Our Bodies, Ourselves (167 page)
Read Our Bodies, Ourselves Online
Authors: Boston Women's Health Book Collective
IN TRANSLATION: BARRIERS TO CONTRACEPTION AND ABORTION
The Polish adaptation of
Our Bodies, Ourselves
Group:
Network of East-West Women
Country:
Poland
Resource:
Nasze Ciala, Nasze Žycie
(
Our Bodies, Our Life
), a Polish adaptation of
Our Bodies, Ourselves
Website:
neww.org.pl
Poland's postcommunist transformation to a market economy has resulted in a massive overhaul of its health sector. Network of East-West Women, OBOS's partner in Poland, reports that traditional gender attitudes, along with laws that enable doctors to deny care they consider morally objectionable, and exorbitant health care fees levied by powerful pharmaceutical companies and private clinics, are serious barriers for girls and women seeking contraceptives and accurate information on sexual and reproductive health.
The entrenched influence of the Catholic Church, conservative media, and political groups has made the situation particularly difficult for women, who feel constant pressure to carry pregnancies to term and are continually denied access to information about their health and their rights.
Polish law is extremely restrictive of abortion, and a growing number of policy makers assume an antiâabortion rights stance that disregards the needs of pregnant women. There is widespread use of abortion pills bought online, and thousands of women have turned to illegal and expensive private clinics or have traveled abroad for abortion procedures. Given these social, political, and economic constraints, Network of East-West Women is committed to ensuring women become decision makers in their own care.
To this end, the Polish adaptation of
Our Bodies, Ourselves
is invaluable. In its preface, the authors state that “it is of vital importance for Polish women to know where and how to get help in case they are sick, what questions they should ask when talking to a physician, what rights they have as patients.”
The book, which has been distributed throughout the country, is empowering women as health consumers by explicitly explaining that they have the right to demand
information. In a country grappling with economic and social transformation, the adaptation is filling a critical need by providing women with a tool they can use to counter institutional conservatism and advocate for change.
FAMILY PLANNING AND GLOBAL FUNDING POLICIES
The ability to plan one's family is essential to a woman's health, autonomy, and empowerment. In the 1960s, only 9 percent of all married women used modern methods of contraception, as compared with about 55 percent of married women in 2010. Africa has the lowest rates of contraceptive useâonly 23 percent of married women use a modern method of contraceptionâwhile in developed regions, about 70 percent of women or more use contraception.
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Owing to increased demand for family planning, as well as a large increase in the number of women of reproductive age due to past high fertility, more than 137 million women globally have an unmet need for family planningâthey do not want to become pregnant within two years, but are not using a method of contraception, either modern or traditional, to prevent this.
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Traditional methods include periodic abstinence and withdrawal. Most women with unmet need live in developing countries, particularly in sub-Saharan Africa, where as many as 45 percent of women want to prevent or delay a pregnancy but are not using contraception.
The reasons for unmet need are varied and include lack of access to modern methods at reasonable or no cost; fear of contraceptive side effects; misperceptions about the risk of becoming pregnant; and opposition (real or perceived) from husbands, mothers-in-law, or religious groups. The availability of a good range of short-and long-acting methods to meet the varied needs of womenâas well as good-quality and respectful service deliveryâhas been shown to increase contraceptive use.
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The United States is the leading international donor for family planning assistance, though funding has been a political football for many years. International family planning funds have been tied to the global gag rule policy, which disqualifies foreign nongovernmental organizations from receiving U.S. funds if they provide legal abortion services or counseling and referral for abortion (even if legal) or lobby to make abortion legal or to expand access in their country. This policy (
discussed more
) was rescinded again by President Obama in January 2008, in what was considered a major victory for reproductive rights globally. The gag rule is an example of how the political battles over abortion in the United States harm the lives and health of women around the world.
The U.S. contribution to the United Nations Fund for Population Activities, UNFPA, has also been a subject of controversy in recent years, owing primarily to its work in China. China's one-child policy is used by antiâreproductive rights politicians as a false rationale for blocking appropriations to UNFPA, despite evidence that UNFPA's presence supports women's rights and in no way provides “assistance for abortion, abortion services, or abortion-related equipment and supplies as a method of family planning.”
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What gets lost in these debates is that while development assistance for some health problems expanded rapidly, international family planning assistance declined over the past decades. In fiscal year 2010, the U.S. government appropriated $648.5 million for family planning (including a $55 million contribution to UNFPA), a moderate 15 percent increase over fiscal year 2009. Stagnating funding for family planning, despite growing demand, reflected the limited support for sexual and reproductive health during President George W. Bush's administration. Funds for maternal and child health were also limited to $549 million, while funds earmarked for global HIV/AIDS programming reached $5.7 billion, a sign of the political support rallied against the HIV/AIDS epidemic after over a decade of advocacy.
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The increase in funding for HIV/AIDS and other infectious diseases in the U.S. foreign assistance budget shows that funding follows political will.
Declining support for international family planning is not unique to the United States, although it is perhaps more acute because of the substantial role that U.S. funding has played. In addition to reducing maternal and child mortality, the Millennium Development Goals include a target to achieve universal access to reproductive health services, including family planning, by 2015.
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The United Nations estimates that $24.6 billion annually is needed between 2011 and 2015 to reach these goalsâa little more than double the current global spending on family planning and maternal and newborn services.
IN TRANSLATION: ABORTION IN LATIN AMERICA AND THE CARIBBEAN
A Spanish adaptation of
Our Bodies, Ourselves
for the Americas and Caribbean
Group:
A collaboration of nineteen women's organizations in the Americas and Caribbean
Country:
Coordinated in the United States
Resource:
Nuestros Cuerpos, Nuestras Vidas (Our Bodies, Our Lives)
, a Spanish adaptation of
Our Bodies, Ourselves
, and peer health educator training materials for the Americas and Caribbean
Website:
ourbodiesourselves.org/publications/ncnv.asp Latin America and the Caribbean have some of the most restrictive abortion policies in the world. El Salvador, Chile, and Nicaragua, for example, do not allow abortions under any circumstance. Women seeking care after a miscarriage may be interrogated first for possible prosecution for suspected abortion, and some states in Mexico have begun such prosecutions. Providers in Costa Rica can be sent to prison.
While most other countries make allowances in certain situations (to save a woman's life or health, or in cases where pregnancy is the result of rape), the ideology and power of the Catholic Church hierarchy, as well as legal, judicial, and medical obstacles, make it nearly impossible to talk about abortion or to seek care. Despite these restrictions, these regions have some of the highest rates of abortion worldwide. Most of the abortions are unsafe, according to the nonprofit organization Ipas, and account for about one out of nine maternal deaths.
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The authors of
Nuestros Cuerpos, Nuestras Vidas
, the Spanish-language cultural adaptation of
Our Bodies, Ourselves
, chose to speak directly to the ethical and spiritual dimensions of abortion decisions in ways that would address Catholic women's concerns. They drew on the work of Catholics for Choice, which courageously challenges church doctrine by placing a woman's decision on abortion within the context of her sacred responsibility for lifeâemphasizing a woman's right and moral agency to make these difficult decisions, while recognizing that many women throughout the
world would rather risk their lives than bear a child they cannot care for. The book also draws heavily from the rich bonds that Latin American women have with their families and communities, voicing the culturally harmonious relational message “If you don't care for yourself, you can't take care of others.” Nineteen women's organizations representing twelve countries worked together to promote personal health while mobilizing for social change and to create a resource that inspires and guides Latinas throughout the Americas. The translation and topics, including abortion and HIV/AIDS, reflect enormous differences in social and economic realities and access to care across Latin America.
To reach Latina women and girls in the Caribbean, Central and South America, as well as those living
entre mundos
âbetween worldsâin the United States,
Nuestros Cuerpos, Nuestras Vidas
emphasizes engagement in a critical analysis of social, economic, political, and religious issues affecting women and girls every day. Additionally, it contextualizes women's ability to access timely, safe, and legal abortion care within other areas of economic, educational, and social life that leave them vulnerable to exploitation. It offers a window into the stories and social movements of women and girls throughout this region and the world, as they strive forâand achieveâequality and wellness.
A simultaneous investment in family planning and maternal and newborn health would ultimately cost less than investing in maternal and newborn services alone, because it would prevent unintended pregnancies and avert maternal and infant deaths.
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The Obama administration is addressing women's health from a more comprehensive perspective than in the past in its Global Health Initiativeâa $63 billion effort over six years to help partner countries improve health outcomes and strengthen health systems.
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The initiative will focus on improving the health of women, newborns, and children, but the specific actions to be taken are still under development.
Legal restrictions on abortion do not affect its incidence. The countries where abortion is the most accessible, in fact, have the lowest rates of abortion. Legal restrictions do, however, influence the safety of the procedure.
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Where abortion is legal and permitted on broad grounds, it is generally safe, and where it is legally restricted, it is often performed unsafely or in unsafe conditions. In South Africa, the incidence of infection resulting from abortion decreased by 52 percent and the number of deaths decreased by 90 percent after the abortion law was liberalized in 1996.
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Eighteen countries, Australia, Benin, Bhutan, Cambodia, Chad, Colombia, Ethiopia, Guinea, Iran, Mali, Nepal, Niger, Portugal, St. Lucia, Swaziland, Switzerland, Thailand, and Togo, as well as Mexico City, liberalized their laws to increase access to safe abortion between 1997 and 2010. Three countries, El Salvador, Nicaragua, and Poland, tightened restrictions on abortion.
