"Sluts, keep yer legs closed!" hasn't been a viable public health solution for the last several thousand years, but if we pray real hard, maybe it someday will be. Until mass abstinence is feasible or permanent pregnancy is desired, sustainable, or safe, though, the best options women have to control their reproductive health are contraception and abortion. And, in at least one African country, they're getting it... no thanks to American conservatives who fought against Kenyan women's access to safe abortion every step of the way.


One might think that it's no business of, say, a white male politician who lives in a New Jersey McMansion to tell an African woman that she must remain pregnant if she doesn't want to be, but for the last several years, anti-abortion rights conservatives have made it their business to occupy not only the uteruses of American women, but the uteruses of women around the world. It's a small, small uterus, after all.

Here's how the battle for abortion rights went down in Kenya, according to Irin Carmon, writing for Salon. Prior to 2010, Kenya required women who wanted to have an abortion to get written approval from three doctors, one of whom had to be a psychiatrist. Because Kenya isn't exactly psychiatrist-dense, the procedure was largely unavailable to women who wanted or needed the procedure. As a result, Kenyan women often sought illegal back alley abortions, which often did not go well — according to Carmon, approximately 20,000 Kenyan women are treated every year for illegal abortion-related complications, and 30 to 40 percent of maternity-related death is caused by unsafe abortion. But just remaining pregnant wasn't an attractive alternative, either. In Kenya, the maternal mortality rate is 488 per 100,000 live births (in the US, it's under 7 deaths per 100,000 live births).


The situation deteriorated during the George W. Bush administration, as Republicans instituted the "global gag rule," which prohibited any family planning organization receiving US aid from even mentioning the fact that safe abortion is a thing that exists. In addition, Bush defunded the UN Population Fund, which provided contraception to women in Kenya and other developing countries, which led to a rise in unplanned pregnancies in Kenya, which led to a rise in unsafe abortions and, presumably, injury and death from those unsafe procedures. Pro-life!

In 2010, after much wailing and complaining by American conservatives who for some reason only care about Africa when we're talking about oil or zygotes, Kenya ratified a new Constitution that allows women to access abortion after getting approval from only one doctor. A step up, certainly, but still something that's taken cultural adjustment. And backward American views on abortion are still negatively impacting access to care, a fact that's frustrating to health care providers and women's health advocates. Writes Carmon,

Take Kisumu Medical and Education Trust (K-MET), which I visited recently. It was ineligible for U.S. funding under the Bush administration because it works on comprehensive reproductive healthcare – from adolescent health to advocating for safe abortion access to caring for women who have had unsafe abortions. Under Obama, they've gotten a U.S. government grant to improve the services of 650 healthcare providers when it comes to infectious diseases like malaria and HIV. "But we are not allowed to spend any of this money on anything related to post-abortion care or abortion," said director of programs Sam Owoko. "You have to separate the room where you're doing post-abortion care and the room where you're doing everything else" – and, he said, even have a separate set of tools, no easy task when resources are already so scarce. Frustrated reproductive health professionals have pointed out that the same commodities USAID won't fund because they can be used for elective abortion – manual vacuum aspirators (MVAs), misoprostol - are the ones recommended for life-saving post-abortion care or post-partum hemorrhage.

It's a completely nonsensical accommodation to an oppressive, borderline imperialist approach to women's health in developing countries. But it's not going away any time soon.

So if abortion is unsafe and pregnancy is even less safe, what options do women in developing countries have? Is simply having functioning ovaries akin to continually playing Uterine Russian Roulette? Not necessarily.


To paraphrase a new Guttmacher report: "Birth Control. Duh." To paraphrase it in a way that wouldn't get a teenager with strict parents grounded: widespread use of advanced contraception in developing countries could prevent millions of unplanned pregnancies, millions of abortions. According to estimates, women worldwide will experience 80 million unplanned pregnancies this year due to contraceptive failure or contraceptive non-use. Forty million of those pregnancies will result in abortion, 30 million in live birth, and 10 million in miscarriage. Widespread availability of contraception to these women could theoretically prevent most — not all, but most — of these pregnancies in the first place.

Governments that operate under the false assumption that women either don't have sex outside of marriage or always want children inside of marriage, and if they don't meet those two criteria, then they deserve to be punished for their transgression with forced pregnancy and childbirth aren't only deluded, they're killing women with their delusions. And the world would be better for it if the men in charge agreed to legislate reality rather than an impossible ideal.


[Salon]