TO: Women, Health Systems, Governments, UN Human Rights Bodies and WHO
We Need a Rational Policy for Safe Abortion in Every Country NOW!
Every day, in every country of the world, women have abortions. Each year, globally, there are 56 million abortions, or an average of 154,000 abortions every single day. Some 45% of those abortions are still unsafe in spite of 100 years of national and international campaigns for safe, legal abortions.
In almost every country, even where abortions are safe, access to abortion is restricted by antediluvian, punitive and medically unnecessary laws and regulations. The only way many women manage to have abortions at all is if they or an abortion care provider breaks the law in some minor or major way – 25 million times each year if we count only the unsafe abortions. The serious effect of the COVID-19 virus on all our lives has put this absurdity into sharp relief.
Abortion clinics are being closed as part of the response to COVID-19, e.g. in Brazil and the USA. Medical abortion pills cause an abortion in a way that is very similar to a spontaneous miscarriage. They are 98% effective in ending a pregnancy when used correctly, both the combination of mifepristone and misoprostol, and misoprostol alone. Millions of women have used the pills safely, including in their own living spaces. Every country could and should move most abortions out of hospitals and clinics by ensuring women can get abortion pills and self-manage their abortions up to 10-12 weeks at home, with a number to call for advice and back-up care if needed.
WE CALL ON:
UN Human Rights Bodies to:
- declare that universal access to safe abortion for everyone who requests it is a human right, an essential part of Universal Health Coverage and an ongoing urgent public health priority.
The World Health Organization to make a public statement to be sent to all governments and Ministers of Health, stating that:
- abortion is an essential health service and all barriers to accessing safe abortions, especially to obtaining abortion pills and self-management of abortion, should be set aside;
- medical abortion pills (mifepristone and misoprostol) are essential medicines and should be approved for use in all countries;
- Ministers of Health should approve the use of telemedicine for provision of medical abortion pills, thus allowing many women to remain at home; to have direct access to abortion pills in pharmacies and by mail, and with information on how to use them. Providers could be pharmacists, nurses, midwives, GPs and abortion information hotlines – without needing an in-person visit.
Governments & Health Systems to:
- lift restrictions on ordering essential medicines from other countries;
- facilitate pharmacy access to medical abortion pills by permitting direct ordering;
- suspend customs regulations that create barriers for countries to import and export essential medicines and for pharmaceutical companies to be able to ship essential medicines abroad without regulatory delays, including abortion pills and contraceptives.
International Campaign members, health professionals & colleagues to:
- advocate that your government takes the above essential actions;
- work with and support national abortion information hotlines to provide women with accurate information and support for the self-management of abortion and where to obtain abortion pills;
- initiate (and work with others to initiate) national abortion information hotlines in countries where they do not yet exist.
- where it is safe to do so, share information with women and ask supportive journalists to write articles on how to self-manage abortions safely and effectively at home; and also share information on where to seek help for those who need a surgical abortion, especially abortions after 12 weeks of pregnancy.
Everyone who is able to get pregnant to:
- always use condoms and/or effective contraceptives to prevent unwanted pregnancy;
- if you have no access to these methods, enjoy safer sex without penile-vaginal contact. There are many safe ways – use your imagination! Or give up sex for a bit – also known as social distancing!
- if you think you are pregnant and don’t want to be, do not delay in seeking abortion pills to end the pregnancy. Used correctly, the pills are effective from the point when you first miss your period. Mifepristone is not yet available in many countries, but you can use misoprostol alone. It can be just as effective if you follow the instructions.