Global News Podcast - Special episode: Abortion rights around the world

Episode Date: July 1, 2022

In June, the US Supreme Court overruled Roe v Wade and ended the constitutional right to abortion in America. In a special episode, we investigate the changing dynamic of abortion rights globally in countries like Colombia, China and Ireland. We'll also be examining the restrictions still faced by women in Africa and places like Malta and El Salvador.Audio for this episode was updated on 4 July 2022, due to a factual error in an earlier version.

Hello, this is the Global News Podcast from the BBC World Service, with reports and analysis from across the world. The latest news seven days a week. BBC World Service podcasts are supported by advertising. If you're hearing this, you're probably already listening to BBC's award-winning news podcasts. But did you know that you can listen to them without ads? Get current affairs podcasts like Thank you. Amazon Music with a Prime membership. Spend less time on ads and more time with BBC Podcasts. This is the Global News Podcast from the BBC World Service. I'm Iona Hampson, and in this special edition of the Global News Podcast, we'll be looking at abortion rights around the world.

We'll be hearing more about the international response to the US Supreme Court's decision to overrule Roe v. Wade, but also understanding how abortion rights and access fairies across the globe. From Africa, where access is limited, to the so-called Green Wave movement liberalizing abortion rights in South America. Abortion rights seem to be improving around the world, but unsafe abortions are still widespread. And... Every day hearing this little heartbeat of this child that we wanted, but the presence of the heartbeat meant that I was still in danger and sort of rejoicing at that sound of that heartbeat and also wanting it to stop.

We hear from a US woman needing an emergency abortion in Malta. Millions of women in the US have lost the constitutional right to abortion after the Supreme Court overturned its 50-year-old Roe v. Wade decision. In America, as well as around the world, it is a highly emotive issue. These are just some of the voices of campaigners outside the Supreme Court in Washington, D.C., as the ruling was announced. People told me it was impossible, that we would never see this kind of victory. And now I know that victory is not only possible, it's happened. We don't want to hear cheers about women being slammed back to the dark ages. It's so

vindicating to know that we can now take tangible steps to lessen the violence of abortion in our country. I'm 21 and I'm terrified. I'm from Texas. Abortion has been in six weeks and it has been since last September. I'm exhausted. At the BBC World Service, it got us thinking about the changing dynamic of abortion rights around the world that we have reported on recently, and how this is part of a political, religious and societal debate on how much access women should get to information and safe abortion services. This podcast is not about the pro-choice and anti-abortion debate, but focuses on how laws and attitudes have changed across the world. To begin our conversation, our global health correspondent Naomi Grimley has been speaking to Dr Shashila Singh from the Goodmacket Institute in Geneva, a research and policy

organisation that aims to improve sexual and reproductive health and rights worldwide. She asked her to describe how abortion rights have changed in the past few decades. The trend globally has been definitely towards more liberalisation. So in the past 15 years or so, since 2008, about 36 countries have moved to liberalise their laws, some in a smaller degree and some very large shifts. Only a few countries have reversed their laws. Most notable ones are Poland, Nicaragua, Honduras, and the U.S. has gone in that direction and joined them.

In terms of trying to explain why would the U.S. go in the opposite direction, the issue is very highly polarised, more so than in most countries. It dominates discussion, elections. It's a major issue at a level where even though it is of some discussion and some concern in both directions in other countries, it's simply, it's very hard to think of a country where it is as dominant as it is in the US. Is there a direct correlation between laws restricting abortion and then, on the other hand, the number of women dying in unsafe abortions? Where the law is restrictive, unsafe abortion will happen and has consequences for health, for the long-term impact on people's situations, their income, their family's well-being, the woman's well-being. And so the evidence on what the impact would be when the law is highly restricted, evidence, the advocacy and the global support have come together to, in different degrees, in different countries to make this

change. When we talk about unsafe abortions, we often refer to back alley abortions or coat hanger abortions. Are abortions becoming safer if they're illegal because people can buy medical abortions online? How is it changing? This method, medication abortion, indeed has helped abortion, even though clandestine, to become safer health-wise. It still requires women to have the information to use it appropriate to their gestation, for instance, and the dosages. But this can be done, and it has improved safety. The thing to look at still is where is it available.

Governments can prevent its access to it. It has to be underground because it's against the law in a way, so that the access might not be to all women, particularly if it's somewhat expensive, as it can be in some countries. It's had a very positive impact and that's a great thing. And I see the need still for law change to make it a right to use this method and to have access to abortion using whichever method a woman prefers. Naomi Grimley talking to Dr. Shashila Singh from the Guttmacher Institute. In the next half hour, we'll be hearing from our correspondents around the world to find out the

international response to the US Supreme Court ruling and how access to abortions vary around the world. First, we go north of the US border to Robin Levinson King in Toronto. Canada doesn't often like to butt its nose into its neighbour's business. The United States is its biggest trading partner after all. But when the Supreme Court overruled Roe v. Wade, Canada's Prime Minister Justin Trudeau, who self-describes as a feminist, spoke up. He called it a devastating setback and horrific for women. Abortion has been decriminalised in Canada since 1983, but access is not a guaranteed right. In many areas, women have to drive for hours to get abortions.

There are also many pro-life Canadians, but the issue has not been politicized to the same degree as it has south of the border. Right now, a Canadian pro-life organisation tweeted that it was a truly historic day for our friends in the United States. Our North America correspondent, Robin Levinson-King. The Maltese government has said they are open to review their law, which completely bans abortion. The announcement comes after an American tourist who was visiting the island had to be medically evacuated to Spain to get a life-saving pregnancy termination. Sara Mineta has been speaking to Andrea Prudente as she recovers in Mallorca after the procedure. It was terrifying. We were in like survival mode at that point, like

we have to get out of here. I'm a ticking time bomb. This is how Andrea describes her last days in Malta. She was 16 weeks pregnant and was visiting the island with her husband Jay when she started bleeding and her waters broke. The doctor told us there's no water, the baby will die. He just said you cannot get on an airplane, there's extreme risk of hemorrhage. You could die. All they could say is as long as there is a fetal heartbeat, it is considered an abortion and we cannot intervene. We will go to jail. You will go to jail. One of the midwives at one point said that if I am on the brink of death, then that might be able to intervene to terminate the pregnancy.

I want to understand if the procedure chosen by the Dr. Zalma today is the standard. So I'm going to speak with Dr. John Mamo. He's the president of the Malta College of Obstetricians and gynaecologists. There are studies that show that even at such an early stage, between 10 to 40% of babies do survive. So with LAD that comes into hospital, we don't rush to terminate the pregnancy. But he insists doctors would not let the woman's condition deteriorate to the point of becoming

life-threatening. We have patients like this about approximately five, less than 10 a year, let's say. But that is the management that we use and we have had no problems with mothers over the past, well, 10 years at least. For Andrea and Jay, this course of action was unbearable, and they say it had a heavy impact on their mental health. Every day hearing this little heartbeat of this child that we wanted, but the presence of the heartbeat meant that I was still in danger and sort of rejoicing at that sound of that heartbeat and also wanting it to stop. Goodbye Malta. Eventually the couple managed to get an emergency medical evacuation to Mallorca, paid for by their travel insurance.

But Maltese women do not have this option. The thought of women who might find themselves in my position and have no out, that's wrong. I don't want this for anyone else. In Spain, Andrea's pregnancy was terminated and she's now recovering. The Maltese government said they're going to review the current law to make sure doctors are not precluded from saving lives. But for Andrea and her husband, this is too little too late. They say they will take legal action and sue Malta. Our reporter, Sarah Moneta, will continue to follow this story here on the BBC World Service. To Ireland now, where our correspondent Emma Vardy

shares the island's reaction to the US Supreme Court ruling. There's been a really emotional and's reaction to the US Supreme Court ruling. There's been a really emotional and passionate response to the US Supreme Court ruling on the island of Ireland and that is because the debate over abortion is still a very live issue here. Abortion was only relatively recently decriminalised both in the Republic of Ireland and in Northern Ireland. So there are still many vocal campaign groups here and activists, very well funded on both sides of the argument. Now, many people have been reminiscing back to the day that abortion was decriminalised in the Republic of Ireland in Dublin in 2018. There were jubilant crowds celebrating as the referendum results were announced on that day. And there's also a story

too of Savita Halapanavar. She was a woman who died of sepsis in Ireland in 2012. Her story was very prominent and a big part really of the campaign which led to abortion being decriminalised in the Republic of Ireland. And her story is now being reshed widely here by people warning Americans really saying to prepare themselves for many similar deaths. There were many campaigners too who were devastated by the legalisation of abortion here. They now feel invigorated by what they see happening in America. Bernie Smith told me she's one of the most prominent anti-abortion campaigners on the island of Ireland. She said there's a lot to be learnt from what's happening in the US

and she's now hoping that one day too there may be some way to reverse legislation here in Northern Ireland. And she said to me, I think the movement in the US have been very wise. They've built to this over a number of years. And she says, look, there's a lot of hope here in the anti-abortion campaign groups in Northern Ireland. And she says, look, for us, the battle goes on. Our Ireland correspondent, Emma Vardy.

According to the World Health Organization, more than 25 million unsafe abortions happen every year worldwide, resulting in the deaths of about 39,000 women and girls, and leading millions more to be hospitalized with complications. The WHO says most of these deaths are among poor women living in lower-income countries, with more than 60% of them in Africa. Our Africa health correspondent Rhoda Odiambo sent this report from Lagos in Nigeria. Abortion is a very emotive subject in Africa. In some instances, religion and culture would take center stage when this topic is discussed. However, stricter laws in some

African countries have made it harder for women to choose whether or not to have an abortion. Some countries like Nigeria and Ivory Coast permit it to only save a woman's life, while others like Ghana and Liberia allow it in cases of rape or incest. According to the World Health Organization, out of the 54 African countries, only seven, that's Cape Verde, South Africa, Tunisia, Mozambique, Sao Tome and Principe, Benin and Angola, a woman can request to have an abortion. Despite significant progress made towards securing abortion rights for African women, the struggle is still far from over. Our Africa health correspondent, Rhoda Odeambo.

To Italy now, where our Southern Europe correspondent, Mark Lowen, tells us that the US Supreme Court ruling is encouraging debate. In 1978, five years after Roe v. Wade, Italy legalised abortion with Law 194. And while it is not the same lightning rod political issue here, the rise of a new hard-right conservative politics ever closer to the Catholic Church has brought it back into focus, and the US Supreme Court's decision is reverberating in Italy too. The majority of Italians say they still support the right to abort. While it's unlikely abortion would be restricted here, Law 194 allowed for conscientious objection by doctors, and across the country, around 70% of medics now refuse to perform the procedure.

In some regions, it's 90%. With the Vatican in its backyard, Italy is often behind the curve on some social issues, such as LGBT rights. There is pride among many that abortion was fought for and enshrined in law decades ago. But it is for some a raw nerve, and the US decision will touch that. Mark Lowen. Still to come. I just kept thinking, why? Why did those who testified against me do this to me?

But these are injustices which happen, and there are many others who are going through what I did. We hear from a woman who was imprisoned after suffering a miscarriage in El Salvador. The overruling of Roe v. Wade has been front page news across the world. Kerry Allen is our China media analyst. China has given prominent media coverage to the US Supreme Court's vote to overturn abortion rights. Newspapers in the country have very much focused on how the move has led to greater divisions in US society, but they've emphasised more than anything that Beijing perceives the move to be a human rights violation. The Global Times newspaper has said

that the move brutally deprives US citizens of their basic human rights, and it's dealt a huge blow to women's fundamental rights. Some papers have said that the move exposes US hypocrisy given how they perceive the US frequently targets China for being the site of human rights abuses. Abortion in China has long been legal and generally accessible. This has in part been due to China having strict family planning policies due to its large population. The one-child policy, which was introduced in 1979,

lasted for nearly 40 years and it meant that families in China were restricted to only having one child. Although not endorsed by the government, there were forced abortions and some underwent compulsory sterilization during this period. Given the historical preference for families to have sons in order to continue the family line, there was also much femicide, meaning that today there are millions more men than women in the country. The policy was abolished in 2016, but women are still restricted to having three children. In the last year, birth control measures like vasectomies and abortions have been scaled back in line with this, with many perceiving that China is now trying to promote births in order to boost its rapidly declining birth rate. There have also been allegations that birth controls have persisted in the western Xinjiang region because of other factors. One such allegation is on how

Uyghur women continue to be subjected to pregnancy checks and have undergone forced sterilization as part of a campaign to curb China's Muslim population. Our China media analyst, Kerry Allen. To Latin America now, where several countries continue to have a total ban on abortions, including in cases of rape, incest and where the mother's life is at risk. In El Salvador, there have been a number of high-profile cases of women who suffered a miscarriage being sentenced to 30 years in prison for murder. Our Central America correspondent Will Grant met one of them in the capital, San Salvador. In February, a group of four women sat down before El Salvador's gathered press.

Between them, they'd served nearly 50 years in jail. Their crime? They had the misfortune to have a miscarriage in a country with one of the strictest abortion laws in the world. There is great suffering inside prison, but I always try to stay occupied to keep me from thinking about time. I went to the church a lot. Among them was Elsie. In June 2011, she was pregnant and working as a domestic worker. All she remembers was going to the lavatory at work one day

and then coming to a little later to find the baby was gone and the police were there. Her boss had reported her for terminating the pregnancy. At her trial, she was sentenced to 30 years for aggravated homicide and served 10 before campaigners managed to get her sentence commuted. I just kept thinking, why? Why did those who testified against me do this to me? But these are injustices which happen, and there are many others who are going through what I did.

Elsie is certainly right about other cases. As recently as May, a woman called Esme was sentenced to 30 years, also for a miscarriage. Campaigners say the battle isn't just in changing the law, but changing society. Mariana Moisa is one of the leading women's rights activists in El Salvador. There is a different take on all this, and it is that Latin America could teach something to the United States through experiences as terrible as ours, in which you'll end up having women deny their freedom under these circumstances. But there are also examples of building common ground and finding solutions.

Inside the Padre Vito Guarato home for abandoned children in San Salvador, five-year-old Ana Lucia is attended to around the clock by her carers. She has microcephaly, where a baby's head is significantly smaller than normal, possibly linked to a Zika virus outbreak. The staff do everything they can to give her a dignified, comfortable life. But in truth, with no option to abort in El Salvador, some parents see no choice but to abandon. I think the mothers should assume their responsibility of being a mother,

says Rosa Evelyn, one of the managers at the church-run children's home. If God gave you the virtue of becoming a mother, then you must be one for as long as God allows it. It is a view shared by many in this traditionally Catholic nation. On the anniversary of his third year in office, El Salvador's controversial president, Nayib Bukele, delivered a national address from inside Parliament. In it, he applauded a plan led by his wife to improve the safety of childbirth in public hospitals. Yet the country's draconian abortion laws

will remain untouched for the foreseeable future. El Salvador resolute in the face of decriminalisation elsewhere in the region and bolstered by the ruling of the US Supreme Court. Our Central America correspondent Will Grant. Let's head to India now with our Women and Social Affairs editor Geeta Pandey. Gender justice activists in India have described the ruling as a huge step back for women's rights and say it's guided by Victorian morality. Dr. Veena J.S., activist and forensic medicine professor who teaches medical ethics to doctors, says the Roe v. Wade ruling will impact women's

reproductive rights not just in the US, but have a cascading effect around the world too. Abortions have been legal in India since 1971, although with riders, especially to curb female feticide in a country with an overwhelming preference for sons. But because of a general lack of awareness among women, stigma attached to the topic and doctors' reluctance to perform abortions out of religious or moral beliefs mean a majority of abortions are still held outside of registered medical facilities. And unsafe abortions continue to kill thousands of women every year. According to the UNFPA's State of the World Population Report 2022, nearly eight women die each day in India from causes related to unsafe abortions. Geeta Pandey in India. Japan is on course to

approve the abortion pill for women, a drug already available in more than 70 other countries. The drug, which costs around $780, has sparked debate in the country, as our Asia business correspondent Mariko Oi, who is from Japan, explains. They're debating whether to approve the use of abortion pills, but that basically put a spotlight on this outdated law, which I have to say I had no idea about. But it's been around for decades, and it says that a woman needs to have a partner's consent before having an abortion. I know of quite a few of my friends who were single and still managed to have an abortion. So I don't think it's, you know, a very strict law that's implemented at the moment.

It depends on which doctors you go to, if you like. But when an official from the Ministry of Health was asked, would a woman need her partner's consent to take abortion pills? His answer was, strictly speaking, yes. And as you can imagine, that just kind of started all the debate. And it's very expensive, this pill. Well, everything to do with contraceptions or abortions are quite costly in Japan. Whether or not that's because of, you know, if there's any kind of intention there is, you know, anyone's guess. But it is true that it is very difficult for one to afford it unless you come from a fairly wealthy background. Also, you know, I remember this long years of process of approving contraceptive pills when, for example, Viagra got approved like within weeks or something.

So, you know, you just do wonder why that happens, you know, whether it has to do with women's rights and the fact that we have so many more male lawmakers than female. You know, does it have anything to do with it? Again, like that's something all speculation, but you do have to wonder because these incidents just keep occurring. We sort of hear about the birth rate being low and things like that. Is that part of the abortion debate and why things haven't maybe moved along? Or would you say it's more to do with the lack of sex education or more conservative views? I think when it comes to Japan's declining birth rate, which we've obviously had for many years now, I think it's partly financial. So I work as a business correspondent, and Japan's

wages haven't gone up in about 30 years. And if you look at the chart of how wages have really stagnated in Japan compared to the UK or the rest of the world, it's very obvious. And, you know, if a new father to be or, you know, wannabe father thinks of, oh, you know, can I, you know, afford this? Because, of course, in Japan, a lot of fathers or men, husbands still take care of the financial situation at home. You know, when they have that doubt, you know, would you actually consider having a child? Same for women as well. You know, if they have any financial insecurity, you know, they might reconsider it. And so that I think that plays the biggest part in terms of the declining birth rate. But I think it is I mean, you know, it's also it's almost a cultural taboo to have a child outside of marriage.

And that obviously affects the situation. I do think that the level of sex education is very low. It's almost culturally taboo to talk about it at school among your friends. Those girls at very young age should be educated a baby bonus, you know, all of that has been debated and some of them have been implemented. But I think, yeah, the level of sex education definitely plays a part. That was Mariko Oi. While Latin America has some of the world's strictest abortion laws, in recent years, a number of countries have seen abortion decriminalised. The movement is known as the Green Wave, the colour given to the campaign for safe and legal abortions. And one place that has seen change is Colombia.

In a landmark decision in February, the Constitutional Court ruled abortion is legal up to 24 weeks, making it the country with the most progressive abortion laws in the region. Phoebe Hobson spoke to Mariana Ardila, a lawyer from Women's Link Worldwide, who explained how they won the case in a country with a Catholic majority. The public debate that we opened was not whether or not you agree with abortion or if abortion is good or is bad. It was like, which is the most effective way to regulate abortion? And saying we have been trying criminal law for so long and it's not serving anyone, it's not reducing abortions, it's just making abortions unsafe. Another strong data that we had was that most of the criminal reports of those 400 annual cases

of abortion, of criminal investigations for abortion, were open due to reports done by people working in clinics and hospitals and health centres in violation of medical confidentiality. What's happened to those women that were facing charges or who were even in prison for having an illegal abortion before the law changed? When any criminal law changes in Colombia, it has a retroactive effect. And there are legal clinics working now in providing services to those criminalised women so investigations can be closed and their convictions are revised. What's the situation in the country now?

We don't have to be naive and deny that actually many of the obstacles that we identified previous to this historic decision are still there. So we have a lot of work ahead and also in what we call the social decriminalization of abortion, meaning that we explain to everyone in the country why is that we should respect a woman's choice whether or not to be a mother, and we have to offer her protection and not jail or judgment. So it has been a long road. We even use music, art, to call for very young women to actually take young women that really owned the process. And when the decision came down, they said, we won and this is ours.

Phoebe Hobson speaking to Mariana Ardila. Back to the United States, where our conversation began. We are only just seeing the beginning of the impact of the ruling, both in terms of the protests against the decision and the motivation it is giving to further the anti-abortion campaign. Our correspondent in Washington, Anthony Zerker, gave his take on what this landmark decision might mean for the country. I think you're going to see the divisions play out in the patchwork of

states across this country that will either be banning abortion or protecting abortion rights. You're going to see divisions on a highly emotional charge moral issue on the state map, the likes of which we honestly have not seen since before the Civil War with slavery, where states are either for abortion rights or anti-abortion, and they're battling out for kind of supremacy on the national stage, imposing their views on this moral issue or attempting to on each other. And then you have a handful of states that are kind of balanced on a razor's edge, where the outcome of one election or the other could determine whether for the coming years that state has abortion rights or has extreme restrictions on abortion.

It is going to make this a political debate that is extremely heated and is being played out across the country. And that's all from us for now. But there will be a new edition of the Global News Podcast later. If you want to comment on this podcast or the topics covered in it, you can send us an email. The address is globalpodcast at bbc.co.uk. You can also find us on Twitter at Global News Pod. This edition was mixed by Ben Andrews and I was the producer. The editor is Karen Martin. I'm Iona Hampson. Until next time, goodbye. If you're hearing this, you're probably already listening to BBC's award-winning news podcasts. But did you know that you can listen to them without ads? Get current affairs podcasts like Global News, AmeriCast and The Global Story, plus other great bbc podcasts

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