In-Depth Notes on Abortion and Health Policy

World Health Organization (WHO)

• Premier global authority on health setting international health policy.
• Defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease.

Abortion and Health Rights

• Access to quality healthcare, including comprehensive abortion care, is a human right.
• Lack of access to safe abortion services can severely impact the physical, mental, and social well-being of women and girls.

Statistics on Abortions

• Each year: 121 million pregnancies are unintended, leading to 6 out of 10 unintended pregnancies resulting in abortion.
• Induced abortion is common and safe when performed by skilled practitioners using WHO-recommended methods.
• 45% of abortions worldwide are unsafe, increasing risks for maternal health complications, including death.

Health Risks of Unsafe Abortions

• Incomplete abortion can lead to infection and hemorrhage.
• Unsafe abortion is a significant preventable cause of maternal mortality (13% of maternal deaths globally).
• About 200 per 100,000 unsafe abortions lead to death, compared to less than 1 per 100,000 for safe abortions.
• Other risks include uterine perforation and bodily injury from unsafe procedures.

Global Health Context

• Criminalizing abortion does not reduce its occurrence; instead, it may lead to increased unsafe abortions.
• Increased abortion rates can be associated with restrictive laws, revealing that prohibition does not equate to cessation of abortion.

Abortion Access by Global Standards

• Different laws worldwide:
• Green countries permit abortion on request.
• Blue countries allow abortion on broad socio-economic grounds.
• Yellow indicates restrictive laws allowing abortion only for health preservation.
• Orange indicates life-saving measures only.
• Dark red signifies total prohibition.
• Example: A legal map of abortion worldwide shows disparities influenced by political climates.

Case Studies

• Ireland: 2018 legalization of abortion after a high-profile case of preventable death helped mobilize public sentiment.
• Honduras: Abortion is severely restricted, now banned constitutionally making it very difficult to change; millions of unsafe abortions occur yearly.

United States Abortion Policy

• The US has historically been a significant funder of global health initiatives but restricts abortion funding via the Helms Amendment.
• Global Gag Rule: Prohibits organizations receiving US funds from discussing or providing abortion services regardless of funding source.
• This rule often fluctuates with changing administrations, significantly affecting global health services.

Abortion Methods in the US

• Two primary methods: Surgical abortion and Medication abortion (involves mifepristone and misoprostol).
• Self-managed abortion methods are becoming more prominent globally, especially with medication abortion common in early stages.

Medication Abortion Protocol

• Mifepristone: Blocks progesterone, stopping the progression of pregnancy.
• Misoprostol: Causes the uterus to expel contents; effective when taken 24-48 hours after mifepristone.
• Misoprostol alone may be used globally and is effective in 80-85% of cases in early stages.
• Organizations provide resources and protocols for self-managed abortions often in restrictive areas.

Challenges in Abortion Care

• Legal Barriers: Identifying exact legal statuses of abortion across regions; lack of documentation and stigmatization create difficulties in obtaining accurate data.
• Public health implications suggest that promoting safe abortion access reduces overall health risks and improves community health metrics.