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Women’s rights to their own body choices

11 July marks World Population Day and this year that covers an estimated 7.7 billion of us. In less than a decade, that number will have climbed to approximately 8.5 billion. However around the world a woman’s womb is becoming a political battleground as fertility rates fluctuate and policy responses often do not consider womens’ choices, health or rights. 

45% of women do not have the freedom to exercise choice over their bodies and fertility according to the United Nations Population Fund (UNFPA) who highlight that ‘women must be empowered educationally, economically and politically” to be able to make those choices for themselves. 

UN Secretary-General, António Guterres expressed his concern, “ These gaps in access to health rights are unacceptable. Women cannot be alone in this fight.” To mark World Population Day, he called for a pledge,

“to ensure the reproductive health rights of everyone, everywhere.

World Population Day references that despite representing basic autonomy over their body, many women globally do not have control over their own reproductive rights or access to sexual health services. In his statement Guterres commented:

“In addition to the millions of lives tragically lost, there has been a less visible toll:  a shocking rise in domestic violence as women were forced into isolation with their abusers; empty maternity wards as women postponed motherhood; and unintended pregnancies due to curtailed access to contraceptive services.”

The pandemic in particular has widened the gaps of gender inequality, increased violence against women, and compromised the health care systems required for women and girls to avoid unplanned pregnancies, female genital mutilation, and child marriage. Lockdown not only saw a significant number of women leaving the workforce, but also increasingly left women in caregiving positions which destabilised them financially. While lockdown has been a temporary measure, the negative impacts it has had on women’s reproductive rights will have long term consequences.

However our planet is at a tipping point with population growth exceeding the planet’s resources. Climate change is reducing the sustainable living areas creating food and water shortages and famine for some and mass migration for others. Economics have driven more people to live in urban, rather than rural areas for the first time ever. We are living longer and although female birth rates have fallen from an average of 4.5 children to 2.5 in less than 50 years, there are more women having children. It is against this backdrop, that many countries are expressing growing concern over changing fertility rates and the inability to plan forward. 

However, it is these very concerns that often trigger extremely harmful responses such as coercive family planning, restricting access to contraception, and even sterilisation. While these measures are often portrayed as helpful and necessary, it is difficult not to see them for what they truly are, a major violation of bodily autonomy for women and an erosion of human rights. As António Guterres stated:

“In every corner of the world, we are seeing a reversal of hard-won gains and an erosion of women’s reproductive rights, choices and agency. With the onset of the pandemic, resources for sexual and reproductive health services were diverted”.

Coercive family planning

Coercive family planning, in the form of birth restrictions, is used as population control in several parts of the world. A two-child policy for example, has previously been used in Iran, and Singapore. Since the 1980s, Vietnam has maintained a rule limiting family size to two children, born roughly three to five years apart. However, the most notable use of a birth control policy can be seen in China. Up to 2016, China enforced a one child limit then increased it to a two-child limit as birth rates fell, then in May 2021 introduced a three-child policy.

Although at first increasing the number of permitted births seems like it is offering women more choice in their family planning, a three-child policy is still stripping women of bodily autonomy and reducing their reproductive rights. As a result of the invasive government measures to control birth rates, women in China routinely face pregnancy discrimination both in the private and public sphere. Even before the three-child policy was introduced, women lost out on workplace opportunities for being able to go on maternity leave twice rather than once. This type of discrimination is only going to increase with the introduction of a three-child policy.

The 37-page report titled “‘Take Maternity Leave and You’ll Be Replaced’: China’s Two-Child Policy and Workplace Gender Discrimination”, published by the Human Rights Watch, describes in detail the job discrimination women face in China as a direct result of the government’s restrictive policies. The report draws on surveys, documents, social media posts, as well as media coverage and has found that several employment ads in China have explicitly stated that men are required for the role since employers fear women will ask to take time off for future pregnancies. Women have also been required to sign contracts, stating they will refuse to have a second child for a minimum of three years in order to get the job. Furthermore, there has been evidence that employers will purposefully create a hostile work environment to force women to resign from the position. For example, a company in the northeast Jilin province made a seven-and-a-half-month pregnant employee work at a construction site in the winter during terrible weather conditions in the hopes that she would resign.

These examples of workplace discrimination are aimed directly at women’s reproductive rights and prevent them from progressing in their work life. By enforcing these birth policies, China is limiting women’s access to education and employment while punishing them both for having too few and too many children. This is a clear violation of human rights. Human Rights Watch researcher Yaqiu Wang, who specialises in women’s rights in China commented:

“By pushing for a higher birth rate without adequate employment protections, the Chinese government has given employers a license to harass and discriminate.”

The Chinese government stated that the three-child policy was introduced to combat China’s decline in birth rates, the direct result of the previous one child policy. If the Chinese government continues to control women’s reproductive rights to achieve its own population targets, China will continue to bounce between restrictive policies that directly encourage pregnancy discrimination. As Sophie Richardson, China director at the Human Rights Watch, stated, “Beijing needs to drop all restrictions on reproductive rights, work against all formed of employment discrimination, and level the playing field on parental leave. Only then might we see real positive change.”

Forced sterilisation

One of the most concerning forms of controlling reproductive rights is the use of coerced or forced sterilisation. Victims of forced sterilisation are often women, disabled people, and intersex and transgender people. While prohibited in the Council of Europe’s Istanbul Convention and considered a crime against humanity by the International Criminal Court’s Rome Statute, it is still used in some countries as a form of population control and usually enforced through surgical procedures.

One of the most recent uses of coerced sterilisation has been documented in Xinjiang, where it is used on Uyghur women in the region. A study by German researcher Adrian Zenz found that the birth control policies used on Uyghur women could reduce the Uyghur population in Xinjiang by up to a third over the next 20 years. During that time, 2.6 to 4.5 million Uyghur births could be cut. In his research, Zenz stated that the Chinese government “planned to subject at least 80% of women of childbearing age in the rural southern four minority prefectures to intrusive birth prevention surgeries, referring to IUDs or sterilisations.”

In addition, despite the introduction of China’s three child policy, documents and testimonies have shown that Uyghur women in Xinjiang are still being subjected to arbitrary detention and punishments for exceeding birth control quotas. Reports also show that the government has purposefully moved people from the mainstream Han Chinese population into Xinjiang neighbourhoods, which are dominated by Uyghurs, while transferring local Uyghurs out of Xinjiang. So far the Chinese government has denied allegations of Uyghur genocide and insists that any drop in the ethnic minority birth rates is due to the implementation of general birth quotas and improved family planning. Yet, its use of coerced sterilisation on a minority population is a clear violation of reproductive and human rights.

Abortion laws

Probably the most common form of restricting reproductive rights is putting strict abortion laws in place. Countries that prohibit abortion altogether include Palau, San Marino, the Marshall Islands, Andorra, Tonga, Micronesia, Sao Tome and Principe, Malta, Suriname, Gabon, Mauritania, Republic of the Congo, El Salvador, Nicaragua, Laos, Honduras, the Dominican Republic, Haiti, Senegal, Madagascar, Angola, Iraq, the Democratic Republic of Congo, Egypt, and the Philippines. Women in countries with strict abortion laws suffer under restrictive family planning, gender-based discrimination, and a lack of access to sexual health services.

In the United States a bill was introduced in Texas (Bill: 87(R) SB 8 – House Committee Report version) that allows not just state officials, but also the residents of Texas to sue women for getting an abortion. The controversial law is planned to come into effect in September 2021 and, as other “heartbeat” bills in US states, will ban abortions after the detection of a “fetal heartbeat”, which occurs around six weeks into pregnancy. However, this concept is highly misleading because the embryo – it is only termed a fetus in the 11th week of pregnancy – does not have a heart at this stage, and there is no audible “beat”. Instead, the use of well-advanced ultrasounds in the last few decades has made it possible to detect a flutter of the group of cells that later on will form the heart. Criminalising abortions just two weeks after a missed menstrual cycle would signify a major step back in gender equality and make Texas one of the toughest state for abortions in the US. In fact, Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health, stated that “90% of abortions happen after six weeks. Most people don’t even know they’re pregnant at six weeks”. The only exception under the abortion ban are medical emergencies which means even women who become pregnant as a result of rape or incest are prohibited from getting an abortion.

Texas is not the only state in America with extremely problematic abortion laws. Republican lawmakers across states have been trying to limit women’s access to abortion clinics through the introduction of several bills. In 2021 alone, legislators have attempted to enforce 561 abortion restrictions, including 165 abortion bans across 47 states. According to the Guttmacher Institute, more than 80 of these restrictions and 10 bans have been enacted in 16 states, making 2021 the most hostile year for abortions in the US since 1973.

Women in the affected states suffer from high teen pregnancies, poor family planning, and some of the highest maternal mortality rates in the country. By restricting access to abortion clinics, these states are demonstrating that they do not value women’s rights to bodily autonomy, neither do they value their human rights.

Female genital mutilation

The UNFPA believe that the COVID-19 pandemic may have made an additional 2 million girls vunerable to female genital mutilation (FGM) in less than a decade. That is in addition to the estimated 3 million girls at risk every year. Education programmes designed to influence parents and female relatives, who are the most likely to take children to be cut, have been scaled back due to the virus restrictions. Putting that in perspective, there are over 200 million women who have been subjected to FGM today, so if even a small percentage of them continue the practice with their own children, then another generation faces this mutilation and the mental and physical harm that it brings.

FGM persists as a practice in some communities who believe it is a way to preserve virginity or as a preparation for marriage. Instead it puts girls’ health in danger, may cause infertility, or other health related issues and often leads to mental harm.  Any time between birth to puberty, girls’ female genitals are deliberately cut, injured or changed, often with no antiseptics and this mutilation is done by a non medically trained person. This is child abuse and girls have no choice, are often restrained against their will and are left with lasting physical and psychological impact of such an invasive and irreversible procedure is a clear violation of human rights.

Despite it being illegal since 1985 in the UK, the government estimates that at least 170,000 women and girls have been subjected to FGM. In 2003, the UK law on FGM was strengthened to prevent parents from taking their daughters abroad to get the procedure done.  The most effective way to prevent parents from subjecting their daughters to FGM is to break the misconception that FGM is beneficial for their children. It is hoped that by providing them with access to comprehensive health care education and to promote gender equality as well as reproductive rights that this abhorrent practice can be stopped. The NHS has provided comprehensive education, working with schools and civil society groups such as Plan International to try and break the cycle of abuse through education of parents and teachers in identifying those in potential risk. While raising awareness of FGM’s adverse health consequences alone will not eliminate the practice, it is an important step to maintain the human rights of women and girls. It is an extremely harmful practice that cannot be justified on religious or cultural grounds.

Healthcare and education

Providing women with easy access to sexual health services and education is an important aspect of maintaining their reproductive rights. Ingrained social norms and stigma have kept women from being able to control their own sexual health and fertility. In addition, impacts of the pandemic such as the lockdown, have further restricted women’s access to necessary health services. In India, for example, nearly two million women faced restricted access to abortion services during the lockdown and 26 million couples faced limited access to contraceptives.

While comprehensive sexuality education (CSE) is viewed as being at odds with some of India’s values, particularly religious ones, encouraging it to be taught in schools would ensure that young people in India are aware of safe sex practices and would remove some of the stigma tied to reproductive health, particularly for those that struggle to access free healthcare and contraception.

Regrettably, the UK government has recently voted to cut the budget for international development to 0.5% of the national income which led to a funding slash of 85% to the United Nations Population Fund which covered reproductive healthcare. Globally, one-third of girls who drop out of school do so because of an unplanned pregnancy. According to data from MSI Reproductive Choices,  simply providing reproductive choice could keep up to 4 million more girls in school each year in sub-Saharan Africa alone.

Restricting women’s reproductive rights through poor access to healthcare and education, carrying out female genital mutilation, denying them the option of abortion, coercing them into sterilisation or enforcing strict birth quotas is a direct abuse of human rights and denies women their bodily autonomy. For gender equality to progress globally, there simply cannot be any restrictions on reproductive rights.

If you’re concerned that someone may be at risk of FGM in the UK please contact the NSPCC helpline on 0800 028 3550 or [email protected].

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