By Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists
The UK has a long track record of promoting global sexual and reproductive health. The upcoming Foreign, Commonwealth & Development Office Women & Girls Strategy is the perfect opportunity for the UK government to continue its legacy by putting reproductive choice at the heart of its plans for global gender equality.
In 2012, the UK Government, led by the Minister for Development, Andrew Mitchell, was at the forefront of the FP2020 Initiative, through which it helped to deliver modern methods of family planning to an additional 16.7 million additional women and girls1. However, any such progress continues to be undermined by the government’s decision not to restore aid to 0.7% of GNI since it was cut in November 2020, with devastating consequences for women and girls.
Estimates suggest that cuts to UK overseas aid have already directly resulted in 9.5 million fewer women and girls having access to modern methods of contraception, resulting in 4.3 million more unintended pregnancies, 1.4 million more unsafe abortions and 8,000 more avoidable maternal deaths2.These statistics are even more shocking when you consider every two minutes a woman dies during pregnancy or childbirth globally.3
Now is not the right time for the UK to turn away from the women and girls around the world who need our support. Whilst there have been several notable wins for reproductive rights in the past year, such as the decriminalisation of abortion in Colombia and the expansion of access to abortion for all women regardless of marital status in India, we continue to see women and girls, from the US to Afghanistan, being denied the right to make decisions about their own lives.
Conflict and crisis also continue to be a disruptive force. In Ukraine, attacks on hospitals have forced women to give birth in underground shelters and subway stations. In Pakistan, women are struggling to access essential services after floods decimated health facilities, roads and bridges. Right now, there are an estimated 356,000 pregnant women seeking refuge in the aftermath of the earthquake in Turkey and Syria, more than 38,000 of whom are expected to give birth in the next month.4
The upcoming publication of the Women & Girls Strategy is an urgently needed answer to the question of how the UK government plans to restore progress towards universal access to sexual health services. Since the publication of the International Development Strategy in June of last year in which the government committed to driving progress on reproductive choice, further cuts have been announced to the UK’s flagship sexual health programme, WISH.
The moral obligation to support women and girls’ reproductive health and rights is clear - bodily autonomy is the foundation upon which women and girls are able to exercise their rights - but it is also a strategic investment. Enabling women and girls to choose for themselves whether and when they have children and to access high quality health services frees them to pursue education and employment, as well as to participate more fully in social and political life.
With fewer unintended pregnancies, the costs of improving pregnancy, birth and new-born care are lowered. It is estimated that for every $1 invested in meeting the unmet need for contraceptives, $120 is accrued due to reduced infant and maternal mortality and long-term benefits from economic growth.5
Supporting women to take control of their reproductive health is therefore inextricably linked to other international development objectives including reducing poverty, strengthening health systems and achieving gender equality.
But the benefits of universal access to sexual and reproductive healthcare services cannot be realised without long-term, predictable funding. The fundamental challenge facing universal SRHR are structural inequalities which mean that the poorest and most vulnerable people bear a disproportionate burden of poor sexual and reproductive health. Sustained and multilateral efforts are essential to overcome this and to ensure that no one is left behind.
If the UK government is serious about driving progress and achieving significant change for women and girls, then prioritising the promotion of reproductive choice within the Women and Girls Strategy and restoring this spending is not only the right decision but the necessary one.
References
2. https://www.guttmacher.org/just-numbers-impact-uk-international-family-planning-assistance-2021-2022