Marcy Bloom does U.S. advocacy and capacity building for GIRE – El Grupo de Informacion en Reproduccion Elegida/The Information Group on Reproductive Choice.

Earlier, I wrote about the evolution of abortion rights as basic human rights and how that legal strategy can potentially be used to change laws in many countries, with the ultimate goal to end the tragically high maternal mortality rates around the world.

I will continue now with a discussion of how four human rights specifically apply to the need for safe and legal abortion.

Women's Right to Life and Survival: The right to life is protected in multiple human rights instruments. Forcing a woman to undergo a clandestine abortion threatens her rights to life and survival, violating the most fundamental of human rights.

Women's Right to Health: Unsafe abortion kills or maims women, and safe abortion care protects women's right to health. In the context of abortion, the right to health can be interpreted to require governments to take appropriate measures to ensure that woman are not exposed to the risk and humiliation of unsafe abortion. With 68,000 women (mostly black and brown) dying from unsafe abortion in the developing world every year, including 34,000 women in Africa, 38,000 women in Asia, and 5,000 women in Latin America, this public health necessity has become a moral, legal, and political imperative.

Women's Right to Nondiscrimination: The right to gender equality is a fundamental principle of human rights law. Denying women access to abortion is a form of gender discrimination because only women need and have abortions, and only women are exposed to risks that are not experienced by men when they are forced to resort to clandestine abortion.

Women's Right to Reproductive Self-Determination: A woman has the right to make decisions regarding her own body. Using human rights as a legal tool is an effective ethical and political strategy because this ensures women's freedom in decision-making about private matters. These provisions include protection of the right to physical integrity, the right to decide freely and responsibly the number and spacing of one's children, and the right to privacy, upon which our own Roe vs. Wade is based. Governments and fundamentalist religious bodies should play no role in forcing women to have babies they do not want and by denying them access to safe abortion and safe contraception.

But, of course, they do.

But there has been progress…and it is very exciting. Societal change takes time, patience, commitment, and innovative strategies. But it is possible.

On November 17^th of last year, the congress of Nicaragua passed a complete ban on abortion. This total ban offers NO exceptions for women's health, for victims of rape or incest…or even for women whose lives are at risk. This means, as is true in the U.S., that women of means will continue to obtain safe, clandestine abortions, and the poor, the marginalized, the young, and the indigenous women of Nicaragua will die. They already are.

By passing this outrageous ban, Nicaragua has joined the ranks of Chile and El Salvador, the only countries in the world to have imposed total abortion bans in the last 20 years. This is tragic beyond words, but I have learned to try to remember that good can come out of bad. In December, the Inter-American Commission on Human Rights released a landmark statement condemning Nicaragua's therapeutic abortion ban. Calling the ban a threat to women's lives, as well as a violation of their physical and psychological integrity, the statement passionately points out that "therapeutic abortion has been internationally recognized as a specialized and necessary health service for women, its ultimate purpose being to save the life of the mother when threatened during pregnancy." The Inter-American Commission's powerful statement places the Nicaragua ban in the context of a wider pattern of abortion-related human rights.

In another landmark case in 2005, called K.L. v. Peru, The United Nations Commission on Human Rights ruled that the rights of a 17-year-old Peruvian woman had been violated when health officials denied her a therapeutic abortion, although her fetus carried a fatal abnormality. She was forced to carry the pregnancy to term and the baby died shortly afterwards. In March of last year, yet another ground-breaking case from the Inter-American Commission on Human Rights was resolved. In the case Paulina Ramirez v. Mexico, the government of Mexico admitted that it violated the rights of a 13-year-old rape victim who petitioned for an abortion, but was frightened and coerced by legal and health officials to continue the pregnancy.

In yet another potential advance in 2006, the European Court for Human Rights agreed to hear the case of a Polish woman who was denied an abortion in 2000 and is now going blind as a result of being forced to continue her pregnancy. And in another huge victory, in May of last year, the Constitutional Court of Colombia ruled that abortion should be permitted when a pregnancy threatens a woman's life or health in cases of rape, incest, and fetal impairment. The court found that denying women access to safe abortion care in such cases violated the nation's constitution and women's human rights. In addition, the Colombian health ministry has sent directives specifying that abortion should be available in public hospitals. We know from the U.S. experience that there is a very big difference between the legal right to abortion and ensuring its actual access, so this is being carefully monitored by women's rights groups. There is still a long way to go in Colombia, but the changes have begun.

Women's decisions about abortion are about our human rights relating to our physical safety, personhood, dignity, and privacy…and, ultimately, our right to life and survival. Abortion services must be in conformity with international human rights standards that relate to the adequacy of health services. For all women, our reproductive destinies are a matter of respect and equality. For our sisters in the developing world, many of whom are black and brown, this matter of human rights and reproductive justice is a matter of life and death. 68,000 women need not die every year and it is an international—and racist—tragedy that we allow this.

Dr. Mahmoud Fathalla, professor of obstetrics and gynecology at Assiut University in Egypt, stated in 1997:

Women are not dying because of diseases or conditions we cannot treat. They are dying because societies have yet to make the decision that their lives are worth living.

Let us, then, vow to make that decision—today.