Pre-Collegiate Global Health Review
Saving Rights Under Siege: Protecting Access to Reproductive Healthcare
Sahil Sud, BASIS Scottsdale, Scottsdale, Arizona, USA
The article illustrates the status quo of abortion advocacy worldwide and introduces the need to improve public support for reproductive rights. It begins with an introduction to prominent abortion restrictions and the growing limitation on abortion access. Thereafter, the article discusses the results of a Pew Research survey regarding support for abortion, and provides potential solutions and analysis based on current levels of support. The author provides context for the necessity of substantial levels of support to maintain access to abortion. Subsequently, the article analyzes the results of a case study in Nigeria that displayed a lack of knowledge among Nigerian adolescents regarding contraception, abortion, and reproductive healthcare. This case study is used as an example of the access to reproductive healthcare in the global South. The author then discusses a counterargument about the complications of unsafe abortion, and explains that unsafe abortion often occurs due to excessive restriction. Finally, the author concludes that abortion must be introduced into educational curriculums in a nuanced manner to protect women’s right to abortion.
Every day, globally, thousands of women struggle to access reproductive healthcare. The current German government maintains a Nazi-era law that prevents healthcare providers from advertising abortion in any way (Eddy, 2019). In El Salvador, women can be imprisoned for up to 40 years for receiving an abortion (Calderón, 2019). In the US, anti-abortion policy includes penalties that effectively criminalize abortion (Ceron, 2022). In one Louisiana abortion clinic, 60% of patients were Texans fleeing recent abortion restrictions (The Guardian, 2021). Moreover, women must wrangle with the increasing prominence of antiquated laws; for example, the state of Mississippi seeks to limit legal abortion to 15 weeks after conception, well below the viability standard (Liptak, 2021). The Supreme Court decision that resulted from this case has overturned Roe v. Wade, which will likely result in at least 26 states implementing near total bans on abortion (Guttmacher Institute, 2021). The greatest barrier to abortion access is public support, making it necessary to examine potential solutions to improve public support through education.
Historically, public opinion has been a critical component of abortion policy. Substantial support is necessary, as four of the seven states that enacted stringent abortion restrictions in 2021 included majorities that opposed legal abortions, Mississippi (59%), Alabama (58%), Louisiana (57%), and Kentucky (57%), respectively. Many other states with high rates of opposition to abortion have stringent abortion laws, showing that when public support is low, politicians take the opportunity to enact strict regulations (Pew Research, 2020). Therefore, relatively large majorities of support are necessary. To understand current trends, Pew Research surveyed 5,129 Americans in April 2021 about whether they believed abortion should be legal in all cases, legal in most cases, illegal in most cases, and illegal in all cases, randomizing the options. Despite the perceived divisiveness of the issue, 60% of respondents took a middling stance, demonstrating the nuances of public support. 82% of religiously unaffiliated respondents supported legalizing abortion in all or most cases, while evangelical Protestants indicated overwhelming opposition, demonstrating the crucial effect religion has on abortion views (Pew Research, 2021). Therefore, to increase support among religious groups, abortion must be presented as separate from religion in education to separate personal faith from public policy. Moreover, greater levels of education generally lead to higher levels of support for legalized abortion, as 68% of college graduates support legal abortion, as opposed to only 50% of high school educated adults. This is likely because universities provide greater exposure to knowledge regarding abortions, which allows students to better understand abortion and empathize with women. To increase support amongst less educated people, policymakers must introduce discussions on abortion into high school classrooms, so students can better understand the nuances and implications of abortion.
Additionally, policymakers must incorporate international policies, specifically in the Global South. The Guttmacher Institute, a global pro-choice organization, held a focus group with Nigerian adolescents to understand their preference for abortion instead of contraception. Safe reproductive healthcare is crucial for adolescents, who comprise 80% of patients with abortion-related complications. The organization was concerned about the prevalence of unsafe abortion in Nigeria, which accounts for 20,000 of 50,000 maternal deaths per year. The results indicated that, in general, adolescents had little knowledge of contraception. Specifically, adolescents believed that contraceptives had long-term and continuous effects on fertility throughout life, and therefore avoided it (Otoide et al., 2001). Thus, expanding education across the Global South will increase access to and use of reproductive healthcare. This is necessary, as only 27% of countries currently provide abortion on request (Berer, 2017).
Some argue, however, that abortion only endangers mothers due to prevalent unsafe abortion. Although abortion is responsible for one-sixth of all maternal deaths, this occurs due to strict regulations that force unsafe abortion. The Harvard School of Public Health concludes that “countries with almost no deaths from unsafe abortion are those that allow abortion on request without restriction” (Berer, 2017). Not only does increasing abortion access prevent deaths from unsafe abortions, it prevents complications resulting from unsafe birth (Berer, 2017). This is crucial, as infections and unsanitary birth conditions resulted in 75% of all maternal deaths (World Health Organization, 2019). Human rights organizations have been crucial in instigating reform: for example, the African Commission on Human and Peoples’ Rights has called for a complete decriminalization of abortion.
The evidence reveals a stark trend: education is the most important factor in predicting support for legal abortion. When college students are introduced to abortion, it provokes sympathy and counteracts any prior misinformation. To increase support among all levels of education, educators must introduce abortion in classrooms for younger students, which is why UK teachers have suggested adding abortion to secondary school curriculums. Providing students with the most accurate information is “essential” to make young female students feel supported and safe (Busby, 2018). Guttmacher provides a framework on how education could be continued well into the professional level, where medical students can learn women’s motivations for abortion. Furthermore, this education should explain that several religious organizations believe abortion to be moral and consistent with religious teachings, which directly counteracts the idea that abortion is morally reprehensible (Stewart et al., 2003). Students must be educated on the various aspects of women’s right to abortion to maintain public support and protect this crucial right.
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