Caution; the intension of this piece reader is not to stir any controversy.
It is almost 27 years since the United Nations held its ground breaking International Conference on Population and Development (ICPD) in Cairo. The ICPD conference often dubbed the “Cairo Consensus” presented a political victory for women. Cairo touched on many sensitive issues often highlighting the will of some to control the lives and values of others. It made significant advances in the formulation of reproductive policies and programs towards strengthening the rights of women. The ICPD became the first international conference explicitly to recognize reproductive rights as human rights. The needs and rights of the individual having control over their sexuality and fertility were emphasized, people were also allowed to choose how to live their lives and that freedom was to be extended to apply to women in that their lives must no longer be governed by men.
The ICPD touched on family planning programs which occupy an unusual place in the public policy arena. They are widespread and are also generally considered effective public health policies, yet family planning programs are persistently controversial. In part because they centre on birth control, reduction of unwanted pregnancies through safe abortion by strengthening family planning programs, a sensitive subject that has drawn criticism from a wide range of perspectives, religious, political, ideological and Scientific.
However, while many may pretend or out rightly deny to have ever carried out abortion, many have participated in carrying out back street abortion and many have done it more than once, using it as a vital reproductive health option. The decriminalization of abortion in South Africa for instance gave rise to cross border abortion operation thus saving many women from Botswana to unwanted pregnancies.
Elsewhere in the global North in Jan 23, 2017, on his fourth day in office, President Donald Trump signed an executive order imposing the global gag rule, an anti-abortion policy that under other conservative presidential administrations has caused serious disruptions to US overseas family planning efforts.
The global gag rule, also known as the Mexico City policy, was first devised in 1984 by the administration of Ronald Reagan to impose a draconian set of anti-abortion rules on US overseas family planning programmes. This policy banned US family planning funds from going to foreign non-governmental organisations (NGOs) that provide abortion services, counselling, or referrals, or advocate for liberalisation of their country’s abortion laws even if they use non-US government funds for these activities.
Under Trump’s order, the gag rule applied not only to US bilateral family planning assistance but also to all “global health assistance furnished by all departments or agencies. Foreign NGOs that received US funding to work on a broad range of health programmes in about 60 low-income and middle-income countries including on HIV/AIDS, maternal and child health, among other were potentially subjected to the same ideological restrictions that hampered family planning aid at points in the past. Thus, President Trump’s version of the global gag rule represented a wider attack on global health aid writ large.
Whilst there has been legislative advances made by a number of countries particularly geared to reducing un-safe abortion, Botswana is still lacking behind. In Botswana abortion is strictly prohibited, It carries stiff penalties, although in 1991 the Penal Code was amended to allow it in the first 16 weeks of pregnancy under special circumstances. That is, if the pregnancy was a result of rape, incest, or defilement, if the woman is mentally deficient, or if the child would be born with a serious physical or mental abnormality. The abortion could only be performed after two medical doctors had approved it, otherwise, under no other circumstances can a pregnancy be terminated in Botswana and any attempt to do so is illegal. Thus the laws of Botswana have made it highly difficult for women to terminate pregnancy. For, example, when former Assistant Minister of Local Government and Rural Development Hon Botlhogile Tshireletso, called for the decriminalization of abortion in the country many people were in disagreement and saw that as very irresponsible and immoral suggestion coming from a minister.
Abortion has become an ever more controversial issue provoking strong reactions both for and against. Proponents, identifying themselves as pro-choice, contend that choosing abortion is a right that should not be limited by governmental or religious authority, and which outweighs any right claimed for a foetus. They say that pregnant women will resort to unsafe illegal abortions if there is no legal option. Opponents identifying themselves as pro-life, contend that person-hood begins at conception, and therefore abortion is an immoral killing of an innocent human being. They say that it is unfair to allow abortion when couples who cannot biologically conceive are waiting to adopt.
Variations exist in arguments on both sides of the debate. Some pro-choice proponents believe abortion should only be used as a last resort, while others advocate unrestricted access to abortion services under any circumstance. Pro-life positions range from opposing abortion under any circumstance to accepting it in case of rape, incest or when a women’s life is at risk.
While the controversy on abortion debate still continues to date and despite the “ Cairo Consensus” it is important to note that sixty years ago, the World Health Assembly (WHA) first identified unsafe abortions as a serious public health problem for women around the world. When performed by qualified persons under safe conditions, complications from abortion are rare, and the procedure is safe. However, when restrictive laws and practices, high costs, and limited services create barriers to access, women still seek the procedure often through dangerous options.
Recently, on June 24, 2022 the United States Supreme Court overruled Roe v. Wade, the 1973 Supreme Court decision that held the right to terminate a pregnancy. In Roe, the majority ruled that up until a pregnancy was viable, “that is, potentially able to live outside the mother’s womb” at roughly twenty-four weeks, states could not broadly proscribe abortion. When making that 1973 judicial decision, the United States found itself at the forefront of a burgeoning international movement toward expanded access to abortion services at a time when such policies were exceptional according to various literature sources.
When the United States Supreme Court decided Roe v. Wade just six years after the WHA’s warning, abortion was legal in just a handful of countries including the United Kingdom and Poland. Even the Soviet Union, allowed abortion on request (i.e., permitting the termination of a pregnancy without requiring the mother to demonstrate specific criteria, such as proving a threat to her life or that the pregnancy was a result of rape or incest). See
In subsequent decades, waves of abortion liberalization swept across the world, with Roe helping to inspire activists and influence judicial thinking. The High Court of Pretoria in South Africa referenced Roe in a 1998 ruling to uphold a national law on abortion, as did the Supreme Court of Canada when it ruled in 1988 that the provision on abortion in Canada’s criminal code was unconstitutional because it violated women’s rights.
For his part Scott Dylon (22) stated that The Supreme Court’s overturning of Roe V. Wade is a development of enormous political and social consequence, one that could almost immediately trigger tectonic changes in health and wellbeing. The Supreme Court’s ruling means the States are expected to quickly ban abortion.
With the recent judgement in the US, what lessons can be learnt from it, are reproductive health and rights under siege? Will this affect defunding the United Nations Population Fund (UNFPA), as well as potentially drastic cuts to US overseas family planning aid.
Fifty years later, the United States is once again making headlines with the recent Supreme Court in Dobbs v. Jackson. The U.S. Supreme Court determined that the right to abortion is not constitutionally protected and returned to U.S. State and Federal legislatures the ability to regulate the procedure. However, in May 2022 federal legislation on abortion failed. It is worth noting that the post Roe era in the USA, restricting and or prohibiting abortion does not stop abortion , but rather forces women into situations that threaten their health and wellbeing.
Commenting on the June 2022 supreme court judgement, Samantha Kiernan noted that abortion services will likely remain available in some states in the immediate future, but the rest of the country trending in the opposite direction. Other states already have “trigger bans “prohibitions that will outlaw abortion within days after the U.S. Supreme Court decision or have already severely restricted access to the procedure.
So one may call the government of Botswana to please stand up and tell us what is next for Botswana in putting un-safe abortion in the policy agenda, one that is detached from Global Health Initiative agenda, because whether or not abortion is permitted or prohibited by law, women will seek abortion services and obtain abortion. They will seek them because of their social, economic, health or other personal circumstances.
*Thabo Lucas Seleke, Doctoral Candidate LSHTM, UK
