Constant harassment and intimidation at abortion clinics continue to limit the ability of abortion providers to do their jobs and of women to obtain abortions in a safe and respectful space. Laws such as the Freedom of Access to Clinic Entrances Act (FACE) are meant to stop the often violent harassment that anti-abortion protesters use outside of abortion clinics. However, local and federal law enforcement can be lax in investigating threats: the report notes that the police often do not understand the provisions of FACE, or are unwilling to interfere with what they perceive as “the expected cost of providing abortion.”

Increasingly, anti-abortion groups are using litigation as a strategy to further harass abortion providers and burden law enforcement and the judicial system. For example, an anti-abortion group in Allentown, Pennsylvania sued the city after their protesters were arrested for “trespass, impeding access, racist and sexual taunting, and residential picketing” outside of a women’s clinic. The city eventually settled after a lengthy case, paying $10,000 to each of the 13 protestors. Experiences such as these have made law enforcement officials reluctant to interfere with protests outside clinics for fear of the legal repercussions. In this case, the Allentown City Solicitor told the clinic director that the city could no longer respond to any complaints at the clinic “unless there is a threat to life or person,” effectively admitting to the city’s almost complete inability to enforce the law with regards to abortion protestors.

As seen with Dr. Tiller’s murder, which occurred while he was attending church with his family, this type of violent persecution is not restricted to the healthcare facilities where abortions are performed. Many abortion providers must take certain precautions, such as holding unlisted phone numbers, listing property in a spouse’s name, and wearing bulletproof vests while traveling to and from work. Anti-abortion protestors also use the internet to further harass both providers and women seeking abortions – a group in Texas used car registry information to send out a mass email identifying by name women who entered a Planned Parenthood clinic.

The many dangers involved in providing abortions take their toll on doctors, staff, and the women themselves. Physicians in particular are driven away from performing abortions due to the significant financial expense required to secure their clinic and workers, the social stigma they and their families face, and the risk of physical harm. The number of abortion providers is shrinking, and is likely to only get worse in the future as abortion providers age and retire — the majority of current providers are over 50 years old. Few medical students are given the opportunity to observe or learn how to provide abortions, as most doctors today never saw an abortion performed during medical school, and half of OB-GYN training programs fail to provide routine instruction in abortions. This shortage means that despite the fact that one in three American women will have an abortion in her lifetime, nearly a quarter of women seeking abortions have to travel 50 miles or more to find a clinic.

Even more disturbing, it has become close to impossible to find doctors who will perform abortions after a woman is 24 weeks into pregnancy. Following Dr. Tiller’s murder, Warren Hern is one of only a few doctors to openly acknowledge that he provides late-term abortions. In a recent article, he describes the precautions, including bulletproof glass and protection from US marshals, that he and his staff members must take to protect themselves and the women they provide abortions for. Dr. Tern describes the anti-abortion movement as “a violent terrorist movement, [with] a fascist ideology,” that publicly deplores acts of violence while continuing to push for “cold-blooded, brutal political assassination[s]” such as that of Dr. Tiller.

Despite the danger, Dr. Hern continues to provide abortions at his clinic because he sees it as the most important work he can do in medicine. However, the unrelenting harassment of anti-abortion protestors threatens the reproductive rights of women seeking abortions and the safety of medical professionals that provide them. Violations of these rights by anti-abortion groups must be taken more seriously by law enforcement and local and federal government. Otherwise, acts of violence against abortion providers such as Dr. Tiller will only continue.

The ban, included in Nicaragua’s revised Penal Code, allows no exceptions, even in the case of maternal health, incest, or rape. Previously, therapeutic abortion (performed if the life or health of the woman is at risk because of the pregnancy) was legal but highly restricted – it was only permissible if three medical practitioners deemed it necessary and a family member agreed. Now, however, medical practitioners can even be arrested for treating a pregnant woman with a condition such as HIV/AIDS or cancer, because the treatment may cause injury or death to the fetus. Health care workers can also be prosecuted if a fetus is accidentally injured or harmed during birth. The threat of these harsh legal consequences may simply keep medical professionals from seeing pregnant women at all, to avoid prosecution in the event of unintentional fetal injury or death. Even women who have miscarriages fear being arrested, as it can be nearly impossible to determine whether an abortion was spontaneous (a miscarriage) or intentional.

Women and girls who are raped or victims of incest are also included under the abortion ban. Most reported rape cases in Nicaragua involve victims under the age of 18, and 87% of rape or incest victims who get pregnant are between 10 and 14 years old. In the report, a local NGO described supporting a nine-year-old victim of incest and rape through pregnancy, because no other legal options were available. Young women and girls who have not reached physical maturity have higher rates of pregnancy complications and are particularly endangered by this abortion ban.

The ban was enacted primarily due to pressure from the Catholic Church and other Christian groups; no health or human rights-based assessment of the law’s impact was carried out prior to its passage. Numerous Nicaraguan medical groups oppose the law, including the Nicaraguan Society of General Medical Practitioners, and the ban is in violation of the Nicaraguan Obstetric Rules and Protocols created by the Ministry of Health. Despite this, the National Assembly voted to revoke therapeutic abortion in October of 2006, seemingly “with full knowledge of the severe pain and suffering that necessarily follows from the denial of essential medical services to pregnant women and girls.”

The UN Committee Against Torture, the UN Committee on Economic, Social and Cultural Rights, the UN Human Rights Committee, and the Inter-American Convention on Human Rights (which Nicaragua is a party to) have all strongly objected to Nicaragua’s abortion ban. The Nicaraguan Constitution itself states that “every person enjoys state protection and recognition of the inherent rights of the human person, the unrestricted respect, promotion and protection of human rights…” However, in enacting an absolute ban on all abortions, the Nicaraguan government has seriously harmed efforts to improve the health of women and girls in the country and failed to meet its obligations to protect the human rights of all citizens.

Airborne: A Journey into the Challenges and Solutions to Stopping MDR-TB and XDR-TB is a powerful new book written by John Donnelly that features interviews and images to put a human face on the TB epidemic across the world. In her foreword, WHO Director-General Margaret Chan wrote, “I urge you to read the personal stories collected in AIRBORNE. These are human tragedies that should never have happened. But these are also stories about the uplifting success possible when the right elements are in place.”

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Australian Abortion-Aid Ban Lifted

A thirteen-year ban in Australia on providing foreign aid for abortions has been lifted and Australia will provide  funding of up to $15 million for reproductive health activities to help reduce maternal deaths across the world.

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$50 Million US Contribution to UNFPA

President Obama has recently signed legislation to provide $50 million to the United Nations Population Fund (UNFPA) to improve the health of women and children and reduce poverty throughout the world.

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US Capital Blighted by HIV/AIDS

The U.S. Capital has an HIV/AIDS rate on par with or worse than some African nations the city’s health department reports.

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US Urged to Fix Iraqi Refugee ‘Mess’ It Created

As the Iraq war enters its 7th year, the United States is urged to provide aid to Iraqi refugees displaced by the fighting.

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In Reversal, US to Engage with Human Rights Council

President Obama’s decision to become actively involved in the U.N. Human Rights Council raises hope that the administration will take a multilateral, human rights approach to international diplomacy.

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Living in a Sea of Mud and Drowning in Dread

Hurricane season has left Haitians to navigate mud-covered towns; without clear evacuation and reconstruction plans, Haitians fear an even worse situation this year.

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Chad: Fighting Violence Against Women — But How?

Violence against women is endemic in Chad, where in December dozens of women took part in a protest march against the legal gaps and cultural norms that allow for rampant domestic violence, sexual abuse, and underage marriages.

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In Iraq, A Story of Rape, Shame and ‘Honor Killing’

Killing of a pregnant rape victim by her brother reveals the terrible frequency of ‘honor killings’ in Iraq.

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Mentally Ill and in Immigration Limbo

Xiu Ping Jiang, an illegal immigrant from China, faces the harrowing choice of deportation  or detention in a facility where she has, allegedly, received inadequate care for her mental condition.

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Women’s Health Insurance Fairness Act

U.S. Senator John Kerry has introduced a bill that would prohibit health insurance companies from charging women higher premiums and from discriminating against women based on whether they are pregnant.

Recently, Human Rights Watch released a report that documents the unique struggles women face in accessing health care in detention. It documents reports of women who suffered from affronts to their health and dignity during detention, including inadequate care during pregnancy, having to beg and plead to get enough sanitary pads not to bleed through their clothes, or not being offered counseling after testing positive for pregnancy. In “Access Denied,” The Texas Observer highlights the denial of reproductive rights for the large number of detainees who are sexually assaulted; they are not identified when they come into ICE’s custody, nor are they informed of their options if they become pregnant.

According to Human Rights Watch, the failures of the detention medical system to adequately respond to women’s health issues “implicates fundamental human rights, including international legal protections to the right to health, the right to non-discrimination, and the rights of detained persons.” The U.S. government has a responsibility to provide quality medical care to the thousands of immigrants it has chosen to take into its custody while they wait for their hearings. Human rights advocates also suggest a long-term solution to the crisis: using an alternative to the costly process of detention, such as intensive supervision appearance programs. In being detained, immigrants should not be denied their right to health.

See also:

Dying for Decent Care: Bad Medicine in Immigration Custody – Florida Immigrant Advocacy Center (FIAC), Mar 2009

Careless Detention – four-part series in Washington Post, May 2008

U.N. Special Rapporteur Denounces U.S. Immigration Detention System – National Immigrant Justice Center, Mar 2008

Briefing Materials Submitted to the U.N. Special Rapporteur on the Human Rights of Migrants – National Immigrant Justice Center, August 2007

Protesters seek legalization of abortion in Brazil

It may be hard to imagine a 9-year-old, all of 79 pounds and four feet tall, 15 weeks pregnant with twins. Now compound that image with the girl’s story– sexually abused repeatedly, allegedly by her stepfather, since the age of 6. While the alleged rape should be enough to raise media attention, it is the tense controversy over reproductive rights in the predominantly Catholic country that is making headlines after the medical team who performed the legal abortion, as well as the girl’s mother, were summarily excommunicated by the Church.

Brazilian Minister of Health Jose Gomes Temporao declared, “It is legitimate for the church to have its dogmas, but theses dogmas must not be imposed on society as a whole.” Archbishop Jose Cardoso Sobrinho of the coastal city of Recife countered in a TIME interview, “They took the life of an innocent… Taking that life cannot be ignored.”

The case highlights both the great intersection between religion and health in Brazil and also the critical feature of abortion-access and abuse in the country. Unwanted pregnancy and clandestine abortions are, sadly, a constant in the nation, in which abortion is only permissible in the case of rape or endangerment to the life of the mother. In fact, a new report by Brazil’s IPAS, a non-governmental organization, indicates that each year more than 1 million women undergo illegal abortions in Brazil. Moreover, the head of the Latin America’s most prominent women’s health clinic, Pérola Byington Hospital in São Paolo, Dr. Jefferson Drezett, estimates that 1 in 3 pregnancies in the country is unwanted. In the Pérola Byington Hospital, which specializes in treating victims of sexual violence, 13 out of 47 abortions performed in the past year involved girls under the age of 18.

In a country where, according to IPAS, 250,000 women a year are treated by doctors for traumas due to botched abortions, it is alarming that the reproductive health of women is subject to religious scrutiny and criminalization. Until Brazil can separate religious doctrine from medical treatment, victimized women like the abused 9-year-old may still have to endure a situation in which dogma is placed above their reproductive rights.

Open your perspective:

New York Times: Abuse in Brazil

The suit highlights the fact that the hospital operated on the woman because of her HIV status, even though the possibility of transmitting the virus to a fetus or newborn can be reduced to less than 2% with proper intervention. Moreover, the case illustrates the violations of reproductive rights frequently suffered by women living with HIV, who may be forced to have abortions against their will or are even excluded from healthcare services. A countrywide study done by Vivo Positivo, a Chilean HIV/AIDS advocacy group, found that 41.9% of HIV-positive women who had been sterilized had done so under pressure from doctors or even without consent. How such a patent violation of human rights in one country could be occurring without international outrage is startling; yet, the Human Rights Watch has documented similar cases throughout the world.

For example, the European Roma Rights Centre has reported on a policy of forced sterilization of Roma women, perpetrated by Czech doctors starting in 1973. Earlier this year 70 sterilized women publicly accused state-run hospitals of performing sterilizations without consent throughout the past 15 years, often like in the Chile case, directly before or after a birth. “In Czech and Slovak societies, Roma are looked down upon, are thought to have too many children, are viewed as uneducated and lazy, so therefore their reproductive rights are relegated to the bottom of the barrel,” explained Kumar Vishwanathan a supporter of Roma rights and a social worker in Ostrava. While in Chile the case centered on the reproductive rights of HIV sufferers, the Roma sterilizations were based on social prejudice and a desire to eliminate so-called “undesirables,” said Claude Cahn, program director at the European Roma Rights Center in Budapest. The Committee on the Elimination of Discrimination against Women has urged the Czech government to provide on-going training in patient rights for health workers, as well as to provide compensation for victims of forced sterilization. However, to date, “no Romani woman victimized by coerced sterilization practices has received an apology for her suffering from her government in Czech Republic, Hungary or Slovakia,” reports the Roma Rights Network.

The Chilean government has responded with a remarkably similar attitude, as neither the Ministry of Health nor the Chilean courts found that the sterilization was a violation of the woman’s human rights, merely a manifestation of the rampant discrimination against individuals living with HIV/AIDS in Chile. The media attention given to the suit provides a crucial opportunity for the Chilean government and citizens to reconsider the rights of HIV-positive men and women. Nevertheless, it is critical that the international community recognizes this case for what it is: a violation of the human right to informed medical treatment.

See also:

Center for Reproductive Rights

Vivo Positivo Reports on the Law Suit (Spanish)

Campaign on Coerced Sterilization