Cross-posted with permission from the ANSIRH blog.

This week I had the opportunity to attend the tri-annual meeting of the International Federation of Gynecology and Obstetrics (FIGO) in Rome, Italy. Despite being on the last day of the conference and running opposite two other panels addressing abortion, our session on abortion stigma was well-attended. My co-panelists, brought together by International Planned Parenthood Federation (IPPF), offered a wide-ranging set of approaches to understanding and addressing abortion stigma worldwide. What struck me most was the simple and direct statement made by Dr. Nozer Sheriar, an obstetrician-gynecologist from India, who explained why he supports women who have abortions: “anything 46 million women do every year can’t be immoral.”

How beautiful was his deep respect for women. And he is right: regardless of the legal paradigm in the country, the presence or absence of safe providers, or the level of risk to their lives, women across the globe have abortions. They do so because they know what is necessary for their families, their circumstances, and their futures. Abortion is a universal experience that transcends the politics and the cultures of the world. And, as Dr. Sheriar notes, it is a moral action taken by moral agents.

After I left the panel, I attended the closing ceremony of the conference. In the echoes of a huge cavernous room, I stared at the poorly-crafted powerpoint slides of the incoming FIGO president. Highlighted among all the organization’s priorities were the four selected for his leadership attention, including “addressing unsafe abortion.” I realized how surprised I was to see abortion called out, not hidden and worked on secretly, but there as an issue that needs to be addressed directly. Care delivery—not just prevention—requires our attention.

Perhaps this focus on abortion-care delivery was so remarkable to me because of the U.S.-based conversation dominating my email inbox at the same time. A new study from the Choices project in Saint Louis had reported a reduction in abortion rates among women who were offered free contraception. Once again, the pro-choice community seemed thrilled at the idea that we had found the solution to the abortion conflict. If only we had free contraception, abortion would be less prevalent and therefore, presumably, the political fight less intense. We seem to believe that the numbers of abortions are the problem, not the lack of respect for women’s control over their lives.

As I have written before, it is not that I do not believe contraception is important—I do. But it is important because it is one of the many tools that should be easily available to help women control their fertility. It helps them avoid an unintended pregnancy—that may be carried to term or terminated. But it is not important because it reduces the number of abortions—a concept that actually increases abortion stigma. Not pitting pregnancy prevention against abortion rates may seem like a semantic difference, but it is a critically important one for women. Making all the tools, all the options available and equally acceptable is an approach that puts women at the center of the conversation.

The 46 million women who have abortions every year throughout the world deserve to be respected—not seen as targets of prevention.