ICMA January 2011 NEWS Newsletter n.4 Asia Safe Abortion Partnership Latin American Consortium Eastern European Alliance African Network Against Unsafe Abortion For Reproductive Choice for Medical Abortion As part of ICMA´s commitment with women´s right to safe and legal abortion and convinced of the need to strengthen collaboration and share expertise and views among global stakeholders, we have invited Women on Web to join this number of our Newsletter to address one of the most promising topics in the abortion field: the hotline strategy as a mean to guarantee the rigth to information and to put the abortion process into women´s hands. “Hello, do you need information about safe abortion?” Hotlines on misoprostol in countries with restrictive laws By Kinga Jelinska, Project Manager, Women on Web Since 2008, Women on Waves and Women The campaigns usually involve non-medical on Web have been supporting local groups in professionals. Safe abortion traditionally creating hotlines that provide information on belongs in the spectrum of knowledge and how to do a safe abortion and how to safely expertise of medical professionals. Abortion self-administer misoprostol. Those hotlines with pills brings a new paradigm; the process run in countries where access to safe abortion is very similar to a spontaneous miscarriage, it services is restricted. Since 2008 local groups is an easy procedure that can be safely done in Ecuador, Chile, Argentina and Peru launched by women themselves if they have reliable the hotlines. In 2010 WoW together to a instructions. The information needs to spread regional ICMA network, Asia Safe Abortion also outside the routine channels of doctors Partnership, worked with local groups in and mid-level health professionals and get Pakistan. into women’s hands. Some of the groups that launched the hotlines were youth feminist Women on Web and Waves for several years groups, fighting for women’s autonomy, but have been running a multilingual email not necessarily working exclusively on repro- helpdesk. In 2010 alone WoW sent 70 000 ductive health issues. Other partners were emails to women from all around the world, LGBT groups. In Latin America the groups cre- advising them on how to do a medical abor- ated a regional network and it is hoped that tion, particularly in contexts where abortion is in 2011 the activists will be able to meet on legally restricted. Through the Women on Web the global level with support of the ICMA. website, women that need the medicines can get both mifepristone and misoprostol sent The hotlines give detailed, practical informa- to them discretely in a courier package. How- tion how to do an abortion with pills, what to ever, access to the Internet in some regions expect, what are the possible complications. remains problematic. To bridge the digital Unsafe abortion does not affect everyone divide and compliment the online work, WoW equally. Women with financial means can works with partners on the ground using always find a way to travel or find a doctor. different strategies, like mobile phones, SMS, The injuries and deaths due to unsafe abor- and word of mouth campaigns, with the goal tion are overwhelming – it’s as if every day of building awareness about misoprostol, a a whole plane crashed, a plane filled only medicine often available locally. with women. This happens purely due to bad laws and stigma, and this tragedy is totally preventable. ICMA NEWSLETTER n.4 | JANUARY, 2011 Page 1 Misoprostol, for many women, is the safest and most often also protected by national constitu- their most basic right to information? Even if it is certainly the cheapest option available locally. tions. The information provided by hotlines is often the safest possible options and it should be Moreover, an abortion with pills is indistinguish- based on the official protocols of the World Health the woman herself to decide what is best for her? able from a spontaneous miscarriage, so there is Organization. no risk of prosecution for the woman to go to the The aura of fear hangs over popularization of doctor, if she does not mention the pills herself. Despite the WHO protocols and practice, some information about the pills for abortion and bring- This is as well a crucial piece of information given doctors and advocates believe the pill does no ing it to the community level and to the women to the callers. magic for women. The controversy brings argu- themselves. This fear mandates that the knowl- ments like: it is not the optimal solution, it is not edge about misoprostol should rather remain out Furthermore, research proves that misoprostol as effective as in combination with mifepristone, of public view and should be over-medicalized. can cut the risk of postpartum hemorrhage (the it can be used also for longer pregnancy termina- Concerns regarding not easily accountable foremost cause of maternal mortality) in half. tion, women can misdiagnose or lie, incomplete outcomes, political backlashes and the govern- Women who will not deliver with a skilled birth abortions will need further treatment and it is mental reactions function as an excuse for not attendant can self-administer misoprostol for safe always better if the doctor supervises the process. talking loudly about misoprostol. The possibility birth. Misoprostol is therefore nothing less than a It’s a long list of smaller and bigger “buts” and of medication being restricted by the government miracle for women’s health. objections. Due to this potentiality of misoprostol can be predicted, and the conflicting agendas can being used in the not utmost correct manner, be strategically challenged. The hotlines, as well as Women on Web’s online some think it is better to hide the misoprostol help service, use the harm reduction model with option altogether from broader public. Should the The difficulty with letting go of the control over the aim of diminishing the mortality from unsafe potentiality that a few women might not obtained this information, and letting it flow into public abortion. From the public health perspective the most desired result get the precedence over domain probably has to do with the very potential awareness about available options, like misopr- of the technology, as well as the issue of trust ostol, are beneficial and live-saving for women’s in women and in their autonomy. We should not health. The hotlines are protect women from any information, or protect women from themselves. It’s up to individuals But it were not public health scientists or activ- determined to get the how they are going to use information. And they ists that stimulated the use misoprostol. Since word out there. have the moral right to use it in any way they the eighties women in Latin America have been want. purchasing the drug and taking it, way before the Hotline in Argentina: 011 156 664 7070 protocols and recommendations were sanctioned The manifesto of the misoprostol hotlines is by research. Still today there is way not enough Hotline in Chile: 08-8918590 straightforward and optimistic. They document the information easily available to women in need, barriers to access, but at the same time the solu- and some women keep on using incorrect proto- Hotline In Ecuador: (593) 098301317 tions and empowerment of resourceful women cols or buy false medication. In Pakistan the tab- that found a safe option and benefitted from it. Hotline in Peru: 01-945411951 lets are cheap and very accessible even without Some of the groups use very creative way of prescription, but unlike in Latin America, very few Hotline in Pakistan: disseminating the information – they do grafit- women, if any, knew about their existence. The 0307 - 494 07 07 - (Urdu, Punjabi) tis in the cities, they use online networks like magic pill is there, but it’s just not yet used to its facebook to pass on the message, they campaign full potential, because of the information deficit. 0315 - 917 04 08 - (Urdu, Pastho) at pop festivals or stamp money with the hotline numbers. For example the Lesbians and Feminists In essence, the right to information is the legal 0315 - 947 33 99 - (Urdu, Sindhi) for the Depenalization of Abortion in Argentina rationale of the hotline projects. The right to published a book that gathers everything you information and the right to enjoy the benefits For more information: want to know about abortion with pills. It was of scientific progress are guaranteed not only by [email protected] distributed with a local newspaper. And the pills human rights treaties ratified by governments but on the cover have very smiley faces. Public Opinion on abortion in Latin American countries: broad consensus for public debate on depenalization of abortion Claudia Dides, M. Cristina Benavente, Isabel Sáez Programa Inclusión Social y Género, FLACSO-Chile The results of the opinion poll on abortion Consequently in Brazil, Chile, Mexico and Nicara- sions is that it is posible to discern attitudes conducted by the Gender Program of the Latin gua, the population supports more flexibility on supporting penalization and depenaliza- American Faculty of Social Sciences, Chile abortion laws in certain circumstances, such as for tion (absolute or relative) not only across (FLACSO-Chile) in Brazil, Chile, Mexico and example when the life of the women is in danger sociocultural and socioeconomic conditions Nicaragua in 2009, reveal that the majority (66 per cent on average), in cases of rape (56 per that affect value scales from conservative of the population favour depenalization of cent on average) or in case of fetal malforma- to liberal, but also according to respond- abortion under certain critical circumstances. tion (61 per cent on average). A common feature ent’s life experiences.