Leila Hessini Director, Community Engagement and Mobilization Ipas December 14, 2010

21 2 million unsafe ach year – affecting >100 million women during their reproductive lifetimes deaths per year, 93% in Africa and South-central Asia Over half of deaths are young women <24 Source: WHO, 2008

Estimated annual numbers of unsafe abortions (2008 Total = 21.2 million Latin America andCaribbean 4.2 million Africa 6.1 million Asia 10.8 million Europe 0.3 million (Source: WHO, 2008

 Close to 40% of pregnancies are unplanned  80 million unintended pregnancies each year (27 million as a result of method failure or ineffective use)  Preventing unintended is critical to reducing unsafe abortions

 14 million unintended in Africa  Various factors: sexual violence, pregnancy outside of marriage, lack of knowledge, access to or use of contraception  1/3 rd of all unintended end of aborted  Age pattern of unintended pregnancies is changing – many more young women

In addition to death, unsafe abortion can lead to: 1.7 million hospitalized annually Significant short- and long-term illness and injury to women Infertility Negative impacts on women, families, children, and communities Increased likelihood of death among children whose mother has died

Without Restriction as to Reason Socioeconomic Grounds To Preserve Mental Health To Preserve Physical Health Legally Permitted to Save a Woman's Life

 Treatment for unsafe abortion costs health systems up to $1 billion per year  OB/GYN hospital capacity often overwhelmed by post-abortion patients  Post-abortion care significantly more expensive than safe abortion (or contraception)  Unsafe abortion can also reflect the overall quality of health systems. WHO; Guttmacher

 Analysis of medieval Arabic texts  Compiling supportive fatwas  Supporting women religious leaders  Legal and policy reform  Health system change  Networking across regions

 Coitus interruptus encouraged others as long as there was mutual consent.  Abortion: debates regarding pregnant women’s circumstances; fetal age and analysis of if more harm would be caused by continuing or by ending the pregnancy.  Maternal life carried precedence over that of the foetus at least until “ensoulment” defined as occurring anywhere between 40, 90 or 120 days.

 Abortions after ensoulment were prohibited unless there was “just cause” – usually defined as saving a women’s life or their health  The lives of existing children were also considered more important than that of the fetus; breast-feeding women or mothers who could not afford another child were allowed to terminate a pregnancy.

 Algeria (1998) rape victims of Islamist violence  Egypt (1998) for unmarried women who had been raped  Saudi Arabia (1991) and Iran (2005) in cases of fetal abnormalities  Indonesia (2004) rape and incest

 Training women - mourshidat – Islamic scholars and spiritual guides  Working through the pesantren, - Muslim boarding schools – to incorporate information on SRHR into school curricula  Building global networks – musawah - gender equality in Islam

 Islam is a strong presence in women’s lives, but it does not necessarily govern women’s everyday reproductive and sexual choices  Women often rely on their belief in God’s compassion rather than on the opinions of religious authorities.  Women may simultaneously believe that abortion is “harem” but yet necessary and even justified  Young and unmarried women experience much more shame and stigma  Women’s social networks are an important source of information, transportation and resources for women seeking abortion care.

 Tunisia: and Tunisia: 1973 and 1982  Algeria (1985) and Benin (2003)  Burkina Faso (1996) and Chad (2002)  Djibouti (1995) and Guinea (2000)  Indonesia (1992) Iran (1991), Kuwait (1981), Mali (2002) Niger (2006),  Pakistan (1990), Saudi Arabia (1990) Sudan (1993) and Togo (2007).

 Menstrual regulation  Medical abortion  Training midlevel providers and midwives  Ensuring that women have knowledge, skills and ability to obtain safe abortion services  Ensuring that women have safe abortion information and care in their communities

 Compile existing resources into a database and toolkit  Develop training and capacity-building curricula for community education  Engender awareness and support from religious leaders and individuals at community level  Share experiences across countries (study tours)

About Law and Policy Gender & Rights Country – Specific Related Sites Tabs SEARCH Welcome! Intro Drop- Down Lists maybe We could use these side tabs to reorganize the resources in another conceptual manner, if need be, for example: Abortion, FP, Contraceptives, ETC. Standard contact links at the bottom SRH and Islam