Sri Lanka – Restricting sterilization: To what purpose? #Vaw #rightoabortion #reproductiverights


 

March 15, 2013,http://www.island.lk/

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I was appalled to read a recent newspaper article that reported a government ban on irreversible methods of contraception. Later I learned that the ban prohibits non-governmental organizations (NGOs) from the provision of sterilization services. According to reliable sources, sterilization services continue to be available through the public sector albeit with additional counseling requirements implemented at some points of access. As this newspaper item coincided with protests against ‘family planning’ held by extremist Buddhist factions concerned about the diminishing ‘Sinhala race’, it is surprising that neither the government nor the Ministry of Health has thus far provided clarification on this issue. In this article, I would like to highlight a few problems with the existing sterilization policy that are unlikely to be resolved through bans or other forms of restriction. Rather than restricting women’s access to contraception to accommodate the views of reactionary groups, it might be more useful to focus our efforts on addressing some of the issues outlined below.

 

General Circular No. 1586 issued by the Office of the Director General of Health Services (1988) includes the following eligibility criteria for sterilization procedures: “1) The clients should be over 26 years of age and should have at least 2 living children; the younger being over 2 years of age. Confirmation of mother’s age should be done by checking the Birth Certificate, Identity Card or any other valid document, which is available; 2) Clients who are over 26 years of age and having 3 or more living children could be sterilized at any time; 3) A client under 26 years of age, and his/her spouse insist on a sterilization, the Medical Officer concerned could use his/her discretion, and perform the sterilization provided the couple has a minimum of 3 living children. In such a situation the officer concerned should personally check the validity of the information provided, in respect of the number of living children, prior to performing the sterilization; and 4) In the event of any medical indication, which warrants sterilization, the client should be referred to a specialist in the relevant field who should make the final decision.”

 

As the subtext of the circular implies, like most contraceptive programmes offered through Ministry of Health, the criteria for sterilization target women. For instance, references to the “mother’s age” and the insistent appeal of the spouse (when the ‘client’ is under 26 years) suggest that women are primary targets of the sterilization programme. In my experience of working for the Ministry of Health, sterilization procedures were, in fact, freely available and did target women, both in terms of availability and accessibility. This is confirmed by data from the most recent Demographic and Health Survey (2006/7): 16.9 % of ‘currently married women’ were sterilized compared with 0.7% of women whose husbands were sterilized (the Demographic and Health Survey is administered to married women and specifies these categories). These statistics must also be considered in light of the fact that the sterilization procedure for men is ‘simpler, safer, easier, and less expensive’ than the procedure for women (WHO, 2007).

 

Importantly, the criteria listed on the circular do not require the ‘client’ to obtain her/his partner’s consent to undergo sterilization (although spousal insistence may add weight to requests from those who are under 26 years of age). Nevertheless, spousal consent is routinely obtained in government institutions before providing sterilization procedures to women (my experience; see also CEDAW Shadow Report, 2010). In my work, I witnessed numerous instances when women’s pleas for sterilization were rejected during Caesarean section simply because the spouse was unavailable to sign a consent form. If these women decide to undergo sterilization on a later date, they are exposed unnecessarily to a second surgical procedure. In this way, doctors take on the role of gatekeepers to contraceptives services, restricting women’s access based on their own gendered presumptions.

 

The Circular of 1988 referenced above was introduced because “[it had] been observed that a significant proportion of females who [underwent] sterilization [were] under 25 years of age, with a notable number being less than 20 years” (General Circular No. 1586). These concerns were valid in the 1980s, a time when coercive tactics were being used as part of the population control agenda imposed on the third world. In 1980, a monetary incentive of Rs. 100 per sterilization procedure was introduced and was subsequently increased to Rs. 500. Surprisingly, this monetary incentive was not omitted in the Circular of 1988 and remains in place today. In fact, another circular was introduced in 2007 in order to “streamline” the payment process so that ‘clients’ would be able to obtain this payment from the institution that provided the sterilization procedure (General Circular No. 01-09/2007). Furthermore, healthcare providers (including the surgeon, anaesthetist and assisting nurses) can still claim, if they so do wish, a negligible sum for sterilization. While Rs. 500 may seem trivial to some of us, continuing to provide incentives for sterilization is problematic and warrants omission.

 

The provision of incentives can be interpreted in many ways, especially when sterilization procedures are mostly sought by particular groups of women. Sterilization is most popular among women in the plantation sector (presumably not Sinhala contradicting the claim of extremist factions in Colombo). According to the Demographic and Health Survey (2006/7), 61% of estate women used a modern method of contraception (including sterilization, contraceptive pills, intra-uterine devices, Depo-Provera, implants, condoms and complete breastfeeding) and 41% resorted to sterilization. In contrast, 54% and 44% of rural and urban women used modern methods of contraception, while 16% and 13% resorted to sterilization (the survey used urban, rural and estate as distinct categories). This set of data completely debunks the proclamations of extremist Buddhist groups who are hell bent on protecting Sinhala women from coercive sterilization. It also makes it incumbent on us to ensure that plantation workers are not coerced into sterilization. On the other hand, the large numbers of estate women accessing sterilization may signify a lack of access to temporary contraceptive options.

 

Imposing restrictions on sterilization may have other implications for women’s health. For instance, it is likely to increase the incidence of unplanned pregnancies. According to the Demographic and Health Survey (2006/7), sterilization is popular among the following categories of women: estate women, women above 35 years of age, women with lower levels of education and women with three or more children. While these associations may point to a need to ensure that these particular groups of women are not coerced into sterilization, it also reflects on who will be most affected by restrictions on sterilization. Not surprisingly, this profile bears similarity to that of women seeking abortion services; induced abortion is most common among rural, married women with at least two children (Senanayake & Willatgamuwa, 2009). Then restrictions on sterilization could result in more women resorting to unsafe abortion, a service that has moved underground since the government led shut down of abortion clinics in 2007.

 

Religious extremism is frequently accompanied by restrictions on access to reproductive health services for women. Although the existing policy is problematic for the reason that in targeting women it burdens them with the responsibility of adopting contraceptive measures, the policy does ensure that sterilization is quite easily accessible to women through the public sector. While there is much room for improvement around health policies governing contraceptive services, such as the removal of incentives and the unofficial requirement of spousal consent for sterilization, imposing restrictions or banning sterilization altogether is hardly the solution. Such restrictions are not only an extension of policies that assume that women are incapable of making decisions concerning their health, but may well be interpreted as an attempt by the state to regulate women’s reproduction in the service of a retrograde agenda of nationalism.

 

Ramya Kumar, MBBS

 

Kandy

 

Srilanka Bans Birth Control Surgery to Protect Dwindling Sinhala Race #Vaw


Govt Bans LRT on Women and Vasectomy on Men After Bodhu Bala Sena Protested Against Birth Control to Protect Dwindling Sinhala Race

24 February 2013, 6:10 am

By Chrishanthi Christopher

Last week the government sent out a communiqué to all government hospitals and private institutions banning all irreversible family planning methods that control birth.

Following the ban Maternity Hospitals and Non Governmental Organizations (NGOs) that do Ligation and Resection of Tubes (LRT) on women and Vasectomy on men shelved their plans and struck off all scheduled procedures from the hospital registers. This follows an announcement by the government that the procedures should not be carried out on women and men unless it is done for medical purposes.

Maternity Hospitals, Gynaecology Units of Base Hospitals and NGOs dealing with population control came under deep shock. They say that the government’s call comes without any warning.

Health Ministry, Secretary, Dr. Nihal Jayatilake said that the procedure hitherto being done on men and women should not be carried out unless it is for a medical reason. He refused to explain the reasons for the ban but stressed that none of the NGOs are allowed to carry out any permanent birth control methods. “This is government policy,” he said.

Ironically this call come at time when the Bodu Bala Sena (BBS), a movement claiming to be protecting Sinhala culture and values called on the government to put an end to all irreversible methods of birth control claiming that the Sinhala nation is dwindling.

Against their will

They say that women and men of the productive age group are pushed into accepting the procedure against their will by certain NGOs who have vested interests. The BBS General Secretary, Gala Boda Atte Gnanasara Thera told Ceylon Today that the Sinhala women who go to the hospitals to give birth are unwittingly opting for the procedure. He blamed the midwives and attendants in the hospitals for misleading young mothers who come there for confinement. “They are trained to advocate the procedure to young mothers. We are against this type of behaviour. Our women are misled or pushed into believing that they should not have more than two children,” he said.

Gnanasara Thera said that the Family Planning Law of 1973 is outdated and cannot be applied today. The Act states that women in the age group of 26 years and above are eligible for family planning “Those days men and women got married early and they had many children at that age. But now they start life at 30 years,” he said.

“The government has got to intervene and ban the procedure before it is too late. There is a conspiracy, our Sinhala population is declining,” Gnanasara Thera added.

He claimed that in the Tamil populated areas, the doctors inform the women and men of the repercussions of the surgical procedures and do not advocate it till they are over 40 years.

Government has to intervene

Pointing a finger at the NGO Marie Stope International, he said that funding for the birth control procedures are done by them. In addition he says that illegal abortions are also being carried out by the institution. “They have a sinister aim behind it,” he said.

However, the Family Health Bureau and the Family Health associations who are in collaboration with Marie Stope International and help it perform the sterilization procedures say that it is totally wrong to say that the mothers and fathers are pushed into this. “It is a misconception. It is purely voluntary and only if they opt for the procedure the surgery is done,” Family Health Chief Dr. Deepthi Perera said.

“Now even we are trying to revise the age limit for this procedure. We are thinking of raising the age limit to 35 and above,” she said.

However, critics argue that the ban will only put older women at risk and drive them to illegal abortion. It is reasoned out that with the ban the older women who have teenage or adult children and would like to have an LRT procedure would be deprived. They maintain that women with grown up children would like to have a permanent method of contraception.

In such instances when and if they get pregnant they would not like to get help from the family planning units and would be pushed to other resources. Most often than not they will seek the help of illegal abortion clinics that would charge them exorbitantly and even put their lives in danger.

It is also argued that abortion parlours which would mushroom and quacks and half baked doctors would perform abortions on mothers most often using makeshift theatres and often not following sterilization methods that could turn aseptic and put the mothers at risk or even kill them.

The Family Health Association (FPA), also a family planning organization has shelved all its scheduled LRT procedures until further notice.

“It is banned, we cannot challenge the government’s decision … the repercussions would be unplanned pregnancies,” said a doctor at the FPA who wished to be anonymous.

“We use to do around 30 procedures once a month and now everything has to be cancelled,” the doctor said.

The Human Rights Commission welcomed the move and said that it is the right to life. Its Chairman Prathiba Mahanamahewa said according to the Human Rights Declaration of 1948 and the Political Rights Convention, everybody has a right to life.

“It is an individual right and this is another issue,” he said.

The Colombo Archbishop’s House also expressed its pleasure for the move to ban the birth control methods. “We believe that birth control and abortions are sinful and we welcome the move,” Fr. Benedict Joseph of the Archbishop’s House told Ceylon Today.

“The ban opens up for birth and it is in keeping with the teaching of the church,” he said.

LRT

LRT is a simple procedure done under local anaesthesia and is performed in a theatre for 20 to 30 minutes. The patient goes home the same day. The procedure will not have any effect on the menstrual cycle of the women.

Vasectomy

Male sterilization or vasectomy is a minor surgery taking only 10 to 15 minutes, also done under local anaesthesia. Post surgery there will be no effect on the sexuality or quality or quantity of the ejaculatory fluid of the person.
COURTESY:CEYLON TODAY

#India -2 tribal women die post ligation surgery #Westbengal #Vaw


pc courtesy indiamike

statesman news service

DURGAPUR, 14 DEC: Two tribal women died today post ligation surgery  at a rural block hospital in Asansol today. Chandmoni Hembram of Kalipathar village and Radharani Tudu of Gaurangadihi village, who underwent ligation at Kelejora Block Primary Health Centre along with 12 other tribal women, died while they were taken to Asansol District Hospital in the late afternoon.

The Asansol administration apprehended that the casualties might provoke the tribals residing in the villages surrounding the rural hospital to unleash attack on the block medical officer and his family. The ADM, Asansol, Mr Jayanta Aikat said: “We have asked police to beef up security surveillance across the hospital area to prevent any untoward situation.”

Tribal housewives queued up at the Kelejora Block Primary Health Centre in Baraboni, about 15 km from Asansol town today where a mass ligation camp was organised. In all 14 women from the adjoining villages underwent tubal ligation surgery at the Kelejora Hospital today.

Chandmoni Hembram and Radharani Tudu, both aged around 40 were also taken to the camp and according to the hospital authorities:

“Their cases became complicated as both complained of gradual deterioration within an hour of operation.” The ADM, Asansol, Mr Jayanta Aikat said: “The medical officers told me that both the women were physically weak, so the rural hospital referred them immediately to the Asansol District Hospital.” On their way to the hospital, both the women died triggering panic among the medical staff. The bodies were kept under supervision at the Asansol Hospital for the night. MLA, Baraboni, Mr Bidhan Upadhyaya said: “Baraboni is a block having 43 villages under eight panchayats and the tribal and downtrodden mass contribute a significant percentage of the demography. The casualties, besides making ligation a fear factor among the backward communities, would also create tension in the area.”

Tubal ligation is a surgery performed to block woman’s fallopian tubes for permanent birth

control.

The district administration has engaged the BDO, Baraboni to table a report on the matter at the earliest.

 

Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012


Wekker voor anti-conceptiepil / Alarm clock fo...

Wekker voor anti-conceptiepil / Alarm clock for birth control pills (Photo credit: Nationaal Archief)

HIGHLIGHTS
June 2012

  1. In 2012, an estimated 645 million women in the developing world were using modern methods—
  2. 42 million more than in 2008. About half of this increase was due to population growth.
  3. The proportion of married women using modern contraceptives in the developing world as awhole barely changed between 2008 (56%) and 2012 (57%). Larger-than-average increases were seen in Eastern Africa and Southeast Asia, but there was no increase in Western Africa and Middle Africa.
  4. n  The number of women who have an unmet need for modern contraception in 2012 is 222 million. This number declined slightly between 2008 and 2012 in the developing world overall, but increased in some subregions, as well as in the 69 poorest countries.
  5. Contraceptive care in 2012 will cost $4.0 billion in the developing world. To fully meet the exist-ing need for modern contraceptive methods of all women in the developing world would cost$8.1 billion per year.
  6. n Current contraceptive use will prevent 218 million unintended pregnancies in developing coun-tries in 2012, and, in turn, will avert 55 million unplanned births, 138 million abortions (of which0 million are unsafe), 25 million miscarriages and 118,000 maternal deaths.
  7. n  Serving all women in developing countries who currently have an unmet need for modernmethods would prevent an additional 54 million unintended pregnancies, including 21 millionunplanned births, 26 million abortions (of which 16 million would be unsafe) and seven million miscarriages; this would also prevent 79,000 maternal deaths and 1.1 million infant deaths.
  8. n  Special attention is needed to ensure that the contraceptive needs of vulnerable groups suchas unmarried young women, poor women and rural women are met and that inequities in knowledge and access are reduced.
  9. n  Improving services for current users and adequately meeting the needs of all women whocurrently need but are not using modern contraceptives will require increased financial com-mitment from governments and other stakeholders, as well as changes to a range of laws, poli-cies, factors related to service provision and practices that significantly impede access to and use of contraceptive service.

Download full report here

Safe abortion: technical and policy guidance for health systems


Pro-abortion march

The awaited “Safe abortion: technical and policy guidance for health systems“, the  second edition of the WHO publication is available online now.

Find the pdf document online at: http://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/

The contents include:


CONTENTS

Executive summary

1

Process of guideline development

10

Background

10

Methods

10

Dissemination of the guidance document

12

Updating the guidelines

13

Chapter 1 

16

Safe abortion care: the public health and human rights rationale

17

1.1 Background

17

1.2 Public health and human rights

18

1.3 Pregnancies and abortions

19

1.4 Health consequences of unsafe abortion

19

1.5 Contraceptive use, accidental pregnancies and unmet need for family planning

22

1.6 Regulatory and policy context

23

1.7 Economic costs of unsafe abortion

26

Chapter 2

30

Clinical care for women undergoing abortion

31

2.1 Pre-abortion care

32

2.2 Methods of abortion

37

2.3 Post-abortion care and follow-up

52

Chapter 3

62

Planning and managing safe abortion care

63

3.1 Introduction

64

3.2 Constellation of services

64

3.3 Evidence-based standards and guidelines

65

3.4 Equipping facilities and training health-care providers

69

3.5 Monitoring, evaluation and quality improvement

72

3.6 Financing

79

3.7 The process of planning and managing safe abortion care

80

viii Safe abortion: technical and policy guidance for health systems

Chapter 4

86

Legal and policy considerations

87

4.1 Women’s health and human rights

87

4.2 Laws and their implementation within the context of human rights

90

4.3. Creating an enabling environment

98

Annex 1

98

Research gaps identified at the technical consultation

105

Annex 2

Final GRADE questions and outcomes

106

Annex 3

106

Standard GRADE criteria for grading of evidence

109

Annex 4

Participants in the technical consultation

110

Annex 5

110

Recommendations from the technical consultation for the second edition of Safe abortion: technical and policy guidance for health systems

113

Annex 6

Post-abortion medical eligibility for contraceptive use, Medical eligibility criteria for contraceptive use, 4th ed. Geneva, World Health Organization, 2009

120

Annex 7

Core international and regional human rights treaties

122

Judgement for women rights : Can’t divorce wife for pushing condom use #FOE


, TNN | May 4, 2012,

Bombay HC: Can't divorce wife for pushing condom use
Planning when to start a family cannot be treated as cruelty, said the Bombay high court on Thursday, upholding the family court’s dismissal of a man’s divorce plea.
 

MUMBAI: Planning when to start a familycannot be treated as cruelty, said the Bombay high court on Thursday, upholding the family court’s dismissal of a man’s divorce plea.

An HC division bench of judges P B Majmudar and Anoop Mohta was hearing a petition by Pradeep Bapat (30), who said that during their honeymoon his wife Prerna (26) refused to have sex unless he wore a condom and subsequently refused to conceive on the grounds that they were not financially stable.

“She must not have shown willingness to become a mother unless there was financial stability. She wanted to give the child a better life,” Justice Majmudar said. “It is a mutual decision and a husband cannot insist,” said Justice Mohta.

The reply of Bapat’s advocate- “Why do people go for honeymoon?” – raised a few titters in the courtroom.

The judges also held that Pradeep’s other grounds for seeking divorce–not knowing to cook, not being religious, not parting with salary and not folding clothes properly–did not amount to cruelty either. Bapat’s lawyer said his family wanted a working graduate as his wife, who would live in their joint family and also do housework. To this, Justice Majmudar said, “A woman is not a slave. The wife is an ardhangini (a man’s other half). Her right of freedom of speech cannot be taken away. You have put (common household troubles) in the plea. If we construe these as cruelty, then no marriage will be safe.”

Observing that Bapat’s family was “conservative” and “full of perfection”, Justice Majmudar said, “You (Prerna) should not have selected this house.”

Her advocate replied, “She was the eldest (child) and unless she married, her younger sister would not have been able to do so either.”

Justice Majmudar said, “Girls are still treated as a burden on parents. A girl must know to which family she is going (after marriage).”

In their order, the judges said the case was an eye-opener for those who were yet to marry. They said that especially in the case of arranged marriages, the prospective husband and wife should get to know each other and see if they could live happily together. “It is the duty of (both sets of) parents to consider various aspects before the actual marriage takes place.”

The judges were told that Prerna was willing to return to her marital home, but Bapat did not want her back. The couple married in February 2007; Prerna left her marital home in June the same year.

The judges noted that in a short span of time, the relationship between Prerna and Bapat had become strained. Also, Prerna was “subjected to ill-treatment” and Bapat “treated her as if she was on probation”. “A girl coming into an entirely new atmosphere would have expected love and affection. The husband and his family are required to see to it that a (newly) married woman does not feel that she has come to an absolutely strange place,” the judges said.

(Names changed)

Prof. Sarah Hodges on Reproductive Health in colonial India


Prof. Sarah Hodges, University of Warwick, explains her research on “family planning” and reproductive health in colonial India. Her  work  is on the social and cultural history of modern South Asia, specifically the politics of health in colonial and postcolonial India (particularly the Tamil-speaking south). Her  interests lie at the intersection of a number of fields: modern South Asian history, gender studies, anthropology, and the history of science, technology and medicine.

She is  currently at work on a book about the contemporary history of medical garbage in Chennai, India, provisionally titled, Biotrash: The Urban Metabolism of Medical Tourism in India.

Dr Mohan Rao  interviews  Sarah Hodges.

 

Listen Up, Guys: If The Catholic Bishops Win, It’s The End of Sex As You Know It


One of the most stunning things about this whole contraception farce is the number of men who are still sitting this out, on the assumption that this is just another “women’s issue.” They don’t think they’ve got a dog in this fight; it’s got absolutely nothing to do with them.

Griswold v. Connecticut is nearly 50 years behind us, which means that three generations of American men have come of age under the sweet delusion that the not-getting-pregnant piece of their sex lives is handled by the same invisible fairies who clean the bathrooms. Since almost all of the top-shelf contraception methods are acquired and managed by women, men have apparently gotten very accustomed to not ever having to think about pregnancy at all. It’s her issue, her body, her problem. And so the politics of contraception have nothing to do with them, either.

Listen up, guys. We need to talk. Because if you don’t think this is your problem, you are simply not paying attention.

Here’s how this goes down. If contraception goes away, your sex life as you have known it is OVER. (It’s impossible to overstate this.) Say goodbye to one-night-stands, third-date sleepovers, friends-with-benefits, debauched Spring Break memories, Hooters, lap dances, living together before marriage, sleeping in the same bed after marriage, and all those friendly girls whose memory still makes you smile years later.

And say hello to stern fathers, uptight women, heavily chaperoned dates, guilt, shame, shotgun weddings, big and early families, separate bedrooms (the only form of birth control the Catholic bishops wholeheartedly approve of), and a whole lot more NO in your life than you can possibly even begin to imagine right now.

Also, gentlemen, make no mistake about this: going solo won’t provide much solace, either. Because once these people have succeeded in taking away your happy, easy love life, they’re coming after your porn stash next. They want you wanking even less than they want you fucking. Hope you enjoy frequent cold showers, because it’s about the only thing you’re going to have left when they’re done with you.

Don’t believe me? Ask you dad, or your granddad, or any straight male over the age of 60 about how it was when they were young. They’re the last ones left who are old enough to remember The World Before Griswold. If you’re younger than that, you cannot possibly have the barest freaking idea how awful it was.

If ignorance is bliss, American men are out there floating around in the seventh level of heaven right now. You’ve been lucky enough to live your lives in the most sexually open era in human history — and contraception is the one and only thing that made all that possible. If it goes away, it’s straight back to the Dark Ages — not just for us ladies, but for you, too.

It’s been lovely here on top of the world. But you need to look down, right now, to fully understand just how far you’ve got to fall.

Source- Sara Robinson, Alternet

WHO- contradictions- Gag order on Reproductive Health and Guidance for hormonal contraceptive


Invitees who attended back-to-back World Health Organization (WHO) consultations at the start of February were required to sign confidentiality agreements prohibiting them from talking about the meetings. They had to promise not to divulge anything that was said during the three days — not to colleagues, not to their networks, and especially not to journalists, who might misreport the facts. The world health body explained that journalists often exaggerate, and the UN doesn’t want to induce panic. The media will be informed when WHO holds an additional meeting of UN insiders on February 15, behind closed doors, and prepares a carefully worded public statement for release the next day.

The highly classified topic of discussion wasn’t a nuclear threat or a new virus that can kill within days. It was birth control.

WHO’s gag order is just the latest in a years-long effort by the United Nations’ AIDS apparatus to limit how much women know about possible links between HIV and injectable hormonal contraceptives. The UN appears to have forgotten that its job is not to control women’s sexual and reproductive decisions, but to inform them.

Here’s what the UN knows: In July 2011, researchers led by Renee Heffron at the University of Washington in Seattle presented findings from studies involving 3,790 sero-discordant couples (one HIV-negative and one HIV-positive partner) in east and southern Africa.1 The data compared women who had and women who had not used hormonal contraceptives during the research periods: twice as many HIV-negative hormonal contraceptive users acquired the virus. The rates of transmission from HIV-positive women to their male partners was also two times higher for users of hormonal contraceptives. (The findings focused on injectables because very few study participants took hormonal contraceptives in pill form, making the higher rates of HIV infection and transmission in that group “statistically insignificant.”)

In laypersons’ terms, hormonal contraceptives are products that adjust a woman’s hormone levels to prevent ovulation and pregnancy. In the east and southern African countries where the research was carried out, injectable hormonal contraceptives (“depot medroxyprogesterone acetate,” or DMPA) are the top choice of women who use contraceptives, and the Depo-Provera brand owned by pharmaceutical giant Pfizer, Inc. is the most widely used. Despite common side effects, popular features of the method are that one injection lasts three months, and a woman’s sex partner need not know that she is using a contraceptive.

The findings by Heffron and colleagues weren’t definitive; it would take years of additional research to determine beyond a doubt whether or not hormonal contraceptives actually double women’s risks of acquiring or transmitting HIV during unprotected sex. But the research team was concerned enough last July to say: “Our findings argue for policies to counsel women about the potential for increased HIV-1 risk with hormonal contraceptive use, especially injectable DMPA use, and the importance of dual protection with condoms to decrease HIV-1 risk.”

Read Original Artical here

and GUESS WHAT ?, WHO has just declared that “hormonal contraceptives are safe to use for women with or at risk of HIV” based on the meetings discussed below.

WHO upholds guidance on hormonal contraceptive use and HIV

Geneva, 16 February 2012. WHO has concluded, on the advice of its Guidelines Review Committee, that women living with HIV or at high risk of HIV can safely continue to use hormonal contraceptives to prevent pregnancy. The recommendation follows a thorough review of evidence about links between hormonal contraceptive use and HIV acquisition.

Current WHO recommendations in the Medical eligibility criteria for contraceptive use (2009 edition) therefore remain: there are no restrictions on the use of any hormonal contraceptive method for women living with HIV or at high risk of HIV. Couples seeking to prevent both unintended pregnancy and HIV should be strongly advised to use dual protection – condoms and another effective contraceptive method, such as hormonal contraceptives.

Read more here

Abortion rate decline stalls, unsafe abortions rise


By Kate Kelland

LONDON, Jan 19 (Reuters) – A long-term decline in the rates of abortion worldwide has stalled and the proportion of terminations that are unsafe and put women’s lives at risk is rising, an international group of scientists said on Thursday.

Researchers from the World Health (WHO) and the Guttmacher Institute, which researches sexual and reproductive health, said a trend of falling numbers of abortions between 1995 and 2003 had levelled out since then, suggesting that increased access to contraception worldwide has also stalled.

“We are also seeing a growing proportion of abortions occurring in developing countries where the procedure is often clandestine and unsafe,” said Gilda Sedgh, lead author of the study and a senior researcher at the Guttmacher Institute.

Between 1995 and 2003, the abortion rate per 1,000 women of childbearing age (15 to 44 years) worldwide dropped from 35 to 29. This new study found that in 2008 the global abortion rate was 28 per 1,000, virtually unchanged from 2003’s level.

“This plateau coincides with a slowdown in contraceptive uptake,” Sedgh told a briefing in London about the findings. “And without greater investment in quality family planning services, we can expect this trend to persist.”

Alarmingly, Sedgh said, the proportion of abortions characterised as unsafe rose from 44 percent in 1995 to 49 percent in 2008.

The researchers, whose study was published in the Lancet medical journal, define unsafe abortion as a procedure for terminating a pregnancy carried out by someone who does not have the necessary skills, or in an environment that does not meet minimal medical standards, or both.

CONTRACEPTION

Despite the decline in the abortion rate, there were 2.2 million more abortions in 2008, when 43.8 million were carried out, than in 2003 when there were 41.6 million. This is due to the increasing global population, the researchers said.

From 2003 to 2008, the number of abortions fell by 0·6 million in the developed world, but increased by 2·8 million in developing countries.

Of all the world’s regions, Latin America has the highest rate, with 32 per 1,000 women in 2008. Africa and Asia follow close behind with rates of 29 and 28 per 1,000 women respectively. Rates for North America and Oceania were the lowest, at 19 and 17.

Sedgh said that while in Europe, around 30 percent of pregnancies end in abortion there was a far higher rate in Eastern Europe than in the rest of the region.

In Western Europe there were 12 abortions per 1,000 women in 2008, while in Eastern Europe at the same time there were 43.

Sedgh said the study’s findings showed strong correlations between abortion rates and access to effective contraceptives, and between abortion rates and the law.

“The abortion rates is clearly lower in places were abortion laws are more liberal,” she said, pointing to Africa and Latin America where rates are high.

There is also a strong link between restrictive laws and higher rates of unsafe abortions. Between 95 percent and 97 percent of all abortions in Africa and Latin America are unsafe, the study found.

Sedgh said family planning services around the world appeared to be failing to keep up with rising demand for effective contraception driven by the desire for small families and better control over the timing of births.

“There are still 215 million women in developing countries who have an unmet need for contraceptives,” she said

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