The significance of September 28th for women's reproductive rights is huge. It marks not only the 16th anniversary of the abortion pill in the U.S. but also International Safe Abortion Day. Coincidence?
The 28th day of September was declared an international day of action for the decriminalization of abortion in 1990 by the women's health movement and has been recognized annually ever since. Launched in Latin America and the Caribbean, regional activists have been organizing in support of safe abortion on this date for the past 26 years.
Fast forward to present day 2016, an open letter written to the United Nations by the International Campaign for Women's Right to Safe Abortion urges the UN to declare September 28th International Safe Abortion Day and make it an officially recognized international UN day. It's worth mentioning that the International Campaign responsible for drafting the letter consists of a network of almost 1,800 groups and individuals representing 115 countries.
Why is this important?
While abortion has been legal in the United States since 1973, and legal for generations in most other developed countries, women are still suffering and dying from complications of unsafe abortion around the world. Deaths from unsafe abortion worldwide are estimated at 68,000 each year.
It is clear and historically proven that making abortion a criminalized act does nothing to decrease the need for abortion. It just makes abortion care more costly and less available which drives those who seek it to desperate and unsafe actions.
U.S. Perspective
Abortion is one of the safest medical procedures performed in the United States. In fact, of the 88% of abortions performed before 13 weeks of pregnancy, it is estimated that 97% of these women report zero medical complications. While anti abortion extremists in this country have attempted to use unsubstantiated claims that legal abortion is harmful to women's health, those claims have been disproven by both medical research and legal analysis.
Sept 28 is also the Anniversary of the approval of Mifepristone in the U.S.
September 28, sixteen years ago today, was the date the FDA approved the drug mifepristone for use in the U.S. Mifepristone, and a second medication called misoprostol, are commonly known as medication abortion. They have been successfully used by more than 2 million women in the United States for early abortion since the year 2000. While great strides have been made in improving access to this safe medication, including the FDA recently approving broader use of this drug for women up to 10 weeks along in their pregnancy, there is still opportunity for its use that is not being realized today.
Every woman's situation is unique. Mifepristone has given women another safe option to end an early pregnancy.
Nearly 50% of pregnancies in the United States are unintended and 40% of unintended pregnancies end in abortion. People decide to have an abortion for a variety of reasons and the proportion of women choosing to end a pregnancy with medication has been steadily growing since mifepristone's FDA approval. Currently, medication abortion accounts for about 36% of all abortions before 9 weeks in the U.S.
Some of the benefits cited by those who choose the abortion pill process include a feeling of greater control and privacy. In the U.S., if a woman chooses to end her pregnancy with medication, she is usually given mifepristone to be followed by another medication called misoprostol. This process requires no surgery and no anesthesia. These medications are often used in the privacy of a person's home and there is overwhelming evidence that medication abortion is safe for virtually all women.
Living in areas of the United States where the number of abortion providers have been limited due to burdensome political restrictions has necessitated some women to travel great distances to seek safe abortion care. In Texas, women living near the border of Mexico have been reported purchasing misoprostol in Mexican pharmacies to start their own abortion once they return home. While women taking abortion into their own hands is not a new development, access to a medication that allows this to be done safely is.
In addition, medication abortion has untapped potential for improving the availability and affordability of abortion in the U.S. Medication abortion could be better integrated into the current health system by expanding training and authorizing a broader range of health care providers to prescribe it; including family practice and internal medicine doctors, nurse practitioners, nurse midwives, and other community health providers. The provision of medication abortion through telemedicine has also been found to be safe, effective, and improve access to early abortion.
Medication Abortion Worldwide
While progress in the U.S. has been slow but steady, the international community has leveraged the abortion pill to actually save lives by decreasing maternal mortality rates. This has been proven in countries where abortion was formerly restricted. For example, in Nepal, hundreds of female health volunteers have been trained to administer pregnancy tests and provide referrals for medical abortion at the village level. According to a government health study, access to safe abortion is one of a number of strategies that contributed to a dramatic reduction in maternal mortality, from 415 to 229 per 100,000 live births.
In Ethiopia, maternal mortality was cut drastically after midwives were trained to counsel women about their pregnancy options. Within three years of the introduction of medication abortion, over 60% of women seeking abortion care chose this method.
Closing thoughts
Let's celebrate the 28th of September, for it's a significant date in women's reproductive healthcare history, but let us not forget there's still work to be done. As seen in numerous developing countries, the road is clear and the tools are here. We need to keep clearing the way for greater access to the methods women need for safe abortion and better health.