Taking a page from the Clinton Global Initiative, the recent Women Deliver Conference in London was full of commitments. The U.K. government announced a $200 million grant to the United Nations Population Fund for contraceptive commodities, and the Japanese government vowed to make global health a priority at the Group of Eight Summit meeting next year in Japan. The John D. and Catherine T. Mac Arthur Foundation placed an extremely large bet–$11 million–on a four-part intervention strategy to dramatically reduce maternal mortality. First implemented in Nigeria and India (where 30% of all maternal deaths occur), the strategy is significant in that it specifically trusts and empowers women, families and communities to take action when a woman's health and life are in danger during childbirth. Following on the heels of Women Deliver, the Global Safe Abortion Conference may not have played host to the grand gestures made at Women Deliver, but private and public donor agencies, with the notable absence of the U.S. government, were there in force.
The take-home message was clear: At least a few thousand people from among the world's 6.6 billion are ready to shake up priorities for women's health and end the unnecessary suffering that in much of the world endures. Both conferences attracted policymakers who actually hold much of the power over that progress. But it was the final policymaker in the final plenary who brought home just how much of an uphill climb we still have to ensure a woman's health and dignity during pregnancy.
In addressing the Global Safe Abortion Conference, Lord David Steel–architect of the 1967 law legalizing abortion in England–underscored his preference for contraception over abortion. His remarks reinforced quotes in that day's Guardian, where he lamented that the law had led to far too many abortions: "If things go wrong you can get an abortion, and it is irresponsible, really…people should be a bit more responsible in their activities, and in particular in the use of contraception." Ann Furedi, Chief Executive of the British Pregnancy Advisory Services, responded that, "Abortion is not in itself the problem. The problem is the unwanted pregnancy and abortion can be the solution to that for many women. There's no right or wrong number; we need as many abortions as are necessary to solve the problem pregnancies that women face." It is unfortunate that Lord Steel's remarks come at a time when the U.K Parliament reviews its abortion law. Though the British public is firmly prochoice, 1 in 10 say that a woman does not have the right to decide to have an abortion.
The debate underscores just how important these two conferences were. Nothing is ever assured when it comes to women's rights and health, and we gain strength from one another. There is no hiding from the fact that achieving Millennium Development Goal number five, to improve maternal health, will require drastic course correction.
Though the conferences were two significant steps forward, we were put at least three steps back by Lord Steel's remarks, the absence of many policymakers at the Global Safe Abortion Conference (especially those who support reproductive rights) and the great distance we have to bridge between maternal health and gender equality and equity.
We need to acknowledge that until women gain equal status, health systems improve and laws change, many women will have a baby or an abortion on their own or with unskilled help. We will have to be vigilantly on the lookout for policymakers who forget or ignore that women have the right and the sense to make their own decisions when it comes to pregnancy and deserve every support that communities and societies can provide.