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Promoting Human Rights and Safe Motherhood through Abortion Policy Changes: African Perspectives

Promoting Human Rights and Safe Motherhood through Abortion Policy Changes: African Perspectives. Shirley Owino Ipas February 5 th , 2008. “Hundreds of pregnant women, alive at sunset last night never saw the sunrise this morning.

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Promoting Human Rights and Safe Motherhood through Abortion Policy Changes: African Perspectives

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  1. Promoting Human Rights and Safe Motherhood through Abortion Policy Changes: African Perspectives Shirley Owino Ipas February 5th, 2008

  2. “Hundreds of pregnant women, alive at sunset last night never saw the sunrise this morning. Some of them died in labor, some died of hemorrhage in a hospital lacking blood, some died in the painful convulsions of eclampsia and some died on the table of an unskilled abortionist trying to terminate an unwanted pregnancy” H. Nakajima,WHO 1999

  3. Impact of Unsafe Abortion Globally • Over 200 million estimated pregnancies occur each year • 75 million (about 1/3) are unwanted leading to approximately 20 million unsafe abortions worldwide. • This results in nearly 67,000 maternal deaths and hundreds of thousands of disabilities, most of which occur in developing countries.

  4. Impact of Unsafe Abortion in Africa • The WHO estimates there are 5.5 million unsafe abortions per year in Africa • Over half of global maternal mortality is related to abortion in Africa • 90 African women die every day • There are 2 unsafe abortions for every 3 women in Africa

  5. Risk of Death fromUnsafe Abortion

  6. International Policies ICPD +5 “…in circumstances where abortion is not against the law, health systems should train and equip health service providersand should take other measures to ensure thatabortion is safe and accessible. Additional measures should be taken to safe guard women’s health” Paragraph 63(iii), ICPD+5 1999

  7. Islamabad Declaration on Strengthening Nursing and Midwifery

  8. This Declaration is founded on our belief that efficient, effective nursing and midwifery services are critical to achieving the Millennium Development Goals, country priority programmes including primary health care, health systems strengthening, and the general health of all nations……………. All people should have access to competent nurses and midwives who provide care, supervision and support in all settings ……..

  9. Impact of Midwives on Provision of PAC and SAC • Midwives in Africa have been trained to provide life saving post abortion care. In countries where the law permits termination, midwives provide safe abortion care to women. • Midwives, being the primary contact for women and their families have the capacity to reach all women, even the poorest, with the care and services they need including safe abortion care.

  10. Ghana PAC provided by MWs: • Improves access to emergency life-saving care • Improves linkages between emergency treatment of incomplete abortion and the provision of postabortion family planning • Is acceptable to women, health care providers, community leaders, and policymakers • Is safe and feasible within the Ghanaian context given the existing health infrastructure.

  11. South Africa • The Choice of Termination of Pregnancy (CTOP) Act passed in 1996 allows women to request a termination of pregnancy (TOP) and authorized MWs to perform abortion. • In November 2004, the government approved an amendment to the CTOP Act which states that women be provided with greater access to TOP services showing the government’s strong sense of commitment. It also extends the definition of qualified providers to include registered nurses, increasing the number of mid-level providers of abortion care services. • Maternal deaths have dropped 91 % since the CTOP Act went into effect.

  12. Impact on Women’s Lives • The work and contributions of midwives in reducing maternal deaths from unsafe abortion should be acknowledged globally. • Call for action: • Increased legal and policy changes to allow MWs to be trained to perform abortion • Pre-service training for MWs • National MW association to set policies endorsing role of MWs on provision of services • Doctors to support broader role for MWs and not stand in the way of policy support and training

  13. “-- women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” Dr. MahmoudFathalla

  14. Who is leading? Africa !

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