Presentation to SAIGE Webinar: Safe Abortion in the Midst of a Pandemic, 27 May 2020, by Susana Chavez, Executive Secretary, CLACAI (Latin American Consortium against Unsafe Abortion)
In a regional context of persistent social and economic inequality, population changes and deep institutional weaknesses:
- 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 out of 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
- There are barriers even to access legal abortions.
The high demand for care and the severity of Covid-19 has reduced and/or affected the provision of essential services for women and girls, including:
- pre- & post-natal care,
- termination of pregnancy,
- contraceptive availability,
- increased use of unnecessary interventions to reduce time in hospital, i.e. caesarean sections, forceps deliveries without medical indications,
- refusal of wellness interventions, i.e. use f analgesia/epidural, presence of a partner at delivery, separation from newborn,
- new barriers to accessing legal abortions, e.g. not including abortion in essential care, impediments to establishing medical boards,
- barriers to accessing safe abortion, e.g. information is available but not supplies, limited telehealth for poor women, and cost of misoprostol increased,
and has made anti-human rights activities worse, including discrediting WHO and states that are responsive to the pandemic, saying the virus is a plot to reduce “freedom”, a punishment from God, etc.
CLACAI presented an analysis to the Inter-American Commission on Human Rights, supported by more than 90 organisations, calling for appropriate guidelines to ensure continuity of care, and ensure personnel, supplies and medications for sexual and reproductive health, including:
- adoption of telehealth strategies for low complexity outpatient care,
- enable at all levels of care provision of SRH services,
- delivery of medications without contact with healthcare personnel,
- remove time limits and other unnecessary requirements,
- ensure sufficient supplies to reduce visits to health centres,
- simplify the medication acquisition process and enable simple prescriptions and electronic prescriptions, and
- guarantee state purchase of supplies to ensure the continuity of care and rights.
They have developed a monitoring system for use in nine countries, in coordination with local organisations, to define monitoring indicators, implement a monitoring system, do national advocacy with national oversight, identify serious cases of neglect, and demand accountability processes.
Other presentations in this webinar were by Sivananthi Thanenthiran (ARROW, Malaysia), Clara Padilla (EnGenderRights/PINSAN, Philippines), Mageda Esolyo (WGNRR Africa), and especially Shanta Laxmi Shrestha (Beyond Beijing Committee, Nepal), all of which are best listened to in full.