Abortion, Birth Control, and Harper

If he doesn’t tackle these issues at the 2010 G8, it will be Canada’s most regressive health policy decision ever.

A pregnant woman dies every minute of every day from mostly preventable or treatable causes. The recent loss of a motion in Parliament to ensure that family planning will be on the agenda at this year’s G8 and G20 summits in Canada is disappointing, but we must not let it distract us from the great opportunity that lies before us to address this international catastrophe.

The reason for introducing the motion was to clarify the Government of Canada’s position on this issue. When Prime Minister Stephen Harper said earlier this year that reducing maternal and childhood deaths would be a focus of this year’s summits, we applauded. But this support turned to concern when Mr. Harper’s ministers started saying that family planning and access to safe abortions would be excluded from the agenda. They also said that they were “not opening the abortion debate.” This set off a firestorm.

So how can we save the lives of mothers and their children?

Reducing maternal deaths, which is Millennium Development Goal 5 (MDG5), has been the most neglected of all the MDGs. This is unconscionable, given that 80 per cent of the 530,000 pregnant women who die every single year do so from five entirely preventable or treatable causes: hemorrhage, obstructed labor, sepsis, eclampsia, and as a consequence of receiving a botched abortion. The catastrophe does not end with the mother’s death, for more than half of her children under the age of five will also perish soon after her death. This tragedy is even more mystifying because treating these complications is relatively simple. It requires that women have access to basic surgical procedures and medications, trained healthcare workers, diagnostics, adequate nutrition, clean water, and a reliable power source. With these resources, 80 per cent of maternal deaths worldwide could be prevented. But 80 per cent of the medical problems encountered in the emergency room could also be prevented, including the world’s major killers: gastroenteritis, pneumonia, malaria, tuberculosis, malnutrition, sepsis, and HIV/AIDS.

Access to various family planning options (condoms, birth control, etc.) is also crucial because it enables women to space out their children so they will not have them too frequently or too early or late in life. It also enables women and men to protect themselves from HIV/AIDS and other sexually transmitted diseases. Depriving men and women of these family planning tools would prevent them from being able to save their own lives. It would also be the most regressive public health policy a Canadian government has ever made and be a major obstacle to curbing the AIDS pandemic that kills three million people each year.

With respect to the thorny issue of abortion, Mr. Harper should embrace the standard medical position championed by the World Health Organization, the Partnership for Maternal, Newborn and Child Health, and indeed previous Liberal and Conservative governments. This position is to support women’s access to safe abortions in those countries where it is legal. Many members of the Conservative government may have their own personal opposition to abortion, and this must be respected. However, they do not have the right to force their views on others when it runs counter to the prevailing scientific consensus. “Not opening the abortion debate” means respecting the status quo, which has been our nation’s position for many years. If the government claims to be pro-life, certainly they would want to reduce the current toll of 63,000 women a year who perish as a complication of a botched abortion and the hundreds of thousands of children who die as a consequence of their mother’s passing. Furthermore, how can our government actively deprive women from the poorest countries in the world of the same rights and access to medical procedures that women have in Canada?

Mr. Harper can square his opposition to abortion while implementing an effective plan to reduce maternal and childhood mortality by proposing that each G8 country take the lead in one of the inputs required to address this tragic situation. For example, Canada could be the lead nation on training healthcare workers and micronutrients, another country could focus on providing medications, another on access to family planning and safe abortions, etc. In this way, a comprehensive plan that focuses on enabling the world’s poorest to access basic primary care services can be implemented, with the G8 countries dividing responsibilities and target resources.

As the host of this year’s G8 and G20 Summits, Canada has the opportunity to lead the world’s most powerful nations in making the most profound, positive change in international health for the world’s poorest people that we have seen in decades. What a legacy that could be.