The Importance of Safe and Legal Abortions in Healthcare

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This article was exclusively written for The European Sting by Ms. Fatima Farooq, a fourth year medical student from Pakistan. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Abortion is the removal of pregnancy tissue, products of conception or the foetus and placenta (afterbirth) from the uterus. Abortion can be completed with medication or by aspiration. A committee of the National Academies of Sciences, Engineering, and Medicine reviewed the data available and confirmed in their report in 2018 that all forms of abortion, including medication and aspiration abortion, are safe and effective and that the only factors decreasing safety are those decreasing access.


Comprehensive abortion care is included in the list of essential health care services published by WHO in 2020. Comprehensive abortion care includes the provision of information, abortion management and post-abortion care. Ensuring that women and girls have access to abortion care that is evidence – based – which includes being safe, respectful and non-discriminatory – is fundamental to meeting the Sustainable Development Goals (SDGs) relating to good health and well-being and gender equality.


Many factors necessitate a woman’s decision to have an abortion. They include, but are not limited to:
• Contraceptive failure
• Barriers to contraceptive use and access
• Rape
• Incest
• Intimate partner violence
• Foetal anomalies
• Illness during pregnancy
• Exposure to teratogenic medications


Pregnancy complications, including placental abruption, bleeding from placenta previa, preeclampsia or eclampsia, and cardiac or renal conditions, may be so severe that abortion is the only measure to preserve a woman’s health or save her life.


Where abortion is illegal or highly restricted, women resort to unsafe means to end unwanted pregnancies, including self-inflicted abdominal and bodily trauma, ingestion of dangerous chemicals, self-medication with a variety of drugs, and reliance on unqualified abortion providers. Today, approximately 21 million women around the world obtain unsafe, illegal abortions each year, and complications from these unsafe procedures account for approximately 13% ofall maternal deaths, nearly 50,000 annually.


Physical health risks associated with unsafe abortion include:


• Incomplete abortion (failure to remove or expel all pregnancy tissue from the uterus)
• Haemorrhage (heavy bleeding)
• Infection
• Uterine perforation (caused when the uterus is pierced by a sharp object)
• Damage to the genital tract and internal organs as a consequence of inserting dangerous objects into the vagina or anus


Criminalisation and restrictive laws on abortion prevent health-care providers from doing their job properly and from providing the best care options for their patients, in line with good medical practice and their professional ethical responsibilities.


Access to safe abortion services is a human right. Under international human rights law, everyone has a right to life, a right to health, and a right to be free from violence, discrimination, and torture or cruel, inhuman and degrading treatment. Access to abortion is therefore fundamentally linked to protecting and upholding the human rights of women, girls and others who can become pregnant, and thus for achieving social and gender justice.


In facilitating access to safe abortion care, community level workers can provide information about safe providers, and provide referrals or accompany women to safe and legal facilities.


References:
https://www.health.harvard.edu/medical-tests-and-procedures/abortion-termination-of-pregnancy-a-to-z
https://www.statpearls.com/ArticleLibrary/viewarticle/17038
https://www.who.int/news-room/fact-sheets/detail/abortion
https://www.who.int/health-topics/abortion#tab=tab_1
https://www.amnesty.org/en/what-we-do/sexual-and-reproductive-rights/abortion-facts/
https://www.acog.org/advocacy/facts-are-important/abortion-is-healthcare
https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-017-0391-1#:~:text=In%20facilitating%20access%20to%20safe%20abortion%20care%2C%20community%20level%20workers,facilities%20%5B14%2C%2015%5D.

About the author

Ms. Fatima Farooq is a fourth year medical student from Pakistan.

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