by Marianne Mollmann, Amnesty International

October 20, 2011 – 9:30am

Restrictions on abortions just don’t work in that they don’t result in the desired outcome.  This is the predictable, yet bold, conclusion of a reportto be presented at the United Nations on Monday, October 24th by Anand Grover, a UN-appointed independent expert on health.  The report, which is part of an annual report-back from various human rights experts to the United Nations’ General Assembly, consolidates years of legal analysis and empirical evidence from other experts and concludes that abortion restrictions are unworkable and damaging to women’s health. Instead, the report advocates access to full, accurate, and complete sex education and information about contraception, as well as to all forms of modern contraception, because these services and state support for women’s equality actually do work to reduce the need for abortions.

Abortion restrictions are generally justified by reference to a desire to lower the number of terminations, be it by limiting access to abortion for all women, as in ChileEl Salvador, and Nicaragua, or just for the “undeserving,” as in most of the rest of the Americas including the United States. Some explicitly prefer pregnant women to die rather than having access to a life-saving abortion, but most refer to some sort of makeshift hierarchy of morals.

“Most people, of course, should have access free of charge,” a high school friend from Denmark told me the other day. “But women who just keep having abortions: there really should be some sort of punishment for them.”

I have heard this sentiment echoed so many times.  “Seriously, I believe in access to abortion,” a young Mexican friend told me. “But really women need to show a minimum of responsibility.” This friend had, in the course of the same conversation, told me he recently had a condom break during intercourse.  When asked if he believed the woman in that case, if she were to become pregnant, had shown the requisite minimum of responsibility he was confused and horrified.  Of course she should have access to an abortion.  At least they had tried.

These considerations about who, if anyone, deserves access to abortion are often at the core of public debate on the issue.  All but the most radical anti-choice activists would say that pregnant rape victims should have access, as well as those whose lives or health are threatened by the pregnancy.  This distinction between the vulnerable madonnas and the physically healthy sluts is, in fact, the bright line in determining public funding for abortion services in the United States today.

The truth of the matter is that abortion restrictions in law and policy have little if anything to do with how women and girls deal with their pregnancies.  Of the hundreds of women I have spoken to about their abortions, none mentioned the law as a deciding factor in whether or not to continue an unwanted or unhealthy pregnancy. Sure, the criminalization of abortion might be an impediment to getting a safe and timely abortion, but never a real barrier to getting one at all.

In fact, the only two questions policy-makers can helpfully ask themselves about their approach to abortion are 1) is it workable; and 2) does it actually work.

Most policies that allow only partial access to abortion for the “deserving” women are not all that workable. You need a process for determining the validity of rape claims, for example, and a solid definition of just how unhealthy a pregnancy needs to be to be unhealthy enough for the woman to be entitled to care.  In Ireland, where abortion is only theoretically legal for women who will die as a result of their pregnancy, a doctor asked me in visible distress: “How terminal does she have to be?  Can I help her if she has a 51 percent chance of dying, or does it have to be more?”

The notion proposed by my Danish friend—that irresponsible women who just have one abortion after another need to be punished—is equally unworkable.  How do you determine responsibility? And how many abortions are too many?  And what would be an appropriate punishment?  Carrying the pregnancy to term?  For many, the key moral question in the abortion debate is whether women who want their pregnancies terminated actually care.  But any policy based on a value-judgement on that count raises more ethical questions than it solves.  It is not workable.