McGinn Therese, Casey Sara E
Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, NY 10032 USA.
Confl Health. 2016 Mar 24;10:8. doi: 10.1186/s13031-016-0075-8. eCollection 2016.
Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'.
However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world's population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion.
As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women's right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women's health and human rights and save lives.
尽管在过去十年里，性与生殖健康服务在人道主义环境中变得更加普及，但安全堕胎服务仍然很少提供。作者的观察表明，造成这种差距通常有四个原因：“没有需求”；“在危机中提供堕胎过于复杂”；“捐助者不资助堕胎服务”；以及“堕胎是非法的”。
然而，这些原因中的每一个都基于错误的前提。不安全堕胎是全球孕产妇死亡的主要原因，危机中卫生系统的崩溃表明在人道主义环境中不安全堕胎情况可能会增加。堕胎手术可由中级医疗人员在没有复杂设备或物资的健康中心安全进行。虽然美国政府援助不资助与堕胎相关的活动，但其他捐助者，包括许多欧洲国家政府，确实资助堕胎服务。在占世界人口99%的大多数国家，在某些情况下堕胎是允许的；只有六个国家完全禁止堕胎。国际法支持增加获得安全堕胎服务的机会。
由于经常被提及的不提供这些服务的原因都不成立，人道主义非政府组织有责任决定他们在遵守人道主义标准以及妇女获得高质量和非歧视性卫生服务权利方面的立场。为战争中因强奸而怀孕的妇女提供安全堕胎服务可能是各组织开始讨论的一个更容易接受的切入点。提供安全堕胎服务将改善妇女的健康和人权并挽救生命。
