Protest the death of Savita Halappanavar

SOLIDARITY REQUEST: Protest the death of Savita Halappanavar in Ireland PLEASE SIGN AND SEND THE E-MAIL BELOW TO THE FOLLOWING: To: Taoiseach Enda Kenny (Irish Prime Minister) cc: Tánaiste Eamon Gilmore (Irish Deputy Prime Minister and Minister of Foreign Affairs) E-mails: taoiseach@taoiseach.gov.ie enda.kenny@oireachtas.ie eamon.gilmore@oir.ie Copy also to the Irish Embassy in your country. Find contact details here     Re: Death of Savita Halappanavar in Galway Honourable Taoiseach, We are writing to you to express our concern about the recent death of Savita Halappanavar, who was repeatedly denied an abortion in Galway. This tragic case demonstrates once again that the prohibition of abortion in Ireland is not just undermining the autonomy of the women across the country, it is leading to unacceptable suffering and even death. Savita Halappanavar made repeated requests for an abortion after presenting at University Hospital Galway on 21 October while miscarrying during the 17th week of her pregnancy. Her requests were refused, and she died one week later after several days in agonising pain and distress. The situation of Savita Halappanavar provides the clearest possible evidence that laws that permit abortion only to save the life of a woman, such as the Irish law, are clinically unworkable and ethically unacceptable. There are numerous clinical situations in which a serious risk posed to a pregnant woman's health may become a risk to her life, and delaying emergency action only increases that risk. There is only one way to know if a woman's life is at risk: wait until she has died. Medical practitioners must be empowered by law to intervene on the grounds of risk to life and health, rather than wait for a situation to deteriorate. You will be aware that the European Court of Human Rights, as well as a number of United Nations human rights bodies, have called upon the Irish government to bring its abortion law in line with international human rights standards. Had these calls been heeded before now, the death of Savita Halappanavar would have been prevented. With the death of Savita Halappanavar, Ireland joins the ranks of countries worldwide where abortion is denied to women and leads to their deaths. We call on your government to take urgent and decisive steps to reform the legislation that led to the death of Savita Halappanavar. Until the Irish legal system is reformed the lives, health and autonomy of women across Ireland are in jeopardy. Yours faithfully, [SIGNATURE]

Happy birthday to us!

Dust off the party poppers, EFC is 20 years old this year!

We were founded back in 1992 as a result of a lack of good quality educational resources on pregnancy and abortion. Teachers were finding that despite the topic of abortion being on many syllabi, there was very little support in terms of teaching it in a sensible and balanced way. Sure, the old anti-choice stalwarts SPUC and Life had been around for a good 20 years, but their offerings tended to be (and still are) partially inaccurate, biased and often insensitive to young people's experiences of pregnancy. A group of sexual health professionals therefore got together to form 'Education For Choice' and ensure that young people could learn the facts about abortion.

Over the past 20 years we're stayed true to our mission - to provide young people with reliable information about pregnancy options. We've done this directly, by providing workshops in schools, colleges and youth centres, but also by producing resources and training up professionals who work with young people. We reckon we’ve reached around 1.8 million young people through this work. Not bad for a tiny project with limited resources eh?

Our 20 years of experience means that we are experts on young people and abortion and are often contacted by the press to provide information and comment. Recent years have seen us work to expose rogue crisis pregnancy centres offering inaccurate information, and highlight the problem of anti-choice speakers giving misinformation to young people in schools. No one else in the UK is doing this vital and unique work.

We’re proud of what we’ve achieved, but while sex education remains a patchy subject and anti-abortion groups continue to mislead young people about their health and wellbeing we think it’s important that EFC continues to shout loud for young people’s right to good education.

We’re asking you to support our work by giving us £20 for our 20 years. Or a monthly donation – even a small amount will make a real difference. To spice things up we’ll be posting some classic tunes from 1992 to now, culminating in our birthday extravaganza in London on 22nd November. We’d love to see you there.

If you believe young people deserve to be give the facts about pregnancy and abortion, then please give what you can to support EFC’s work.

Wonder Women and Other Women

As part of the Telegraph’s new ‘Wonder Women’ collective Cathy Newman has written a piece entitled ‘How the agony of my abortion made me see both sides’. In the article Newman shares her own experience of having ended a wanted pregnancy due to a diagnosis of severe fetal abnormality. She notes that she was lucky to find out about this abnormality relatively early, at 13 weeks, as many women would be having this scan at 20 weeks. She goes on to describe the difficulty of having to wait another week to access the procedure after having had this news:

‘Most women whose babies suffer from this condition wouldn't find out until the 20 week scan, if then. I was immediately offered an abortion, but quite apart from the emotional turmoil, it was extremely difficult to arrange. I was told I'd have to wait a fortnight, but eventually managed to fix the operation in a week - a week which seemed like a year as I dealt with the trauma of what was happening to me.’

We appreciate Newman sharing her personal experience, and acknowledging that there are complex situations and real people behind later term abortion, and that unavoidable delays can affect access and emotional wellbeing. However, there are a few points in the rest of the article we’d like to have seen more clarity on, this being such an important and emotive subject.

Firstly, the conclusions reached about later abortion are not entirely accurate. Newman claims that ‘if the law changes, women in similar situations might not have the choice I did’. The article’s ‘hook’ seems to be that Maria Miller, new Minister for Women and Equalities, voted in 2008 to reduce the abortion time limit to 20 weeks. In fact, if this part of the law changed it would presumably not affect somebody in a similar situation to Newman – that is somebody who had had a diagnosis of fetal abnormality, as this is a ground under which abortion can be accessed after the 24 week limit.

The more troubling statement which has been left unexplored, with no reference to scientific evidence, is that made by Miller herself regarding her reasons for supporting a reduced time limit. She claims to be:

‘driven by that very practical impact that late term abortion has on women...What we are trying to do here is not to put obstacles in people's way but to reflect the way medical science has moved on.’

There are two issues here. What is the ‘very practical impact’ that late term abortion has on women? Has this been measured against the ‘very practical impact’ which might arise from being forced to continue an unwanted or non-viable pregnancy to term? Secondly, Miller claims to be reflecting ‘the way medical science has moved on’. When Miller was voting on the 2008 Human Fertilisation and Embryology Act she would have heard that medical and scientific consensus remained in favour of maintaining a 24 week limit due to a lack of significant changes to viability before this point:

‘Having considered the evidence set out above, we reach the conclusion, shared by the RCOG and the BMA, that while survival rates at 24 weeks and over have improved they have not done so below that gestational point. Put another way, we have seen no good evidence to suggest that foetal viability has improved significantly since the abortion time limit was last set, and seen some good evidence to suggest that it has not.’

Miller’s insistence that it is ‘common sense’ which drives her desire to change the time limit should surely be questioned and backed up by relevant evidence. Rather Newman, (ironically Channel 4’s ‘factchecker’) allows this, as well as talk of ‘trauma’ to pass by, unexamined.

We know that only a tiny minority of women are accessing abortion after 20 weeks (1.5% in 2011) and as Newman acknowledges, this may be due to fetal health or delays to access (or an array of other issues, see this report from Marie Stopes for background on the reasons some women have later abortions). However, the article seems to support Newman’s own reasons for ending a pregnancy, but is shaky on the necessity of later abortion for ‘other women’. For example, women whose local hospital may not be 'one of the world's best in the field’. The quotes from Nadine Dorries in the piece are very telling – she claims that ‘prochoicers’ who support the current time limit are ‘ignoring the number of women who are traumatised and vulnerable during the abortion process’. Clearly, there are Wonder Women who can make logical, justifiable decisions about their pregnancy and there are Other Women who are vulnerable, whose choices need to be limited and who need to be ‘protected’ by politicians like Miller and Dorries.

Todd Akin's not the only one claiming that pregnancy as a result of rape is rare

Earlier this week Republican politician Todd Akin came under fire for claiming that pregnancy occurring as a result of rape is ‘really rare’. In arguing for a ban on abortion without exceptions for pregnancies conceived through rape he stated the following:

“First of all, from what I understand from doctors [pregnancy from rape] is really rare... If it’s a legitimate rape, the female body has ways to try to shut that whole thing down”

Akin’s claims have rightly been attacked by various pro-choice groups and media outlets in the States for having no basis in scientific fact. Indeed, research from the Journal of American Obstetrics and Gynecology suggests that rape-related pregnancy occurs with significant frequency, something to which many women themselves can attest. So huge was the outcry that even the President released a statement condemning the claim that “legitimate rape” is unlikely to end in pregnancy. President Obama used Akin’s disingenuous comments as an example of why "we shouldn’t have a bunch of politicians, the majority of whom are men, making healthcare decisions on behalf of women."
 
Unfortunately, this kind of thinking isn’t limited to one rogue politician in the States spouting misinformation in order to push a ban on abortion. The idea that it is impossible or very unlikely for pregnancy to occur as a result of rape has been spread by a number of anti-abortion groups, including those based in the UK. The Society for the Protection of Unborn Children (SPUC) state the following in their ‘Exploring Abortion’ school resource:

“Pregnancy as a result of rape is extremely rare. A woman is only fertile for 3-7 days during her cycle and the extreme physical and psychological trauma of being raped makes it difficult for fertilisation or implantation to occur.”

Earlier this year, SPUC were criticised for giving young people misleading information about pregnancy and rape but we are yet to see the same public outcry Todd Akin’s comments have attracted in the States.

Young people here and abroad deserve to hear factual information about pregnancy and abortion, and we should certainly be concerned when damaging myths like this are allowed into our classrooms. EFC are currently working on a report into abortion education in the UK which will pull together the types of misinformation being given to young people in schools. If you have information you'd like to feed into the project please do contact us efc@brook.org.uk and keep an eye out for the launch of the report this autumn.

EFC Youth Advisors produce short film about pregnancy testing

We're very pleased to announce that the short film produced by our lovely Youth Advisory Group is now up on our You Tube channel (and you can view it below!)

The group wanted to make a film which would give other young people information about pregnancy testing and pregnancy options but which would also make the process seem a little less intimidating.

Chau: 'I have definitely learned more about sexual health and am able to tell others more precise facts'
Namratha: 'It's a great resource for young people to know of their concerns and options locally available to them'
Nataliah: '(the film allows) young people to gain information on services available to them without feeling embarrassed or intimidated to directly ask someone.'

Well done guys!

40 Days for Lies? Audio files

Our latest blog exposed the crisis pregnancy centre (aka Central London Women's Centre/Albany Women's Centre/Good Counsel Network) that the 40 Days for Life protesters have been giving out literature for. Here are a few sound clips of a counselling session which took place at that centre.
Central London Women's Centre Audio

1. ...if you make this decision, this baby will have no life. And also it dies in terrible pain
2. ...the risk of getting cancer after abortion is 100%
3. ...many women have many miscarriages from abortion
4. ...we will harm the baby.  We will kill the baby.  We, we will do something horrible to the baby
5. ...abortion is something that comes from the powers of darkness because it’s about destroying

40 Days for Lies?

40 Days for Life UK claims to be ‘a peaceful, prayerful and legal vigil’ where volunteers sign a ‘"Statement of Peace" with a pledge that they will conduct themselves in a Christ-like manner’. Twitter has been awash with claims that volunteers associated with the group have been filming women entering a BPAS clinic in London, a claim which is being denied by 40 Days for Life.

Something we do know for sure is that 40 Days for Life volunteers are handing out literature which gives grossly inaccurate information about abortion and which signposts to a crisis pregnancy centre doing just the same. Of the mystery shopping EFC has carried out, this centre really is the lowest of the low in terms of bias and inaccuracy, so bad in fact, that it was featured in this Channel 5 news report a few years ago. As a result of EFC’s complaint the ASA issued a ruling against the centre’s misleading advertising but it simply changed its name and continues to offer services and provide misinformation to vulnerable women (offering special services for Irish and young women).

This centre appears to be run by anti-abortion organisation The Good Counsel Network. The phone number is displayed on the leaflets handed out by 40 Days volunteers and is linked to from the website under the heading ‘considering an abortion?’

The quotes below are from a mystery shopping visit EFC carried out at ‘Albany Women’s Centre’. They are just an example of the misinformation and bias given in a two hour session in which the ‘counsellor’ spoke incessantly about the purported mental, physical  and spiritual risks of abortion:

“So the post-abortion cancer, breast cancer, cervical cancer, ovarian cancer, is very, very common now.  And they say from the statistics that a hundred, the risk of getting cancer after abortion is one hundred percent...The problem with the post-abortive cancer is that it’s quite aggressive.  It’s very difficult to treat, and most women die.  From my friends who had abortion and who developed the cancer, none of them lived longer than a few years.”

“And abortion is something that goes very contrary to our maternal instinct, because we know that what we are doing is totally opposite our maternal instinct.  We will harm the baby.  We will kill the baby.  We, we will do something horrible to the baby.  That’s abortion.”

“Abortion is something that comes from the powers of darkness because it’s about destroying.  Anything that’s about destroying, harming, eh, doing evil, comes from the powers of darkness, and there are a lot of people on this planet who are under their influence."

“But there are many, many, many other physical side effects...thirty percent, couldn’t have children.  The first reason was many of them wouldn’t, they didn’t give the percentage, couldn’t get pregnant.  They were sterile, okay?  The other problem is miscarriages.  Miscarriages are very common after abortions.  Many women have many miscarriages from abortion.  From our clients here I can tell you that on average it will be like five, six miscarriages.  Some have more.”

EFC Professional Training - Special Offer!

Education For Choice has been delivering well-evaluated training days for professionals working with young people for years. We are currently offering our most popular day, 'Abortion: Decisions and Dilemmas' at the discounted rate of just £850 per day (for up to 15 participants). And throwing in some free resources if you book now. A bargain!

For details on the training see the website and for further information, or to book, contact us efc@brook.org.uk

Here's what some of our participants have had to say about the day:

"My knowledge about abortion, language to use and exercises to use with young people have been enhanced. I enjoyed the training very much. I feel well informed and I think the facilitator was very knowledgeable and engaging" - Youth worker, London

"A full, interactive course which exceeded my expectations" - Sexual health service provider, Durham

“I would recommend the Abortion Dilemmas and Decisions training to support the development of key members of the workforce, in a range of settings. The training is engaging, lively and thought-provoking and offers strategies to enable workers to talk about some of the difficult aspects of pregnancy choices, as part of their day to day work with young people” - Teenage Pregnancy Co-ordinator, Devon

"I didn’t know there was such a thing as an implant": Sixth Formers tell us about their sex education lessons

I recently visited a school in Essex to deliver EFC’s Talk About Choice presentation to the Sixth Form there. I was lucky enough to be able to speak to a few of the students afterwards to get their thoughts on the presentation and what they’d learnt.

I was surprised when the students told me that a lot of the information on contraceptive methods had been new for them:

‘The contraception methods I didn’t know about’

‘I didn’t know there was such a thing as an implant’

 ‘I didn’t know you could get injections’

‘We know the usual stuff like pills and condoms but we didn’t know the sort of more unconventional stuff’

As years 12 and 13 I had expected them to have covered basic sexual health topics such as STIs and contraception in earlier years but it seems that had been limited and worryingly, for most of them, had taken place in R.E lessons as a purely abstract discussion of religious views:

 ‘They did talk about some types of contraception but it was more about what religions thought’

‘It was sort of like, if you were Christian what would you think about abortion’

Sex education outside of R.E lessons had only been experienced by some of the students:

 ‘A good 60 people a year group don’t have that lesson so all they have is the RE side’

‘If you did triple science you don’t do it’

These students were articulate about what was missing from their sex and relationships education. Sadly, their clear need and desire for sexual health education was not being met thanks to patchy delivery. With little knowledge of their own rights and responsibilities, or practical information about local services the students recognised that they were less able to practice safer sex. As two pupils remarked on their lack of condom education:  ‘if you don’t use it properly then you’re gonna be at a higher risk’ and ‘if you don’t know how to do it then obviously you’re gonna worry when you do it and also then you might be more embarrassed and then you don’t use it’.

The students also gave an extremely mature and thoughtful take on what abortion education should look like. They appreciated having a talk about contraception and abortion which was not attempting to push a moral agenda but rather gave factual information:

‘(you)made it less daunting, like saying, don’t be scared to talk to who you need to talk to rather than saying like, I dunno, you’ll be punished and shamed’

 ‘I think when approaching the subject of abortion...you can’t be biased, like ‘abortion is completely wrong’ or ‘abortion is fun, it’s really good’ you have to be neutral, it’s neutral territory when it comes to approaching teenagers I think’

‘It’s good when you’re not really presented with ‘a viewpoint’, because a lot of the time you already have some form of viewpoint and if you just give the statistics, ...then it’s more like making up your own mind’

They were also concerned about the effect a strongly anti-abortion speaker might have on a young audience. When I asked how they would feel if a speaker used images in their talk, one young man said:

‘Doesn’t matter as long as they’re not being biased, like if they’re using it to influence...then it’s a bit unfair. Cos if there was a girl in that room for example who was pregnant she might look at that and feel awful’

It was refreshing and heartening to hear them speak so enthusiastically and sensibly about the need for a non-biased approach to abortion education, but it’s disappointing that a school which clearly had good intentions had so clearly failed to provide the students with what they needed. I’d like to think this is a blip, but all the evidence from surveys, questionnaires and anecdotes suggests it’s pretty typical.

Brook survey shows almost half of secondary school students felt that their SRE was unsatisfactory

Advertising abortion services on T.V

The Broadcast Committee of Advertising Practice (BCAP) has announced a change in its regulations which would allow any organisation providing ‘post conception advice services’ to advertise in the broadcast media.

This changes everything...or does it?

Some anti-abortion organisations and anti-abortion MPs have expressed dismay that this ruling will lead to our airwaves being awash with advertising for abortion services, thereby ‘de-sensitising’ the public to how serious abortion is. In reality it is unlikely to lead to much new advertising. Those providing abortions in the not-for-profit sector like the big two, bpas and Marie Stopes, were already allowed to advertise and have only done so once between them (Marie Stopes in 2010). The private sector only provides 4% of abortions in England and Wales and though private clinics are now allowed to advertise are unlikely to do so as the cost would probably be prohibitive. So, it is unlikely we will see any significant increase in broadcast advertising of abortion services as a result of these changes.

The other important aspect of the new regulations is that they require those offering post conception services to be transparent about whether they refer women for abortion. The BCAP has said that this decision was made on public health grounds. This is because of a concern that a woman seeking abortion could be delayed if she chose to go to an independent pregnancy counselling service, not realising that they would not or could not refer her directly into an abortion service if this is what she chose. This change in regulation is welcomed by all those who – like EFC – are concerned that some women may be unnecessarily delayed from accessing abortion by making and waiting for an appointment with a service that might slow down the process -  either deliberately or through simple logistics. Some people have objected to this transparency requirement on the grounds that while pregnancy advice organisations have to be honest about not referring for abortion, organisations like MSI and bpas do not have to disclose that they are abortion providers when offering post conception advice services. In reality it would be impossible to visit the bpas and MSI websites without realising that they provide abortions....If anything, the normal criticism of bpas and MSI from anti-choice campaigners like Nadine Dorries, is that they are constantly promoting their abortion services.

So, what will this part of the regulations change? Some independent (or ‘crisis’) pregnancy counselling centres are currently vague about what they offer. Some try to give the impression that they will support women to access abortion, although in fact they don’t. In July last year EFC published a report based on mystery shopping crisis pregnancy centres. We found that while some did explain clearly how to access an abortion to a client who had chosen to have one, others could not or would not provide any practical information to mystery shoppers. We think it is vital that any woman seeking support with pregnancy decision-making should also be given support to access abortion as quickly as possible if that is what she chooses. If this regulation helps women to identify the most suitable place to go to get the service they need and prevents women experiencing unnecessary delays in accessing abortion, then it will have made a positive difference.

Myth-Busting Monday - Same - Sex Marriage Leads to Abortions

The anti-abortion organisation SPUC has launched a campaign against the legal recognition of same-sex unions. This document comes as no surprise as we know that SPUC Director John Smeaton has written a number of blogs attacking same-sex unions, and calling homosexuality ‘disordered’. However, we are baffled by the argument that  ‘allowing same sex marriage would damage society and would put the unborn child at a far higher risk of being aborted’.

SPUC’s position paper on same-sex marriage links to Government abortion statistics to back up its claim that ‘unborn children are much safer within marriage than outside marriage'. Abortion Statistics for England and Wales do show that overall, the majority of abortions are requested by unmarried women. But the partial use of these figures to argue that traditional, heterosexual marriage ‘protects children born and unborn’ is disingenuous. A closer look at the abortion statistics shows that age is the most significant factor. Only 1% of women under 20 having abortions are married. This is unsurprising considering the average age of marriage for women in the UK is 28. It should not lead us to the conclusion that being married in and of itself stops women requesting abortion. By the time they are 35 or over, married women make up a significantly larger proportion (40%) of women requesting abortion. The overall figures for the proportion of abortions carried out for married women are strongly skewed by the fact that  70% of abortions are provided for women under 30 many of whom aren’t married (yet).

Apart from age, there may be lots of reasons why women who are married may be under-represented in abortion statistics none of which points to a magical protective effect of marriage. What is certain is that nothing in the statistics demonstrates that allowing gay couples to marry will result in more abortions. The leap from ‘most women who have abortions are unmarried’ to ‘same-sex marriage causes abortion’ is bizarre. The attempt to dress up good old fashioned homophobia as social science is worse.

This blog from the brilliant Abortion Gang reminds us why the LGBT and pro-choice movements need to work together for reproductive justice. We have blogged before about our concern that organisations with a homophobic agenda are welcomed into our schools to talk to our children about abortion.We only have to look to the current situation in the States to see that if there is a connection between same sex marriage and abortion it is this: all too often those wishing to restrict women’s right to access safe, legal abortion are the very same people who are attempting to restrict the choices we make about who we can love and live with; how we define, create and care for our families; the way we live – in fact who we are.

Myth-Busting Monday: ‘Abortion causes mental health problems’

In light of the recent Systematic Review of Induced Abortion and Women’s Mental Health it’s time to put to rest any myths about abortion increasing risk of mental health problems.

The comprehensive review stated that:
•    The rates of mental health problems for women with an unwanted pregnancy were the same whether they had an abortion or gave birth
• An unwanted pregnancy was associated with an increased risk of mental health problems.
• The most reliable predictor of post-abortion mental health problems was having a history of mental health problems before the abortion.
• The factors associated with increased rates of mental health problems for women in the general population following birth and following abortion were similar.
• There were some additional factors associated with an increased risk of mental health problems specifically related to abortion, such as pressure from a partner to have an abortion and negative attitudes towards abortions in general and towards a woman’s personal experience of the abortion.

The recommendation is that ‘future practice and research should focus on the mental health needs associated with an unwanted pregnancy, rather than on the resolution of the pregnancy’. So let’s make sure that rather than invent or inflate risks to mental health we focus on trying to prevent unwanted pregnancies and ensuring women have the support they need during the decision-making process when they are pregnant. Jennie Bristow has a thoughtful piece on this in the Huffington Post.

Myth Busting Monday – The morning after pill is a ‘DIY abortion’

Every Monday EFC busts myths and take names, cutting through the misinformation, disinformation, and straight up nonsense to bring you the facts.

In yesterday's Daily Mail, Peter Hitchens frothed;

'There is no better symbol of the squalid New Britain than the choice of Christmas to make the ‘morning-after pill’ easier to get. Now this do-it-yourself abortion for people who are not just feckless but incompetent too is to be given out by post, in advance (surely it should be renamed the ‘night-before’ pill, in that case?). Under-age girls will easily be able to get it. Like all such measures, it will be followed by more under-age sex and more abortions. And nobody will make the connection.'

We are getting sick and tired of national newspapers (and in this case, well known journalists!) touting the myth that taking emergency hormonal contraception (aka the morning after pill) is an abortion. We’ve posted about this myth in the past but it just doesn’t seem to go away. In fact, the Telegraph are guilty of posting similar just last week.

For some, there is a belief that pregnancy begins at fertilisation, when the sperm meets the egg. So yes, those people may well consider the taking of contraception which can act to prevent implantation of the fertilised egg as ending a pregnancy, akin to an abortion. However, what is rarely made clear in such missives against accessible contraception is that this is a belief. Legally and medically, pregnancy begins following implantation of the fertilised egg meaning that abortion and contraception are different things.

From the British Medical Association’s ‘Abortion Time Limits’ paper:

‘What is abortion?
The term 'abortion' is used throughout this paper to refer to the induced termination of an established pregnancy (i.e. after implantation). It does not include the use of emergency hormonal contraception which the High Court has confirmed is not an abortifacient. All current methods of emergency contraception work prior to implantation and therefore are not abortifacients.’

Myth Busting Monday: ‘Where abortion is legal, all women will be able to access safe, legal abortions'

This week The Guardian has published some interesting short articles on unsafe abortion in Zambia, written by Alice Klein, a young mother who has recently had an abortion herself.

Klein writes about the places women in Zambia can access illegal abortions for varying sums of money: an unhygienic Chinese clinic, drug stores selling misoprostol illegally, and ‘witch doctors’ offering herbal ‘medications’. There are also horrifying stories of women attempting to end pregnancies themselves; ‘inserting knitting needles and turkey basters into their vaginas, [to] drinking laundry bleach and jumping off stairs on to their stomachs’.

You’d be forgiven for taking from this that abortion is outlawed in Zambia, but another article reveals that this is not the case. In fact, Zambian ‘abortion law is one of the most liberal in sub-Saharan Africa and allows the procedure if the pregnancy risks the mother's physical or mental wellbeing’. However access to legal abortion is affected by a number of barriers: ‘it requires three doctors' signatures, almost impossible in a country with one doctor per 8,333 people (compared with one doctor per 435 people in the UK)’; also, in a country with an 80% poverty rate, costs of safe, clinical procedures can be prohibitive. The article also highlights the widespread stigma and religious objection to abortion in Zambia, which again, contributes to misinformation about available services, further reducing accessibility. One ‘healer’ offering illegal, herbal abortions advises the researcher to ‘avoid hospital abortions, saying metal clamps are used to open the vagina and scratchy cotton wool used to clean the womb. She repeated common myths, such as clinical abortions leave women infertile and unclean.’

Clearly, in Zambia, although abortion is effectively legal, this doesn’t mean it is accessible to all women who want to end their pregnancies. As a result, women undergoing illegal, unsafe abortions are risking their health, and in some cases, lives.

Of course, this is one example – there are many areas of the world where, although abortion is technically legal it is difficult (and generally for poorer, or younger women, virtually impossible) to access. Abortion has been legal in the U.S since 1973 but 88% of all U.S counties have no abortion provider (this rises to 97% in rural areas).

For more information on abortion worldwide, including the gaps between legality and accessibility, visit the Guttmacher Institute website.