Abstract
BackgroundAlthough sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors’ observations suggest that four reasons are typically given for this gap: ‘There’s no need’; ‘Abortion is too complicated to provide in crises’; ‘Donors don’t fund abortion services’; and ‘Abortion is illegal’.DiscussionHowever, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world’s population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion.SummaryAs none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women’s right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women’s health and human rights and save lives.
Highlights
Sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided
Unsafe abortion is defined by the World Health Organization (WHO) as ‘a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both’ [13]
Humanitarian organizations may provide safe abortion services, as permitted by international or national law, to women affected by crises with non-US government (USG) funds, even if they receive USG funding
Summary
There’s no need The lack of reliable data published on unsafe abortion in humanitarian settings must not be interpreted to mean there is no need for safe abortion services. Humanitarian organizations may provide safe abortion services, as permitted by international or national law, to women affected by crises with non-USG funds, even if they receive USG funding. They may with USG funds, provide information and referral to clients on legal abortion services. The European Union (EU) explicitly reminded its member states that EU humanitarian aid should be kept independent of US restrictions on humanitarian aid to ensure access to abortion for survivors of rape in war [58, 59] These policy discussions may facilitate changes in humanitarian NGOs’ practice regarding safe abortion in crises. Providing abortion to women who become pregnant as a result of rape may be a more acceptable entry point for a more thorough discussion on safe abortion for all women
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