The Roadmap to Safe Abortion Worldwide: Lessons from New Global Trends on Incidence, Legality and Safety

摘要

The Trump administration and social conservatives in Congress are engaged in broad-based attacks on sexual and reproductive health and rights in the United States and globally. In the international sphere, the administration has imposed and expanded the global gag rule and defunded the United Nations Population Fund (UNFPA), while calling for outright elimination of all U.S. international family planning aid during its first year in office (see “ When Antiabortion Ideology Turns into Foreign Policy: How the Global Gag Rule Erodes Health, Ethics and Democracy ,” 2017, and “ The Benefits of Investing in International Family Planning—and the Price of Slashing Funding ,” 2017). At the heart of these attacks is an extreme animus toward abortion rights. Advocates for women’s health fear that these attacks will roll back improvements in sexual and reproductive health services that were built over decades. This is especially true in developing regions where unsafe abortion is a serious public health issue and the limited progress to date is in jeopardy. Almost all nations, including donor countries such as the United States, have pledged to financially support at least some measures to decrease the incidence and negative consequences of unsafe abortion through their commitments at the landmark International Conference on Population and Development in Cairo in 1994 and subsequent United Nations conferences. 1,2 In the years since, researchers and health care practitioners have continued to compile evidence about the most effective means to decrease the impact of unsafe abortion globally and the obstacles to implementing these measures. This body of evidence provides a roadmap for policymakers to take concrete measures to protect the health, rights and lives of women worldwide. Much of this evidence has been synthesized in a new study by the Guttmacher Institute on abortion around the world. 3 This study found substantial changes over time in abortion incidence, legality and safety. Abortion is becoming safer worldwide as a result of slow but important improvements made to abortion policies, programs and practices in a number of countries. Yet, millions of women living in developing countries where abortion is highly restricted continue to experience the widespread and dangerous consequences of unsafe abortion.