Governments should respect a woman's human right to make decisions regarding her reproductive life. A woman who decides to have an abortion must have access to the facilities and care that will enable her to terminate her pregnancy safely. Governments that prosecute and punish women who have had abortions penalize women for exercising their basic rights. These rights are no less compromised when a woman who decides to terminate a pregnancy can do so only by undertaking a serious risk to her health.

The international legal support for a woman's right to safe and legal abortion can be found in numerous international treaties and other instruments, and the relevant provisions of these documents are listed in Table I. The right to choose abortion has support in guarantees of autonomy in reproductive decision-making, freedom from discrimination, and protection of health and life.

Abortion is a Woman's Choice

A woman has a right to make decisions regarding her own body. Support for this right is found in a number of human rights instruments, which contain provisions that ensure freedom in decision-making about private matters. Such provisions include protections 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.

Women have the right to decide whether or not to bring a pregnancy to term.

• The right to physical integrity ensures freedom from unwanted invasions of one's body. When a pregnancy is unwanted, its continuation can take a heavy toll on a woman's physical and emotional well-being. A woman's right to physical integrity entitles her to decide whether or not she will carry a pregnancy to term.
• A woman's right to determine the number and spacing of her children requires governments to make abortion services legal, safe, and accessible to all women. Women are entitled to have access to all safe, effective means of controlling their family size, including abortion. In addition, there are a number of circumstances in which abortion may be a woman's only means of exercising her right to plan her family. A woman who becomes pregnant through an act of non-consensual sex would be forced to bear a child were she denied her right to an abortion. For women who live in settings in which family planning services and education are unavailable, access to safe abortion services may be the only means of controlling their family size. Finally, contraceptive failure will inevitably occur among some of those women who regularly use contraception.
• Decisions one makes about one's body, particularly one's reproductive capacity, lie squarely in the domain of private decision-making. A woman's right to privacy, therefore, entitles her to decide whether or not to undergo an abortion without government interference. Only a pregnant woman knows whether she is ready to have a child, and governments can play no role in influencing that decision.

Abortion Bans Discriminate Against Women

The right to gender equality is a fundamental principle of human rights law. Freedom from discrimination in the enjoyment of protected human rights is ensured in every major human rights instrument.

Denying women access to abortion is a form of gender discrimination.

• According to the Convention on the Elimination of All Forms of Discrimination against Women, "discrimination against women" includes laws that have either the "effect" or the "purpose" of preventing a woman from exercising any of her human rights or fundamental freedoms on a basis of equality with men.¹ Laws that ban abortion have just that effect and that purpose.
• Restricting abortion has the effect of denying women access to a procedure that may be necessary for their enjoyment of their right to health. Only women must live with the physical and emotional consequences of unwanted pregnancy. Some women suffer maternity-related injuries, such as hemorrhage or obstructed labor. Denying women access to medical services that enable them to regulate their fertility or terminate a dangerous pregnancy amounts to a refusal to provide health care that only women need. Women are consequently exposed to health risks not experienced by men.
• The discriminatory purpose of the restrictive abortion laws of a number of countries also bears examination. Laws that deny access to abortion, whatever their stated objectives, relegate women to their traditional roles as nurturers and mothers. The tendency to define women by their reproductive capacity remains highly prevalent throughout the world. Governments continue to downplay the importance of women's participation in the areas of political, economic, social, cultural, and civil affairs. In contrast, societies that have welcomed women's participation in affairs outside the home have increasingly recognized that reproductive decision-making is best left to women themselves.

Women's Right to Health Entitles Them to Safe Abortion

International law guarantees women the right to "the highest attainable standard of health."² Unsafe abortion can have devastating effects on women's health. Where death does not result from unsafe abortion, women may experience long-term disabilities, such as uterine perforation, chronic pelvic pain, or pelvic inflammatory disease.

Safe abortions services protect women's right to health.

• The World Health Organization defines "health" as "a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity."³ While the right to health does not guarantee perfect health for all women, it has been interpreted to require governments to provide health care and to work toward creating conditions conducive to the enjoyment of good health.⁴ In the context of abortion, this right to health can be interpreted to require governments to take appropriate measures to ensure that women are not exposed to the risks of unsafe abortion. Such measures include removing legal restrictions on abortion and ensuring access to high-quality abortion services.
• The Programme of Action adopted at the International Conference on Population and Development (ICPD) called upon governments to consider the consequences of unsafe abortion on women's health.⁵ It states that governments should "deal with the health impact of unsafe abortion as a major public health concern."⁶
• At the 1995 Fourth World Conference on Women, the international community reiterated this language and urged governments to "consider reviewing laws containing punitive measures against women who have undergone illegal abortions."⁷ In addition, in a paragraph addressing research on women's health, the Platform for Action urges governments "to understand and better address the determinants and consequences of unsafe abortion."⁸

Unsafe Abortion Threatens Women's Right to Life

The right to life is protected in multiple human rights instruments. It is widely acknowledged that in countries in which abortion is legally restricted, women seek abortions clandestinely, under conditions that are medically unsafe and therefore life-threatening. According to the World Health Organization, unsafe abortions are responsible for the deaths of 78,000 women each year.

Forcing a woman to undergo an unsafe abortion violates her right to life.

• Because unsafe abortion is closely associated with high rates of maternal mortality, laws that force women to resort to unsafe procedures infringe upon women's right to life.
• While the phrase "right to life" has been associated with the campaigns of those who oppose abortion, it has not been interpreted in an international setting to require restrictions on abortion.

* The Vienna Declaration
+ The Vienna Programme of Action

Endnotes

1 The Convention on the Elimination of all Forms of Discrimination Against Women, opened for signature Dec. 18, 1979, art. 1, 1249 U.N.T.S. 14 (entry into force Sept. 3, 1981) [hereinafter Women's Convention}.
2 International Covenant on Economic, Social and Cultural Rights, opened for signature Dec. 16, 1966, art. 12, 993 U.N.T.S. 3 (entry into force Jan. 3, 1976) [hereinafter Economic, Social and Cultural Rights Covenant].
3 World Health Organization, Definition of Health (last visited Feb. 17, 2000) .
4 Anika Rahman & Rachel Pine, An International Human Right to Reproductive Health Care, 1 Health and Human Rights 405, 406 (1995); Brigitte Toebes, The Right to Health as a Human Right in International Law 245-258 (1999).
5 Programme of Action of the International Conference on Population and Development, Cairo, Egypt, 5-13 September 1994, in Report of the International Conference on Population and Development, para. 8.25, U.N. Doc.A/CONF.171/13/Rev.1 (1995) [hereinafter ICPD Programme of Action.]
6 Id.
7The Beijing Declaration and The Platform for Action, Fourth World Conference on Women, Beijing, China, 4-15 September 1995, para. 106K, U.N. Doc.DPI/1766/Wom (1996) [hereinafter Beijing Platform for Action].
8 Id., para 109(I).
9 Universal Declaration of Human Rights, adopted Dec. 10, 1948, G.A. Res. 217A (III), U.N. Doc. A/810 (1948).
10 International Covenant on Civil and Political Rights, opened for signature Dec. 16, 1966, 999 U.N.T.S. 171, 6 I.L.M. 368 (entry into force March 23, 1976).
11 Economic, Social and Cultural Rights Covenant, supra note 2.
12 Women's Convention, supra note 1.
13 Convention on the Rights of the Child, opened for signature Nov. 20, 1989, G.A. Res. 44/25, 44 U.N.GAOR Supp. (No. 49), U.N. Doc. A/44/49, 28 I.L.M. 1448 (1989) (entry into force Sept. 2, 1990).
14 Vienna Declaration and Program of Action,World Conference on Human Rights, Vienna, Austria, June 14 -25, 1993., U.N. Doc. A/CONF.157/23, July 12, 1993.
15 ICPD Programme of Action, supra note 5.
16 Beijing Platform for Action, supra note 7.