The potential for medical abortion to save women’s lives in Africa was a major focus at the World Congress of the International Federation of Obstetricians & Gynecologists (FIGO) in Cape Town in October. For the first time in FIGO’s 55-year history the meeting was held in Africa, a region where access to basic reproductive health care poses a particular challenge to women.

Source: ipas.org

African doctors and other health-care providers at the conference, who see the impact of unwanted pregnancy and unsafe abortion every day in their practices, welcomed the opportunity to exchange experiences and strategies for improving women’s health. Unsafe abortion is a particularly pressing issue in Africa, which accounts for more than half of all deaths from unsafe abortion globally each year. Most women in Africa live in countries with restrictive abortion laws, contributing to the high death rate.

Medical abortion — abortion using pharmaceutical methods — was an important topic for discussion during the FIGO Congress because of its potential to make safe abortion care more accessible to women in remote or poor areas. A panel led by Ipas Vice President for Africa Dr. Eunice Brookman-Amissah explored how medical abortion has been used in South America (where abortion laws are particularly strict) and Asia (where access to doctors is particularly limited) to reduce injuries and deaths from unsafe abortion. She pointed out that in Africa, only a few countries have registered the medications required (mifepristone and misoprostol), even though it has been widely used in Europe and North America, and shown to be safe, effective and acceptable to women.

“It’s time for African women to get what women in Europe have had for 20 years,” Dr. Brookman said, “and what is increasingly available to women in other regions too.”

The medical abortion panel followed a panel sponsored by Ipas and the FIGO Working Group on Prevention of Unsafe Abortion, in which speakers outlined the public health, clinical, ethical and human rights considerations that are basic to expanding access to safe abortion care. Dr. Susheela Singh of the Guttmacher Institute presented the latest data from a report on the worldwide abortion situation released the following week. Dr. Leonel Briozzo of Uruguay emphasized a doctor’s obligation to promote women’s human rights, including sexual and reproductive rights for women facing unwanted pregnancies.

The Ipas-sponsored panels were among nearly a dozen scientific panels on abortion, ranging from clinical discussion and trainings to the use of medical abortion drugs to treat miscarriage and other obstetric conditions. Ipas also led visits by FIGO delegates to clinics providing abortion care in and around Cape Town. It is notable that South Africa is one of a handful of countries with a liberal abortion law; however, it too faces the challenge of making abortion accessible to women in remote or low-income areas. Dr. Roland Mhlanga, Ipas board member and a Chief Director within the South Africa National Department of Health noted that health centers need to be equipped to provide the full range of reproductive health services – but also called for society at-large to adjust its attitudes to support sexual and reproductive rights at home, in schools and in relationships.

The FIGO Congress took place against a backdrop of a changed international reproductive health environment. Since the last FIGO Congress in 2006, the U.S. White House has changed hands and President Barack Obama has repealed the Global Gag Rule barring U.S. foreign assistance to organizations that provide abortion counseling or care with their own funds. While this policy change has opened up discussions about abortion in the international arena, many are unaware that important U.S. policy restrictions remain in place, including the 1973 Helms amendment banning the use of U.S. funds for abortion care, even when the abortion would be legal, and even where unsafe abortion is a major public health concern.

“For health-care providers practicing in USAID-funded programs and clinics, it is regrettable that the Helms restriction continues to put them in conflict with longstanding FIGO ethical guidelines affirming a woman’s right to safe abortion care,” declared Ipas Executive Vice President Barbara Crane.