January 2020

– The European Commission’s decision not to stop EU funding for safe abortion was confirmed by the General Court and the Court of Justice

– Half of Irish GPs ready to give abortion pills, says Limerick university study

– Achieving Universal Health Coverage requires meeting the challenge of delivering services to those most in need and more specifically to those who are hardest-to-reach. A study by the Reach Project at the University of Toronto found that ensuring no one is left behind is expensive.

– The Constitutional Court of Colombia issued an important decision recognising that women and girls who suffered forced contraception and forced abortion by their own armed groups should be recognised as ‘victims of armed conflict’ and can receive reparations.

– A study in Nigeria found that misoprostol was the most common abortion method used in the community and women had considerable knowledge about access locations, prices and doses typically used, learned from friends, doctors, pharmacists, NGOs, web pages, social media or hair saloons. Health workers in different facilities believed that over the previous few years there had been a drop in critically ill patients seeking care after abortion due to the shift to misoprostol.

– An international study of research covering 15 countries found that only a small proportion of primary healthcare professionals provide medical abortion services. General practitioners, nurses and trainees had mixed knowledge of medical abortion and emphasised the need for training and dissemination of guidelines. Pharmacists reported poor knowledge regarding medical abortion regimens and complications.

© 2018 My Body My Life, Open
University/designed by The Liminal Space
in The Lancet, 2018

– Backstreet abortions are still being done in Zimbabwe using knitting needles, spoons, dishwashing liquid, dangerous pills and concoctions. They are putting the lives of hundreds of women at risk. A lot are dying and suffering in silence, while others do not seek medical help until it is too late. There are more than 60,000 unsafe abortions each year, half of them in adolescents. 16% of maternal deaths are due to unsafe abortions.

– In the Central African Republic, one-third of maternal mortality is caused by unsafe abortions (MMR: 882 deaths per 100,000 live births). Each day, six women die as a result of their pregnancy or childbirth; this is why the government launched an analysis to adapt its policy. The Health Minister blamed the criminal nature of the law on abortion; he called for a new law and better sex education and better access to family planning methods.

February 2020

– In the Philippines, Catholics for Reproductive Health, Center for Reproductive Rights, EnGendeRights, Family Planning Organization of the Philippines, Filipino Freethinkers, Philippine Safe Abortion Network, WomanHealth Philippines, Women’s Clinic Pilipinas, and Women’s Global Network for Reproductive Rights submitted a report to the Office of the High Commissioner for Human Rights (OHCHR) that outlined grave violations of fundamental human rights resulting from one of the most restrictive abortion laws in the world.

In Argentina, a huge demonstration called for safe, legal and free abortion.

SOURCE: @PorAbortoLegal

In Thailand, the Constitutional Court ordered the revision of Penal Code (Articles 301 + 305) that punish abortion. There are an estimated 200,000 women seeking abortions outside the law annually in Thailand.

The Campaign published How to Talk about Abortion with Pill: Facts for Journalists

A study in Nepal was published that evaluated the safety, acceptability and feasibility of a one-day outpatient medical abortion service at gestations 13–18 weeks. It found that the process was safe, effective and feasible, and that nine of ten cases can be managed as an outpatient day service.

A study in Argentina discussed the importance of stigma. Women experience abortion only once or a few times in their lives. For abortion providers, their work identity is connected to abortion, and exposure to stigmatising beliefs and behaviours may be continual, and is the main reason that explains the low number of providers. The evolving abortion debate that moved abortion from the margins to the heart of political debate and public policies between 2007 and 2017 made it possible for providers to move from providing silent and hidden abortion care, to acknowledging it with pride.

Women Enabled International published “Abortion and Disability: Towards an Intersectional Human Rights-Based Approach”.

In Côte d’Ivoire, it was announced that the law now authorises abortion of pregnancies resulting from rape.

March 2020

Covid-19 emerged and began to have an immediate effect. Our first report mentioning it was an Advisory Note from UN Women on 2 March 2020, cancelling “all side events planned by Member States and the UN system in conjunction with CSW64”.

In late 2019, the UK Parliament decriminalised abortion in Northern Ireland. In March 2020, an ongoing survey being conducted by Ulster University, Northern Ireland, and University College London found that a significant majority of National Health Service obstetricians and gynaecologists in Northern Ireland indicated their support for delivering abortion services – 77% were willing to provide medical abortion pills, 62% were willing to participate in providing surgical abortion and 88% welcomed training on the new regulations on abortion.

In El Salvador, unpublished recommendations to the government from the UN Working Group on Arbitrary Detention were leaked that said three women put into prison for abortion-related crimes have been detained unfairly and arbitrarily, that they were denied due process, and that their convictions should be reviewed. Two of the women were currently serving long sentences – one for 30 years. Both were arrested when they sought hospital care for pregnancy complications. The third, a teenage rape victim, had already been freed.

Mozambique liberalised its abortion law in 2014, granting legal abortion on request in the first 12 weeks of pregnancy, and longer upper limits in cases of rape, incest and fetal anomaly. However, barriers that prevent women accessing abortion care remain; the law is often not being implemented. Avoidable deaths are still happening. An estimated 11-18% of hospital maternal deaths are due to unsafe abortion, the same figure as in 2008.

The Campaign newsletter published a feature on USA politics, law, policy & advocacy issues, covering Ruth Bader Ginsburg’s key role in the Supreme Court; Abortion Provider Appreciation Day; major research that found women and their families saw long-term harms when they were denied wanted abortions, including falls in living children’s developmental progress and women’s income, and an absence of evidence that women regret their abortions;

An international study found that there were anti-abortion ‘crisis pregnancy’ centres where women are targeted with disinformation about abortion in 18 countries. These centres were on five continents, inside hospitals and women’s shelters, near university campuses and advertised in schools. In Spain and Italy they have received public funding. Italy has 400 such centres. Only the USA has more. They are run by anti-abortion activists, backed by powerful US religious groups, some with close links to the Trump administration.

A review found that between 2005 and 2018, 83 studies were related to medical abortion (MA) in Nepal. Only five of them reported on pharmacy workers’ involvement in the provision of MA. Findings suggested that trained pharmacy workers can safely and effectively provide MA, and MA services provided by pharmacy workers were acceptable to women, who were satisfied with the service they had received.

In Venezuela, there has been a precipitous rise in abandoned infants, as the financial crisis spurred an exodus of 4.5 million people from the country. Nearly a million children had been left behind.

An epidemic of teenage pregnancies is sweeping Rwanda; teenage pregnancies have increased by 200% in the last ten years in the midst of a continuing “culture of silence”. Early pregnancies in high schools have contributed to 50% of school dropouts among girls under age 18. Calls to change the law so that girls under 18 years of age do not have to involve their parents to access contraceptives have been made.

In Antigua and Barbuda, a journalist learned that it was normal to get abortion pills at pharmacies.

At the end of March two editions of the Campaign newsletter shared guidance, publications, statements, information and commentaries from an international and country-level perspective about access to abortion, pregnancy, contraception, and other SRHR care in the context of Covid-19 and called for a rational policy for safe abortion in every country. The role of telemedicine for abortion care was introduced as a means of maintaining access and increasing safety for both those needing abortions and those providing services.

Ireland became the first country to allow telemedicine for first trimester medical abortion provision.

April 2020

The first Campaign newsletter in April called for international action to call for safe abortion as essential health care, for telemedicine to be permitted, to allow dispensing of abortion pills by mid-level providers & pharmacists as well as doctors, approve abortion pills as essential medicines, ensure local pharmacy supplies, approve a bona fide online pharmacy for direct orders, and expand post-abortion care where needed. It also looks at the immediate effects of the virus on workers and on healthcare and SRH services in India, China, and crisis settings. It summarises telemedicine for abortion policy in Canada, an independent clinic in Colombia, and in Brazil, Uganda, Argentina, USA and Great Britain. The call was translated into French, Spanish, Portuguese, Russian and Arabic.

A two-year debate on whether to amend the abortion law in Jamaica has not happened. Yet even in 1976, among a national sample of 120 Jamaican physicians, public health nurses, and licensed midwives, more than 80% favoured legalisation of abortion, and changes in the health service to accommodate demand.

In Northern Ireland, abortion regulations were published that are only partially being implemented.

For the rest of the year, we share abstracts from the growing number of journal articles on self-managed abortion and telemedicine.

Polish government puts forward two bills, anti-abortion and anti-sexuality education, that are shuffled to committees in April but will lead to mass protests for the remainder of the year.

In Romania it had become very difficult to find a hospital that would provide an abortion that was not related to a health issue, though abortion on request is legal. Many health services were restricted, including antenatal care.

France supports telemedicine for abortion; Netherlands says no.

We begin to share a range of information on Covid-19: calls by a wide range of  healthcare professionals for joint global action, safe sex during the pandemic, the importance of personal protective equipment for health workers, who are becoming infected

The Reproductive Health Network Kenya established online referral systems through their social media platforms from communities to their healthcare providers to ensure continuity of safe abortion services and provision of contraceptives.

The government of Nepal, agencies and NGOs moved to ensure services for abortion remained open.

The G20 call for a “transparent, robust, coordinated, large-scale and science-based global response to Covid-19 in the spirit of solidarity” and commit to ‘do whatever it takes’ to overcome the pandemic.

By late April, the supply chain for medical abortion pills throws up problems. slowdowns in receiving supplies: longer lead times between ordering and receiving supplies, transportation issues as flights are grounded, sea freight affected, reduced manufacturing and supply chain workforces, Covid-19 emergency supplies prioritised over other supplies, diversion of resources to Covid-19: health workers, budgets, procurement, products sitting somewhere unused, access to medical abortion pills decreased. But this was righted by social marketing groups before too much time passed.

In partnership with the Safe Abortion Action Fund and supported by Options Canada, the Reproductive Health Training Center set up a telemedicine abortion service in Moldova after a year’s work preparing, obtaining pills and developing materials, particularly videos, for patients. The programme was ready to launch when Covid-19 hit. They began working with the public health system to offer the service nationally.

Absurd rules requiring numerous in-person visits obstruct access to abortion services in Italy.

The pandemic is having a major impact on the delivery of sexual and reproductive healthcare around the world, according to an IPPF survey of its national members’ services, including reduced HIV testing, contraceptive care services, gender-based violence support and abortion care, published on 9 April 2020.

The Archbishop of Uganda urged women to use contraception during lockdown, but was criticised for negative comments about abortion and LGBT people made earlier.

Tunisia’s Ministry of Health confirms access to contraception, including emergency contraception, and abortion, including medical abortion, are essential services during the pandemic in response to a petition signed by more than 50 local and international NGOs and 70 well-known individuals from civil society.

Conflicting reports on whether abortions have been stopped in all but three of Moscow’s 44 abortion clinics, while a survey of all eight federal districts outside Moscow indicates abortion services not affected by Covid-19.

In Mexico, where many women normally travel to Mexico City for legal abortions, hotels and transport have shut down, and many in-clinic abortions have been stopped. Abortions with pills continue.

The UN General Assembly calls for international cooperation to ensure global access to medicines, vaccines and medical equipment to face Covid-19, while WHO highlights the importance of integrating a human rights-based approach in response to Covid-19.

The InterAgency Working Group on Reproductive Health in Crises calls for maintenance of sexual and reproductive health in humanitarian and fragile settings during the pandemic.

May 2020

In South Africa, the Sexual & Reproductive Justice Coalition monitored access to SRHR services across the country and used personal contacts in some cases to encourage services to stay open and adapt. The Health Professions Council of South Africa decided to permit telemedicine even if the provider did not have an established relationship with the patient, in order to help to keep patients out of waiting rooms and clinics and adhere to social distancing.

In Lithuania, some healthcare institutions that were no longer providing “non-essential services” included abortion among these. In response, the Health Minister suggested women should “reconsider their choice”.

Standards for online and remote provision of contraception and other sexual and reproductive health services begin to be addressed.

The Choices Network Thailand, Tamtang and other Thai NGOs have drafted a letter to the Thai Department of Health calling for access to contraception and safe abortion to be ensured during the Covid-19 pandemic.

The Irish Family Planning Association has created videos and a guide for self-managed abortion with pills that are excellent materials.

In Pakistan, lockdown has resulted in lack of access to contraceptives, including IUDs and condoms, and family clinics and outreach services have stopped or been taken over for Covid-19 care. There is concern about an increase in unsafe abortions and a baby boom.

In Uganda, the ban on public transport has meant some women have to walk long distances to hospitals to give birth, leading to reports of deaths along the way.

In Africa, the economic impacts of Covid-19 are hitting women harder. 74% of women in Africa are engaged in the informal economy – as street vendors, domestic workers, in the service, tourism and hospitality industry, much of the subsistence farming sector and informal cross-border trade.

In Slovakia, the Public Defender of Rights challenged the Health Minister’s call for refusal of abortions, while abortion care is being treated as essential healthcare in Slovenia.

In Germany, telemedicine for pre-abortion counselling was permitted during the pandemic but a call for the suspension of the obligation to provide counselling during the crisis was not taken up. A number of groups called for abortion with pills at home but this was not accepted.

Even as health workers scramble to contain raging Covid-19 across the globe, services for other infectious diseases such as cholera, Ebola, measles and polio are simultaneously being disrupted, and especially child vaccination programmes.

The Ministry of Health of Mexico issued guidelines on essential care for those with Covid-19 infection, confirmed or suspected for maternal healthcare during pregnancy, childbirth and the puerperium, and newborn care. Safe abortion care in line with the law is included.

The Bombay High Court allows 24-week abortion for teen rape survivor via telemedicine, but many Indian women are panicking if they get a positive pregnancy test as they are afraid to try to get to a hospital, and young women living with parents may not even have the privacy to phone a helpline.

More than 50 countries require people to cover their faces/wear a face mask while out in public, the majority since the beginning of April, and the numbers are growing.

An open letter was sent to the United Nations representing more than 5 million public health practitioners, scientists, academics, health-care professionals, and advocates calling for a multisector Global Health Equity Task Force, housed within WHO, for an comprehensive, equitable response to the pandemic.

In Malta, six new local Facebook pages were offering abortion pills for sale online, and were considered to be unreliable by women’s rights groups.

The Campaign issued a statement on 21 May to express our support for the World Health Organization, other UN agencies and everyone working in tandem with them to end the Covid-19 pandemic in response to unjustified attacks by US President Trump. We also shared five other statements – by the Campaign, an international group of CSOs, IAWG, IPPF and Ipas – in response to demands by the US government for the UN and WHO to omit any language or abortion and sexual and reproductive health from the Covid-19 response.

On 28 May, the International Day of Action for Women’s Health, the Campaign published the first call to action for 28 September, International Safe Abortion Day 2020, with the theme “Self-Managed Abortion” and the hashtag #IManageMyAbortion.

The current context of access to safe abortion in Latin America and the Caribbean during Covid-19, is that 97% of women live in countries with very restrictive abortion laws, 6 countries prohibit abortion and punish it as murder, 9 allow abortion only to save a woman’s life, only 1 in 4 abortions is considered safe, unsafe abortion is the second highest cause of hospitalisation, poor women are the ones who get complications, misoprostol use outside the health system widespread and has reduced complications by a third, and there are barriers even to access legal abortions.

“Self Managed: An Abortion Story in Eight Parts” is a podcast series that dives into the practice of self-managed abortion.

June 2020

In WHO’s “Maintaining Essential Health Services: operational guidance for the Covid-19 context”, safe abortion is described as essential health care. Representatives of IWHC and the Campaign had requested this in the March 2020 Human Reproduction Programme annual meeting. The request was supported by women government representatives and others in the meeting.

Thai pro-choice activists handed in their petition to the government calling for access to safe abortion with telemedicine

Child marriage was steadily increasing in India during the lockdown.

In Nigeria, the reproductive health information hotline run by Generation Initiative for Women and Youth Network (GIWYN) has addressed women’s challenges during the Covid-19 outbreak, supporting access to information, services, medications and treatments, affected by Covid-19.

In Afghanistan, four decades of war have devastated the health care system and left more than five million Afghans, especially women and children, living in fear of abuse, neglect, conflict, exploitation and violence. Covid-19 is exacerbating this. Almost 11 million people face severe food insecurity.

In France, a request for an extension of the upper time limit for surgical abortion from 14 to 16 weeks LMP was rejected by the Senate by 156 votes to 143, though it was approved later in the year. An attempt to stop the use of telemedicine for arranging medical abortion did not pass either.

Brazilian feminists published a statement and protested against the dismissal of two Ministry of Health personnel for having issued a protocol to guide the sustainability of sexual and reproductive services during the Covid-19 pandemic.

A Sudanese doctor who worked in one of the largest hospitals in Khartoum reported that she was devastated to witness the deaths of 50 young women who had had unsafe abortions, usually from sepsis, in just three months. She also said she would see 16 cases of failed abortions on any given day, and had removed syringes, leaves and other items inserted by midwives to induce a miscarriage.

In Vietnam, a young woman had come from another country seeking a second trimester abortion within the terms of the Vietnamese law. With support from a youth organisation, she tried two public hospitals but in both cases she was given a hard time and ultimately refused. She then tried several private hospitals with exorbitant prices who legally should not have agreed to help her. Finally, a third public hospital agreed. There is now concern Vietnamese women may also face this, not just one foreigner.

July 2020

Non-communicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally. Services for treating NCDs have become increasingly disrupted as countries move from sporadic cases to community transmission of Covid-19. Efforts to ensure people with NCDs get the treatment they need are increasing as awareness of the risks is high.

At least 80 million children under the age of one are at risk of diseases such as diphtheria, measles and polio as Covid-19 disrupts routine vaccination efforts, Gavi, WHO and UNICEF warned.

In Ireland, prior to abortion law reform, there were between 15 and 32 abortions per year between 2014 and 2018. In 2019, there were 6,666 abortions. These included 6,542 abortions on request up to 12 weeks, 100 for conditions likely to lead to fetal death, 21 for risk to life or health, 3 for risk to life or health in an emergency, and at least 67 Northern Irish women.

In June 2020, a young woman called on Namibians to support a petition to make abortion legal in Namibia. By mid-July 2020, the petition had 61,310 signatures. An anonymous midwife wrote an article supporting this call on behalf of “a girl child who is in a remote village, pregnant, alone and no one to talk to. I am advocating for a woman who has found out that she is pregnant after being raped by her husband and wants to retain the dignity of her husband because of her other children; advocating for a young woman who is impregnated by a church elder and is pressured to abort because of the reputation of her church; for a girl whose only source of information on pregnancy is Google” and others.

In Brazil, an anonymous 31-year-old woman was the first woman known to die from a clandestine abortion during the coronavirus pandemic. She was two months pregnant, according to her husband. Twice she sought help at unsafe abortion houses. She tried a hose, potassium permanganate, syringes. She died of cardiac arrest. Her death was not from Covid-19, but from the policies that rule women’s bodies through the criminal law. But neither “cardiac arrest,” “unspecified abortion” explain what she died of. The manual of diseases should offer more complex numbers, for deaths related to “low income.” She died because she was poor…

“We’re not all in this together.” In many countries Black, ethnic minority and poor communities are being disproportionately affected by three public health crises: Covid-19, racism and poverty.

The Slovak Parliament considered four new bills restricting access to abortion and if any of them move to a second reading, they will be voted on, probably in September.

In Algeria in June 2020, three providers of clandestine abortion and a pregnant woman were charged with illegal abortion. Additional information has been found showing that since the beginning of 2020, there have been at least 20 more people arrested in Algeria, either for seeking an abortion or helping a woman to have an abortion.

A coalition of local and international organisations in Latin America have re-activated the #NiñasNoMadres (“Girls, Not Mothers”) campaign to shine a light on the increased risks of sexual violence girls are facing in the context of Covid-19 lockdown policies, which is further aggravated by additional barriers to accessing essential reproductive health services.

In the Democratic Republic of Congo, the youth peer educators of ABEF-ND have been using their WhatsApp and Facebook CSE groups to inform adolescents and youth about protective measures against Covid-19, as well as SRHR. They have recorded the impact of the pandemic on SRHR, such as unintended pregnancies, sexually transmitted infections and unsafe abortions. The peer educators then formed a delegation to meet the Ministry of Health and advocate for better sexuality education and access to SRH services for young people based on the information they collected.

CEDES and Gynuity Health Projects have announced a new resource for providers with access to misoprostol to ensure that safe medical abortion can still be offered during the Covid-19 pandemic and in accordance with social distancing practices. It was developed in response to an outspoken need among providers around the world. The guidance reviews the steps of providing misoprostol for medical abortion and makes evidence-based recommendations for limiting personal contact and reducing in-person visits.

In El Salvador, Evelyn Hernández was finally, definitively acquitted.

In Côte d’Ivoire, fears of an increase in unwanted pregnancies have been expressed in view of the drop in usage of services for contraception during the Covid-19 pandemic. Action against Unwanted and At-Risk Pregnancies, a subgroup of 29 organisations who form the Civil Society Coalition for Reproductive Health and Family Planning called on the State to harmonise its law with Article 14.2c of the Maputo Protocol, which allows for legal abortion on wider grounds.

Although Senegal has integrated the SDGs into its policies, continuing socio-economic, cultural and religious norms and attitudes impede women’s and girls’ access to sexual and reproductive health services and rights, especially in remote and rural areas. The challenges include early marriage, unmet contraceptive needs, early pregnancy and unsafe abortions. Many pregnant rural women, living below the poverty line, don’t follow through on their prescriptions and delay their antenatal visits until their third trimester, which puts them at greater risk of pregnancy-related complications. And although there is a national health insurance organisation per person that costs $6 per annum to receive services, many people in remote and rural areas do not join as the local services have limited medications and treatment options.

Through airport closures, restricted border crossings, socially distanced buses, 14-day quarantine periods, lockdown-restricted childcare options, hotel and guesthouse closures, clinic closures, mandatory Covid-19 testing policies before entering a country, and more, Abortion Without Borders in Europe have been making the abortion fund magic happen.

In Haiti, abortion could be legalised, according to the Minister for the Status of Women, who defends the new penal code, published 24 June 2020, because it allows voluntary termination of pregnancy under certain conditions.

“I was afraid to see my patients, and yet felt more committed than ever, given the other never-ending health emergency for women who wish to end their pregnancies in a state where it is prohibited. As Covid took hold, my patients also were afraid. When they came to appointments, they brought what protective gear they could, simple face masks or cloth bandanas. We spaced out appointments as much as possible. My assistants and I used what safeguards we had at our disposal: boots, a double layer of gloves, hairnets, and surgical gowns, along with face shields we purchased from the same guy who sells pirated DVDs in the pueblo. The medical procedures continued, as they had to, even as my breath fogged up my plastic face shield, and I struggled to see what I was doing. The risk of making a mistake increased, even when conducting this simple outpatient procedure. Anxiety took hold, and I had to fight the impulse to tear off my uncomfortable and unwieldy gear…And yet, everything turned out fine, every time…” (Abortion provider, Mexico)

French feminist and abortion rights supporter, Gisèle Halimi, who never resigned herself, died aged 93.

August 2020

Every hour, four Brazilian girls under the age of 13 years are raped, according to the Brazilian Public Safety Yearbook, and most of these crimes are committed by a relative. On 8 August 2020, the Brazilian press reported the case of a 10-year-old girl who became pregnant after being raped by her uncle. She said she had been sexually abused since she was 6 years old and had never told anyone because the uncle had threatened to kill her. The doctor established that she was about 20-22 weeks of pregnancy. Because she was taken into custody, the girl’s “case” had to be decided in the local Juvenile Justice System. The prosecutor was told by both the girl and her grandmother, who is legally responsible for her, that they wanted the pregnancy terminated. A judicial authorisation for an abortion was issued. The girl had to be taken halfway across the country for the abortion. When she arrived, an anti-abortion brigade was demonstrating in front of the hospital, opposed by a feminist protest. The abortion took place, but the story goes on.

A report released by the UN Office of the High Commissioner for Human Rights describes allegations of human rights violations committed against North Korea women who are detained upon being forcibly returned to the Democratic People’s Republic of Korea. The women are said to undergo forced labour, sexual violence, forced abortion and forced infanticide in the country’s detention centres, among many other violations.

On 12 August 2020, International Youth Day, YANAA (Young Activist Network for Abortion Advocacy), the Campaign’s youth network, posted videos made by two of its members, from France and Sri Lanka.

The National Abortion Federation in the USA published 2019 statistics on violence and disruption against abortion providers. They show a disturbing escalation of intimidation tactics, clinic invasions, and other activities aimed at disrupting services, harassing providers, and blocking women’s access to abortion care. Since 1977, there have been 11 murders, 26 attempted murders, 42 bombings, 189 arsons, and thousands of incidents of criminal activities directed at abortion providers.

A study in 2018-19 found that 98% of adolescent abortions were safe in Ethiopia, but only 33% in Zambia and only 4% in Malawi. Findings came from interviews with 313 adolescents (aged 10-19 years) in one health centre and one hospital in each country.

A study in January-March 2020 in six states in India found an overwhelming shortage of MA drugs across 26 cities (five in each state plus Delhi) among 1,500 retail chemists. The study also busts the common misconception that MA drugs are being purchased over the counter without prescription. Chemists reported that 71% in Assam, 84% in Delhi, 100% in Haryana, 97% in Madhya Pradesh, 80% in Punjab and 97% in Tamil Nadu came with a prescription. Six out of ten purchasers were men; four were women.

The journal Contraception published seven papers on medical abortion subjects in June-August 2020.

September 2020

The Constitutional Court of Uganda was the first in Africa to declare maternal health a constitutional right.

A student at a public high school in Guayaquil, Ecuador, was sexually harassed and seduced by the vice-principal, after having requested his help to improve her declining academic performance. When she appeared to be pregnant, the vice-principal urged her to terminate the pregnancy and requested the school doctor to provide an abortion. The physician agreed to carry out the procedure, but expected Paola to have sexual intercourse with him as a condition. She swallowed a lethal dose of white phosphorus and fell ill at school. School authorities did not take effective measures to provide or summon medical assistance or contact her family. She died the next day. Her case was taken to the Inter-American Commission on Human Rights and to the Inter-American Court of Human Rights, who imposed a long list of responsibilities on the state, including to institutionalise an official day against sexual abuse in schools.

In Bangladesh, a Supreme Court lawyer argued that sections of the British colonial-era Penal Code contradict articles of Bangladesh’s Constitution. She said the Penal Code violated constitutional rights to life, body, privacy, liberty and freedom of choice, and that giving birth to a child and accepting motherhood constitute essential parts of these rights.

The UN Working Group on Discrimination against Women and Girls wrote a letter to the US Government re abortion restrictions in eight states.

The Planned Parenthood Association of Ghana has rolled out a Comprehensive Abortion Care Accountability programme to curb unsafe abortion in three regions of the country. It will engage women and youth leaders as an advocate for change, and recruit 18 civil society organisations and empower them to engage with duty bearers on safe abortion service provision.

In a TV soap opera in Cuba, where abortion has been legal since 1965, a teenager becomes pregnant as a result of sexual abuse by her stepfather, and the question of whether she should continue the pregnancy or not is raised by other characters in the story. This led to a heated debate about abortion on social media.

The Federation of Reproductive Health Associations Malaysia called for a range of measures to reduce adolescent pregnancy and at the same time uphold sexual and reproductive health.

Turkey’s Constitutional Court ruled that a young woman’s rights were violated when she was denied an abortion for a pregnancy that was the result of sexual assault.

The University of British Columbia’s Contraception and Abortion Research Team worked with Canadian federal drug regulators and health professional licensing bodies from 2016-2019 to remove restrictions on mifepristone in Canada, and are in the process of publishing a range of papers about it. The first paper, in Annals of Family Medicine, is entitled: “Perspectives among Canadian physicians on factors influencing implementation of mifepristone medical abortion: a national qualitative study”.

In Colombia, a lawsuit was filed in the Constitutional Court to take abortion out of the Penal Code.

The European Safe Abortion Networking Group published a statement for International Safe Abortion Day calling on every European country to take responsibility for removing restrictions on safe and legal abortion in their countries and bring abortion laws, policies and services into the 21st century.

A statement on behalf of the Task Force for Legal Access to Safe Abortion in Senegal, Association of Senegalese Women Lawyers, called for access to safe abortion in cases of rape and incest, which has become an urgent and absolute necessity.

The International Campaign coordination team were pleased to report that 2020 was probably the biggest ever 28 September so far. We probably say that every year, because it is probably true every year. Heartfelt solidarity with everyone’s work to make free, safe and legal abortion a reality for everyone who may need it.

Romania: After the death of the woman, he offers them the money back.

Indonesia: Jakarta police plan to block abortion websites, crack down on illegal clinics.

Ruth Bader Ginsburg, the second woman to sit on the United States Supreme Court, much loved legal architect of the modern women’s movement in the USA and fierce supporter of abortion rights, died on 18 September.

Amnesty International announced their updated policy on abortion.

28 September 2020: International Safe Abortion Day. Reports of activities, many of them online, come in from all over the world, filling the Campaign newsletter throughout October. As just one example, in Japan there was a call to action for safer and more reliable contraceptive options, safer abortion methods that meet established global standards, and a fundamental review of the sexist criminal abortion law. A whole newsletter listed media reports collected about the Day in several languages.

October 2020

In Northern Territory, Australia, following law reform, there was rapid uptake of early medical abortion in the Northern Territory after a family planning service was funded to provide it, devolving the majority of abortions from tertiary to primary healthcare and increasing the use of effective contraception. However, women from more remote areas of the Northern Territory were under-represented and further work is required to ensure equity of access to services for them.

In Poland, after the government had failed to pass a law banning all abortions, they asked the Constitutional Tribunal to rule whether abortion on the ground of severe fetal anomaly was “unconstitutional”. The judges complied, and for the past two months there have been mass protests in the streets in response.

In Madagascar, Covid-19 has increased unemployment, prostitution and unwanted pregnancies.

In Malawi, MPs pledged to table the Termination of Pregnancy Bill yet again but nothing happened.

In Ecuador, the women’s movement said: “Our grandmothers gave us the vote. Our mothers gave us the right to divorce. We will give our daughters the right to decide”.

In the Philippines, the petition calling for abortion law reform gathered more than 10,000 signatures.

In eSwatini, the issue of addressing unsafe abortions and abandonment of unwanted babies was raised publicly.

In China, less educated young women are more likely to experience a premarital pregnancy than their university educated counterparts, indicating the need for a change in policy on contraceptive provision.

In South Africa, a three-day event brought together academics, researchers, students, activists, practitioners, and policy makers for in-depth discussions about abortion advocacy, policy, and practice in rural areas of the country. It covered abortion services, abortion counselling training and support for abortion health care providers, and methodologies to improve abortion service provision.

November 2020

In Ghana in 2017, 53% of all pregnancies are unintended, 23% of all pregnancies in Ghana ended in abortion, an estimated 71% of all abortions in Ghana would be considered illegal even though the abortion law is considered liberal, and unsafe abortions contributed substantially to Ghana’s high maternal mortality. Stakeholders in the health sector called on the government and non-governmental partners to reduce the burden of unsafe abortion.

In Russia, Vladimir Putin orders government to improve “abortion prevention” efforts by trying to dissuade women from having abortions.

A study in Indonesia of the experience of buying misoprostol online for pregnancy termination in Indonesia found major problems as regards what drugs were supplied and in what quantities, and in the failure to provide adequate information on how to use them, how to recognise complications and when to seek help.

A study in Colombia sending mystery clients to drug sellers to purchase misoprostol found similar problems and lack of knowledge of effective misoprostol use among drug sellers.

In a letter to Prime Minister Mateusz Morawiecki, the leaders of five European Parliamentary groupings – the European People’s Party (EPP), the Socialists and Democrats, the Greens, Renew Europe (Renew) and the United European Left – protested against Poland’s recent ban on abortion for fetal anomaly.

A review of studies among Syrian refugees in Jordan found a number of barriers pertaining to access, utilisation, and implementation of SRH services, particularly for refugees outside camps.

The newsletter of 13 November 2020 featured reports of Donald Trump’s war against women and the 30 or so governments supporting his efforts, all of whom are hostile to women’s rights. It includes a collection of materials published by Trump and his supporters and a range of analyses and responses by women’s rights advocates in Peru, Kenya, Hungary, Indonesia, Uganda and Brazil.

In Poland, demonstrations continue and police increasingly use well-known tactics to try to disperse them, making a large number of arrests. Over 200 Parliamentarians call on the European Commission to launch an infringement procedure against the Polish government to protect women’s rights, LGBTI rights & the rule of law.

In South Australia, the only Australian state where abortion law had not yet been reformed, a bill to decriminalise abortion was introduced, described by its proposers as “a highly regulated, medical model that allows abortions up to 23 weeks and removes abortion entirely from the criminal law, bringing South Australia “in line with all other Australian states and territories”. The bill passed in the first chamber and went to the second chamber in December.

A study of SRH services for adolescents in Ethiopia, Zambia and Malawi found that the extent of access to services for abortion care was closely related to abortion law and the extent of its implementation.

In Argentina, President Fernández presented a new abortion bill to Congress that was debated in the Chamber of Deputies and on 4 December it was passed by 131 votes to 117 with a few abstentions. It has now gone to the Senate.

Abortion services provided by trained mid-level providers via “task-shifting” are common in low-and-middle income countries (LMICs) due to resource constraints. A study that explored the quality of early abortion services provided in primary care in Bangladesh, Ethiopia, India, Kyrgyzstan, Nepal, Nigeria, North Korea, and South Africa found that the way services are organised, using a task-shifting and decentralised model, results in high quality services. The authors recommend this model should be considered for adoption in countries that still reply on doctors and hospital-based services.

In Mexico, the Observatory on Gender and Covid-19 involving 29 national and local organizations was launched to study the impact of Covid-19 on women. Their research found that the pandemic has aggravated the inequality of gender: “Although the disease itself affects men more than women and the “stay at home” has hit everyone, the pandemic has done much more harm to women than to men… It has set us back decades on issues such as employment, reproductive health, care work and the right to decide.”

December 2020

Abortion Without Borders was formed in December 2019. It consists of groups in Britain, Netherlands, Germany and Poland who provide information, practical support and funding to people in Poland who need abortions, both in Poland (with early medical abortion pills) or abroad, and raise funds to pay for this. It is now a year later and so far, they have helped 5,000 people to have safe abortions.

In their end-of-year newsletter, Gynuity Health Projects published a study of use of mifepristone and misoprostol for treatment of delayed menses without prior pregnancy confirmation, which they call “missed period pills”. The pills will terminate a pregnancy if one is present, but those using the method can do so without knowing if they had been pregnant. The method garnered a lot of interest.

As women in Croatia encounter even greater difficulties in obtaining access to terminations of pregnancy, feminists are launching a new project called Brave Sisters in the new year to establish “a network of women in Croatia who will provide support to women who want an abortion”.

The Campaign published a report of 28 September 2020 activities on social media. Testimonies of abortion experiences complemented fact-sharing activities. Platforming peoples’ lived experiences of abortion showed the diversity of barriers to safe abortion access, which helps to dismantle abortion stigma.

More Cambodians seem to be accepting the idea of safe abortion despite the social stigma, and the prevalence of abortion seems to have increased as a result, e.g. among female migrant workers from rural areas working in the capital.

In Jamaica, 20% of the population are adolescents, and the country has the third highest adolescent pregnancy rate in the Latin America & Caribbean region. The HIV/AIDS Officer at the UN Population Fund Sub-Regional Office for the Caribbean has urged interested parties to focus on adolescent pregnancy prevention, as one of the social and economic consequences of the Covid-19 pandemic.

A growing number of studies are reporting high levels of effectiveness of self-managed abortion with pills and with accompaniment support. Of the data that do exist, however, there are important limitations, including a heavy reliance on retrospective records that were not collected for the purposes of research. Evidence suggests that a high proportion of abortions occur outside of the health care system and changing global dynamics may continue to shift more abortions outside of the healthcare system. Well-designed, rigorously-collected data are needed to assess the safety and effectiveness of medical abortion administered completely outside of the formal healthcare system – such as the accompaniment model – to contribute to our understanding of de-medicalised models of abortion care.

The Campaign published a report of the 31st Special Session of the UN General Assembly in response to the Covid-19 pandemic (3-4-14 December 2020).

Note: We will be closed from 19 December through 3 January.