The Asia-Pacific region is home to 4.5 billion people^[1] living in the region, and women and girls comprise half of this. In our region, 287,000 women die yearly from childbirth and pregnancy-related causes.^[2] Unsafe abortion is estimated to have caused 13% of all maternal deaths in Southeast Asia and in South Asia.^[3] About 63% of the adolescent pregnancies in the region are unintended with some Pacific countries having the highest percentage of adolescent pregnancies in the world, with almost 1 in 10 girls become pregnant by the age of 16 in South and Southeast Asia. In contexts, where abortion is legally accessible, it remains highly stigmatised and prevents women, especially young girls, to seek safe abortion services and post-abortion care. Consequently, young girls are at a higher risk of abortion-related morbidity and mortality.^[4]

In 2016, the President of the United States of America announced implementation of the ‘protection of life in global health assistance’ expanding the reinstatement of the Mexico City Policy or the Global Gag Rule, which was a significant blow to efforts to ensure SRHR globally and in the region. It clears the path for donors, as well as governments, to justify cuts in funding for critically needed financial and technical resources that help ensure women’s sexual and reproductive health and rights. It puts non-government organizations who need funding in a difficult position on whether to continue their other services and yet avoid abortion services, referral, or advocacy, or to seek alternative funding and potentially close down services altogether. Thus, it affects access to contraception, comprehensive sexuality education, and services related to sexually transmitted infections, including HIV and AIDS.

At the same time, this policy reinforces extremist notions of religion over women’s rights, bodily integrity and power; institutionalising and entrenching patriarchy and sexism even further in policies and programmes. Such conservatism cements pro-life arguments and actions towards limiting women’s SRHR, reducing women’s access to healthcare and adding to their inability to make informed decisions about their health. Further, it actively puts women’s lives in danger by withholding essential information and services with regard to women’s SRHR including, but not limited to, maternal mortality and morbidity, prevention of STIs, HIV and AIDs among others. In the Asia-Pacific, women and girls’ access to information and services is often restricted by narrow policies, practices, mind-sets, religion/beliefs, and traditions that are rooted in structural inequalities and patriarchal notions. These patriarchal notions are justified as socio-cultural and religious norms that use conservative and narrow interpretations to control their access to SRHR citing family “honour.” Culture and religion are both dynamic and have progressive interpretations, however, in many societies, extreme interpretations of religion are utilised to place controls on women’s and girls’ rights,^[5]especially their SRHR.^[6]

In this time, it is essential to highlight human rights principles around SRHR and reiterate that women’s and girls have the choice to have or not have children. The right to sexual and reproductive health is an integral part of the right to health enshrined in article 12 of the International Covenant on Economic, Social and Cultural Rights.^[7]  The adoption of the Programme of Action of the International Conference on Population and Development in 1994 further highlighted reproductive and sexual health issues within the human rights framework.

We now live in the SDG era and goals 3^[8] and 5^[9] deal with health and gender equality. Achieving gender equality in law and practice necessarily require governments to repeal discriminatory laws, policies and practices in all areas including sexual and reproductive health rights. Governments should acknowledge that women’s right to sexuality and their sexual and reproductive health and rights are essential human right. The World Health Organisation (WHO) has highlighted that the legality of abortion availability on request does not affect a woman’s likelihood of having an unintended pregnancy and seeking induced abortion dramatically affects her access to safe abortion. However, legal restrictions, together with other barriers, mean many women induce abortion themselves or seek abortion from unskilled providers. Where legislation allows abortion under broad indications, the incidence of and complications from unsafe abortion are generally lower than where abortion is legally more restricted.

On this International Day for Action for Women’s Health, the Asian-Pacific Resource and Research Centre for Women (ARROW) – an ECOSOC accredited NGO, based in Malaysia, working since 1993 to advance women’s health and rights, empowering women through information and knowledge by monitoring international commitments, advocacy and mobilisation – call for all governments to acknowledge women’s bodily integrity and their SRHR and provide access to safe abortion.

We further call governments to;

• Recognise that access to safe abortion services is a human right for all women and girls.

• Remove restrictions and laws that criminalise access to safe abortion services, including religious justifications that deny these services to women. Eliminate all punitive measures for women and girls seeking abortion, and health care providers performing abortions.

• Regulate service provision to ensure that women, including young women, have safe access to abortion service and post-abortion care should they choose to have an abortion.

• Provide adequate care facilities, counselling services and referral, and change attitudes and perceptions that result in stigmatisation within health institutions, including when women seek post-abortion care. In addition, ensure respect for women, informed decision making, autonomy, confidentiality and privacy in the provision of safe abortion services.

• Ensure context-specific and rights-based continuum of quality care (CQC) for women’s sexual and reproductive health which spans across a woman’s life-cycle – before and during pregnancy to post-partum/post-abortion and menopause – and across various locations, for example, the home, community and health facilities.

• Ensure that women, including young women, have access to adequate information and services to contraception at no-cost or at minimal cost.-Decision making with regards to contraception use should be rights-based.

• Ensure that new and safe technologies, such as medical abortion and manual vacuum aspiration, are available in all facilities, including the public health facilities.

^[1] http://www.unescap.org/our-work/social-development/population-dynamics

^[2] http://www.maternityworldwide.org/the-issues/

^[3] http://apps.who.int/iris/bitstream/10665/75173/1/WHO_RHR_12.01_eng.pdf

^[4]https://www.guttmacher.org/report/adolescent-womens-need-and-use-sexual-and-reproductive-health-services-developing-countries

^[5]https://arrow.org.my/global-gag-rule-response-asian-pacific-resource-research-centre-women-arrow-malaysia/

^[6] https://arrow.org.my/global-gag-rule-response-asian-pacific-resource-research-centre-women-arrow-malaysia/

^[7] General Comment on SRHR by the ECOSOC

^[8] Ensure healthy lives and promote well being for all at all ages

^[9] Achieve gender equality and empower all women and girls