A Lesson in Medicine and Morality: Argentine Physician Pioneers Abortion Education in Medical School

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A Lesson in Medicine and Morality: Argentine Physician Pioneers Abortion Education in Medical School

A group of Argentine doctors moves beyond the polarized political debate to equip a new generation of medical professionals with the training necessary to care for patients who requiring abortion care.

By Marissa Rosenberg-Carlson -
Jun 17, 2017

Dr. Raquel Tizziani identifies herself as an educator. Anti-abortion activists think she’s a murderer. The professor of medicine at the National University of Rosario (UNR) is spearheading Argentina’s first university curriculum on abortion. Two months before the program’s start date, its faculty is already under fire. In the three days after UNR announced the plan, no fewer than 10,000 emails demanding an immediate halt to the program flooded the inbox of Ricardo Nidd, Dean of the College of Medicine.

Continued at source: The Bubble: http://www.thebubble.com/a-lesson-in-medicine-and-morality-argentine-physician-pioneers-abortion-education-in-medical-school/

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Argentina: “Belén” acquitted: Tucumán Provincial Supreme Court overturns sentence for aggravated homicid

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STOP PRESS: ARGENTINA “Belén” acquitted: Tucumán Provincial Supreme Court overturns sentence for aggravated homicide
by Safe Abortion
March 31, 2017

In 2014, “Belén”, a 27-year-old woman from the province of Tucumán went to her local hospital with a serious vaginal haemorrhage. The duty doctor diagnosed a spontaneous miscarriage, but “Belén” was accused of having disposed of the fetus in a hospital washroom. She was tried and sentenced to eight years in jail for aggravated homicide in a trial riddled with irregularities. She spent more than two years in prison until August 2016, when the Tucumán Supreme Court ordered her release after a long-running, nationwide campaign. Seven months later, the Court has now acquitted her due to the absence of evidence against her.

In overturning the lower court’s decision, the provincial Supreme Court highlighted the importance of patient confidentiality, the rights of women who have undergone an abortion and the right of women to be treated with dignity and not subjected to violence.

Her lawyer, Soledad Deza, told El País, that the ruling will set a precedent that will help to prevent other women from being treated as she was: “This ruling provides justice twice over: for Belén and all other women who do not want to be mothers who have a spontaneous or induced abortion. I believe this ruling will encourage women to use the public health system because they now know they will not be arrested when they leave.” She said Belén is also considering whether to bring legal action against the state for the time she has lost, the violation of her rights, the loss of her freedom and for changing the course of her life.

SOURCE: El País, 28 March 2017 (in English) ; Absuelta una joven argentina que estuvo dos años presa por un aborto (en español) ; PHOTO

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Source: International Campaign for Women's Right to Safe Abortion: http://www.safeabortionwomensright.org/stop-press-argentina-belen-acquitted-tucuman-provincial-supreme-court-overturns-sentence-for-aggravated-homicide/

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Argentinian woman reveals she gave herself an abortion at age 18 because the procedure is still illegal in her country

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'Seeing it come out of me was the worst moment of my life': Argentinian woman reveals she gave herself an ABORTION at age 18 because the procedure is still illegal in her country

An anonymous woman shared her story with Humans Of New York on Friday
Said she made 'the hardest decision of her life' when she got pregnant as a teen
'It's not legal here. So I researched it on the Internet,' the woman said
Performed the procedure on herself in her bedroom and didn't tell anyone

By Clemence Michallon For Dailymail.com

Published: 7 February 2017

A woman from Argentina has shared a heart-breaking tale of how she was forced to give herself an abortion at the age of 18, because the procedure is still illegal in her home country.

Continued at source: Daily Mail: http://www.dailymail.co.uk/femail/article-4199894/HONY-woman-gave-abortion.html

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The law, trials and imprisonment for abortion in Argentina

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8 November 2016
by Alice Finden, Researcher, International Campaign for Women’s Right to Safe Abortion

This report summarises the law and policy on abortion in Argentina and cases of trials and imprisonment for abortion between 2011 and 2016.

Abortion in Argentina has been legal in certain circumstances since the adoption of the Penal Code in 1922. According to Article 86 of the Penal Code, abortion is illegal except to "save the life of the mother or where the pregnancy results from a rape or indecent assault committed on a female idiot or insane". In the past, courts have interpreted the rape/assault provision to require that the rape victim suffer from a mental disability for the abortion to be legal.[1] In cases where abortion is illegal, the law stipulates prison sentences ranging from 3 to 10 years and as high as 15 years for those who carry out abortions. Women who consent to or cause their own abortion can be imprisoned for up to 4 years.[2] However, this can be greatly increased if the courts decide to convict the woman of homicide, such as occurred in the case of “Belén” in 2016, which will be described later in this report.

Between 2011-13, according to the national Ministry of Health, there were approximately 700,000 live births in Argentina annually, and between 370,000 and 460,000 abortions. Approximately one-third of maternal deaths in the previous decade had been due to the consequences of unsafe abortion.[3] According to Institute for Health Metrics and Evaluation data, in 2013 the total maternal mortality ratio was 54.7 per 100,000 live births (range 45.3-64.6).[4] For 2015, WHO found a similar MMR of 52 per 100,000 live births (range 44-63).[5] Compared to estimates from previous years, the MMR has not fallen much since 1990. The legal barriers that both women and health care providers face, especially in poorer and rural provinces, act to force women into unsafe, illegal “backstreet” abortions that risk their health and sometimes their lives, as well as possible imprisonment.

Data and cases reviewed by the Centro de Estudios de Estado y Sociedad (CEDES) and the Asociación por los Derechos Civiles (ADC), published by Ipas in 2014,[6] identified 417 cases recorded for the crime of abortion during the period from 1990 to 2008. The judicial records did not indicate whether these people were imprisoned, paid a fine or were granted conditional freedom, but they were all declared guilty of a crime.

The greatest percentage of sentences for the crime of abortion were against unskilled individuals who provided abortions. Based on national level data between 2002 and 2008, these sentences represented 80% of the total and were four times greater than sentences recorded against women who had an abortion. Between 1996 and 2008, a total of 234 sentences for this crime were confirmed nationwide. The jurisdictions with the most convictions were also the most populous provinces – Buenos Aires, Santa Fe, Córdoba – and the city of Buenos Aires.[7]

The 1966 legal case Natividad Frias had established that a criminal complaint presented by a health care provider against a woman for an illegal abortion violated her confidentiality rights and her right against self-incrimination. In 2010, the National Supreme Court of Justice reaffirmed this principle, which may explain the low number of cases of women who have
been investigated or found guilty of illegal abortion in comparison with the number of cases against health care service providers who have been investigated, prosecuted and sentenced.[8]

In 2011, there was an exceptional case involving a woman physician who spent more than a year waiting to face a charge of criminal action for prescribing misoprostol for a 12-year-old girl in a marginalized neighbourhood for the termination of a pregnancy, in order to protect the girl's health, as the girl was adamant she would abort the pregnancy. The girl bought the medication and aborted on her own. It was the girl's parents who reported the doctor when they found out. The case was not heard for a year until the doctor could find a competent lawyer to represent her, when the case was finally closed. At the time, the doctor stated that providing this kind of counsel was standard at the clinic where she worked, and that she would do it again.[9]

It is important to note the correlation between the number of cases brought by the police or to the courts, the number of sentences that ended in imprisonment, the extent of limited access to health care and the maternal mortality ratio (MMR).

Legislative progress in support of sexual and reproductive health and rights (SRHR) has occurred a number of times in Argentina. In 2002, the National Programme for Sexual Health and Responsible Procreation aimed to lower maternal mortality. In 2004, the national government defined reproductive health as one of the key areas of national health policy for the next three years.[10] In 2006, Law 26.150 introduced comprehensive sexuality education. In 2012, the Supreme Court supported a lower court ruling that had allowed an abortion for a 15-year-old girl who had been raped by her stepfather. The Supreme Court determined that the entire article in the law on rape and assault supported the interpretation that all rape victims may legally seek abortions. The Court also said that future rape victims would not be required to seek judicial approval for an abortion.[11]

All these victories were achieved under pressure from feminist, human rights and other advocacy groups supporting sexual and reproductive health and rights, throughout a period of government when the then President Néstor Kirchner’s relationship with the Vatican had broken down.[12]

The violence of institutions
A case that was widely publicised and recently celebrated is that of “Belén”.[13] Belén was originally charged with aggravated murder on 3 May 2016. She had been held in jail for two years, since 2014. Belén was 25 years old when she went to a state hospital in San Miguel de Tucumán state, complaining of severe abdominal pains and heavy vaginal bleeding. The doctor she saw told her that she was 22 weeks pregnant and that she was experiencing a miscarriage. Other medical staff, who found a 32-week-old fetus in a hospital bathroom, claimed that it was hers. They then reported Belén to the police, claiming that she must have induced a very late abortion. She was charged with homicide, held in pre-trial detention for two years and then sentenced to 8 years and imprisoned in March 2014, all without legal representation. Yet, there was no DNA testing to connect Belén to the fetus, and the discrepancy between the diagnosis of miscarriage of a 22-week pregnancy and a 32-week-old fetus in a bathroom was never examined.[14]

After her case became known, thanks to the lawyer who agreed to represent her, there was growing criticism of the miscarriage of justice by dozens of feminist, human rights, political and social organizations and the UN Human Rights Committee. Amnesty International collected 120,000 signatures a petition calling for her release. Following demonstrations on 12 August 2016 in cities across the country, centred in the capital of Tucumán, the Supreme Court of Justice of Tucumán ordered that she should be released from prison pending an appeal of her sentence, which is still pending at this writing.[15]

In countries with restrictive abortion laws and legal requirements to report any breaking of the law they encounter, health care providers face a moral conflict as to whether to uphold a patient’s right to confidentiality, including when it is a woman in need of post-abortion care for complications of unsafe abortion. In Argentina, the abortion law states, “each member of a woman’s health team should ensure confidentiality and privacy when providing abortion care in circumstance allowed by law”. Post-abortion is allowed by law.[16] However, a combination of lack of legal awareness, pressure from conservative and religious groups, and the fear that they themselves may be arrested for providing an abortion often means that health professionals do report women in these circumstances to the police.[17]

This conflict has disastrous results for women and girls seeking legal abortion care. The denial of abortion to a 12-year-old indigenous girl in the Salta province, who was raped in November 2015, is an example of this. The girl, known as “Juana”, should have been permitted a legal abortion, as her pregnancy was the result of gang rape by five men and three adolescent boys, and her health and mental state were at risk. However, she did not receive proper medical care, nor was a pregnancy test even done. At seven months of pregnancy she was found to be carrying an anencephalic baby and was delivered by caesarean section.[18]

Considering Belén’s case in Tucumán and Juana’s in Salta, Mariana Álvarez, a professor of human rights at the University of Tucumán told the Buenos Aires Herald: “There is a systematic pattern of human rights violations in the district [Tucumán] relating to women, reflecting an agreement between the health care system and the judiciary to criminalize women who face pregnancy complications.” [19]

Health care providers
Institutional connections between the courts and the health care system may be more likely due to a lack of adequate medical education on abortion for health care students in Argentina. Indeed, a case study in 2015-2016 of health care students’ knowledge of abortion law in Argentina found that of 740 students who answered the questions about abortion according to current Argentinean law, half the students (52.5%) answered correctly that abortion was legally restricted, 24.9% thought it was always illegal, and 21.5% admitted they did not know.[20] The authors of this study worried that lack of knowledge may lead these future health care providers to deny a legal abortion to someone with an unwanted pregnancy who is legally entitled to it, resulting in recourse to unsafe abortion.

Anti-abortion groups also using the law
Alongside the progress represented by some SRHR laws and policies in Argentina, an article in 2014 describes how anti-abortion NGOs have sought to use litigation to undermine sexual and reproductive health policies, and especially to oppose any extension of the right to abortion.[21] The authors describe these groups as the “civil arm of religion”, particularly since 1998, when the conservative NGO Portal de Belén successfully achieved the banning of emergency contraception through the courts. There have also been several attempts to force the withdrawal of the National Programme for Sexual Health and Responsible Procreation, one of which temporarily succeeded in December 2002, although it was revoked a few weeks after the ruling was published.[22] As early as 1994, anti-abortion groups were using legal arguments to oppose sexual and reproductive health and rights. Under a collective writ of amparo in 1994, they were able to enforce legal recognition of the so-called “right to life from conception”, and since then have tried to use the 1994 ruling as a legal precedent to try to criminalise legal abortions, for example by attempting to block young women from accessing legal abortion following rape.[23]

Monica Gogna et al. note that the “defence of life from conception” clause, promoted by former President Menem in 1994, was a “manifestation of Argentina’s then complete alignment with Vatican policy on abortion”.[24] They note that Menem’s enthusiasm for this initiative stemmed from his wish to gain support of the Church hierarchy in the 1995 presidential elections. More recently, with the election of the Argentinian Pope in 2013, the Argentinian national executive, Conservative NGOs and the Vatican have strengthened their relationship. This has already led to the Catholic hierarchy putting pressure on the government, and succeeding in influencing the reform of the Civil and Commercial Code. Consequently, the final version of Article 19 states that “life starts at conception”,[25] giving conservative NGOs the potential to counter progress made by abortion rights groups.

The coalition of the Catholic hierarchy and conservative NGOs with the Argentinian national executive has highly negative effects for the health and well-being of women and health care providers all over Argentina. The Asociación por los Derechos Civiles (ADC) indicates that the majority of Argentinian provinces are not following guidelines on abortion set out by the national Supreme Court.[26] Indeed Juana’s case in the Salta province evidences the ability of local authorities to disregard the law at will. The Salta province, among 15 others, either does not have any protocols in place to allow access to legal abortion, or has protocols in place that aim to hinder access to legal abortion.[27] The ADC found for example that Salta was the “worst province in terms of guaranteeing access to non-punishable abortion” through its collusion in blocking the right to abortion in cases of rape and risk to the woman’s health. Salta province allows doctors to refuse to carry out an abortion in cases other than moral objection, requires the intervention of the Public Ministry, and the presence of parents in cases involving minors for an abortion to take place. It also limits the time until which abortion is legal to 12 weeks.[28] As Shena Cavallo notes, practice more often than not differs from what is written in law and facilities supposedly provided. [29] Because of Juana’s case, the Lower House of Congress issued a report stating that “all courts and administrative authorities are to comply with comprehensive health care protocols to deal with cases of non-punishable abortions.”[30] It remains to be seen whether this will be acted upon.

The use of advocacy and information in support of women's need for safe abortion
Civil society organisations, women’s groups and safe abortion information hotlines, such as the Socorristas en Red[31] and La Linea Aborto,[32] are increasingly helping women to get accurate information on the medical abortion pills called misoprostol, and provide pre- and post-abortion counselling and support.[33]

Moreover, to end on a positive note, legislative and judicial progress in the past few decades has created legal space for women and health care providers to counter conservative NGOs. This has been mirrored in statements by the new UN Special Rapporteur on Torture from Argentina, Juan Méndez, who supported the release of "Belén" and called on all nations to decriminalise abortion and to ensure access to safe and legal abortion. He said: “States have an affirmative obligation to reform restrictive abortion legislation that perpetuates torture and ill-treatment by denying women safe access and care.”[34]

The conditional release of "Belén" has been described as a “collective triumph of the women’s movement”.[35] Over 300 feminist, women’s rights and abortion rights groups worked together in Argentina to secure her release and to press for confirmation of her innocence. Belén’s lawyer described the cancellation of her preventative detention and release as “the beginning of the end of injustice.”[36] Today activists are waiting on the appeal court to overturn Belén’s conviction, which will hopefully create a legal precedent, preventing the same thing happening to other women in future.

Acknowledgements
Thanks to Mariana Romero, Senior Researcher, Centro de Estudios del Estado y Sociedad (CEDES), Argentina, for reviewing this report and regularly sharing news of events in Argentina. Edited by Marge Berer.

[1] Penal Code of the Nation of Argentina, Law 11, 179 of 1984, Second Book, Title I, Chapter I, Articles 85-88. http://servicios.infoleg.gob.ar/infolegInternet/anexos/15000-19999/16546/texact.htm

[2] Ibid. Penal Code

[3] Argentina Ministry of Health data, noted in: Belén Provenzano-Castro, Silvia Oizerovich, Babill Stray-Pedersen. Healthcare students’ knowledge and opinions about the Argentinean abortion law. Sexual & Reproductive Healthcare 2016;7:21-26. http://www.srhcjournal.org/article/S1877-5756(15)00063-4/pdf

[4] Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384(9947):980–1004. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60696-6/abstract

[5] Trends in maternal mortality 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: WHO, 2015. http://apps.who.int/iris/bitstream/10665/194254/1/9789241565141_eng.pdf?ua=1

[6] Gillian Kane, Beatriz Galli, Patty Skuster, 2014. Argentina. When Abortion is a Crime: The threat to vulnerable women in Latin America. Ipas. http://www.ipas.org/en/Resources/Ipas%20Publications/When-Abortion-is-a-Crime-The-threat-to-vulnerable-women-in-Latin-America.aspx

[7] Ibid Kane, Galli and Skuster

[8] Ibid Kane, Galli and Skuster

[9] Ibid Kane, Galli and Skuster

[10] Mónica Petracci, Silvina Ramos, Dalia Szulik, 2005. A strategic assessment of the Reproductive and Responsible Parenthood Programme of Buenos Aires, Argentina. Reproductive Health Matters 2005;13(25). http://www.rhm-elsevier.com/article/S0968-8080(05)25174-1/pdf

[11] Rebecca DiLeonardo. Argentina Supreme Court legalizes abortion for rape victims”. The Jurist. 14 March 2012. http://www.jurist.org/paperchase/2012/03/argentina-supreme-court-legalizes-abortion-for-rape-victims.php quoting https://www.scribd.com/fullscreen/85219759 and ref 1.

[12] Ibid, DiLeonardo, p.87.

[13] International Campaign for Women’s Right to Safe Abortion Newsletter. Demonstrations in Buenos Aires and Tucumán to release woman sentenced to prison for miscarriage. 5 May 2016. http://www.safeabortionwomensright.org/demonstrations-in-buenos-aires-and-tucuman-to-release-woman-sentenced-to-prison-for-apparent-miscarriage/

[14] International Campaign for Women’s Right to Safe Abortion Newsletter. STOP PRESS: Belén released from prison. 19 August 2016. http://www.safeabortionwomensright.org/stop-press-belen-released-from-prison/

[15] Ibid. International Campaign

[16] Jina Dhillon. Protecting Women’s Access to Safe Abortion Care-A Guide to Understanding the Human Rights to Privacy and Confidentiality: Helping Advocates Navigate ‘Duty to Report’ Requirements. Ipas, 2014. http://www.ipas.org/en/Resources/Ipas%20Publications/Protecting-Womens-Access-to-Safe-Abortion-CareA-Guide-to-Understanding-the-Human-Rights-to.aspx

[17] Betraying women: provider duty to report. Ipas, 2016. http://www.ipas.org/en/Resources/Ipas%20Publications/Betraying-women-Provider-duty-to-report.aspx

[18] Ximena Schinca. Activists protest in Buenos Aires after 12-year-old is denied legal abortion. Buenos Aires Herald, 16 June 2016. Reported in: International Campaign for Women’s Right to Safe Abortion. 17 June 2016. http://www.safeabortionwomensright.org/activists-protest-in-buenos-aires-after-12-year-old-is-denied-legal-abortion/.

[19] Ximena Schinca, 2016. Tucumán’s abortion trials placed in spotlight. Buenos Aires Herald, 23 August 2016. http://www.buenosairesherald.com/article/220404/tucum%C3%A1n%E2%80%99s-abortion-trials-placed-in-spotlight

[20] Op cit. Provenzano-Castro, Oizerovich, Stray-Pedersen, p.21

[21] Maria Angelica Peñas Defago, José Manuel Morán Faúndes. Conservative litigation against sexual and reproductive health policies in Argentina. Reproductive Health Matters 2014;22(44):82-90. http://www.rhm-elsevier.com/article/S0968-8080(14)44805-5/pdf

[22] Ibid. Peñas Defago, Morán Faúndes.

[23] Ibid. Peñas Defago, Morán Faúndes.

[24] Mónica Gogna, Mariana Romero, Silvina Ramos, Mónica Petracci, Dalia Szulik. Abortion in a restrictive legal context: the views of obstetrician-gynaecologists in Buenos Aires, Argentina. Reproductive Health Matters 2002;10(19). http://www.rhm-elsevier.com/article/S0968-8080(02)00014-9/pdf

[25] Op cit. Peñas Defago and Morán Faúndes, p.87.

[26] Asociación por los Derechos Civiles, 2015. Acceso al abortion no punible en Argentina: Estado de situación. http://despenalizacion.org.ar/pdf/publicaciones/ADC-Acceso-al-aborto-no-punible-Marzo-2015.pdf

[27] Celina Andreassi. Majority of provinces not complying with abortion rights. The Argentina Independent. 13 March 2015. http://www.argentinaindependent.com/currentaffairs/majority-of-provinces-no-complying-with-abortion-rights/

[28] Ibid. Andreassi.

[29] Shena Cavallo. Abortion in Argentina: women twice betrayed. Open Democracy, 3 May 2016. https://www.opendemocracy.net/democraciaabierta/shena-cavallo/abortion-in-argentina-women-twice-betrayed

[30] Op cit. Schinca, ref 18.

[31] http://www.socorristasenred.blogspot.com.ar/

[32] http://www.abortoconpastillas.info/

[33] Silvina Ramos, Mariana Romero, Lila Aizenberg. Women’s experiences with the use of medical abortion in a legally restricted context: the case of Argentina. Reproductive Health Matters 2015;22(44/Supplement):4-15. http://www.rhm-elsevier.com/article/S0968-8080(14)43786-8/pdf

[34] International Campaign for Women’s Right to Safe Abortion Newsletter, Statement: Special Rapporteur on Torture. 20 May 2016. http://www.safeabortionwomensright.org/statement-special-rapporteur-on-torture/

[35] Luciana Peker. Cuando Belén se escribió con V. Página12, 19 August 2016. http://www.pagina12.com.ar/diario/suplementos/las12/13-10798-2016-08-19.html

[36] Ibid, Peker.

Source: International Campaign for Women’s Right to Safe Abortion

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Continuing the Reports from 28 September

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4 October 2016

More reports on September 28 events from the International Campaign for Women's Right to Safe Abortion, including from Poland, Nicaragua, Netherlands, UK, Armenia, Macedonia, Croatia, Argentina, Brazil, Mexico, Kenya, Nigeria, and Ghana.

TOP STORIES: POLAND AND NICARAGUA

[continued at link]
Source: International Campaign for Women's Right to Safe Abortion

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Campaign Statement in Celebration of International Safe Abortion Day, 28 September 2016

International Campaign for Women's Right to Safe Abortion

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Sept 26, 2016

The first international day dedicated to the decriminalisation of abortion was in 1990, initiated by the feminist movement at a regional conference in Argentina. The choice of date was inspired by the abolition of slavery for children born to slave mothers in Brazil in 1871, when it was named the Day of the Free Womb. Slavery can be imposed by one set of human beings on another in a myriad of ways. In the face of the threat of slavery and other forms of coercion, the achievement of freedom, both freedom from and freedom to, is a constant and unending struggle, including for women.

Most women have children. To force women to have children they do not wish to have, however, is a form of slavery and of violence against women. There are only two ways women can avoid unwanted pregnancy. The first is not to have sex with men, thereby removing the risk of pregnancy. But, of course, not every sexual encounter is consensual. Historically, women have collectively declared a boycott of sex in a number of countries, for a range of political reasons, sometimes effectively. A boycott of sex has not yet been used to demand universal access to safe abortion, but it is always possible. It might be assumed that, given the choice, most heterosexual men would support access to safe contraception and abortion over the refusal of sex, especially in the longer term although this is an untested assumption.

The only other way women can avoid unwanted pregnancy is through universal access to safe, effective contraception and safe, legal abortion. Contraception is not enough on its own because it comes with a failure rate and it isn't always used or there to be used. That makes access to safe abortion a necessity.

World Contraception Day, first launched in 2007, is being celebrated today, 26 September. The Campaign office is supporting this day today through social media, using the hashtags #WCDChat and #WCD2016.

International Safe Abortion Day is being celebrated in the week surrounding 28 September. It is probably a coincidence that these two international days are so close to each other, but it is surely appropriate.

On 17 August this year, with the support of signatories from 73 countries who are actively involved in policymaking, health services, research, human rights and advocacy in support of safe abortion, the Campaign asked the UN Secretary-General and the heads of UN agencies (+ Español) to take a stand and make 28 September an official UN Day. We asked them to acknowledge that making abortion safe is in line with a growing number of inter-governmental agreements, starting with the International Conference on Population and Development Programme of Action in 1994, the Beijing Women’s Conference Platform for Action in 1995, the Latin American Convención de Belém do Pará in 1996, the African Maputo Protocol of 2005, and most recently the call for the decriminalisation of abortion across Africa by the African Commission for Human and Peoples’ Rights (ACHPR).

This year, for 28 September, inspired by ACHPR, we are calling for the decriminalisation of abortion across the world. We are asking that abortion is no longer treated as a crime under laws passed in the 19th century by colonial powers. Inspired by Laurence Rossignol, the French Minister for Families, Children and Women’s Rights in a speech at the UN last year, we are calling for a moratorium on prosecutions of women who have had abortions and safe abortion providers.

And we are calling for universal access to safe abortion.

We say: "Abortion is not a crime!"
If it is legitimate to use contraception to prevent unwanted pregnancy then it is legitimate to have an abortion for the same reason. Abortion must be removed from the criminal law as an essential step towards making it safe. It is in the power of all governments to do this and make safe abortion accessible and available to every woman who requests it, thereby eliminating unsafe abortion. In recent decades, every United Nations human rights body has recommended that governments take these steps. And indeed, in recent years a growing number of governments in countries where abortion is legally restricted have acknowledged the extent of unsafe abortion in their countries and the serious consequences for women and their families. Research has shown how high the costs are to their public health systems for treating complications of unsafe abortion, which would disappear if they were providing safe abortions. Research has also found that adolescents are most at risk, including those who became pregnant due to sexual abuse. This is the case in Africa, parts of Asia and in Latin America today.

We call for decriminalisation of abortion around the world
Yet as soon as a government takes steps to alleviate this situation through proposals for law reform, even minimal ones that will affect only a small number of women, or proposes guidelines for implementing their current laws less restrictively, a brigade of conservative religious and others come on the scene and seek to block change. The pressure behind the scenes is often enormous. Governments become timid, forget their national, regional and international commitments to reduce maternal mortality and morbidity, among which deaths and injury from unsafe abortion constitute either a first or second cause, and go silent. The most egregious example early this year was in Sierra Leone, where in spite of not one but two votes in favour of law change in the national parliament, the second vote being unanimously in favour, the president has for the past nine months refused to sign the Safe Abortion Act into law, creating an unresolved constitutional crisis.

Mozambique, where the abortion law was reformed between 2014 and 2015, is a notable exception – where government, legal experts, health professionals and NGOs worked together to implement change. We call on governments to follow in the footsteps of countries like Mozambique and Uruguay, where a harm reduction model was used to reform the law and make abortions safe.

In contrast, this year has seen a bill in the parliament of El Salvador to increase the number of years of prison for abortion, and last week in Poland a bill was sent to a parliamentary committee that would not only ban all abortions, even if the woman's life is at risk, but also antenatal screening and sexuality education.

The anti-abortion movement has changed a great deal over the past decades. From a movement that used to try and convince everyone that abortion was wrong, they have morphed into a group who want to convince people that a fertilised egg has more value and more right to protection than a living person. They talk about vulnerability, but they never call for nor put their considerable energy or resources into improving the lives of living children, millions of whom have very precarious lives and are very vulnerable indeed. Moreover, they completely discount women's deaths and suffering from unsafe abortion. Nonetheless, in spite of decades of trying, they have failed to convince anyone that making abortion illegal will stop abortion. They have particularly failed to convince women to stop having abortions, the very same women who would do anything to nurture and protect the children they do have. Even women who think abortion is wrong have abortions, including women in the anti-abortion movement.

Pregnancy happens in women's bodies, not in the disembodied womb they portray. They appear not to care about the deaths of women from unsafe abortions, which inevitably lead to the deaths of fertilised eggs, embryos and fetuses as well. Their language often reads like a declaration of holy war against women. Their slogans, calling for protection of the so-called "unborn", are actually a call to force women to become mothers at the whim of their own biology. Taken to the extreme, using the analogy of oak trees and acorns, they would enforce the planting of every acorn that falls from the tree, even if the thousands of trees that would result would choke and kill the mother tree. How do they seek to achieve their aims? They work for the criminalisation of women who have had abortions, that is, to make up to one in three women in the world a criminal. And they imprison women who are poor and have no recourse to private doctors or legal advice. They reserve particular hatred for those who help women to have safe abortions – murdering them or destroying clinics in the USA, for example, or putting them through years of unwarranted prosecution, as with Dr Carlos Morin in Spain.

It's time for a moratorium on prosecutions for abortion!
But things have also gone further. We are beginning to see support for the criminalisation of women who have had a miscarriage or a stillbirth, that is, any pregnancy that does not result in a living child. This is an appalling new form of blame. The imprisonment of women for these reasons in El Salvador is well known, but this is also taking place in the USA, and there was a case in England at the end of last year as well. In Northern Ireland, it is apparently well known that hospitals are reporting instances of miscarriage for investigation. Elsewhere, women are being demonised who have died after unsafe abortions. In Brazil, for example, the body of Caroline, a 29-year-old woman who died from an unsafe abortion, was dumped in the street not long ago in a city near Rio de Janeiro. Commenting on press reports of her death, anti-abortionists have said she deserved it. This reveals an incredible hatred of women, and seeks to dehumanise all of us by association.

The anti-abortion goal – of taking away any autonomy from women over our bodies and reproductive lives – will not be defeated by rational, public health, ethical, evidence-based or human rights-based argument alone, no matter how eloquent. It is, however, essential in building a critical mass of support, until governments can no longer look the other way.

Our movements, worldwide have achieved widespread support for women's right to decide the number and spacing of their children, yet countries where abortion is legally restricted are dragging their feet or even trying to take us backwards e.g. when right-wing parties have taken control of government. History has shown that change which benefits women comes excruciatingly slowly. In the end, it is about power, at the individual as well as the social level. Women will have abortions; the real issue is whether those who seek to help them or those who seek to hurt them have more power to affect their experience and whether they survive it.

We are an international movement supporting universal access to safe abortion
Movements to support access to safe, effective contraception began more than 100 years ago; they are large and growing, and in recent years, extremely well-funded. Contraceptive use has grown substantially, though more in the global north, where the rate of abortions has been falling apace. In the global south, however, the use of contraception has not yet risen to the point where the rate of abortions has begun falling, especially in the least developed countries. This is because women's status and freedom to take charge of and control many aspects of their lives, including having the right to decide the number and spacing of their children, remains far more restricted. Hence, with the global growth in population, the numbers of abortions have continued to rise; at last estimate (for 2014) they had reached 56.3 million abortions per year. This is the ultimate failure of the anti-abortion movement, but the fact that half of those abortions remain unsafe also represents a failure of the abortion rights movement to convince our governments to act.

Movements for abortion rights also began 100 years ago. Many countries reformed their laws on abortion, starting with the Soviet Union in the 1920s and later the then Soviet bloc of Eastern Europe and Central Asia. In the second half of the 20th century, most European countries, the USA and Canada, Cuba, India, some states in Australia, New Zealand, South Africa and others also began to reform their laws.

The abortion rights movement is fighting for protection of the health and rights of women, and women's right to decide what happens in their own bodies, so that whether a woman wants to be pregnant and have a child, or she feels she cannot continue a pregnancy, she can do so safely in both cases.

Many of us have been engaged in this struggle throughout our lives, as have countless others who came before us. All over the world, for 28 September, we are declaring with one voice that in law and policy and in service delivery, and as a matter of human rights and public health, women have a right to safe abortion.

What's happening this week for International Safe Abortion Day
On 23 September, we published a whole newsletter with a list of activities planned or taking place in Uganda, Zimbabwe, DR Congo, Ghana, Tanzania, Thailand, New Zealand, Nepal, North India, Egypt, Sexual Rights Initiative, Ireland, UK/London, Russia, Sweden, El Salvador, Argentina, and Brazil, and by regional/international NGOs Asia Safe Abortion Partnership, WGNRR, Ipas, IPPF Europe Region, and of course the Campaign.

We would like to call special attention to a day-long national meeting organised in the Democratic Republic of Congo, where 120 representatives from a range of government ministries, members of parliament, representatives of UN agencies, professional associations for midwives and doctors, a long list of civil society organisations and the media came together in a meeting on the problem of unwanted pregnancy and abortion in the context of the DRC as part of a 28 September commemoration. This is how change happens on the ground in our countries, through coalition- building, through working together among all the institutions and groups, governmental and non-governmental, both those who have responsibilities as state bodies and those among civil society who have a huge amount of knowledge and experience and so much to contribute.

More activities :

  • Poland: A new protest against the bill in the parliament intended to criminalise all abortions is planned for 1 October.
  • Ireland: (1) On 24 September, tens of thousands marched in Dublin. (2) Parents for Choice in Pregnancy and Childbirth has made a video with the REPEAL project about the issues that Ireland’s abortion law creates for women who are keeping their babies as well as for those trying to access abortions.
  •  India: 'Voice Your Abortion. Defeat Stigma', a platform for women from all walks of life to share their abortion stories and experiences will be hosting a Twitter chat in collaboration with Feminism In India about abortion storytelling and using it as a medium to end abortion stigma.
  • Bogotá, Colombia: La Mesa por la Vida y la Salud de las Mujeres will carry banners in the street, in honour of the peace being signed, that say, for example: “Yes to peace! No to violence! It starts with our bodies! Women must decide! Total decriminalisation of abortion!". Posters with slogans such as "Don't judge me!" will also be placed in the main stations of the public transport system.
  • Perú: CLACAI (Latin American Campaign against Unsafe Abortion) is re-launching their video “Poder Elegir” (The Right to Choose) on social media, made with well-known singers and musicians, which makes visible in a clear and sensitive way the violence that governments of the Latin American region exercise against women because of the prohibition of access to safe abortions.
  • Tanzania: the NGO Governance Links Tanzania will hold a dialogue with media groups on 28 September to reflect on "Common but different roles of social actors in abortion stigma reduction – Building a community of the willing."
  • Women Help Women, an international group linking activists, organisations and researchers around the world to increase the availability of reproductive health choices, is collecting statements from women around the globe about why they risk imprisonment to help women access the abortion pills they need to preserve their rights and autonomy.

On Wednesday, 28 September, we will publish more from these reports and from everyone else we have heard from.

Send your reports with visuals and weblinks to: info@safeabortionwomensright.org

Source: International Campaign for Women's Right to Safe Abortion

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A Harm Reduction Model for Safe Abortion in Uruguay and Argentina

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This newsletter summarises all the papers in this supplement, based on excerpts from the actual text, with permission from Anibal Faúndes. The full papers are available on an open access basis under a Creative Commons licence.

12 September 2016

Reducing Maternal Mortality by Preventing Unsafe Abortion: The Uruguayan Experience

International Journal of Gynecology & Obstetrics 2016;134 (Supplement 1, August)
Anibal Faúndes, Editor

IJGO Table of Contents or http://dx.doi.org/10.1016/j.ijgo.2016.06.010

EDITORIAL

What can we do as gynecologists/obstetricians to reduce unsafe abortion and its consequences? The Uruguayan response

Anibal Faúndes

As health care professionals, we are often confronted with situations in which we feel powerless to deal with the suffering, illness, and death of individuals whose care is our responsibility, particularly in public health facilities. The most common reaction is to protest against the authorities that have failed to provide the necessary resources or to implement the measures required to rectify situations that penalize almost exclusively those most economically disadvantaged. These health problems and their consequent mortality have remained the same for decades, largely because the individuals suffering from them have neither the power nor the political influence to trigger changes that could improve their situation.

Unsafe abortion—with its dramatic consequences for the poorest and most helpless women in countries with restrictive abortion laws—is one of the clearest and most persistent examples of a severe problem that impels us to protest against the authorities that have failed to resolve it.
A small group of physicians from the Pereira Rossell Hospital in Montevideo, Uruguay, decided that they could no longer wait for an external solution… Those doctors decided to implement an original preventive intervention to resolve the problem… [T]hey had no resources, no adequate physical space, and no designated personnel for the task they were proposing to undertake… [but were] inspired by the wise words of Professor Mahmoud Fathalla when he invited all gynecologists and obstetricians to cease being part of the problem and start being part of the solution [1]—achieved what seemed a miracle, namely to reduce maternal deaths from abortion (the primary cause of maternal death in Uruguay at that time) practically to zero.

[continued at link]
Source: International Campaign for Women's Right to Safe Abortion

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Argentina: Tucumán’s abortion trials placed in spotlight

Demonstrators take part in a march demanding Belén’s release in front Tucumán’s courts. A sign reads “my body, my choice”.

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By Ximena Schinca
Herald staff
Tuesday, August 23, 2016

Rights groups hail the release of ‘Belén’ — but activists say the problems in the province run deeper
An online campaign, in the wake of the temporary release of a prisoner from jail, is seeking to build momentum and pile pressure on the authorities in Tucumán province, while abortion rights are currently high on the national agenda.

“The #YoSoyBelén (“I am Belén”) campaign is aimed at the medical and judicial staff who displayed intent to violate ‘Beléns’ privacy, and at showing that all women, any of us could be ‘Belén,” said Alejandra del Castillo, a member of a campaign group who battled for the 27-year-old’s release from jail, in conversation with the Herald.

Del Castillo was addressing the recent social media campaign that was launched in order to build awareness about health rights and the victim’s recent experiences in the northern province.

[continued at link]
Source: Buenos Aires Herald

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Belén’s release from prison ordered following demonstrations across Argentina

Photos by Gerardo Dell'Oro (http://www.clarin.com/sociedad/Marchan-libertad-condenada-aborto-espontaneo_0_1630637093.html)

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International Campaign for Women's Right to Safe Abortion
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18 August 2016

On 16 August, the Supreme Court of Justice of Tucumán in Argentina finally ordered that "Belén", the young woman unjustly convicted of homicide after having had a miscarriage, should be released from prison, in the face of growing criticism by dozens of feminist, human rights, political and social organizations and the UN Human Rights Committee. However, 24 hours later, she had not yet been released, according to Amnesty International, who had collected 120,000 signatures on a petition calling for her release.

The decision was announced after demonstrations on 12 August in cities across the country, convened via the hashtag #LibertadParaBelén, with the epicentre in the capital of Tucumán. Belén has been in prison since March 2014, after she attended the Hospital Avellaneda with strong stomach pains, unaware that she was pregnant, and miscarried in the hospital. Although she was initially diagnosed with the miscarriage of a 20-week pregnancy, she was then accused of homicide of a 32-week pregnancy. She was held in pre-trial detention for 2 years and then sentenced to 8 years.

[continued at link]
Source: International Campaign for Women's Right to Safe Abortion

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Argentina: UN report slams punishment for abortion

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Protesters ask for the freedom of Belén, condemned to eight years of prison after a miscarriage.

July 16, 2016

Human Rights Committee also voices concern about media concentration in Argentina The United Nations Human Rights Committee has released a report slamming the state of abortion rights in Argentina and criticizing President Mauricio Macri’s decision to strike down key articles of the Broadcast Media Law and its subsequent effects on freedom of expression yesterday.

The UN body, which is comprised of a collective of human rights experts from UN member states, published its findings on Argentina and voiced “serious concerns” over the possibility of a “concentration” of power following the abolition of the Broadcast Media Law and existing repressive abortion law in the country.

The report said that restrictions placed on reproductive rights in Argentina undermined human rights and strongly recommended that the de-facto criminalization of abortion in Argentina be reversed.

“The state must revise existing legislation on abortion, including criminal legislation, in particular by introducing additional exceptions to the prohibition of abortion, including when the pregnancy is the result of rape, regardless of the intellectual ability or psychology of the women,” the report said.

The committee expressed concern about the “reduction of staff and institutional changes in areas destined for human rights protection, in particular with respect to the institutions working on the process memory, truth and justice.”

President Mauricio Macri, like his predecessor former president Cristina Fernández de Kirchner, won the presidency on a “pro-life” ticket that guaranteed to preserve existing laws surrounding abortion in Argentina, which is only permitted in limited circumstances and with a court order. Court-approved abortions have also proven hard to come by.

The report said the state’s failure to provide abortion throughout the country threatened human rights of Argentines and called on Macri’s administration to make sure that everyone in need had access to reproductive health services.

“The state must ensure that all women and girls can access reproductive health services in all regions of the country and that the legal barriers and the lack of medical protocols do not force women to resort to clandestine abortions that put their health and lives at risk.”

There are an estimated 500,000 abortions carried out per year in Argentina, the vast majority of which are clandestine.

The report also referenced the ongoing “Belén case” surrounding the incarceration of a 27-year-old Tucumán resident who suffered a miscarriage in March 2014, was arrested and convicted of murder earlier this year.

Belén was in custody for the two years previous to her conviction. Human rights group Amnesty International has launched a worldwide campaign for her release, and the Committee’s report reiterated the organization’s demands calling for her release from jail.

“The state must revise the ‘Belén case’ in light of international standards in the field, with a view to her immediate release, and in light of the case, consider the decriminalization of abortion,” the report said.

The Committee’s highlighting of existing abortion laws in Argentina undermining human rights followed a statement by Macri last month where he doubled down on campaign rhetoric surrounding the issue, saying that he “defends life from the moment of conception until death.”

A cross-party group of national lawmakers recently submitted a bill calling for the legalization of abortion in Argentina, a move lawmakers in favour of reform have attempted repeatedly, though without the necessary support it is unlikely to make it past the congressional committee stage.

Media law reforms may violate ICCPR

While abortion rights in Argentina have long been a concern for human rights groups and agencies including the committee, the report also highlighted more recent developments and cited concerns over Macri’s use of a presidential decree to undo key elements of the 2009 Broadcast Media Law.

The law was introduced under Macri’s predecessor Fernández de Kirchner and won international praise, including from the UN, for its attempts to prevent monopoly ownership of media in Argentina by capping the number of media outlets private companies could own and limiting to 33-percent each the market share that private companies, NGOs and state agencies had across national media.

Under a subtitle “freedom of expression”, the report recommended Macri’s government to “reconsider” the effective abolition of the Broadcast Media Law via presidential decree, which Macri implemented with majority congressional approval in April.

“The Committee notes with concern the recent reforms in audiovisual services which may have the effect of concentrating the ownership of media communication and negatively affect freedom of expression,” the report said.

It added that Argentina may be in violation of Article 19 of the International Covenant on Civil and Political Rights (ICCPR), an international agreement on the preservation of human rights entered into by most UN member states and the basis of the Committee’s review. Article 19 concerns freedom of expression. The Committee was reviewing the implementation of the ICCPR.

“The state must adopt all necessary measures to ensure that its legislation is entirely compatible with Article 19 of the Covenant, with a view to guaranteeing the rights of freedom of expression and freedom of the press,” the report added.

International agreements and laws have a higher rank over domestic laws according to Argentina’s constitution.

Bad news, good news

The Committee, which welcomed an Argentine official delegation and non-governmental organizations for comment on the compliance with the ICCPR in June, also called for the appointment of an Ombudsperson as soon as possible. The last Ombudsman, Eduardo Mondino, resigned in 2009 and the position has not been filled. Instead the Ombudsperson’s office has been held on an interim basis.

Investigations into the “economic complicity” of numerous corporations and businessmen in the crimes of the last military dictatorship have failed to materialize, according to the report, which slammed the “obstacles in the progress of the investigations of these crimes ... including offences committed by businesses and businessmen involved in human rights abuses.”

Meanwhile, numerous ongoing human rights issues were also highlighted by the report, including a call for the government to “intensify all efforts in the demarcation and legal recognition of lands over which indigenous communities have rights.”

Macri promised to incorporate indigenous concerns into his agenda and welcomed influential Qom leader Felix Díaz to the Pink House for talks in the hope of resolving land disputes in Formosa province.

However, Díaz joined other indigenous leaders in voicing disdain for the lack of progress on indigenous rights issues since Macri’s inauguration. “They think of us as disposable materials. To use us and then throw us out after elections,” he told C5N news channel on Thursday. As the Herald reported last month, a recent UN report on xenophobia in Argentina also slammed the “horrible” living conditions many indigenous communities currently experience in the country.

The Committee report also examined the ongoing presence of what it labelled as “institutional violence” within Argentina’s law enforcement and prison services and said that Article Seven of the Covenant, which concerns freedom from torture and other inhumane treatment, must be adhered to, highlighting “recurrent cases” of law enforcement failing to do so “in Buenos Aires province in particular.”

The report did praise a number of legislative measures taken by the Argentine state in recent years aimed at solidifying human rights in Argentina.

It praised the Fernández de Kirchner government’s introduction of the National Plan for the Prevention and Eradication of Gender Violence Against Women, which was introduced in 2014 and won widespread backing in Congress following the rise of the #NiUnaMenos social movement against gender violence last year. It also considered the adoption of the Justicia 2020 programme a positive development.

Source: Buenos Aires Herald

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