Reproductive rights of women seeking abortion

Galina Maistruk, СoordinatorEuropean Alliance for Reproductive Choice

The question of abortion is a part of the question of reproductive health, reproductive choice and reproductive rights.

The decision of special session of General assembly UN (June, 1995, item 8.25): ...In conditions at which abortion doesn't contradict the legislation, abortion performance should be safe...

Throughout centuries the problem of abortion was and remains a subject of fierce disputes, interdictions, struggle....

Russian empire/USSR/ The countries of Eastern European region

Before 1917 year – prohibited...

Since 1920 year – permitted…

Since 1937 year – again prohibited...

Since 1955 year - again permitted …

In most countries of Eastern European region abortion is legal.

Russian empire/USSR/ The countries of Eastern European region

Despite the widespread availability of abortion on legal grounds for more than 50 years, unsafe abortions account for 24% of maternal deaths in countries Eastern European region (WHO, 1998).

Abortion rates remain high.

Abortion is commonly used as a primary means to regulate fertility; the use of modern contraception methods remains low.

Medical abortion is still inaccessible for general population and remains an “elite” method for most of the women (officially permitted in Russia since 1999, in Ukraine since 2001 year).

Low level of the awareness and limited information about

the method, low demand for comprehensive abortion care services, many existing myths;

Cost of the pills for MA is prohibitive;

Statistics sometimes is not correct;

Lack of providers motivation to use a new methods, the misuse, low efficacy;

Unwillingness of the public health systems to take the necessary steps for the implementation of the medical abortion services, and unnecessary barriers imposed by their regulations.

The analysis of the access to safe abortion in Eastern European countries has showed the following common trends:

23

,4

21

,14

19

,5

18

,6

17

,2

16

,6

35

,8

40

14

4,8

12

8,9

12

1,3

4

92

,7

84

,4

73

,0

63

,97

58

,8

50

,5

44

,88

15

,1

56

,6

36

,66

27

,25

25

,78

44

,79

0

20

40

60

80

100

120

140

160

180

200

1995 1997 1999 2001 2002 2003 2004 2005 2006 2007 2008 2009

0

100000

200000

300000

400000

500000

600000

700000

800000

Число абортів на 100 пологів

Число абортів на 1000 жінокфертильного віку

Кількість абортів

The level of abortion in Ukraine

Mortality from abortion in Ukraine (absolute number)

Methods of abortion in Ukraine

Curettage Vacuum aspiration

Medical abortion about 1% (2008 year)

The “Abortions and Contraception in Ukraine” WHO/MOH Strategic Assessment of policy and programmes in the sphere of unplanned pregnancy, abortions and contraception is a considerable contribution to the sphere of preserving reproductive health of the population of Ukraine (2007- 2008 years).

The main aim of the publication is to present information on the results, recommendations and further steps of the Strategic Assessment.

No idea about reproductive rights!!!

Low knowledge of the population (RR, safe abortion, ect).

Insufficient level of knowledge of medical specialists in RR & Legislation.

Low knowledge of medical specialists. The negative relation from medical specialists («Safe abortion doesn't happen!»).

Primary use of out-of-date (“unsafe”) methods.

Restrictions (terms of pregnancy). Exp: 49 days for medical abortion.

Obstacles to wide introduction of safe abortion in Ukraine:

The dose of mifepristone is still 600 mg. !!!!

High cost of services in private and state medical institutions.

lack of necessary equipment (MVA, EVA) and materials.

Imperfection of clinical protocols and standards.

Absence of monitoring system

Obstacles to wide introduction of safe abortion in Ukraine:

16 /09/2010 in Ministry of Health Care Ukraine was provide Round table: “Medical, social, psychological aspects of unofficial termination of unwanted pregnancy”.

Concerns about declining birth rates, pressure from religious groups have reduced support for family planning and abortion.

Promoting choice for Safe abortion – important way to guarantee Reproductive rights of women seeking abortion.

Advocacy on international and national levels:Development of advocacy strategy;Improvement of advocacy skills; Development of advocacy tools.

Education on international and national levels (ToT, est.):Creation of Education Programme;ToT regional & national level;Improvement of knowledge among providers;Exchange of experience.

Research and Documentation:Strategic Assessment;Country Profiles;IEC activities;Access to research programs, evidence-based info.

Dissemination: Comprehensive care of unwanted pregnancies models;Good clinical practice (GCP);Exchange of experience.

Promoting choice for Safe abortion – important way to guarantee Reproductive rights of women seeking abortion.

Thanks!

Welcome to Ukraine!