Uganda: Harm reduction model for access to safe abortion

August 31, 2017

Congratulations and thanks to Moses Mulumba and his colleagues at the Center for Health, Human Rights and Development (CEHURD) in Kampala for collaborating with Dr. Charles Kiggundu, a gynecologist and obstetrician, on a newly published article in the Legal and Ethical Issues section of the International Journal of Gynecology and Obstetrics.

Access to safe abortion in Uganda: Leveraging Opportunities through the Harm Reduction Model” by Moses Mulumba, Charles Kiggundu, Jacqueline Nassimbwa and Noor Musisi Nakibuuka, International Journal of Gynecology and Obstetrics 138 (August 2017): 231–236.  PDF free online for 12 months Submitted text  online at SSRN.

Access to safe and legal abortion services is a far reach for women and girls in Uganda. Although unsafe abortion rates have fallen from 54 to 39 per 1000 women aged 15-45 years over a decade, absolute figures show a rise from 294 000 in 2003 to 314,000 women having unsafe abortions in 2013.  Unfortunately, only 50% of the women who develop abortion complications are able to reach facilities for post-abortion care.  Despite the clinical evidence and the stories from undocumented cases, debate on access to safer and legal abortion is constricted, moralized, and stigmatized.  The harm reduction model has shown evidence of benefit in reducing maternal mortality and morbidity due to unsafe abortion while addressing related stigma and discrimination and advancing women’s reproductive health rights.  This article presents a case for promoting the model in Uganda.

Key words:  Abortion laws; Abortion policies and guidelines; Constitutional rights; Ethics; Harm reduction model; Human rights; Ugandan abortion law; Unsafe abortion

“Theorizing Time in Abortion Law” by Joanna N. Erdman

June 29, 2017

Congratulations and thanks to Alicia Ely Yamin, Paola Bergallo, and Marge Berer, guest editors of the Health and Human Rights Journal, issue 19.1,  for their wide-ranging special section on “Abortion and Human Rights” (Table of Contents below), including this article by Prof. Joanna Erdman, MacBain Chair in Health Law and Policy at the University of Dalhousie’s Schulich School of Law:

Joanna N. Erdman, “Theorizing Time in Abortion Law and Human Rights,” Health and Human Rights 19.1 (June 2017): 29-40. HTML | PDF

The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion—pregnant women. With respect to health, abortion law as health regulation should be evidence-based to counter the stigma of later abortion, which leads to overregulation and access barriers. With respect to justice, in recognizing that there will always be a need for abortion services later in pregnancy, such services should be safe, legal, and accessible without hardship or risk.  At the same time, justice must address the structural conditions of women’s capacity to make timely decisions about abortion, and to access abortion services early in pregnancy.

“Abortion and Human Rights” section in Health and Human Rights Journal 19.1:
Contents page.

Narratives of Essentialism and Exceptionalism: The Challenges and Possibilities of Using Human Rights to Improve Access to Safe AbortionAlicia Ely Yamin and Paola Bergallo  HTML | PDF

Abortion Law and Policy Around the World: In Search of Decriminalization  (Discussion) by Marge Berer   HTML | PDF

Theorizing Time in Abortion Law and Human Rights,   Joanna N. Erdman

The Dublin Declaration on Maternal Health Care and Anti-Abortion Activism: Examples from Latin America,  Lynn M. Morgan   HTML | PDF

Regulation of Conscientious Objection to Abortion: An International Comparative Multiple-Case Study,  Wendy Chavkin, Laurel Swerdlow, and Jocelyn Fifield  HTML | PDF

The Role of International Human Rights Norms in the Liberalization of Abortion Laws Globally, Johanna B. Fine, Katherine Mayall, and Lilian Sepúlveda   HTML | PDF

Pregnancy and the 40-Year Prison Sentence: How “Abortion is Murder” Became Institutionalized in the Salvadoran Judicial System,  Jocelyn Viterna and Jose Santos Guardado Bautista   HTML | PDF

Pregnancies and Fetal Anomalies Incompatible with Life in Chile: Arguments and Experiences in Advocating for Legal Reform,  Lidia Casas and Lieta Vivaldi   HTML | PDF

Legal Knowledge as a Tool for Social Change: La Mesa por la Vida y la Salud de las Mujeres as an Expert on Colombian Abortion Law, Ana Cristina González Vélez and Isabel Cristina Jaramillo   HTML | PDF

The Battle Over Abortion Rights in Brazil’s State Arenas, 1995-2006, by Marta Rodriguez De Assis Machado and Débora Alves Maciel    HTML | PDF

Abortion Rights Legal Mobilization in the Peruvian Media, 1990–2015, by Camila Gianella   HTML | PDF

The Moderating Influence of International Courts on Social Movements: Evidence from the IVF Case Against Costa Rica, by Julieta Lemaitre and Rachel Sieder   HTML | PDF

Why is a “Good Abortion Law” Not Enough? The Case of Estonia,  by Liiri Oja   HTML | PDF

Macro- and Micro-Political Vernaculizations of Rights: Human Rights and Abortion Discourses in Northern Ireland  by Claire Pierson and Fiona Bloomer  HTML | PDF

Exploring Legal Restrictions, Regulatory Reform, and Geographic Disparities in Abortion Access in Thailand  by Grady Arnott, Grace Sheehy, Orawee Chinthakanan, and Angel M. Foster    HTML | PDF

Decriminalization and Women’s Access to Abortion in Australia, by Barbara Baird   HTML | PDF

Australia: Abortion and Human Rights, by Ronli Sifris and Suzanne Belton   HTML | PDF

PERSPECTIVE Abortion Care in Nepal, 15 Years after Legalization: Gaps in Access, Equity, and Quality, by Wan-Ju Wu, Sheela Maru, Kiran Regmi, and Indira Basnett   HTML | PDF


The REPROHEALTHLAW Blog is compiled by the International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, Canada,  reprohealth*law at and @reprohealthlaw.   For Program publications and resources, see our website, online here.
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Uterus transplants: Legal and Ethical Issues

June 14, 2016

Congratulations to Bernard M. Dickens, Professor Emeritus of Health Law and Policy and Co-Director of the International Reproductive and Sexual Health Law Program at University of Toronto’s Faculty of Law, who recently published the following article:

Bernard M. Dickens, “Legal and Ethical Issues of Uterus Transplantation,” International Journal of Gynecology and Obstetrics 133.1(2016): 125-128.

The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors’ genuine altruism and motivation. Donation by deceased women – i.e. cadaveric donation – raises issues of uterus suitability for transplantation, and how death is diagnosed. Organs’ suitability for donation is often achieved by ventilation to maintain cardiac function for blood circulation, but laws and cultures could deem that a heartbeat indicates donors’ live status. Issues could arise concerning ownership and control of organs between recovery from donors and implantation into recipients, and on removal following childbirth, that require legal resolution.

Keywords: Altruistic uterus donation, Brain death, Cadaveric uterus donation, Ethics in uterus donation, Legality of uterus donation, Organ transplantation, Uterus donation.

The entire article is online here.

72 other IJGO articles on “Ethical and Legal Issues in Reproductive and Sexual Health” are online here.

Patients’ Refusal of Recommended Treatment

April 21, 2016

Congratulations to Professors Bernard Dickens and Rebecca J. Cook, who recently published a new article, now online here.   The full bibliographical reference and abstract are provided below:

Bernard Dickens and Rebecca Cook, “Patients’ Refusal of Recommended Treatment,”  International Journal of Gynecology and Obstetrics 131 (2015) 105-108.

When patients require information to decide whether to accept recommended treatments, a question in both law and ethics is whether the same information is adequate whether they consent or refuse, or whether refusal requires more or repeated information. Refusals of recommended treatment can carry increased risks for patients’ well-being and so require more emphatic disclosure without imposing pressure. A related question is whether guardians of dependents who would decline recommended treatment for themselves — for instance on religious grounds — can similarly decline it for their dependents. When pregnant women, children, and adolescents are able to give consent for recommended treatment, the question arises whether they are equally competent to refuse it and prevent their decisions being overridden by guardians or courts. Consenting to and refusing medical treatments recommended in one’s own or dependents’ best interests might not be the same sorts of decisions and could require different levels of disclosure and capacity.

The full text is now available online here.

“Ethical and Legal Issues in Reproductive Health” series, more than 70 articles online.


Decisions, Guidelines, Courses, Resources, News & Jobs

April 10, 2013

April 10, 2013


United States:  Emergency Contraception must be made available over-the-counter, without prescription, to women of all ages.
Decision of April 5, 2013,  Tummino et al. v. Hamburg et al.
can be downloaded here.
Initial press release from Center for Reproductive Rights:  online here.
Overview of CRR’s decade-long litigation campaign is online here.


New FIGO guidelines on “Safe Motherhood” published by the FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health in the International Journal of Gynecology and Obstetrics 120.3 (March 2013): 312-313, mention: “Where abortion is not against the law, every woman should have the right, after appropriate counseling, to have access to medication or surgical abortion. The healthcare service has an obligation to provide such services as safely as possible. Proper medical and humane treatment should be made available to women who have undergone an unsafe abortion.”

For other FIGO Ethical Guidelines on abortion, contraception and related subjects, in English French and Spanish, click here


[Argentina] Diplomatura en Salud y Derechos Sexuales y Reproductivos (SDSR). Gestión Integral de Políticas, Programas y Servicios, Inicia 18 de abril de 2013, Buenos Aires, Argentina.
Spanish course information online.

[US] The Global School on Judicial Enforcement of ESC Rights Course on Health Rights Litigationone-week intensive course, Sept. 16-20, 2013 at Harvard University in Boston, MA, includes reproductive and sexual health;  designed for PhD students, scholars, practitioners (e.g., law, public health, human rights or development), policy-makers and advanced master’s students. The number of participants is restricted, and applications are due to rcantor{at}  by June 1, 2013.  For application and more course details,
see Current Projects, Item 3(A), here.  


[abortion: Barbados] “Capturing the Moment: The Barbados Experience of Abortion Law Reform – An Interview with Dame Billie Miller,” by Dame Billie Miller and Nicole Parris in Social and Economic Studies 61.3(Sept 2012) Special Issue on Women’s Reproductive Health and Rights in Select Caribbean Countries (Guest Editors: Taitu Heron and Shakira Maxwell): Article online.

[abortion: Germany and Canada]“ The German Abortion Decisions and the Protective Function in German and Canadian Constitutional Law by Vanessa MacDonnell and Jula Hughes, forthcoming in Osgoode Hall Law Journal (Summer 2013): Text available online.

[abortion: Guyana]  “Legal but Inaccessible: Abortion in Guyana.” by Fred Nunes in Social and Economic Studies 61.3(Sept 2012) Special Issue on Women’s Reproductive Health and Rights in Select Caribbean Countries (Guest Editors: Taitu Heron and Shakira Maxwell):  
Article online.

[abortion, Jamaica]  “Fighting a Losing Battle? Defending Women’s Reproductive Rights in Twenty-First Century Jamaica.” by Shakira Maxwell in Social and Economic Studies 61.3(Sept 2012) Special Issue on Women’s Reproductive Health and Rights in Select Caribbean Countries (Guest Editors: Taitu Heron and Shakira Maxwell):  
Article online.

“Religion, Culture and Tradition: Strengthening Efforts to Eradicate Violence against Women,” by Shareen Gokal and Sandra Dughman Manzur, AWID briefing document for CSW57, contains useful links and summaries of relevant international human rights instruments and discussion of religious justifications for human rights violations. Download from AWID.

[emergency contraception] UN 57th Session of the Commission on the Status of Women agrees to end violence against women and girls, including and the agreed language explicitly calls for accessible and affordable health care services, including emergency contraception, for victims of violence:  Agreed conclusions online.  

[Farsi / Persian resource for Iranian women] 1500-word excerpt from Rebecca Cook’s “State Responsibility for Violations of Women’s Rights,” (1994) has been translated and published in an online open-access journal, Law, Culture and Gender, issue 11, (2013) by the Institute for War and Peace Reporting:   
1500-word excerpt in Farsi (Persian).

“Human Rights and Accountability,” PMNCH Knowledge Summary #23, Partnership for Maternal, Newborn and Child Health, 2013:
4-page overview with references.

Jurisprudence on Health and Reproductive Rights, summarized by Center for Justice and International Law (CEJIL)
 in English and  in Spanish

Jurisprudence summaries on gender violence, equality and discrimination, rights of children and adolescents, also by CEJIL:
in English     and in Spanish  

 Other CEJIL Publications, including summaries of Norms in the Inter-American Human Rights System:   in English;   in Spanish

“Religion, Culture and Tradition: Strengthening Efforts to Eradicate Violence against Women,” by Shareen Gokal and Sandra Dughman Manzur, AWID briefing document for CSW57, contains useful links and summaries of relevant international human rights instruments and discussion of religious justifications for human rights violations. Download from AWID.

Reprohealthlaw – Legal commentaries on past decisions and developments are online here.


France’s Free Abortion Law Takes Effect.  Huffington Post article.

[abortion] Indonesia and Pakistan have new hotlines for info about safe medical abortion     ASAP blog post
More info re Pakistan hotline.

Northern Irish women risk jail for using abortion pills.  news report.

Philippines Supreme Court stops implementation of Reproductive Health Law for 120 days. news report.

Philippines needs resolute political support on reproductive health. editorial by Melissa Upreti.

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


Legal Assistant for Europe and Global Advocacy Programs, Center for Reproductive Rights, NY USA, apply by April 18, 2013.  Job details.

Program Associate, Global Legal Program, Center for Reproductive Rights.  Apply by April 13, 2013. Job details.

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

Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at For Program publications and resources, see our website, online here.
Our Annual Report for 2012 is now online through our homepage.