Last week, two stories on the recently released worldwide trends on abortion by the Allan Guttmacher Institute and World Health Organization highlighted two notable points: (1) worldwide, abortion rates were on a decline in countries where they were, for the most part, legal (with the reverse trend in countries where they remain illegal) and 2) the legal status of abortion doesn't actually deter women and even couples from seeking abortion, even when it is illegal and more likely unsafe.

Noting the link between declining abortion rates and wider contraceptive use, the story reported:

The number of abortions annually fell to under 42 million from 46 million between 1995 and 2003, with rates decreasing most significantly in Eastern Europe, said the report from the Guttmacher Institute and the World Health Organization. The number of abortions fell most in developed countries where it is legal compared to poorer countries where it is largely banned and considered unsafe, the researchers said. The report said an estimated 20 million unsafe abortions occurred in 2003, 97 percent of them in developing regions and places where the procedure is banned.

Meanwhile, the story reported that majority (that is over 35 million) of abortions take place in the developing world and that 97 percent of all unsafe abortions in poor countries.

These raise important questions in the sexual rights, abortion and reproductive health discourses today. One of course is contemplating the role of law and policy on the issue of abortion (if prohibition never worked to deter women and couples from seeking it, what is the basis for criminal sanction on consented abortion? What is it good for? What laws and policies do we need?) and second, the fact that contexts of inequality, marginalization and prohibition ultimately raise the stakes for women and their families.

Organzanizing and activism around women's right to access safe abortion has usually been structured alongside popular claims about "choice" and "privacy," which no doubt remain important bases for building both legal assertions and realization of women's reproductive choices.

This is also very true in the Philippines, where in the context of the prohibition of abortion, combined with a constitutionally vague provision declaring "equal protection of the life of the mother and the unborn," popular reproductive health discourse is often buttressed by claims of "reproductive choice," which in turn are supported by both equality, privacy and freedoms guaranteed in a constitutional "bill of rights."

While the current language of the "reproductive health bill" has no provision to challenge the illegal status on consented abortions (lacking as yet a broad enough consensus among reproductive health and family planning advocates), the bill instead targets making available (and accessible), the critical service of post abortion care, as well as a standard of humane treatment in receiving this service.

The "humane treatment" provision in post abortion care is one significant aspect of the Philippine experience on this issue. Studies have demonstrated how even as the health intervention is not exactly "illegal" and health providers are never in any danger of criminal liability (in fact the reverse is true since both professional and legal standards dictate professional duties), women coming in for the treatment (both in cases of intentional abortions or miscarriages), have been systematically subjected to maltreatment by health workers, ranging from a denial of anaesthesia, to being subjected to blaming and humiliation.

Indeed, in this case, the appeal, in order to make abortions safer and to stem rising maternal deaths and injuries from predominantly unsafe abortions, takes on language that while still based on notions of rights, is not really one of simple or straightforward "individual entitlement," but also "a general appeal to compassion," in the form of adequate care and ethical treatment.

This as expected doesn't come easy in contexts where standards of general and primary health care are not exactly ideal. As noted in the cited report: "Because providing safe abortions depends on a working health care system, experts said tackling the problem is difficult."

Given a situation of grave lack in resources (not just economic but also information and viable frameworks which impacts on public opinion and perceptions), the challenge of "rights articulation" requires a bit more than the traditionally "legally framed and individually focused" demand of a purported "state mandate," (which always presupposes a state and agencies interested in fulfilling constitutional mandates, in this case for women). Ultimately it also requires a parallel frame and equally substantial appeal to not just to the common weal, but one which resonates with the best of our moral aspirations.

This fall, I began graduate studies in law and have been blogging since late September from the University of Toronto, where I was awarded a Fellowship on Reproductive and Sexual Health. The scholarship is focused on the legal and ethical issues in reproductive and sexual health. I hope to bring coverage of a range of discussions (and conference coverage) as well as contribute a variety of insights informed by the current work of experts in the field.