Self-managed abortion: law, policy and medical evidence

Congratulations and thanks to Patty Skuster, Heidi Moseson and Jamila Perritt, whose article was recently published in the “Ethical and Legal Issues in Reproductive Health” section of the International Journal of Gynecology and Obstetrics. Prof. Skuster holds the Beck Chair in Law at the Beasley School of Law at Temple University, Dr. Moseson is Senior Research Scientist at Ibis Reproductive Health, and Dr. Perritt is President and CEO of Physicians for Reproductive Health. We are pleased to circulate the abstract of their co-authored article, which is now freely accessible online. 

Patty Skuster, Heidi Moseson and Jamila Perritt, “Self managed abortion:  aligning law and policy with medical evidence,” International Journal of Gynecology and Obstetrics 160.2 (February 2023): 720-725. Abstract and Article.  

ABSTRACT: People have always and will always find ways to try to end their pregnancies when necessary. Many do so safely without the involvement or direct supervision of healthcare professionals by self-managing their abortions. In 2022, the well-established safety and efficacy of abortion medications prompted WHO to fully endorse self-managed medication abortion as part of a comprehensive range of safe, effective options for abortion care. But despite robust evidence supporting the safety and effectiveness of the self-use of medications for abortion, abortion laws and policies around the world remain at odds with clinical evidence and with the realities of self-managed medication abortion in the present day. The present article considers legal issues related to self-managed abortion and addresses the role of obstetricians, gynecologists, and other healthcare professionals in promoting clinical and legal safety in abortion care through support of self-managed abortion.

RELATED RESOURCES

World Health Organization, Abortion Care Guideline, 2022. Online here.

“The WHO Abortion Care Guideline: Law and Policy–Past, Present and Future,” by Joanna N. Erdman, in International Journal of Gynecology and Obstetrics, 162.3 (Sept 2023): 1119–1124. . Abstract and Article. 

Ethical and Legal Issues in Reproductive Health, more than 110 concise articles are online here.
__________________________________________________________________________
Contributed by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of this blog, then check your email to confirm the subscription.

Italy: Hyper-Regulation of Abortion Care

Congratulations and thanks to Dr. Elena Caruso, whose article on “The Hyper-Regulation of Abortion Care in Italy” was recently published in the International Journal of Gynecology and Obstetrics‘ “Ethical and Legal Issues in Reproductive Health” section, edited by Professors Rebecca J. Cook, Bernard M. Dickens and Charles G. Ngwena. The author, Elena Caruso, is an Italian legal scholar who completed a doctorate in Law at Kent University and who now holds an AMTD Waterloo Global Talent Postdoctoral Fellowship at the University of Waterloo in Ontario, Canada. We are pleased to circulate the following abstract of this article, which is now fully available online in both English and Italian:

The Hyper-Regulation of Abortion Care in Italy, by Elena Caruso in International Journal of Gynecology and Obstetrics 163.3 (December 2023):1036-1042.  PDF at Wiley Online.  Italian translation.

ABSTRACT: This paper argues that the current abortion regulation by Law 194/1978 is an inadequate basis for the provision of good quality abortion care and must be reformed. First, the paper explains why Law 194/1978 creates a hyper-regulatory regime that is inconsistent with the best clinical evidence and practices in the field as well as relevant international human rights law, as outlined in the World Health Organization’s (WHO) 2022 Abortion Care Guideline. Second, it highlights gaps between what the law says and what happens in practice, pointing out how the everyday life of Law 194/1978, especially in the practices of gynecologists, is far removed from international standards of quality abortion care and has yet to comply with international human rights law. Third, it sets out some alternative routes to abortion access “outside” Law 194/1978. Finally, it concludes with some suggestions for a change in the practice of gynecology and a call for the reform of Law 194/1978, in favor of a bodily autonomy model of regulation grounded on decriminalization, demedicalization, dehospitalization, and self-management to ensure compliance with the WHO standards and international human rights law.

The entire paper is now freely available in English and Italian: English article PDF.  Italian translation.

RELEVANT RESOURCES:

Law 194 of 1978: an English translation of this Italian law is online here.

The WHO Abortion Care Guideline: Law and Policy–Past, Present and Future,” by Joanna N. Erdman, in International Journal of Gynecology and Obstetrics162.3 (Sept 2023): 1119–1124.   PDF at Wiley Online. 

Abortion Law Decisions webpages, now updated in English and in Spanish.

Ethical and Legal Issues in Reproductive Health – more than 110 other concise articles are online here.
________________________________________________________________________________________
Contributed by: The International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of this blog, then check your email to confirm the subscription.

Mexico: Supreme Court decriminalizes abortion

Congratulations to Leticia Bonifaz Alfonzo and Rosalba Mora Sierra, whose article on the 2023 decriminalization of abortion by the Mexican Supreme Court was recently published in the “Ethical and Legal Issues” section of the International Journal of Gynecology and Obstetrics, and is now freely available. Leticia Bonifaz Alfonzo, a member of the UN CEDAW committee, is affiliated with the National Autonomous University of Mexico (UNAM) in Mexico City. Rosalba Mora Sierra is Director of Access to Justice at the General Unit of Scientific Knowledge and Human Rights, Mexican Supreme Court in Mexico City. The article is now freely available online:

Leticia Bonifaz Alfonzo and Rosalba Mora Sierra, “Decriminalization of Abortion by the Mexican Supreme Court,” International Journal of Gynecology and Obstetrics 165.1 (April 2024): 375–381. 
Article and Abstract Online.  Spanish translation of Abstract by CLACAI .

ABSTRACT: In September 2021, the Mexican Supreme Court issued a decision disallowing any federal or local judicial authority to indict someone for the offense of voluntary or consensual abortion. This decision also declared unconstitutional penalties imposed on medical personnel who facilitate or assist such procedures. Furthermore, the Court decided that limiting access to abortion in cases of rape to a specific time frame was disproportionate. Later on, in September 2023, the Supreme Court confirmed that absolute criminalization of abortion was unconstitutional and declared that the rule supporting criminalization in the Federal Penal Code was without effects. Consequently, healthcare providers who work in public federal health institutions cannot be criminalized for guaranteeing the right to abortion. This article reviews the reasons advanced by the Supreme Court to guarantee the right of reproductive self-determination, as well as the effects of both decisions beyond the decriminalization of abortion by Mexican federal and state legislatures. The paper also examines the scope and limitations of these rulings and identifies the remaining challenges regarding voluntary abortion procedures in Mexico.

The entire article can be read or downloaded here: Article and Abstract Online. 

Spanish translation of Abstract by CLACAI.

OTHER RELEVANT RESOURCES:

The new Mexican decision: Suprema Corte de Justicia de la Nación [Supreme Court], 2023. Review of Constitutional Protection. Amparo en revisión 267/2023. Sept. 6, 2023.Speaker: Justice Ana Margarita Ríos Farjat. Decided in the session of September 6, 2023. Official Press release in Spanish.  Decision in Spanish. 

“Recursos Jurídicos” del RepoCLACAI – For a comprehensive and searchable database of legal resources on abortion care in Latin America, visit the Legal Section of the CLACAI Repository “Recursos Juridicos” online.

Abortion Law Decisions webpages, now updated in English and in Spanish.

Ethical and Legal Issues in Reproductive Health – more than 110 other concise articles are online here.
________________________________________________________________________________________
Contributed by: The International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of this blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – 2023-24

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS

[Argentina, preventable maternal death,”obstetric violence”] Britez Arce et. al. v. Argentina. (Inter-American Court of Human Rights, November 16, 2022). Decision in English. Decision in Spanish. Press Release Jan 18, 2023. Comment by CRR. [Earlier: Merits report by the Inter-American Commission on Human Rights (Report 236/19, Case 13.002. Report in English-download.)

[Bolivia, rape of a minor, revictimization] Losado v Bolivia (Inter-American Court of Human Rights, November 18, 2022) English press release Jan 19, 2023 Summary in Spanish. Decision in Spanish. The Court held Bolivia responsible for gender and child discrimination, and revictimization of an adolescent victim of sexual violence during the judicial process.

[Colombia, abortion decriminalized] Sentencia C-055-22.  Expediente D-13.956. Demanda de inconstitucionalidad contra el artículo 122 de la Ley 599 del 2000. (Constitutional Court of Colombia, February 21, 2022). Decision in Spanish (414 pages).  Backup decision in Spanish.  Unofficial English translation. 27-page Spanish press release.  English summary of Press Release.  1-page Spanish press release. [Abortion is decriminalized within 24 weeks of gestation, and thereafter permitted on specified grounds.] 

[El Salvador, abortion, anencephaly] Beatriz v. El Salvador, Case 13-378, Report No. 09/20, Inter-Am. C.H.R. (2020) (Inter-American Commission of Human Rights, January 5, 2022): Report in Spanish. Case Summary in Spanish.  Press release in English. [Woman with lupus and kidney failure denied abortion for fetus with anencephaly.] Inter-American Court of Human Rights held hearings in March 2023.

France made abortion a fundamental constitutional right. March 4, 2024. Parliamentarians voted to revise the country’s 1958 constitution to enshrine women’s “guaranteed freedom” to abort. News report in English.

[Mexico, Abortion decriminalized], Suprema Corte de Justicia de la Nación [Supreme Court], 2023..Review of Constitutional Protection. Amparo en revisión 267/2023. Sept. 6, 2023. Speaker: Justice Ana Margarita Ríos Farjat. Decided September 6, 2023. Official Press release in Spanish.   [Abortion is decriminalized throughout Mexico.]

[Northern Ireland, UN CEDAW] Report of the Inquiry concerning the United Kingdom of Great Britain and Northern Ireland under article 8 of the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination against Women, (2018) U.N. Doc. CEDAW/C/OP.8/GBR/1  Original CEDAW 2018 report.  Comments by Clare Pierson. [abortion, a crime in Northern Ireland following sections 58 and 59 of the Offences Against Persons Act 1861, was legalized in 2020.]
—Follow-up report submitted by the United Kingdom of Great Britain and Northern Ireland, 16 January 2023, published March 14, 2023 as CEDAW/C/OP.*/GBR/3/Add.1.  Followup report in different formats, English, French and Spanish.  [Among other reforms, Northern Ireland established a Gender Equality Strategy Expert Advisory Panel whose Report of December 2020 is online here]. 

[Peru, UN Committee on the Rights of the Child] Camila v. Peru, Communication No. 136/2021.U.N. Doc CRC/C/93/D/136/2021 (June 13, 2023) Decision online in Spanish, Arabic and Russian.  Decision in English (May 25, 2023, *unofficial draft). Case note by Godfrey Kangaude.  [Child raped by her father. Ruling: Peru violated child rape victim’s rights by failing to guarantee access to abortion and criminally prosecuting her for self-abortion.]

[Peru, child marriage] Ley N.º 31945 to prohibit and eliminate any possibility of marriage with minors under the age of 18 was promulgated on 25 November 2023. Prior to the new legislation, Article 42 of Peru’s Civil Code permitted adolescents to marry from the age of 14 under certain conditions, with consent from at least one parent, despite the minimum legal age of marriage being 18 years for girls and boys. Context in English.

[Poland, ECtHR ruled against fetal abnormality abortion ban] M.L. v. POLAND (Application no. 40119/21) (European Court of Human Rights, December 14, 2023) [Woman forced to travel for abortion of malformed fetus. Court found violation of ECHR Article 8 (right to respect for private and family life) of the ECHR, following a 2020 Constitutional Court ban on legal abortion in case of foetal abnormalities. Press release. Decision of 14 Dec 2023.

[Poland, fetal abnormality risk, inadmissible] A.M. and others v. Poland (application no. 4188/21, 4957/21, 5014/21,5523/21, 5876/21, 6114/21, 6217/21, 8857/21) (European Court of Human Rights, May 16, 2023) ruled these 8 cases inadmissible because each applicant could not claim to be a victim of a violation of the ECHR owing to risk of a future violation. Press Release. Decision of 16 May 2023.

[Spain, access to abortion information] Tribunal Supremo de España, Sala Tercera, de lo Contencioso-administrativo, Sección 4ª, S 1231/2022, 3 Oct. 2022 (Rec. 6147/2021)  Decision in Spanish.  Spanish backup copy.  Decision in English.  English backup copy. [The Government cannot block public access to a website containing information or opinions without judicial authorization.  This includes the site of Women on Web, which discusses access to abortion.

[Turkey, abortion for rape victim], [Case of] R.G. [GK], B. No: 2017/31619, 23/7/2020,.July 23, 2020. (Grand Chamber of the Turkish Constitutional Court)   27-page decision in Turkish. Backup copy. Official press release in English. Backup copy.  Comment  in English on IACL/AIDC Blog. Article in English from a Turkish Journal of Constitutional Law  [procrastination after rape victim applied for abortion violated the right to protect one’s corporeal and spiritual existence (provided under Article 17 of Turkish Constitution.

[UK – challenge to fetal abnormality ground for abortion] R (on the Application of Crowter and Ors) v Secretary of State for Health and Social Care EWCA Civ 1559 Case No: CA-2021-000314 (UK Court of Appeal (Civil Division) London, 25 Nov., 2022, Judgment summary. Decision online.  [UK legislation allowing abortion for substantial risk of a born child’s serious handicap (such as Down syndrome) is not incompatible with disabled persons’ human rights to respect for their private and family life and to nondiscrimination.] This was an appeal of [2021] EWHC 2536 (Admin) Case No. CO/2066/2020 (High Court of Justice, Queen’s Bench Division, London) Sept 23, 2021.  Judgment and summary.    [fetus has no established rights under the European Convention on Human Rights (ECHR), so UK abortion law allowing legal abortions in cases of severe fetal abnormalities is compatible with ECHR.]

[Venezuela, obstetric violence] Inter-American Court of Human Rights – Case of Rodríguez Pacheco et al. v. Venezuela. Preliminary Objections, Merits, Reparations and Costs. Judgment of September 1, 2023. Series C No. 504. Press release in English. Official Summary in Spanish. 82-page judgment in Spanish. Download partial dissent by Judge Sierra Porto. Download: partial dissent by Judge Pérez Goldberg. The Court ruled that Venezuela is responsible for deficiencies in Judicial Proceedings on a Complaint of acts of obstetric violence and medical malpractice that took place in a private hospital.

SCHOLARSHIP

[comparative abortion law] Rebecca J. Cook and Bernard M. Dickens, “Abortion,” in Jan M. Smits, Jaakko Husa, Catherine Valcke and Madalena Narciso, eds., Elgar Encyclopedia of Comparative Law, 3rd ed., (Cheltenham, UK: Elgar Publishing, 2023), 3-11. Abstract online here. Full text and PDF online

[abortion law, Colombia] “The new Colombian law on abortion,” by Isabel C Jaramillo Sierra, International Journal of Gynecology and Obstetrics 160.1 (January 2023): 345-350.  Abstract and Article. 

[abortion law and policy] “Self managed abortion: aligning law and policy with medical evidence,” by Patty Skuster, Heidi Moseson and Jamila Perritt, in International Journal of Gynecology and Obstetrics 160.2 (February 2023): 720-725. Abstract and Article.  

[abortion law and policy, guideline] “The WHO Abortion Care Guideline: Law and Policy–Past, Present and Future,” by Joanna N. Erdman, in International Journal of Gynecology and Obstetrics, 162.3 (Sept 2023): 1119–1124. Abstract and Article.  WHO Abortion Care guideline, 2022.

[adolescents, Africa] “Integrating child rights standards in contraceptive and abortion care for minors in Africa,” by Godfrey Dalitso Kangaude, Catriona Macleod, Ernestina Coast and Tamara Fetters, International Journal of Gynecology & Obstetrics 159.3 (December 2022): 998-1004.   Abstract and Article.

[Africa, Zimbabwe, rewrite abortion decision, gender equality] Charles Ngwena and Rebecca J. Cook, “Restoring Mai Mapingure’s Equal Citizenship,” In: Rebecca J. Cook, ed., Frontiers of Gender Equality: Transnational Legal Perspectives (University of Pennsylvania Press, 2023). Abstract online.  Book available here. Introduction to the book (by Rebecca Cook).

[gender equality, health, CEDAW GR 24] “Gender Equality in Health Care: Reenvisioning CEDAW General Recommendation 24,” by Joanna N. Erdman and Mariana Prandini Assis, in Frontiers of Gender Equality: Transnational Legal Perspectives, ed. Rebecca J. Cook (University of Pennsylvania Press, 2023). Abstract online in English. Portuguese translation of this chapter. Book available here. Introduction to the book (by Rebecca Cook).

[gender equality] Rebecca J. Cook, “Many Paths to Gender Equality,” Introduction to: Frontiers of Gender Equality: Transnational Legal Perspectives (University of Pennsylvania Press, 2023). Introduction online.

[infertility] “”Human Rights Approaches to Reducing Infertility,” by Payal K. Shah and Jaime M. Gher, in International Journal of Gynecology and Obstetrics.162.1 (July 2023): 368–374.  Abstract and Article. 

US-focused news, resources, and legal developments are available  on Repro Rights Prof Blog. View or subscribe.

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.

______________
Contributed by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

Colombia’s new law on abortion

Congratulations and thanks to Isabel C Jaramillo Sierra, a Professor of Law at the Universidad de los Andes in Bogotá. As she explains in “The new Colombian law on abortion“ published in the Ethical and Legal Issues in Reproductive Health section of the International Journal of Gynecology and Obstetrics, the new law authorizes abortions on request up to week twenty-four and on an indications model for the remaining weeks of pregnancy. We are pleased to circulate the following abstract:

“The new Colombian law on abortion,” by Isabel C Jaramillo Sierra, International Journal of Gynecology and Obstetrics 160.1 (January 2023): 345-350.  PDF at Wiley Online.  Spanish translation of abstract by CLACAI.

Abstract: On February 21, 2022, the Colombian Constitutional Court decided that the existing regulation of abortion was unconstitutional and repealed it (Sentencia C-055/2022). The new abortion law, as per the Court’s decision, considers the voluntary interruption of a pregnancy a crime only when it happens after week twenty-four and does not fall under the health, rape or malformation indications developed through precedent from 2006 to 2022. The decision is generally binding and of immediate application. The decision’s rationale builds on the right to health, substantive equality, and freedom of conscience. It acknowledges severe restrictions in access to abortion faced by Colombian women and the costs these restrictions have on their lives. It also recognizes that the indications model forces women to obtain permission from medical doctors to access abortion, and thus fails to recognize women’s freedom of conscience.

Keywords: Colombian Constitutional Law; Colombia judgment Sentencia C-055/2022; Right to health; Right to equality; Freedom of conscience; Criminal law as last resort; Reproductive health

RELATED RESOURCES:

The decision: Corte Constitucional [Constitutional Court] February 21, 2022, Sentencia C-055-22.  Expediente D-13.956. Demanda de inconstitucionalidad contra el artículo 122 de la Ley 599 del 2000. Decision in Spanish (414 pages).  Backup decision in Spanish.  Unofficial English translation. 27-page Spanish press release.  English summary of Press Release.  1-page Spanish press release.. [Abortion is decriminalized within 24 weeks of gestation, and thereafter permitted on specified grounds.] 

Abortion Law Decisions webpages, now updated in English and in Spanish.

“Recursos Jurídicos” del RepoCLACAI – For a comprehensive and searchable database of legal resources on abortion care in Latin America, visit the Legal Section of the CLACAI Repository “Recursos Juridicos” online.

Ethical and Legal Issues in Reproductive Health – more than 110 other concise articles are online here.
________________________________________________________________________________________
Contributed by: The International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of this blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – Autumn 2022

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS

COLOMBIA: Corte Constitucional [Constitutional Court] February 21, 2022, Sentencia C-055-22.  27-page Spanish communicado.  27-page unofficial English translation.  Nota de Prensa (Spanish).   Download unofficial English translation.  (Abortion is decriminalized within 24 weeks of gestation.]

INTER-AMERICAN COURT OF HUMAN RIGHTS – EL SALVADOR Manuela et al. v. El Salvador,  Inter-Am. Ct. H.R. (ser. C) No 441. (November 2, 2021).  Decision in English.. Backup copy. Decision in Spanish.  Backup copy in Spanish..Comment by Centre for Reproductive Rights.  [El Salvador was held accountable for the arbitrary detention, torture, and conviction of a woman after obstetric emergency and loss of pregnancy in 2008. Convicted of “aggravated homicide.” Two years later, Manuela died from cancer, in prison.]

KENYA: PAK & Salim Mohammed v. Attorney General & 3 Others (Constitutional Petition E009 of 2020) [2022] KEHC 262 (KLR) (24 March 2022) (High Court of Kenya at Malindi)  Decision online.   Backup copy.    Press release by CRR. [Abortion care is a fundamental constitutional right. Arrests of patients and clinicians are illegal. Parliament is directed to align law and policy with the Constitution.]

MEXICO: AI 148/2017 Suprema Corte de Justicia de la Nación 2021,  Acción de inconstitucionalidad AI 148/2017, Sept 7, 2021  Decision in Spanish.   News report in English.   Official press release in Spanish.  Official press release in English.  [Criminalizing abortion is unconstitutional; state interests in protecting fetus cannot outweigh the reproductive rights of women.]

MEXICO AI 106/2018: Suprema Corte de Justicia de la Nación [Supreme Court] 2021, Acción de inconstitucionalidad AI 106/2018 and 107/2018), Sept. 7, 2021.  Decision in Spanish.  Official press release in English.  [States may not establish a right to life from the moment of conception in their local constitutions]

MEXICO AI 54/2018: Suprema Corte de Justicia de la Nación 2021, Acción de inconstitucionalidad AI 54/2018, Sept 21, 2021.   Decision in Spanish.  Decision backup.    Official press release in English.  [This ruling struck down part of the General Law regulating health services nationwide, because it established an expansive right to conscientious objection by medical personnel, without establishing the limits necessary to ensure patients’ rights to healthcare.]

NEW ZEALAND: High Court decision in NZ Health Professionals’ Alliance v Attorney-General, Sept. 24, 2021, upholds sections of the Contraception, Sterilisation, and Abortion Act 1977 (‘CSAA’), amended in the Abortion Legislation Act 2020, regarding conscientious objectors’ duty to refer and (within reason) accommodation of objecting employees. News report.  Decision online. Commentary on decision. 

NORTHERN IRELAND Judicial review by Northern Ireland Human Rights Commission: In re NIHRC (Abortion), “In the matter of an application by The Northern Ireland Human Rights Commission for Judicial Review – In the matter of the failure by the Secretary of State, Executive Committee and Minister of Health to provide women with access to Abortion and Post Abortion Care in All Public Health Facilities in Northern Ireland [2021] NIQB 91 Delivered 14 October 2021.    Decision online.  Backup copy.    Official Summary.  News story.   [Secretary of State failed to comply with 2019 Act  to “expeditiously” provide women in Northern Ireland with access to high quality abortion and post abortion services].

POLAND: Applications have been filed before the European Court of Human Rights by more than 1,000 Polish women who were denied abortions or who postponed their reproductive decisions out of fear. [because of the Constitutional Tribunal’s October 2020 ruling that disallowed abortion in cases of severe and irreversible fetal defects. Result: almost total ban on abortion.] Human Rights Watch report.

POLAND: “Izabel”, 22-weeks pregnant, died of septic shock in Sept 2021 while doctors waited for her doomed fetus to die within her.  Washington Post Nov 2021 article. Mass protests focused on the Oct 2020 abortion ban ruling, but, so far, only hospital and staff have been held accountable. Notes from Poland, Sept. 2022.

UNITED STATES: Dobbs v. Jackson Women’s Health Organization, No. 19-1392, 597 U.S. _ (2022) (Supreme Court of the United States), held that the Constitution of the United States does not confer a right to abortion. Case summary by CRR. Amicus brief by Martha Davis et al. IJGO article and other amicus briefs.

NEW INTERNATIONAL ABORTION CARE GUIDELINE

[WHO] Abortion Care Guideline (Geneva: World Health Organization, 2022). Chapter 2 discusses Law and Policy.
Download the Guideline, or see Overview and Supplementary resources.

SCHOLARSHIP

[abortion law, France] [Why and how to constitutionalize abortion law]: ‘Pourquoi et comment constitutionaliser le droit à l’avortement,” par Stéphanie Hennette-Vauchez, Diane Roman et Serge Slama, La Revue des Droits de l’Homme, Actualités Droits-Libertés | 2022 Juillet 2022. Full text in French.

[abortion law, Latin America] “Pushing Past the Tipping Point: Can the Inter-American System Accommodate Abortion Rights?” by Patricia Palacios Zuloaga, Human Rights Law Review 21.4 (Dec 2021): 899–934. Abstract and Article.

“Abortion Lawfare in Latin America: Some Reading Keys for a Changing Scenario, ” special issue eds. Catarina Barbieri, Camila Gianella, Maria Defago, and Marta Machado (2021) Rev. Direito GV vol. 17 no 3, Sao Paulo, Brazil. Epub Dec 15, 2021. Overview and three articles in English.

[abortion law, Mexico] “The Decriminalization of Abortion: A Landmark Decision by the Mexican Supreme Court,” by Joy Monserrat Ochoa Martínez,and Roberto Niembro Ortega, I-CONnect Blog, Posted: 12 Oct 2021. Expert comment.

[abortion law, Poland] “The Scales of the European Court of Human Rights: Abortion Restriction in Poland, the European Consensus, and the State’s Margin of Appreciation,” by Julia Kapelańska-Pręgowska, Health and Human Rights Journal 23.2 (Dec 2021): 213-224. Abstract and article.

[abortion law, USA] “The state of abortion rights in the US,” by Martha F. Davis. International Journal of Gynecology and Obstetrics 159.1 (Oct 2022): 324-329 Abstract online. Article: free access .

[abortion law, USA] Abortion and the Law in America: Roe v. Wade to the Present, by Mary Ziegler. (Cambridge University Press, 2020). Publisher’s abstract.

“Conscientious Objection and the Duty to Refer,” by Bernard M. Dickens, International Journal of Gynecology and Obstetrics 2021; 155: 556-560. PDF at Wiley Online.  Submitted Text at SSRN.

[conscientious objection: Argentina] “Regulating Conscientious Objection to Legal Abortion in Argentina: Taking into Consideration Its Uses and Consequences,” by Agustina Ramón Michel, Stephanie Kung, Alyse López-Salm, and Sonia Ariza Navarrete, Health and Human Rights Journal 22.2 (Dec 2020): 271 – 384. Abstract and article.

[Conscientious objection: South Africa, nurses] “Power dynamics in the provision of legal abortion : a feminist perspective on nurses and conscientious objection in South Africa” by Satang Nabaneh, Doctoral Thesis (LLD)–University of Pretoria, 2020, now online: Doctoral thesis – 290 pages.

Conscientious Objection / The Right to Conscience, an annotated bibliography, updated Feb. 15, 2021 Conscience Bibiography.

[Conscientious objection] Global Map of Norms regarding Conscientious Objection, a searchable interactive map for comparative law, by Agustina Ramón Michel (coordinator) and Dana Repka (CEDES / REDAAS) with the support of Ipas and the ELA team. Updated December 15, 2022: Global Map of Norms re Conscientious Objection.

“Contested Rights: Abortion and Sexual Orientation and Gender Identity in the United Nations,” by Erin Aylward, Ph.D. thesis, University of Toronto, Canada, Nov. 2020. Abortion/SOGI thesis.

[migrants] “International migrants’ right to sexual and reproductive health care,” by Y. Y. Brandon Chen, International Journal of Gynecology and Obstetrics 2022;157: 210–215  PDF at Wiley online.  Submitted Text at SSRN. 

US-focused news, resources, and legal developments are available  on Repro Rights Prof Blog. View or subscribe.

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Research resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – Autumn 2020

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS
Amnesty International’s new institutional policy on abortion, released Sept 28, 2020, has been endorsed by the International Federation of Gynecologists and Obstetricians (FIGO). Amnesty Abortion Policy.
Press release. Explanatory note. Key messages. FAQ.

[Poland] Constitutional Tribunal ruled that abortion on grounds of congenital fetal defects is unconstitutional. Sygn. akt K 1/20, October 22, 2020. Decision in Polish. News report in English.

[The Philippines] PINSAN (network of NGOs and individuals) released proposed text of a “decriminalization bill” and an international petition to decriminalize abortion in the Philippines, September 28, 2020.
Proposed legislation. International petition. Bill launch on Facebook with Q & A.

SCHOLARSHIP
Access to Abortion: An Annotated Bibliography of Reports and Scholarship. (Toronto: International Reproductive and Sexual Health Law Program, 2020) 44 pages. Abortion access bibliography.

[abortion] “Why self-managed abortion is so much more than a provisional solution for times of pandemic,” by Mariana Prandini Assis & Sara Larrea, Sexual and Reproductive Health Matters, 28:1 (2020) Article online.

[Africa] “Adolescent sexual and reproductive health and universal health coverage: a comparative policy and legal analysis of Ethiopia, Malawi and Zambia,” by Godfrey Kangaude, Ernestina Coast & Tamara Fetters (2020) Sexual and Reproductive Health Matters, 28:2, 1-15. Abstract and article. Policy briefs: Ethiopia brief, Malawi brief. Zambia brief.

[Argentina] “A Case for Legal Abortion: The Human Cost of Barriers to Sexual and Reproductive Rights in Argentina,” (Human Rights Watch, 2020) 77-page report in English. Overview in English. Informe en Espanol.

[Australia] “Advancing Reproductive Rights through Legal Reform: The Example of Abortion Clinic Safe Access Zones,” by Ronli Sifris, Tania Penovic and Caroline Henckels, University of New South Wales Law Journal 43.3 (2020): 1078-1097. Abstract and Article.

[Belgium, Ireland] “Abortion law reform in Europe: The 2018 Belgian and Irish Acts on termination of pregnancy,” by Fien De Meyer – Medical Law International 20.1 (2020): 3-30. Abstract and article.

[India-abortion law] “The MTP 2020 Amendment Bill: anti-rights subjectivity,” by Alka Barua, Anubha Rastogi, V. Deepa, Dipika Jain, Manisha Gupte, and Rupsa Mallik. Sexual and Reproductive Health Matters 28.1 (2020). Commentary online.

[India] “Reimagining Reproductive Rights Jurisprudence in India: Reflections on the Recent Decisions on Privacy and Gender Equality from the Supreme Court of India,” by Dipika Jain and Payal K. Shah, Columbia Journal of Gender and Law 39.2 (2020): 1-53. Abstract and PDF access.

[Mexico] “Bioethics training in reproductive health in Mexico,” by Gustavo Ortiz-Millán and Frances Kissling, International Journal of Gynecology and Obstetrics 151.2 (November, 2020): 308-313  PDF free access for 12 months.  Submitted Text. 

[Nigeria] “The Conflict in Northeast Nigeria’s Impact on the Sexual and Reproductive Rights of Women and Girls.” by Onyema Afulukwe and Chinonye Obianwu (Nairobi: Center for Reproductive Rights and Legal Defence and Assistance Project, 2020) 26 page report.

[Philippines] “Reasons Why We Need to Decriminalize Abortion” by Clara Rita A. Padilla (of EnGendeRights and PINSAN).
Seven reasons op-ed, 22 reasons – full report.

[Surrogacy] “Paid surrogacy abroad does not violate public policy: UK Supreme Court,” by Bernard M. Dickens, International Journal of Gynecology and Obstetrics 150.1 (July 2020): 129-133 PDF- Free Access till July 2021.  Submitted Text.

“Transsexuality:  Legal and Ethical challenges,” by Bernard M. Dickens.  International Journal of Gynecology and Obstetrics 151.1 (October, 2020): 163-167 PDF free access for 12 months.   Submitted Text.

US-focused news, resources, and legal developments are available  on Repro Rights Prof Blog. View or subscribe.

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – Summer 2020

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates bi-monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS
[Argentina, abortion, conscience]  Argentina Ministry of Health issued a protocol expanding hospital abortion access to pregnancies resulting from rape. Raped girls 13 and over can have abortions without parental consent. The protocol also weakens a doctor’s ability to refuse to perform such abortions due to personal objection. New York Times, Dec 12, 2019.

[IACtHR, Ecuador], First standards for protection from sexual violence in schools: Paola del Rosario Guzmán Albarracín et al. v. Ecuador, Case C No. 405 (June 24, 2020) Sentencia en espanol – 85 paginas. Public Hearing Jan. 28 2020.  Resolución (Asuntos) 7 paginas. Reprohealthlaw blog summary.
Case comment in English (10 pages).

Ugandan Constitutional Court declares maternal health a constitutional right. First African court to do so. The Center for Health Human Rights and Development (CEHURD) and 3 Others v Attorney General [2020], Constitutional Petition No. 16 of 2011 (Constitutional Court of Uganda at Kampala). [Maternal health] Decision of August 19, 2020. Reprohealthlaw blogpost. Longer comment with the Court’s twelve “Declarations.”

[United Kingdom, surrogacy] Whittington Hospital NHS Trust (Appellant) v. XX (Respondent) [2020] UK Supreme Court 14. (April 1, 2020) allows paid surrogacy, where legal, in foreign countries. Decision (24 pages). Article by Prof. Bernard Dickens.

WEBINARS
“Access to medical abortion: Global South perspectives,”, with Panelists Dr. Shilpa Shroff, Prof. Dipika Jain, Dr. Sana Durvesh, and Moderator, Sai Jyothirmai Racheria. Organizers: SARJAI and SAIGE. Friday, Sept. 4, 2020, 14:30 (GMT+8, Kuala Lumpur time). Register here for Sept 4.

“Telemedicine, self-managed abortion and access to abortion in the context of the Covid-19 pandemic,” chaired by Mariana Romero (Argentina). Speakers: Jade Maina (Kenya), Maria Mercedes Vivas (Colombia), Wendy V. Norman (Canada), Rodica Comendant (Moldova), Jasmine Lovely George (India), Kinga Jelinska (The Netherlands), Marge Berer (United Kingdom), to be held: Wednesday, September 23, 2020 (2:00-3:30 p.m. British Summer Time). Register here for Sept 23.

“Telemedicine / self-managed abortion is critical to strengthening women and girls’ reproductive rights and reducing maternal mortality” FIGO webinar, chaired by Prof. Dame Lesley Regan (FIGO), with speakers: Ambassador Dr. Eunice Brookman-Amissah (Ghana), Marge Berer (UK), Christina Zampas (Switzerland), Nelly Munyasia (Kenya), Evelyn Odhiambo (Kenya). Will be available in English, Spanish and French. To be held Thursday Sept. 24, 2020 at 15:00-16:30 (British Summer Time). Register for Sept 24.

SCHOLARSHIP
“Access to Abortion: An Annotated Bibliography of Reports and Scholarship,” prepared by the International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, 2nd edition, 2020, 44 pages, (organized by country, focuses on barriers and recommendations, ) Annotated bibliography.

[abortion] “Abortion,” thematic chapter in Comparative Human Rights Law, by Sandra Fredman (Oxford UP, Nov. 2018). Institutional access through Oxford Scholarship Online. About the book.

[abortion, Argentina, Ireland, US] “Argentina’s path to Legalizing Abortion:  A comparative analysis of Ireland, the United States and Argentina,” by  Andrea F. Noguera, Southwestern Journal of International Law 25.2 (2019): 356-392.    Article online.

[abortion, Brazil, Argentina, Uruguay ] “Challenges and opportunities for access to legal and safe abortion in Latin America based on the scenarios in Brazil, Argentina, and Uruguay,” by Beatriz Galli – Cadernos de Saúde Pública, 2020 – SciELO Public Health

[abortion, Brazil] Understanding the sexual and reproductive health needs in Brazil’s Zika-affected region: placing women at the center of the discussion,” by D. Diniz, L. Brito, I. Ambrogi, AB Tavares, M. Ali. International of Gynaecology and Obstetrics 2019; 147: 17 Institutional access

[abortion, India] “Reimagining Reproductive Rights Jurisprudence in India: Reflections on the Recent Decisions on Privacy and Gender Equality from the Supreme Court of India,” by Dipika Jain and Payal Shah. Columbia Journal of Gender and Law 39.2(2020), 1-53. Article online.

[abortion law, India] “A Womb of One’s Own: Privacy and Reproductive Rights,” Arijeet Ghosh & Nitika Khaitan (2017) 52:42/43 Economic & Political Weekly, [1-9], re landmark Aug 24, 2017 privacy decision (Puttaswamy) already helped decriminalize homosexuality, adultery–potentially abortion. Article online.

Human Rights Quarterly is freely available online during the COVID-19 pandemic.  All issues.

[obstetric violence] “Operationalizing a Human Rights-Based Approach to Address Mistreatment against Women during Childbirth,” by Christina Zampas, Avni Amin, Lucinda O’Hanlon, Alisha Bjerregaard, Hedieh Mehrtash, Rajat Khosla, and Özge Tunçalp, Health and Human Rights Journal, 22(1) 2020: 251-264 Article online.

[surrogacy] “Paid surrogacy abroad does not violate public policy: UK Supreme Court,” by Bernard M. Dickens, International Journal of Gynecology and Obstetrics 150.1 (2020): 129-133. PDF at Wiley Online.    Abstract and Submitted Text.

[U.S. reproductive decisions] Feminist Judgments: Reproductive Justice Rewritten, ed. Kimberly Mutcherson, Cambridge UP, 2020. Book details.

US-focused news, resources, and legal developments are available  on Repro Rights Prof Blog. View or subscribe.

Violence Against Women’s Health in International Law, new book by Sara De Vido, Manchester University Press, 2020. Abstract and Table of Contents.

JOBS
Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

South Australian gov’t welcomes SALRI recommendations for decriminalization

Congratulations to the South Australian Law Reform Institute (SALRI), based at the Adelaide Law School. In October, 2019, after extensive research and public consultations, SALRI submitted a 506-page report commissioned by the Attorney General of South Australia. Many thanks to Katelyn Sheehan, LL.M., for providing this brief overview:

“Abortion: A Review of South Australian Law and Practice,” by John Williams, David Plater, Anita Brunacci, Sarah Kapadia and Melissa Oxlad, (Adelaide, Australia: South Australian Law Reform Institute, Oct. 2019) 560-page review.

So far, all Australian states and territories except South Australia have fully decriminalised abortion, starting with Western Australia in 1998. South Australia’s current abortion laws, based on the UK Abortion Act 1967, date back to its Criminal Law Consolidation Amendment Act of 1969, in which abortion is deemed a criminal offence, except with the approval of two physicians who deem that continuance of the pregnancy endangers the woman’s life, physical or mental health, within her actual or reasonably foreseeable environment, or that the resulting “child would suffer from such physical or mental abnormalities as to be seriously handicapped.” (p.15) Half a century later, many provisions of this law no longer reflect best clinical practice, nor significant advances in health care provision, such as medical abortion (using pills) outside medical facilities. These outdated provisions now obstruct equal access, particularly for South Australian citizens who are disabled or who live in rural areas.

In February 2019, the Attorney-General of South Australia commissioned SALRI “to consider changes to the State’s abortion laws with a view to improve access and modernise the practice in the State and with a view to making abortion a regulated medical procedure under health legislation as opposed to a criminal law issue.” (p.11)

SALRI then undertook extensive community consultation on the inadequacies of the current law, and analyzed recent reports and legislation in other Australian regional jurisdictions, as well as New Zealand.  SALRI’s 66 recommendations (outlined pp.17-22, cf. 24-36) include:
— Allow abortion on request within 24 weeks, with the same informed consent that is already integral to health law and practice, but without any mandatory waiting period.
— After 24 weeks’ gestation, require approval from two medical practitioners, an approach which reflects current clinical practice and also ‘recognises that terminations at this later stage often involve disadvantage, distress, complexities and higher risks to the pregnant woman’. (pp.18-19). Late-term procedures should be “very rare and only undertaken after careful consideration by all parties and in the most compelling circumstance.”(p.20)
—Disability or ‘fetal abnormality’ should no longer be mentioned as a ground for abortion.
— Exempt the woman and her qualified healthcare provider from criminal liability, but an unqualified person who performs or assists in an abortion commits an offence.
— Remove outdated restrictions as to where a pregnancy can be terminated, and by whom, which impede equitable and effective access, especially for regional, rural, remote and Aboriginal communities.
—Conscientious objection should be limited to those health practitioners directly involved in the procedure, except in an emergency situation.  Objectors must provide timely referral to a willing and able provider nearby.
—Counselling, including genetic counselling, should be impartial and non-directive, at the request of the woman.
—Safe access zones are needed to prevent harassment of women or healthcare providers.  Base such provisions on the law in Victoria, recently upheld by the High Court of Australia (Clubb v. Edwards – see our blogpost)

One month after the Attorney-General received the report, South Australia’s Ministry of Health and Well-being responded individually to SALRI’s 66 recommendations, accepting the majority of them, and noting 15 recommendations to which they would defer to the Crown for specific legal advice.

We look forward to hearing which of SALRI’s recommendations will be addressed in the South Australian health ministry’s proposed plan for decriminalization, now openly discussed on the ministry’s new “Abortion Legislation Reform” webpage.

RELEVANT RESOURCES:
SALRI’s 2019 independent report on the operation of South Australia’s existing abortion laws, with 66 recommendations for decriminalization:. 506-page review.

Response to SALRI Report by South Australia, Ministry of Health and Well Being – Nov. 2019. 15-page response. “Abortion legislation reform” webpage.”

“Access to Abortion: An Annotated Bibliography of Reports and Scholarship.”  Second edition 2020, 44 pages, analyzes reports and other resources, focusing on hidden barriers to abortion access and recommendations for reform. Annotated Bibliography.
_____________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.

REPROHEALTHLAW Updates – April/May 2020

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates bi-monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS
[Ecuador] Inter-American Court of Human Rights. Caso Guzmán Albarracín y otros Vs. Ecuador. Decision (January 27 2020) against sexual abuse in educational system. Decision online. 8-hour Public hearing, Jan. 28, 2020.  Guardian newspaper report  

CASEBOOKS
[India] Securing Reproductive Justice in India: A Casebook, ed. Mrinal Satish, Aparna Chandra, and Payal K. Shah, (New York: Center for Reproductive Rights, 2019) 520-page book/chapters online.

[United States] Feminist Judgments: Reproductive Justice Rewritten, ed. Kimberly Mutcherson, Feminist Judgment Series: Rewritten Judicial Opinions. (Cambridge: Cambridge University Press, 2020). Institutional access.

SCHOLARSHIP
“Abortion in the context of COVID-19: a human rights imperative,” by Jaime Todd-Gher & Payal K Shah (2020) Sexual and Reproductive Health Matters, 28.1 Article online.

[abortion, India] “Reimagining Reproductive Rights Jurisprudence in India: Reflections on the Recent Decisions on Privacy and Gender Equality from the Supreme Court of India,” by Dipika Jain and Payal Shah. Columbia Journal of Gender and Law, 39.2(2020), 1-53. Article online.

[abortion, U.K.] “Decriminalising Abortion in the UK- What Would It Mean?” ed. Sally Sheldon and Kaye Wellings. (Bristol: Policy Press, March 23, 2020) 112 pages, Open Access book.

[abortion laws: Uruguay, South Africa] “Abortion, health and gender stereotypes: a critical analysis of the Uruguayan and South African abortion laws through the lens of human rights,” by Lucia Berro Pizzarossa, Ph.D. dissertation, University of Groningen, 2019. 304 pages. Complete thesis. Abstract.

[conscience, Europe] “Conscientious Objection under the European Convention on Human Rights: The Ugly Duckling of a Flightless Jurisprudence,” by Stijn Smet, in The European Court of Human Rights and the Freedom of Religion or Belief: The 25 Years since Kokkinakis, ed. Jeroen Temperman, T. Jeremy Gunn and Malcolm D. Evans (Brill, 2019) 282–306. Institutional access.

[conscience, Italy] “The impact of gynecologists’ conscientious objection on abortion access,” by Tommaso Autorino, Francesco Mattioli e Letizia Mencarini,  Social Science Research 87 (March, 2020): 102403  16-pages, Institutional access.

Conscientious Objection / The Right to Conscience – annotated bibliography, updated March 17, 2020. Download here.

Human Rights Quarterly is freely available online during the COVID-19 pandemic.  All issues.

US-focused news, resources, and legal developments are available  on Repro Rights Prof Blog. View or subscribe.

WEBINAR:
“COVID-19: What implications for SRHR globally?” by Sexual and Reproductive Health Matters, webinar March 27, 2020. 100-minute video.

JOBS
University of Toronto, Faculty of Law @UTLaw seeks new Director, International Human Rights Program. Apply by June 17, 2020. Details and application information.

Links to employers in the field of Reproductive and Sexual Health Law are online here.
______________
Compiled by: the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   See Program website for our Publications,  Information resources, and Reprohealthlaw Commentaries Series.  TO JOIN THE REPROHEALTHLAW BLOG: enter your email address in the upper right corner of our blog, then check your email to confirm the subscription.