Bush Attacks Reproductive Rights at UN Special Session on Children

The Bush administration wants a 10-year-old Bangladeshi girl who is married to just say "no" to sex. It tells overseas health care providers that it's appropriate to treat a woman who is hemorrhaging after an unsafe abortion, but that it is forbidden to ensure safe abortion services are available in the first place.

In essence, the Bush administration was advocating such regressive policies when it used strong-arm tactics to impose its abstinence-only education and anti-choice agenda upon the rest of the world in its campaign to undermine reproductive rights at the United Nations General Assembly Special Session on Children (Children's Summit) in May.

"It was appalling to witness our government callously disregard the reality facing millions of adolescent girls in the U.S. and around the world," said Katherine Hall Martinez, acting director of the Center for Reproductive Rights' international program. "As a result of the U.S.'s questionable diplomatic maneuvers, the world's governments lost an opportunity to come together and aggressively address the HIV/AIDS epidemic and unwanted pregnancies that continue to destroy the lives of millions of adolescent girls."

Fortunately, because advocates and progressive governments rebuffed the Bush agenda, the agreement brokered at the Children's Summit reaffirmed previous global agreements protecting adolescents' reproductive rights. However, additional proactive commitments to improve adolescents' reproductive and sexual lives were not adopted and the agreement fails to explicitly spell out what action governments should take to ensure the reproductive rights of adolescents.

Reportedly, the Bush administration was willing to use the threat of trade and aid reprisals if other nations, particularly in Latin America, did not endorse its anti-reproductive rights policy. The Bush administration's efforts to restrict sexual education and information to "abstinence-only until marriage" in the Children's Summit agreement was only defeated after Latin American, European and other industrialized countries held firm against the U.S. delegation.

The Bush administration has turned a blind eye to the glaring needs of adolescents for information and services to protect themselves from unwanted pregnancy and HIV/AIDS and other sexually transmissible infections.

The Bush administration allied itself with governments that it has consistently identified as human rights violators, including Sudan, Libya, Cuba and Iraq. What resulted was a compromise in which no one, least of all adolescent girls, emerged the victor. In the end, the U.S. agreed to retain references to reproductive and sexual health care, and in return was granted its bid to weaken references to the importance of the Convention on the Rights of the Child in the agreement.

At previous UN conferences, the consensus was that where abortion is legal, it should be safe. Nowhere in the Children's Summit agreement is there such language.

"Concerning references in the document to UN conferences and summits and their five-year reviews. The United States does not understand any endorsement of these conferences to be interpreted as promoting abortion," said U.S. Ambassador Sichan Siv at the UN following the Children's Summit.

He added that none of the language in the Children's Summit agreement, such as "reproductive health care," should be construed to include abortion, abortion-related services or the use of abortifacients.

The Bush administration's attacks on reproductive rights in the Children's Summit agreement has real consequences for adolescents. UN conferences are crucial to shaping an international consensus on issues such as adolescents' reproductive rights. International and local reproductive rights groups use agreements like the one brokered at the Children's Summit to lobby their governments for legal reform and for budget allocations that affect adolescents. Many countries have used these international agreements to help guide them in tackling pressing issues such as maternal mortality.

The Bush administration's views on abortion, sex education, and contraception totally disregard the reality that millions of the world's adolescents, particularly girls, face on a daily basis. The numbers do not lie.

• A pregnant adolescent under the age of 18 is two to five times more likely to die as a result of pregnancy than a pregnant woman between 18 and 25 years old.

• Worldwide, every minute, nearly 40 desperate women undergo an unsafe abortion; at least one-fourth of these women are girls aged 15 to 19.

• Fifty percent of all new HIV infections occur in young people aged 15 to 24.

• Up to 60% of HIV infections in young women occur by the age of 20.

• In Bangladesh a demographic and health survey in 1996-7 reported that 5% of 10 to 14 year olds were married.

• In rural Northern Ethiopia, the average age of marriage is 13.5 years for girls and 19.5 years for boys.

Few Hospitals Offer Emergency Contraception to Sexual Assault Victims

In May, a medical study confirmed the fears of many in the reproductive rights and health community: few U.S. hospitals are informing sexual assault victims about emergency contraception (EC).

The study released at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) found that just one in three U.S. hospitals routinely offer EC to sexual assault victims. In half of the emergency departments of 125 Pennsylvania hospitals surveyed, counseling on and the provision of EC to a rape victim depended on the personal beliefs of the doctor treating the patient. Approximately 5% of women who are raped in the U.S. become pregnant, which results in an estimated 25,000 unintended pregnancies each year, according to the study's author Dr. Ashlesha Patel, an obstetrician/gynecologist at the University of Illinois in Chicago.

"Emergency contraception should be readily available at hospitals for any woman who fears pregnancy following unprotected sex," said Janet Crepps, a Center for Reproductive Rights staff attorney. "It is unconscionable that women seeking medical care following a sexual assault would be denied this treatment because of ignorance, the personal objections of hospital personnel, or institutional restrictions. Any hospital that does not provide these women with information and meaningful access to emergency contraception is not providing adequate care."

According to the study, the situation is even worse in Catholic affiliated hospitals. Only 6% of Catholic hospitals offer counseling on and provide EC, compared to 38% of non-Catholic hospitals. Organizations often hide behind so-called "conscience" clauses to opt out of providing EC, claiming to have a religious or even moral objection to EC.

Last year, the Center for Reproductive Rights petitioned the U.S. Food and Drug Administration to make EC available over-the-counter. The Center for Reproductive Rights has also supported legislative efforts to establish the provision of EC to all rape victims as standard medical care, both in the U.S. and overseas. In April, Representative Connie Morrella (D-MD) introduced a bill in Congress to require hospitals to provide EC to sexual assault victims.

Some states have passed laws mandating the provision of EC to rape victims. Washington and Illinois require hospital emergency rooms to provide rape victims with EC while they receive medical treatment and evidence is gathered. In April, California's General Assembly, by a vote of 44-0, passed a similar bill. The bill is now with the California Senate.

EC prevents pregnancy via a two-dose regimen: the first dose is taken within 72 hours of intercourse, followed by a second dose taken 12 hours later. EC is most effective if the first dose is taken within 24 hours after unprotected sex. If the regimen is started within 72 hours of intercourse, the efficacy rates remain high. Preven and Plan B, both available brands of EC, reduce a woman's risk of pregnancy by approximately 75% and 89%, respectively.

Center for Reproductive Rights Fights Oklahoma Parental Consent Law

In May, the Center for Reproductive Rights was in court fighting an Oklahoma law that makes those who perform abortions on minors without parental consent liable for the cost of any subsequent related medical treatment of the minor. Of the 19 states enforcing parental consent laws, only Oklahoma does not allow a minor to go before a judge to bypass the parental consent regulation.

"This law fails even to provide exceptions for young women who may have been physically or sexually abused by a parent or who require emergency abortions to preserve their health or life," said Bebe Anderson, a Center for Reproductive Rights staff attorney and lead counsel in Nova Health Systems v. Fogarty, et. al.

On May 10, Anderson argued in U.S. District Court for the Northern District of Oklahoma in the challenge to determine the constitutionality of the law. The law is unclear in many respects, such as exactly how much information must be given to a parent or whether only one parent is required to have knowledge of or consent to the procedure. The law was passed on June 4, 2001, and was challenged four days later by the Center for Reproductive Rights and health care providers.

In Oklahoma, abortion services are alarmingly unavailable to most women, and this law threatens to further decrease the availability of this reproductive health service. There are no abortion providers in 95% of the counties in Oklahoma, and more than half of Oklahoma women of reproductive age live in counties with no provider.

Court Allows Louisiana Law Imposing 10-Year Unlimited Liability on Providers

A three-judge panel of the Louisiana First Circuit Court of Appeals reversed a decision blocking a statute that could make abortion services unattainable for women in Louisiana. Abortion providers sued the state charging that the law would essentially ban abortions in Louisiana. The law, which holds physicians liable for any civil damages caused by an abortion, including damage to an "unborn child," for up to ten years after the procedure is performed. The Center for Reproductive Rights, which represents the abortion providers, will continue to pursue the appeal, ensuring that the decision will not immediately become final.

"By declining to consider the merits of the challenge, the court gives the State of Louisiana carte blanche to craft bans on abortion by placing enforcement power in the hands of private parties," said Priscilla Smith, acting director of the Center for Reproductive Rights' domestic program and counsel for the plaintiffs in Women's Health Clinic v. State of Louisiana.

Due to the law's ambiguous provisions, physicians providing abortions, who are singled out from all other specialists, are given no guidelines on avoiding liability and are trapped by the threat of unlimited legal and financial claims. Under the statute, women can sue for up to a decade for "damage" to the "unborn child", defined as from the moment of conception, or any harm to themselves, such as depression or regret over their decision, they believe resulted from the abortion.

Arizona Supreme Court Reviews Ban on Abortion Funding for Low-Income Women

In April, the Center for Reproductive Rights argued in Arizona's Supreme Court that the state's ban on funding medically necessary abortions in its Medicaid program violates protections afforded by the Arizona Constitution. The Center for Reproductive Rights argued that the ban, which was upheld by the Arizona Court of Appeals last year, violates women's right to privacy and to equal treatment under the law.

"The State is selectively excluding women who medically require abortions in order to protect their health from the very program designed to meet the health needs of Arizona's indigent citizens," said Bebe Anderson, a staff attorney with the Center for Reproductive Rights, which represents the plaintiffs in Simat Corp. Arizona Healthcare Cost Containment System Administration v. Hull.

There are many reasons why abortions can be medically necessary for women. Women with pre-existing health conditions including heart disease, diabetes, and epilepsy may endanger their health if they carry their pregnancy to term. Other women must take medication or receive treatments such as chemotherapy, which pose a risk to the fetus, forcing the woman to endanger her health or the health of the fetus if she continues her pregnancy.

Pakistani Law Discriminates Against Rape Victims

Imagine this scenario. A married woman is raped. When she attempts to seek justice against her attacker, the police do not charge him with a crime, but instead charge the woman with adultery and sentence her to death by stoning.

This is not a nightmare. It is reality for a 26-year-old Pakistani woman who alleges she was raped by her brother-in-law, but has been sentenced to death by stoning for adultery, and a frightening example of how discriminatory laws can turn the victim into the accused.

This woman's injustice is a product of discriminatory laws enacted by a former military ruler of Pakistan. In 1979, General Zia-ul-Haq, Pakistan's military leader, enacted the Hudood Ordinances, under the guise of making Pakistan's laws consistent with Islamic teachings. Among these ordinances is the Zina Ordinance, which criminalizes sex outside of marriage, or zina. If a woman brings a rape charge, but cannot prove it, the law exposes her to prosecution for the offense of zina. As many as 80% of all women in Pakistani jails were convicted for crimes related to bans on sex outside of marriage, according to Aurat, a Pakistani non-governmental organization.

"The Hudood Ordinances have had disastrous consequences for women's reproductive health and well-being by silencing survivors of sexual crimes and punishing those who come forward to seek justice," said Melissa Upreti, the Center for Reproductive Rights' legal advisor for Asia. "These laws are inherently discriminatory and must be repealed. As long as these laws remain in force, the Pakistani government shall be guilty of violating women's human rights guaranteed under international law and Pakistan's constitution."

Beyond the fear of having a rape charge turned against them, rape victims who want to take their attackers to court are up against highly discriminatory evidentiary requirements. To seek the highest level of punishment for their attacker, death by stoning, the law requires that four "pious" adult Muslim men testify that the woman was raped or that the accused must confess. Only when the victims seek a lower level of punishment, up to 25 years in prison and 30 lashes, does the testimony of any woman or the victim bear any legal weight.

High evidentiary requirements are not the only deterrent for rape victims who want to press charges. Rape victims can be charged with a false accusation of zina, known as qazf, if they cannot make their case. The offense of qazf is punishable with up to 80 lashes. In addition, laws against statutory rape have been repealed and there is no specific law against incest. Marital rape is not considered a criminal offense either.

Even before rape victims navigate Pakistan's discriminatory laws, they face biased, incompetent and corrupt law enforcement and medical and criminal justice systems, which only serve to increase the odds against them obtaining justice against their attackers.

"Sexual violence victims' first contact with the law enforcement system generally occurs at the police station," according to a 1999 Human Rights Watch report on violence against women in Pakistan. "Here, right from the start, they typically encounter rejection of their complaints and harassment."

The chilling effect of these laws is stark. According to Amnesty International, only about 5% of rape and "honor" crimes are reported to authorities, with less than 10% of rape cases in Pakistan ever making it to trial.

Many Pakistani women have accepted domestic and sexual violence as a part of life. Surveys have shown that 42% of women accepted violence as a part of their fate and more than 33% felt too helpless to stand up to it. The Human Rights Commission of Pakistan, a non-governmental organization, estimates that of the average eight women raped each day in Pakistan, five are below the age of 18, and more than two-thirds are victims of gang-rape.

In the end, Pakistani women face a legal system that is horribly biased against them, making it nearly impossible for them to turn to the law for protection against sexual violence.

The Center for Reproductive Rights will examine the impact of Pakistan's brutal laws and policies on women's reproductive rights in our "Women of the World: South Asia" report, which is expected to be released later this year.

UPDATE: Pakistani Court Acquits Woman Sentenced to Death for Adultery On June 6, Pakistan’s highest Islamic court acquitted a woman sentenced to death by stoning for adultery. A three-judge panel of the federal shariah court in Islamabad reversed a lower court’s ruling sentencing the woman, Zafran Bibi, to death by stoning for adultery or zina, which is a considered a crime under Pakistan’s Hudood Ordinances. Bibi was charged with adultery after she told authorities that her brother-in-law had raped her. The lower court convicted her for adultery after she gave birth to a son while her husband was in prison. "Zafran Bibi’s acquittal is incredible news, but her case does nothing to address the discriminatory nature of the Hudood Ordinances," said Melissa Upreti, the Center for Reproductive Rights' legal advisor for Asia. "Until these laws are repealed, women will continue to be victimized for crimes committed against them." She added, "Justice will not be served until Bibi’s attacker is held accountable and all women can rely on Pakistan’s laws to protect them from domestic and sexual violence." The Pakistani government has an obligation under domestic and international law to repeal the Hudood Ordinances. Pakistan’s constitution prohibits discrimination on the basis of sex alone. Pakistan is also a party to the Convention on the Elimination of Discrimination against Women (CEDAW) which calls upon governments to remove laws that discriminate against women. Pakistan ratified CEDAW in April 1996. "Bibi’s acquittal does not absolve the Pakistani government and the courts from their legal responsibility to other women prosecuted under discriminatory laws," said Upreti.

Polish Woman Sues Doctors Who Denied Her Prenatal Tests

In Poland, a case is shedding light on how restrictive abortion laws can lead medical providers to deny women crucial reproductive health care.

A Polish woman, known as Barbara, is suing two doctors who denied her an amniocentesis. She needed the prenatal test in order to determine if the fetus suffered from a debilitating genetic disease that affects her four-year-old son. Under Polish law, if the test had shown "irreversible damage of the embryo or incurable illness threatening the life," then Barbara would have been entitled to a legal abortion. The doctors, knowing Barbara's first child suffered from a disease that causes severe pain, disfigurement of the joints, and underdevelopment of limbs, refused to give her referrals for prenatal testing to deny her the basis to seek a legal abortion.

Barbara's experience was first publicized at a mock abortion tribunal organized by FWFP and the Center for Reproductive Rights last summer in Warsaw. From left to right: Wanda Nowicka, FWFP; Christina Zampas, Center for Reproductive Rights; Francoise Girard, IWHC.

"It is clear that even under the limited circumstances in which women are entitled to a legal abortion in Poland, women are being denied access to the service," said Christina Zampas, the Center for Reproductive Rights' legal advisor for Europe. "Women are permitted to undergo an abortion procedure if there is fetal impairment, but when doctors and hospitals deny pregnant women prenatal tests, they deny women their legal rights. This case seeks the enforcement of already existing law."

Poland has one of the most restrictive abortion laws in the world; other than cases of fetal deformity, a woman can have an abortion in only two other circumstances:

• When pregnancy constitutes a threat to life or health of the pregnant woman, which is confirmed by a doctor other than the one performing the abortion, and

• There is justified suspicion, confirmed by a prosecutor, that the pregnancy is a result of an illegal act.

Barbara later gave birth to a daughter with the same disease that afflicts her son. She and her husband are struggling to support the medical needs of their children, according to the Federation for Women and Family Planning (FWFP), the Center for Reproductive Rights' partner organization in Poland. Barbara is suing the doctors for 1.4 million Polish Zloty or roughly $350,000. At the moment, there is no official date for the start of the trial.

Barbara's experience was first publicized at a mock abortion tribunal organized by FWFP and the Center for Reproductive Rights last summer in Warsaw. The mock tribunal was convened to let Polish women tell about their struggle to exercise their reproductive rights. The tribunal consisted of seven real-life stories of women's experiences of trying to obtain abortions. The Center for Reproductive Rights' "Women of the World: East Central Europe" explores how Poland's laws and policies affect women's reproductive rights.

British Court Rejects Anti-choice Challenge to EC

In April, a British High Court judge forcefully rejected an anti-choice group's claim that allowing emergency contraception (EC) to be dispensed by pharmacists without a prescription was equivalent to "procuring a miscarriage" in violation of the terms regulating abortion under British law.

Justice James Munby called the group's claim erroneous. He stated that the case did not only concern emergency contraception, but also "any form of birth control which may have the effect of discouraging a fertilized egg from implanting in the lining of the womb - that is to say, not merely the morning after pill but also IUDs, the mini-pill and even the pill itself."

Justice Munby said there would be something "grievously wrong" if a judge "in 2002 were to be compelled by a statute 141 years old to hold what thousands, hundreds of thousands, indeed millions of ordinary, honest, law-abiding citizens have been doing day-in, day-out for so many years is and always has been criminal."

He added, "I cannot see that it is any part of the responsibilities of public authorities, let alone criminal law, to be telling adult people whether they can or cannot use contraceptive devices of the kind which I have been considering."

Last year, British Health Secretary Alan Milburn allowed women over the age of 16 to buy EC directly from the pharmacist.

"This decision is a forceful affirmation of a policy that helps put EC in the hands of women who need it," said Laura Katzive, legal advisor for global projects in the Center for Reproductive Rights' international program. "Its clear articulation of the law and science relating to EC can bolster the position of advocates in other countries who are working to persuade their governments to make EC more widely available."

European Parliamentarians Convene to Give Perspective on Global Gag Rule

As part of continued efforts to advocate for the repeal of the "global gag rule" (GGR), the Center for Reproductive Rights is bringing together several European parliamentarians to express their view of this anti-choice policy.

The parliamentarians will convene on June 4 for a congressional briefing in Washington D.C. to discuss how the GGR affects their countries' foreign assistance programs. The GGR restricts overseas non-governmental organizations that receive U.S. family planning assistance from using their own funds to provide legal abortions, and prohibits these groups from counseling on abortion and participating in any activities to support abortion law reform, again even with their own funds.

"Through the global gag rule, the Bush administration is 'federalizing' other donor country's activities and violating universal principles guaranteeing freedom of speech and democratic participation," says Julia Ernst, Center for Reproductive Rights legislative counsel. "The policy would clearly be unconstitutional if directly applied to U.S.-based non-governmental organizations, and creates a hypocritical double standard."

The GGR goes far beyond gagging U.S. groups: it also compromises the foreign aid programs of other donor countries, including our European allies. These countries are prohibited from partnering with foreign organizations on projects - such as training to reduce the number of women dying from unsafe abortions - if those organizations also receive U.S. family planning assistance. In effect, the U.S. is gagging our allies.

The panelists for the event include:

• Tony Worthington: Member of the House of Commons from the United Kingdom; Member of the Select Committee on International Development; Member of the UK All-Party Parliamentary Group on Population, Development and Reproductive Health.

• Ulla Sandbaek, PhD: Member of the European Parliament from Denmark; Member of the Committees on Development, Environment, and Women; Vice-Chair of the Inter-European Parliamentary Forum on Population and Development; Chair of the Working Group on Population, Sustainable Development and Reproductive Health; Lutheran Minister.

• Mikhail Rafaelovitch Rokitzsky, PhD, MD: Member of the State Duma Russian Federation; Deputy Chair of the Committee on Health and Sports Issues; Deputy Chair of the Committee on Ethics; Vice-Chair of the Commission on Population.

• Ans Zwerver: Member of Senate of the Netherlands; Author of Motion for Resolution condemning the Global Gag Rule in the Council of Europe Parliamentary Assembly.

The International Planned Parenthood Federation - European Network and Planned Parenthood Federation of America are co-sponsors of the event.

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