by Dipika Jain
International Journal of Gynecology & Obstetrics
Volume 168, Issue 3. 22 December 2024. p. 1345-51.
https://doi.org/10.1002/ijgo.16119
Ethical and Legal Issues in Reproductive Health
Free Access
Abstract
In Asia as elsewhere, strict regulations on who is authorized to provide abortion services and to prescribe or dispense medical abortion adversely impact access, especially for marginalized persons and residents in remote areas. The 2022 Abortion Care Guideline of the World Health Organization (WHO) provides an important framework for states to formulate and implement policies to serve sexual and reproductive rights of access to abortion services. The Guideline calls for decriminalization of abortion services to increase authorization to provide abortion services and to promote self-managed medical abortion. This review examines the legal and policy frameworks of Bangladesh, India, Indonesia, Malaysia, and Nepal against the WHO Guideline. Legal and policy reforms successfully introduced in Bangladesh and Nepal to grow the provider base allow healthcare systems to expand safe abortion. This review outlines further challenges where the WHO Guideline on decriminalization and availability of medical abortion is disregarded and advocates a reproductive justice approach promoting egalitarian access to services even among the most marginalized.
Editor’s Note: This article does an excellent job of showing how almost all the countries studied in Asia:
>fail to implement the latest WHO Abortion Guideline in various crucial ways,
>fail to decriminalise abortion across the board, and
>fail to provide access to services from the range of providers that WHO has gone to great lengths to show are needed,
in order to ensure that everyone who seeks an abortion will be able to have it, as early as possible, as safely as possible, and in good conditions. It is well worth reading for the complex picture of what is needed to provide an excellent abortion service and in how many ways different countries’ provision is lacking.