Reproductive Rights Prof Blog

Joanna Erdman on Moral Authority in English and American Approaches to Abortion Law

Joanna Erdman (University of Toronto Faculty of Law) has posted Moral Authority in English and American Abortion Law on SSRN.  Here is the abstract:

In R. (on the application of Axon) v. Secretary of State for Health & Another, the English High Court affirmed that young women are entitled to seek and receive sexual health care, including abortion care, without parental notification. This chapter examines the Court’s use of comparative constitutional authorities in its reasoning, focusing on the rejection of American authorities. Contrast and rejection, it is argued, can be an exercise in self-reflection, revealing how a court understands its own constitutional approach. Aversive constitutionalism presents opportunities to deconstruct claimed similarities and differences in constitutional approaches, to uncover and contest characteristics and assumptions otherwise unexamined.

This chapter uses the contrast and rejection of American authorities in Axon to expose a fundamental characteristic underlying the English constitutional approach to young women’s abortion care. It is a shared rather than contrasted characteristic in American and English law. The characteristic is moral authority, defined as the legal authority to protect a state interest in prenatal life through moral abortion decision-making. Both American and English abortion law seek to protect a state interest in prenatal life by entrusting decision-making about young women’s abortion care to third parties: the family, the court, and the medical profession. Neither constitutional approach vests moral authority in young women themselves. . . . 

Trinidad & Tobago to Begin HIV/AIDS Education in Primary Schools Next Year

Trinidad & Tobago Express: AIDS education for primary pupils from Jan, by Aabida Allaham:

THERE are more than 200 HIV-infected children attending public schools in Trinidad and Tobago and they are silently shouting out for something to be done about the discrimination they are faced with, chief education officer at the Ministry of Education Peter O’Neil says.

’There are approximately 204 children in our system [who] are currently accessing treatment for HIV/AIDS and that in itself suggests that children are not least affected by this,’ O’Neil said yesterday, while addressing a small gathering of teachers at the Ministry’s World AIDS Day 2009 symposium at the Crowne Plaza hotel in Port of Spain. The event was entitled Let’s talk HIV/AIDS.

O’Neil, who spoke on behalf of an absent Education Minister, Esther Le Gendre, said in addition to the stigma and discrimination these children are faced with on a daily basis, ’some 38 children die every day in the Caribbean from HIV/AIDS’.

As a result, he said, AIDS education will be a part of the primary school curriculum from January.

South Africa Announces Plan to Expand Treatment for HIV-Positive Babies

Wash. Post: South Africa to treat all HIV-positive babies, by Donna Bryson:

PRETORIA, South Africa -- South Africa announced ambitious new plans Tuesday for earlier and expanded treatment for HIV-positive babies and pregnant women, a change that could save hundreds of thousands of lives in the nation hardest hit by the virus that causes AIDS.

President Jacob Zuma - once ridiculed for saying a shower could prevent AIDS - was cheered as he outlined the measures on World AIDS Day. The new policy marks a dramatic shift from former President Thabo Mbeki, whose health minister distrusted drugs developed to keep AIDS patients alive and instead promoted garlic and beet treatments. Those policies led to more than 300,000 premature deaths, a Harvard study concluded.

The changes are in line with new guidelines issued a day earlier by the World Health Organization that call for HIV-infected pregnant women to be given drugs earlier and while breast-feeding. By treating all HIV-infected babies, survival rates should also improve for the youngest citizens in South Africa, one of only 12 countries where child mortality has worsened since 1990, in part due to AIDS. . . .

South Korea Tested by Recent Boom of Mixed Children

NY Times: Baby Boom of Mixed Children Tests South Korea, by Martin Fackler:

YEONGGWANG, South Korea — Just a few years ago, the number of pregnant women in this city had declined so much that the sparsely equipped two-room maternity ward at Yeonggwang General Hospital was close to shutting down. But these days it is busy again.

More surprising than the fact of this miniature baby-boom is its composition: children of mixed ethnic backgrounds, the offspring of Korean fathers and mothers from China, Vietnam and other parts of Asia. These families have suddenly become so numerous that the nurses say they have had to learn how to say “push” in four languages.

It is a similar story across South Korea, where hundreds of thousands of foreign women have been immigrating in recent years, often in marriages arranged by brokers. They have been making up for a shortage of eligible Korean women, particularly in underdeveloped rural areas like this one in the nation’s southwest.

Now, these unions are bearing large numbers of mixed children, confronting this proudly homogeneous nation with the difficult challenge of smoothly absorbing them. . . .

World AIDS Day: U.S. Policies Still Lag

 Guttmacher Institute news release: World AIDS Day-- U.S. Policies Still Not Where They Need to Be:

World AIDS Day presents an opportunity to examine where we stand in the struggle against HIV/AIDS. One clear area of progress is the high degree of consensus at the global level that better linkages between HIV and reproductive health services are key both in meeting the needs of HIV-positive women and men and in preventing HIV transmission.

A solid body of evidence now demonstrates that these linkages are especially important in countries with high HIV prevalence and weak health infrastructures. It makes eminent sense to offer sexually active women the services they need—whether related to HIV or to reproductive health—in settings they already frequent. Women should be able to receive HIV testing, counseling and referrals at sites that they visit regularly to obtain family planning services. In turn, they should be able to obtain family planning counseling and services to help them to avert pregnancies they don’t want at places they visit to receive HIV services.

But while the global community recognizes the crucial role of linking these services, U.S. policy lags. Unaccountably, the law that guides the U.S. global AIDS program (PEPFAR), although revised and reauthorized little more than a year ago, fails to mention these linkages at all.

In fact, U.S. policy—unquestionably strong in the AIDS treatment area—lags generally in terms of HIV prevention. In no area is this more so than in its failure to adequately meet the needs of young people. PEPFAR still overemphasizes abstinence as the officially preferred strategy to prevent sexual transmission of HIV among all unmarried people, and imposes many restrictions on young people’s ability to receive comprehensive sex education and to obtain condoms. . . .

Catholic Church to Deny Communion to Spanish Politicians Who Voted to Liberalize Abortion Laws

Reuters: Pro - Abortion Bill Spanish Politicians Sinful - Church:

MADRID (Reuters) - The Catholic Church will deny communion to Spanish members of parliament who have voted in favour of a bill to make abortion more readily available, the spokesman of Spain's Bishops' Conference said on Friday.

"This is a warning to Catholics, that they can't vote in favour of this and that they won't be able to receive communion unless they ask forgiveness," Juan Antonion Martinez Camino told a news conference.

"They are in an objective state of sin," he said.

The government-sponsored bill, which passed the first of a series of votes in parliament on Thursday, will allow abortion until the 14th week of pregnancy and, in cases of extreme foetal deformity, at any time in the pregnancy.

Afghan Mullahs Get a Lesson on Birth Control

NY Times: Broaching Birth Control With Afghan Mullahs, by Sabrina Tavernise:

MAZAR-I-SHARIF, Afghanistan — The mullahs stared silently at the screen. They shifted in their chairs and fiddled with pencils. Koranic verses flashed above them, but the topic was something that made everybody a little uncomfortable.

“A baby should be breast-fed for at least 21 months,” said the instructor. “Milk is safe inside the breast. Dust and germs can’t get inside.”

It was a seminar on birth control, a likely subject for a nation whose fertility rate of 6 children per woman is the highest in Asia. But the audience was unusual: 10 Islamic religious leaders from this city and its suburbs, wearing turbans and sipping tea.

The message was simple. Babies are good, but not too many; wait two years before having another to give your wife’s body a chance to recover. Nothing in Islam expressly forbids birth control. But it does emphasize procreation, and mullahs, like leaders of other faiths, consider children to be blessings from God, and are usually the most determined opponents of having fewer of them.

It is an attitude that Afghanistan can no longer afford, in the view of the employees of the nonprofit group that runs the seminars, Marie Stopes International. The high birthrate places a heavy weight on a society where average per capita earnings are about $700 a year. It is also a risk to mothers. Afghanistan is second only to Sierra Leone in maternal mortality rates, which run as high as 8 percent in some areas. . . . 

Student Scholarship: Sex Selective Abortions

Christopher Balding (Political Science Graduate Program, University of California, Irvine) has posted On Sex Selective Abortion on SSRN.  Here is the abstract:

Abortion is a sensitive issue around the world. Acting as a clear dividing line in American politics, countries around the world treat abortion policy with a range of approaches. From near complete prohibition to encouraging its use as a tool of population control, countries utilize a variety of approaches to abortion policy. An abortion and technological issue of ethical concern is the practice of parental sex selection of the fetus. Ignoring basic questions of incentives for agents has overlooked key factors of the factors driving sex selective abortion. The economic incentives and clear decision making principles behind sex selective abortion, access to family planning, and reproductive services has not been widely studied. In this paper, I provide a theoretical economic defense to the practice of sex selective abortion given the existing ethical framework. Rather than proceeding from a moral position, this paper will defend the practice of sex selective abortion using the accepted ethical precepts of society and the economics of family planning.

Analysis of the practice of sex selective abortions fails to account for value discrimination of human life and choice fungibility. I find that opposition to sex selective abortion establishes significant inequalities based upon inconsistent standards between individual agents, fetuses, technological standards, and income levels. This has four primary implications. First, agents in societies which engage in sex selective do so out of economic incentives not gender preference. Second, in developed economies which do not face the economic constraints of parents in lesser developed countries, parents have distinct non‐distortionary aggregative gender preferences. Third, the ethical dilemma of gender preferences of potential parents in developed countries concerns the methods by which they seek to obtain their preferred gender or other characteristics. Fourth, at its core, ethical arguments against the practice of sex selection abortion are not arguing against sex selection, abortion, or sex selective abortion. Critics of sex selective abortion are arguing against societal gender imbalance.

Added by AH on 11/13/09

New Report on Clandestine and Unsafe Abortions in Pakistan

Guttmacher Institute news release: Clandestine and Unsafe Abortions are Common in Pakistan and Threaten Women's Health and Lives:

Poor Women Most Affected by Unsafe Procedures

Induced abortion is legal under very limited circumstances in Pakistan, yet it is commonly performed, according to a new literature review, Abortion in Pakistan, released today in Karachi by the National Committee for Maternal and Neonatal Health (NCMNH) and the Guttmacher Institute. Researchers estimate that 890,000 abortions were performed in Pakistan in 2002, a rate of 29 abortions per 1,000 women of reproductive age (15–49) annually. Because access to abortion is highly restricted, the majority of these procedures take place under clandestine—and often unsafe—conditions. As a result, many Pakistani women suffer from serious health complications that sometimes result in long-term disabilities and death.

A major factor contributing to Pakistan's level of unsafe abortion is the country's low level of contraceptive use, which results in high levels of unintended pregnancy. Only 30% of married women of reproductive age use any contraceptive method and more than a quarter of these women use traditional methods, which are less effective than modern contraceptives. . . . 

China Lacks Sex Education Despite One-Child Policy

Slate Magazine: Everything You Always Wanted To Know About Sex (But Didn't Learn Because You Grew Up in China), by Michelle Tsai:

BEIJING—The first time Hu Jing tried to have sex with her college boyfriend, there was a technical difficulty. "We knew we had to use a condom," she said. "But we didn't know how."

Faced with this conundrum, Hu and her boyfriend went looking for answers—he from his more experienced friends, she from the university library, where she combed through Dream of the Red Chamber, a literary classic from the Qing Dynasty.

The following week, they reconvened for a second try. This time, they managed to roll on the condom but then … well, where was the penis supposed to go? It took another week of research before they succeeded in doing the deed.

After three decades of the one-child policy, you'd expect people here to know how to have sex without getting pregnant. And you'd be wrong. In July, Chinese health officials said that 13 million abortions are performed in registered medical institutions each year, largely because people lack sex education. The number of unwanted pregnancies is even higher when you take into account abortions at unregistered medical clinics, not to mention the 10 million abortion-inducing pills sold each year. . . . 

Center for Reproductive Rights To Host Webinar on Teaching Reproductive Rights

The Center for Reproductive Rights is hosting a webinar on Teaching Reproductive Rights – What is the Role for Transnational Law? on Friday, November 13^th, from 3 - 4 pm (Eastern):

To take part, all you need to do is call a toll-free number. You can also watch a PowerPoint presentation on your computer during the call.

The webinar will focus on an important new article by Professor Martha Davis of Northeastern  - “Reproductive Rights in the Legal Academy: A New Role for Transnational Law,” which was published in the American Journal of Legal Education in September. The article can be found on SSRN. As you will see, the article summarizes Professor Davis’ research and findings about how reproductive rights are currently being taught in US law schools and opens the conversation about the value of bringing in comparative and international law.

Responding to Professor Davis will be Professor Erika George from the University of Utah.

After hearing from the presenters and responders, we will open up the call for conversation. We hope to both discuss Martha’s findings, and hear some personal experiences with teaching reproductive rights and using (or not using) non-U.S. materials. The call is intended to be collegial and informal and to promote reflection and exchange about current teaching approaches.

This webinar is part of the CRR’s wider Law School Initiative which, as you may know, has undertaken a range of activities to encourage teaching and scholarship around reproductive rights. For teaching, we are focusing on the value of bringing in comparative and international law. To that end, we have produced supplemental course modules for law teachers who would like to integrate transnational materials into their teaching of Family Law, Reproductive Rights, and Reproductive Technology and Bioethics. More about what the Law School Initiative has been up to can be found here: http://reproductiverights.org/en/our-work/law-school-initiative.

If you are interested in taking part in this webinar, please contact Diana Hortsch and she will forward you the call-in number on November 12th, the day before the event.

Diana Hortsch (Director of the Law School Initiative at the Center for Reproductive Rights)

Phone: (917) 637-3669

dhortsch@reprorights.org

Premature Births Are Main Reason for High Infant Death Rates in U.S.

NY Times: Premature Births Are Behind Infant Death Rates in U.S., Report Says, by Denise Grady:

High rates of premature birth are the main reason the United States has higher infant mortality than do many other rich countries, government researchers reported Tuesday in their first detailed analysis of a longstanding problem.

In Sweden, for instance, only 6.3 percent of births were premature, compared with 12.4 percent in the United States in 2005 — the latest year for which international rankings are available.

Infant mortality also differed markedly: for every 1,000 births in the United States, 6.9 infants died before they turned 1, compared with only 2.4 in Sweden. Twenty-nine other countries also had lower rates.

Uganda has Highest Unmet Need for Contraceptives in East Africa

Guardian News: Huge unmet need for contraceptives in Uganda, by Joseph Malinga and Liz Ford:

Uganda has the highest unmet need for contraception in east Africa, but lacks the resources to address the problem

Sarah Arawo is aware of the problems of having more children. The mother of seven is HIV-positive and knows there is a risk of passing on the virus to a child (one of her children already has the virus), and because of the recent drought she and her husband, Francis Esweu, would struggle to feed any extra mouths.

Arawo, from Obiol village in Katine, north-east Uganda, wants to stop having children altogether, but she does not know how. She wants to find out more about family planning, but fears it could lead to conflict with her husband, whom she says is reluctant to use a condom when they have sex. At the same time, because of her condition, she fears she might experience complications if she takes another form of contraceptive.

Arawo is not alone. Limited access to family planning services, fears about side effects, opposition from partners and religious beliefs have led to Uganda having the highest unmet need for contraception in east Africa. . . . 

Philippine Congress Considers Measure to Expand Access to Birth Control

NY Times: Birth Control Bill Has Enemies in Philippines, by Carlos H. Conde:

Abortion is illegal in the Philippines, though birth control and related health services have long been available to those who can afford to pay for them through the private medical system. But 70 percent of the population is too poor and depends on heavily subsidized care through the public health system. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed. Many communities responded by making birth control unavailable.

More recently, however, family planning advocates have been making headway in their campaign to change this. Legislation before the Philippine Congress, called the Reproductive Health and Population Development Act, would require governments down to the local level to provide free or low-cost reproductive health services — from condoms and birth control pills to tubal ligation and vasectomy. It would also mandate sex education in all schools, public and private, from fifth grade through high school.

South Korean Court Finds Stem Cell Scientist Guilty of Research Fraud

ABC News/BBC: Stem cell scientist guilty of research fraud:

A South Korean court has given a suspended two-year jail sentence to disgraced stem cell scientist Hwang Woo-suk after finding him guilty of fraud in a case that shocked the global scientific community.

His work raised hopes of finding cures for diseases such as Alzheimers, but three years ago an investigation found some of his work had been faked.

After a long legal process, a court of law has now found him guilty of using his fabricated research to embezzle state funds, some of which it says were diverted for his personal use.

Hope Lewis on FGM and FGC as a Violation of Human Rights

Hope Lewis (Northeastern University School of Law) has posted Female Genital Mutilation and Female Genital Cutting on SSRN.  Here is the abstract:

Female Genital Mutilation (FGM) or Female Genital Cutting (FGC) refers to a range of harmful traditional practices performed on infants, girls, and women in certain ethnic groups. This article, published in The Encyclopedia of Human Rights (David Forsythe, et al, ed., Oxford University Press, 2009) discusses the practices in the context of international human rights law. FGM-FGC, violates a number of international human rights standards, including the right to bodily integrity, the right to life, the right to the highest attainable standard of health, the rights of children, and the rights of women and girls to equality and non-discrimination. Nevertheless, the practices have been difficult to eliminate because they are often deeply-rooted in cultural (but not religious) norms. The article discusses historical and contemporary indigenous and cross-cultural movements to end FGM-FGC.

Spain's Plans to Liberalize Abortion Laws Draw Protesters

BBC NEWS: Big Anti-Abortion Rally in Spain

More than a million people are said to have taken part in a march in Madrid to oppose government plans to liberalise Spain's abortion law.

Several dozen centre-right opposition party joined the demonstration, which was backed by Roman Catholic bishops.

Socialist Prime Minister Jose Luis Rodriguez Zapatero wants to introduce abortion on demand.

At present, a pregnancy can only be terminated in mainly Catholic Spain under specific circumstances. . . .

New Guttmacher Report on Increased Contraceptive Use and Declining Abortion Rates Worldwide

Guttmacher Institute news release: Abortion and Unintended Pregnancy Decline Worldwide as Contraceptive Use Increases:

Increases in global contraceptive use have contributed to a decrease in the number of unintended pregnancies and, in turn, a decline in the number of abortions, which fell from an estimated 45.5 million procedures in 1995 to 41.6 million in 2003. While both the developed and the developing world experienced these positive trends, developed regions saw the greatest progress. Within the developing world, improvement varied widely, with Africa lagging behind other regions, according to “Abortion Worldwide: A Decade of Uneven Progress,” a major new Guttmacher Institute report released today.

The decline in worldwide abortion occurred alongside a global trend toward liberalizing abortion laws. Nineteen countries have significantly reduced restrictions in their abortion laws since 1997, while only three countries have substantially increased legal restrictions. Despite these trends, 40% of the world’s women live in countries with highly restrictive abortion laws, virtually all of them in the developing world. In Africa, 92% of reproductive-age women live under highly restrictive abortion laws, and in Latin America, 97% do so. These proportions have not changed markedly over the past decade.

Unsafe Abortions Kill 70,000 Women Every Year

Reuters: Unsafe abortions kill 70,000 a year, harm millions, by Kate Kelland:

LONDON, Oct 13 (Reuters) - Increased use of contraceptives has pushed global abortion rates down, but unsafe abortions kill 70,000 women each year and seriously harm or maim millions more, a global report said on Tuesday.

Despite easier access to abortion with restrictions being relaxed in many countries, the number of abortions fell from an estimated 45.5 million in 1995 to 41.6 million in 2003, the report by the U.S.-based Guttmacher Institute said.

But the study found a stubbornly high number -- almost 20 million -- of unsafe abortions, mostly in poorer countries and often carried out by the women themselves using inappropriate drugs or herbal potions, or by untrained traditional healers.

Guttmacher Institute Study Shows Costs of Treating Complications from Unsafe Abortions

Guttmacher Institute news release: Unsafe Abortion Costs the Developing World Hundreds of Millions of Dollars Each Year:

New Study from the Guttmacher Institute Quantifies Burden on Health Care Systems

Treating the complications that result from unsafe abortion costs Africa and Latin America $227–280 million each year, according to a new study from the Guttmacher Institute. These costs (reported in 2006 US$) place a considerable added strain on struggling national health systems in Africa and Latin America, which spend an estimated $490 million annually treating complications from pregnancies and births. Moreover, unsafe abortion costs the developing world at least $341 million when the Asian and Pacific regions are taken into account.

Using two approaches—a World Health Organization model and a comparison of 20 empirical studies—the authors calculated that on average, treating postabortion complications costs an estimated $83 per patient in Africa and $94 in Latin America. When overhead and capital costs are included, these averages jump to $114 for Africa and $130 for Latin America, which are significant burdens for developing country clinics and hospitals.

“Because virtually all unsafe abortions are a direct consequence of unwanted pregnancies, the costs calculated in this study result from the failure to prevent those pregnancies through family planning or, where legal, to terminate them safely,” said lead author Michael Vlassoff, a senior research associate at the Guttmacher Institute. “Unsafe abortions are a significant cause of maternal mortality and threaten women’s health in these regions and around the world.” . . .

The study, “Estimates of Health Care System Costs of Unsafe Abortion in Africa and Latin America” appears in the September 2009 issue of International Perspectives on Sexual and Reproductive Health.