Worldwide there are 56 million abortions each year, of which an estimated 45 per cent are unsafe. Over the past year, there have been successes and setbacks in the fight for the right to safe abortion. Progressive abortion law reform has been enacted in countries such as Argentina, South Korea, Thailand and Ecuador, and telemedicine has been used to provide abortion pills in Ireland, Britain, France, during the pandemic. But in many places, the situation has become worse.

On International Safe Abortion Day, Putri Widi Saraswati and Sanskriti Shrestha, two of KIT’s Alumni who studied a master’s in public health in 2020-21, look at the status of abortion rights in their home countries and explain what they are doing in own capacity to help #MakeUnsafeAbortionHistory.

In Indonesia, an expansion of the law in 2014 allowed for safe abortion when the life and health of the mother are at risk and for victims of rape. However, implementation lags behind, and the government provides no services, no training for providers, appoints no designated health facilities and has no clear financing arrangements. Despite this fact, abortion is still common irrespective of marital status.

Indonesia also lacks data on the impact of unsafe abortions. Despite unsafe abortion accounting for 1 in 5 maternal deaths globally and even more in low- and middle-income countries, the Indonesian government is hesitant to mention it. Many unsafe abortion cases are most likely recorded under the category of ‘bleeding or haemorrhage’ – rendering them invisible.

As a public health professional and healthcare provider, I am calling on the Indonesian government, Ministry of Health and policymakers to delay the provision of safe abortion services no longer, to provide reliable data on the consequences of unsafe abortions, and to make safe abortion accessible and affordable for all. Our laws, health system, and national health insurance scheme certainly have room for those actions. Furthermore, providing safe abortion services, connected to equitable access to contraception, is ultimately more cost-effective than paying for the consequences of unsafe abortions.

As a civilian and a woman, I am calling on all Indonesians to remember that no one deserves to die because of unsafe abortion. Globally, it has been proven that making abortion inaccessible or illegal does not make them stop, it only makes them more dangerous, especially for those who are already vulnerable such as the poor and marginalized.

Reproductive rights are basic human rights, we need to push for the government to do what it has been mandated to do: protecting and fulfilling every citizen’s rights. Unintended pregnancy – the cause of abortion – can happen to anyone who can get pregnant, and no one’s rights are fully protected until everyone is protected.

Putri Widi Saraswati, MD, M.Sc (KIT MPH/ICHD alumna 2020-2021)

Abortion rights are more than just a part of my work, I believe everyone has the right and should have access to safe abortion services.

In my work for YUWA, a youth-led organization in Nepal, I was engaged in provincial, national, and international advocacy spaces to improve abortion-related policies and access to safe abortion services for young people. I had first-hand experience of abortion policies and how they impacted young people.

Despite the legalization of abortion nearly two decades ago, knowledge about the legal status of abortion and access to safe abortion services remains poor.

Many factors such as a lack of information, lack of physical access to health services, the judgmental attitudes of health service providers, a lack of confidentiality and stigma around abortion, lead to unsafe abortions.

Among young people, low contraception use, and high abortion stigma have made them even more vulnerable to unsafe abortions. At KIT, my dissertation focused on the portrayal of abortion issues in the Nepalese news media. Some key findings included an emphasis on adolescent and young girls in abortion news articles, abortion mostly associated with negative legal and health consequences, and the use of stigmatizing language and images in both print and online news media.

Decriminalization of abortion, media sensitization, and engagement in order to disseminate safe abortion information and services are crucial to normalize abortion as a fundamental healthcare service, to reduce stigma, and to consign unsafe abortion to history.

Sanskriti Shrestha, (KIT MPH/ICHD alumna 2020-2021)