Interview: Domestic
provider, international perspective
The U.S. Supreme Court decision striking down a Texas law placing
undue requirements on abortion clinics is a significant victory not only
for women in the United States, but for women around the world. It
highlights both the importance of women’s access to abortion and the
clear evidence that abortion is an extremely safe medical procedure.
Ipas Director of Clinical Affairs, Dr. Dalia Brahmi, is also a
practicing abortion provider in North Carolina. We asked for her
thoughts on the court’s most sweeping ruling on abortion in more than
two decades:
What was your immediate reaction to the ruling on the Texas law?
Brahmi:
I was struck by how this is a win for women everywhere—and for those
who genuinely want everyone to have access to health care, including
safe abortion. As a provider working in North Carolina and as a
physician who travels frequently to health clinics in many of the
countries where Ipas works, I am keenly aware that unnecessary barriers
to abortion are a threat to women’s health.
In its majority opinion, the court speaks at length about
the evidence pointing to the safety of abortion, noting that “many
medical procedures, including childbirth, are far more dangerous to
patients…”
Brahmi:
It was heartening to see the Supreme Court acknowledge so explicitly
that abortion is extremely safe and that complications from abortion are
rare.
Each year, Ipas publishes Clinical Updates in Reproductive Health
to give health-care providers around the world access to evidence-based
recommendations on abortion and postabortion care. And year after year,
the evidence about safety and low complication rates is very clear. In
the case of first-trimester abortion with vacuum aspiration, for
example, complication rates are under two percent, and serious adverse
events are very rare.
The backers of the Texas law said that the regulatory
restrictions it imposed were meant to improve the health and safety of
abortion – yet the court said there was no evidence indicating that even
one woman had received better treatment as a result of the law.
Brahmi: That’s
not surprising! In many countries around the world, governments have
placed—and are continuing to propose—unnecessary burdens on women
seeking abortion care, even though there is absolutely no evidentiary
basis for those requirements.
In countries where Ipas works, we routinely encounter regulatory
barriers that do not make abortion safer. Zambia is one example. There
is a great shortage of doctors in Zambia, especially in rural areas. Yet
the Zambian abortion law requires women seeking an abortion to obtain
the signatures of not just one doctor – but three. Complying with that
requirement is nearly impossible for many women and is contrary to
evidence compiled by WHO and promoted by Ipas that a range of trained
providers, including nurses and midwives, can safely provide abortion
care.
What happens when laws and government regulations overly restrict women’s access to abortion?
Brahmi: Laws
that restrict or criminalize abortion do not stop women from having
abortions – they deny women dignity and access to health care they
deserve. A recent study published in the The Lancet,
on the global incidence of abortion, said there is no association
between the rate of abortion and the grounds under which abortion is
legally allowed. In other words, if your goal is to keep women from
having abortions, restrictive laws don’t work! They simply force women
to have less safe abortions that may pose a risk to women’s health.
As Justice Ruth Bader Ginsburg wrote in her concurring opinion yesterday, “Given [these] realities, it is beyond rational belief that H. B. 2 could genuinely protect the health of women, and certain that the law would simply make it more difficult for them to obtain abortions.”
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