Abortion -- It Should Be Your Decision After All

"I wish people weren't so hypocritical... It's about defending women's freedom to decide when to have a baby. I can't have a child now," says Maria. The Uruguayan echoes the words of young women from so many parts of the world.

She shares her experience in a short film for IPPF's "Women's Voices" series. These films show how four women in different settings -- Uruguay, India, Cameroon and France -- and from different socio-economic backgrounds experience abortion.

Despite these women's different situations and locations, there are many similarities in their experiences. What they have in common, among other things, is that the decision they made was right for them and their families. And that decision enabled them to move forward with their lives on the path that they chose.

Maria reflects that in Uruguay openly talking about abortion is taboo, even though abortion is legal. But up until three years ago, abortion was highly restricted in Uruguay, and the ability to access safe abortion was a challenge.

This same challenge is currently shared by women living in the 66 countries worldwide that either prohibit abortion entirely or permit it only to save a woman's life.

Globally, approximately 85 million women each year will experience an unintended pregnancy. If those who do not want to continue with a pregnancy are denied their right to an abortion through safe and legal means, they will seek an unsafe abortion.

In Latin America, a region in which abortion is illegal under most circumstances in most countries, 95 percent of all abortions are unsafe. Each year, an estimated 22 million unsafe abortions occur globally, resulting in the death of 47,000 women and injury for an additional 5 million women.

Almost every death and injury as a result of unsafe abortion is preventable through the provision of safe abortion services. That's why IPPF Member Associations work every day to provide women with safe abortion services when and where the law permits it, and they fight tirelessly to amend laws and policies to enable greater access to safe abortion services.

However, until such changes can be achieved, in settings where abortion is highly restricted IPPF is pioneering an innovative evidence-based approach to reducing mortality and morbidity from unsafe abortion.

The 'harm reduction model' is grounded in the idea that even in these settings, women who want to end their pregnancy have the right to accurate and comprehensive information about their options, so that they can make a fully informed choice.

Under these circumstances, health professionals have a clear responsibility to reduce the risks and harms associated with unsafe abortion by providing information, counseling and post-abortion care.

Pioneered by our Member Association Iniciativas Sanitarias in Uruguay, prior to the liberalization of the abortion law there in 2012, this approach focuses on the time before and after an abortion -- counseling before to discuss options, the risks associated with the most unsafe practices, and providing information about safer methods like medical abortion; and then post-abortion care focusing on treatment of complications and contraceptive counseling to prevent unwanted pregnancies.

Harm reduction can help us work in the most restrictive settings to ensure that women have the information, resources and support to end an unwanted pregnancy safely. While this is an approach that we will continue to use where and when we have to, it is also an approach that we want made redundant.

Women everywhere should have access to safe and legal abortion - whether they choose to have an abortion provided in a clinic setting, or to self-induce safely in their own home. IPPF and our Member Associations will continue to fight for the realization of this right, while also ensuring that women who are currently denied this right have access to comprehensive pre-abortion information and counseling, and quality post-abortion care services.

As Maria says: "I had an abortion because I thought it was the right thing to do. It's your decision after all."