An Announcement, Some Publications
& More 28 September Reports 

13 October 2017



Dr Natalia Kanem has been appointed as the new Executive Director of the United Nations Population Fund (UNFPA). Dr Kanem, who is from Panama, was appointed UNFPA Deputy Executive Director in July 2016 under Dr Babatunde. She brings more than 25 years of strategic leadership experience in medicine, public and reproductive health, peace, social justice, and philanthropy. She studied at Johns Hopkins and Columbia University Schools of Medicine and Public Health. She was a Ford Foundation officer in West Africa from 1992 to 2005, where she funded pioneering work in women’s reproductive health and sexuality, and then became the Foundation’s Deputy Vice-President for its worldwide peace and social justice programmes globally. From 2012-13, she was a senior associate of the Lloyd Best Institute of the West Indies dedicated to development in the Caribbean, and in 2014 became UNFPA representative in Tanzania.
SOURCE: UN Press releases




In July 2017, during its 120th session, the Human Rights Committee (HRC) finalised its first reading of draft General Comment on article 6 of the Covenant and invited all interested stakeholders to comment on the Committee’s Draft. Comments had to be received by 6 October 2017.
The document was 22 pages long with 71 paragraphs on the many pressing issues that the right to life raises. There was only one paragraph about abortion, paragraph 9.
Comments were submitted by 21 States, most of them from the developed regions; 6 UN bodies/experts; 33 academics and other professionals; 3 national institutions; and over 100 NGOs. They can be accessed and read on the
website reporting the progress of the General Comment.
We submitted a brief comment from the Campaign. The Center for Reproductive Rights, Amnesty International, Human Rights Watch, International Commission of Jurists and Ipas submitted a joint statement, which garnered 70 signatories.
Given the complexity of the meaning of the right to life, the many ways in which all other human rights depend upon it, and the many ways in which the right to life is currently being violated, it is disappointing to say the least that the anti-abortion movement has again overwhelmed the Human Rights Committee with submissions complaining about abortion. Hopefully those submissions which are about the right to life of persons are more enlightening and will support the HRC in finalising what is overall an incredible document.



Harmonizing National Abortion and Pregnancy Prevention Laws and Policies
for Sexual Violence Survivors with the Maputo Protocol
Regional Technical Meeting Report
Lusaka, Zambia, April 11-13, 2016
In April 2016, the Population Council, the World Health Organization, and the International Consortium for Emergency Contraception convened a three-day regional technical meeting aimed at helping participating countries meet their obligations under the Maputo Protocol to protect and promote the reproductive health rights of women and girls, with a special emphasis on survivors of sexual and intimate partner violence. Participants included representatives from six countries in sub-Saharan Africa – Botswana, Ethiopia, Kenya, Malawi, Rwanda, and Zambia – as well as international and regional experts on reproductive health, law, and human rights. Presentations and discussions focused primarily on the prevention and management of pregnancy in the context of sexual violence (SV) and intimate partner violence (IPV), as well as the broader requirements of Maputo relating to emergency contraception (EC) and safe abortion services.


Access to safe abortion in Uganda: leveraging opportunities through the harm reduction model
by Moses Mulumba, Charles Kiggundu, Jacqueline Nassimbwa, Noor Musisi Nakibuuka

International Journal of Gynecology & Obstetrics, 16 May 2017    Full text available
Access to safe and legal abortion services is a far reach for women and girls in Uganda. Although unsafe abortion rates have fallen from 54 to 39 per 1,000 women aged 15–45 years over a decade, absolute figures show a rise from 294,000 in 2003 to 314,000 women having unsafe abortions in 2013. Unfortunately, only 50% of the women who develop abortion complications are able to reach facilities for post-abortion care. Despite the clinical evidence and the stories from undocumented cases, debate on access to safer and legal abortion is constricted, moralized, and stigmatized. The harm reduction model has shown evidence of benefit in reducing maternal mortality and morbidity due to unsafe abortion while addressing related stigma and discrimination and advancing women's reproductive health rights. This article presents a case for promoting the model in Uganda.




Community-based distribution of misoprostol for early abortion: evaluation of a program along the Thailand–Burma border
by Angel M Foster, Grady Arnott, Margaret Hobstetter

Contraception, Volume 96, Issue 4, October 2017, Pages 242-247
Background: Although abortion is legal in Thailand for a number of indications, women from Burma residing in Thailand are rarely able to access safe services. We evaluated the outcomes of a community-based distribution program that provides migrant, refugee, and cross-border women from Burma with evidence-based information about and access to misoprostol for early pregnancy termination.
Results: From January 2012 through December 2014, 918 women received early abortion care using misoprostol through the community-based distribution program. Of these, 885 women (96.4%) were not pregnant at follow-up, 29 were pregnant at follow-up (3.2%), and four women were lost to follow-up (0.4%). Our interviews revealed that providers are motivated to participate due to concerns surrounding unsafe abortion in the community and frame their work as a public health intervention.
Conclusions: The documented outcomes from this initiative may be valuable for those working to
reduce harm from unsafe abortion in other legally restricted, low-resource, and/or conflict-affected settings.



Accuracy of gestational age estimation from last menstrual period among women seeking abortion in South Africa, with a view to task sharing: a mixed methods study
by Deborah Constant, Jane Harries, Jennifer Moodley, Landon Myer

Reproductive Health (2017) 14:100. DOI 10.1186/s12978-017-0365-7  Open access
Plain English abstract
Medical abortion was introduced in 2011 in South Africa, is very effective and safe for abortion up to 9 weeks and does not require specialized surgical skills. However, introductory protocols required an ultrasound examination be done to date the pregnancy using equipment and expertise not widely available, especially in more remote rural areas. If women can remember the first day of their last menstrual period (LMP), this can be used to work out their pregnancy duration, and if community health workers (CHWs) can ascertain pregnancy duration from women’s LMP, this could assist expansion of medical abortion services into primary care public health facilities across the country.




Rise in abortion rates
According to data released by the Iranian Health Ministry, last year (ending in March), 12,281 women put in applications for the medical termination of their pregnancies. The figure was 23.4% higher compared to the preceding year.
“Permission was granted to 8,537 applicants, which indicates that the number of permits increased by 19.8% compared to the preceding year,” said Ahmad Shojaee, head of the Legal Medicine Organization (ILNA) reported.
Termination of pregnancy is illegal in Iran unless the woman can prove that giving birth would pose a health risk to herself or her baby. “Verified genetic testing, ultrasound, written consent of mother, gestational period of less than 19 weeks of the fetus, besides approval by three medical specialists is mandatory for therapeutic abortion,” Shojaee said.

The reason for the increase can be attributed to the people’s raised awareness of genetic counselling.
According to Mohammad Mahdi Akhundi, head of the Iranian Society of Embryology and Reproductive Biology, import of abortion pills is banned in Iran. However the pills (misoprostol) and vials (prostaglandin) that can cause miscarriage are available in the black market and from peddlers in Nasser Khosrow Street near Tehran’s downtown Grand Bazaar.
Iran has committed to reduce maternal mortality to zero by the year 2030.
Financial Tribune, 28 August 2017 ; PHOTO



BRIEFING PAPER, by Center for Reproductive Rights



BULLETIN: SRHR in the era of the SDGs
Covers the impact of Trump policies, Global Gag Rule, trade agreements, patents in the health care industry, economic empowerment and climate change, abortion and sexual rights, what it means for sex workers, young key populations, LGBTIQ, and women who live with HIV and who use drugs not to be left behind, and a preliminary examination of Asia-Pacific governments’ commitment to SRHR based on their reporting at the 2017 High-Level Political Forum.


Safety of medical abortion provided through telemedicine compared with in person

Obstetrics & Gynecology, by Daniel Grossman, Kate Grindlay, 5 September 2017
During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were managed. Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events.

Zika: From the Brazilian backlands to global threat, by Debora Diniz,
Zed Books, 2017
Zika disappeared from the headlines soon after the World Health Organization’s decision to declare the end of the global public health emergency in November 2016. It is easy to say now that the virus is at most spreading at a slow, non-threatening way. But, for the nearly forgotten, more than 14,000 Brazilian families affected by suspected cases of congenital Zika syndrome and the 2,800 families with confirmed cases, the lasting impacts of the epidemic are very real. This book stresses the continued lack of support for families affected by one of the country’s most devastating public health crises. This is the English translation of the book first published in Brazil in August 2016.

Global Doctors for Choice's new
Knowledge Hub, is an online database of reproductive health resources. You can use it to search for resources (e.g., publications, trainings, websites, etc.) relevant to reproductive health (e.g., conscientious objection, the health exception to abortion, creating collaborations and partnerships, political mapping, etc). Content will also be offered in Spanish soon. They are continuously adding new resources and welcome your suggestions for resources to include.

"What You Need to Know About the Protecting Life in Global Health Assistance Restrictions on U.S. Global Health Assistance” –
PAIs unofficial guide, to educate about what is permissible under the expanded Global Gag Rule.

Abortion in Good Faith advertisement campaign
Catholics for Choice has released the second phase of its campaign
Abortion in Good Faith that lifts up the voices of everyday Catholics nationwide who believe that all women deserve the right to equitable reproductive healthcare, including abortion access – no matter how much money they have, where they live or what they believe. 60% of Catholic voters nationwide believe having an abortion can be a moral decision and a majority support Medicaid coverage for abortion.

Reasons why women have induced abortions: a synthesis of findings from 14 countries

Contraception, by Sofie Chae, Sheila Desai, Marjorie Crowell, Gilda Sedgh, Vol 96, No 4, October 2017, pp.233-241 
The study examined nationally representative data from 14 countries collected in official statistics, population-based surveys, and facility-based surveys of abortion patients. In each country, they calculated the percentage distribution of women who have abortions by main reason given for the abortion. In most countries, the most frequently cited reasons for abortion were socioeconomic concerns or limiting childbearing. With some exceptions, little variation existed in the reasons given by women's socio-demographic characteristics. Data from three countries where multiple reasons could be reported showed that women often have more than one reason for having an abortion.

International Campaign Social Media Report

by Sara Barnes, Social Media Editor
28 September is anything but a one-day event. In fact, it's still not over. On 14 October, there is a march in the streets of Belfast, Northern Ireland, to demand that we all #TrustWomen to make their own decisions about their pregnancies.
The social media response this year, although it started on 28 May (International Day of Action for Women's Health), really got going in the week of 28 September and is ongoing with #KnowYourRepealers (started in Ireland) and opposition to the 20-week abortion ban bill in the US Congress keeping up the momentum.
Our top tweet in September was the Campaign's call to world leaders to stand up for women's right to safe abortion. Our tweet which most engaged the media reported the statement by UN experts urging "all States to end the criminalisation of abortion". Over all almost 20,000 organisations and individuals saw our tweets from 27 September to 30 September, around 500 of these actively engaged with our content.
A really exciting visual development on the day was the release of
WHO's infographics in support of safe abortion. These garnered thousands of retweets as a valuable resource.
Overall, there was a lot of excitement on the day itself – we engaged with more than 360 different accounts from more than 40 countries. We had chats and shared ongoing live events with many members from Nigeria to Indonesia, Argentina to Ireland, the United States to Kenya.
We were overwhelmed by the number of reports of members' activities and didn't manage to individually tweet all those shared in our newsletter (or vice versa). But they are all being uploaded to our website and can soon be found
Facebook was slower to stir, as usual, but we gained an extra 166 followers on the day! Our Instagram account, while still small at 180 followers, mostly SRHR organisations, did particularly well. On all platforms our new logo and posters, designed by Laura Malan, received a lot of positive feedback from members as well as the public. The posters were translated into 4 languages (English, French, Spanish, Italian) thanks to pro-active members who initiated them. For the first time, we felt we had given a personality to the Campaign Coordination's engagement with the day.
The main hashtags for the day – #LeavingNoOneBehind, #IResistWePersist, and #UnGritoGlobal – were all widely used but were occasionally mixed up or wrongly worded. The date itself was variously represented on #28S, #28Sept and #Sept28.
Overall, the day was an incredible success, and we hope the social media exposure and the relationships we've built will contribute to the day continuing to grow year on year. 

The Share-Net Bangladesh team has promoted International Day on Safe Abortion on 28th September with an informative banner on abortion policy in Share-Net country nodes and an infographic on menstrual regulation (MR) and unsafe abortion in Bangladesh. The team has also published an interview on the starting of MR service in Bangladesh, major challenges and possible solutions with Quazi Suraiya Sultana, Executive Director, RHSTEP.
According to the infographic they produced (Guttmacher data), there were 1,194,000 induced abortions in Bangladesh in 2014 and 430,000 menstrual regulations in health facilities. Some 53% of public sector facilities and 20% of private sector facilities are permitted to provide menstrual regulation but these figures are down 66% and 36%, respectively, from 2010.  384,000 women suffered complications from unsafe abortion in 2014
Share-Net Bangladesh, September Newsletter, 9 October 2017


Members of the Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito organised the production of a video of a "Debate of political candidates on the right to abortion in Argentina", which took place on 20 September at the University of Buenos Aires, Social Sciences School, in the context of #UnGritoGlobal por el #AbortoLegal. It was one of the many activities they planned for 28-29th September. The debate was moderated by Martha Rosenberg and María Alicia Gutiérrez, both members of the Campaña since the very beginning. You will see lots of green in the video, especially from their handkerchiefs, a colour that has been the Campaña's distinctive hallmark for 12 years. The debate was recorded by Emergentes, a social media partner, and can be found


Association Hera XXI participated in the global campaign on abortion rights for the Global Day of Access for Safe and Legal Abortion! #LeavingNoOneBehind. The Youth Group of HERA XXI has collected life stories of women in rural regions of Georgia. Their campaign aimed to increase the discussion of abortion rights, whether it is financially accessible or not, and related issues in Georgian society. The main priority of the 2017 campaign was calling for financial accessibility of abortion services for every women.
Mariami, 23 years old, from Samtskhe-Javaxeti
I got married when I was 17. I have two kids. I have terminated a pregnancy six times with a method taught to me by my neighbour because I did not have the money for getting an abortion at the hospital. We have financial problems in my family. My husband works very hard, he goes away to work for two weeks at a time, so he cannot help me in bringing up the kids. I try to cope with everything.
Anna, 19 years old, from Tbilisi
When I learned I was pregnant, I was very afraid, maybe because of my age. I was used to taking all responsibilities on myself, but it was very difficult for me to make this decision, and in addition my boyfriend and I are not financially independent. We are students. The amount of money needed for an abortion was a lot for us, which was the main barrier and challenge. All of this had a very big psychologically influence on me.
Georgia has the highest number of abortions in the Eastern European region. Abortion services are not accessible for youth, women living in rural areas or women from vulnerable groups.

Editor: Marge Berer

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