be linked to reproductive and social justice movements and should include actions that address the needs and rights of communities that have been historically discriminated against. 

What can I do?

Join staff members who are demonstrating their opposition by asking organisations that they collaborate with to avoid hosting events in, or engaging with, US states that legislate against reproductive rights, or by explicitly choosing not to attend such events. If you would like to add your name to this statement, please email march@lshtm.ac.uk.

If you work in healthcare outside LSHTM, encourage your organisation to sign the global statement on the International Federation of Gynecology & Obstetrics (FIGO) website. Use the communications toolkits, available in English, Spanish and French, to promote the statement in your network.
 

Professor Susannah Mayhew, Maternal, Adolescent, Reproductive & Child Health Centre Co-Director

Professor Joy Lawn, Maternal, Adolescent, Reproductive & Child Health Centre Co-Director

Professor Debra Jackson, Maternal, Adolescent, Reproductive & Child Health Centre Co-Director

Associate Professor Neha Singh, Health in Humanitarian Crises Centre Co-Director

Dr Michelle Lokot, Health in Humanitarian Crises Centre Co-Director

Professor Cicely Marston, Maternal, Adolescent, Reproductive & Child Health Centre member

Josie McAllister, Communications Officer, Maternal, Adolescent, Reproductive & Child Health Centre

Dr Heidi Hopkins, Associate Professor, Faculty of Infectious and Tropical Diseases, Department of Disease Control

Dorothy Boggs, Research Fellow, Staff PhD Candidate, Faculty of Epidemiology and Population Health, Department of Population Health

Dr Ona McCarthy, Co-Deputy Director Centre for Evaluation & Maternal, Adolescent, Reproductive & Child Health Centre member

Dr Emma Harding-Esch, Associate Professor & Co-Director STI Research Interest Group (STIRIG)

Dr James Smith, Honorary Research Fellow, Health in Humanitarian Crises Centre

Dr Melissa Neuman, Assistant Professor of Epidemiology, Department of Infectious Disease Epidemiology

Dr Melisa Martinez-Alvarez, Senior Scientist, MRC Unit The Gambia at LSHTM

Dr Giorgia Gon, Assistant Professor, Department of Infectious Disease Epidemiology

Ruwan Ratnayake, Epidemiologist and PhD candidate, Department of Infectious Disease Epidemiology and Health in Humanitarian Crises Centre

Dr Jennifer Palmer, Assistant Professor, Department of Global Health & Development

Dr Samuel Boland, LSHTM alumnus