The legal status of emergency contraception.

Emergency contraception (EC), an intervention within 72 h of unprotected intercourse, dates back approximately 30 years, to the Yuzpe method. Recent development of a second generation of 'morning after,' better called 'emergency' contraceptives, has raised claims that they are abortifacient. These claims are largely rejected in medical, legal and much religious reasoning. Pregnancy is usually ascribed to the postimplantation period; means to prevent completion of implantation do not terminate pregnancy. An alternative attack on EC has arisen under South American laws that protect human life 'from conception.' The chance of conception from a single act of unprotected intercourse is very low, in view of limited times of fertility during menstrual cycles. The protection of a woman's life is not suspended during pregnancy. Risks to women's interests are more credible than the chance of conception having occurred. The claim to prohibit EC to protect embryonic life from conception is therefore problematic.

La anticoncepción de emergencia es un derecho / The emergency contraception is a right

Amparada por sus derechos a la libertad de pensamiento y de conciencia en en ejercicio de su autonomía reproductiva es la mujer a quien corresponde en su fuero interno decidir si evita o no un embarazo, acudiendo por ejemplo a la anticoncepción de emergencia

[Towards safe motherhood. World Health Day]. / Hacia la maternidad segura. Dia Mundial de la Salud.

PIP: The objective of the 'safe motherhood' initiative is to reduce maternal mortality by 50% by the year 2000. A strong policy is needed to permit development of national and international programs. The lifetime risk of death from causes related to complications of pregnancy is estimated at 1/16 in Africa, 1/65 in Asia, 1/130 in Latin America and the Caribbean, 1/1400 in Europe, and 1/3700 in North America. A minimum of 585,000 women die of maternal causes each year, with nearly 90% of the deaths occurring in Asia and Africa. Approximately 50 million women suffer from illnesses related to childbearing. A principal cause of maternal mortality is lack of medical care during labor, delivery, and the postpartum period. Motherhood will become safe if governments, multilateral and bilateral funding agencies, and nongovernmental organizations give it the high priority it requires. Women also die because they lack rights. Their reduced decision-making power and inequitable access to family and social resources prevents them from overcoming barriers to health care. Women die when they begin childbearing at a very young age, yet an estimated 11% of births throughout the world each year are to adolescents. Adolescents have very limited access to family planning, either through legal restrictions or obstacles created by family planning workers. Maternal deaths would be avoided if all births were attended by trained health workers; an estimated 60 million births annually are not. Prevention of unwanted pregnancy and, thus, of the 50 million abortions estimated to take place each year would avoid over 200 maternal deaths each day. Unsafe abortions account for 13% of maternal deaths. The evidence demonstrates that rates of unsafe abortion and abortion mortality are higher where laws are more restrictive.^ieng

Improving quality at many levels. Profamilia's experience in Colombia.

PIP: Profamilia, the Colombian family planning association and the country's largest family planning provider, began diversifying its services in 1982 to offer prenatal care services as well as general medical consultations. The organization has since attempted to integrate quality assurance at all levels of operation. Specifically, Profamilia is aiming to provide care which is of sustainably high quality to satisfy present clients and attract new ones without overtaxing available organization resources, thereby prompting the eventual financial collapse of the programs and the failure to increase coverage especially among the middle and lower classes of the country. Drawing from the credo of modern corporate enterprise, "the client is always right," Profamilia listens and responds to clients' needs with the goal of making their satisfaction the ultimate objective. Moreover, organization staff receive regular training to motivate their receptiveness to client needs, while the pursuit of quality exists as a major goal at the managerial level. Profamilia regards quality maintenance and improvement as indispensable in program sustainability.^ieng

[Equal rights for women and the United Nations convention in Latin America]. / La igualdad de derechos de la mujer y la convencion de la O.N.U. en America Latina.

PIP: Although Latin American institutions have, directly or indirectly, established the juridical equality of the sexes, institutional power continues to be concentrated in the hands of men. It is necessary that Latin American governments seek ways to eliminate the legal, cultural, economic, political and social discrimination that persists against women in these patriarchal societies if men and women are to enjoy equality of rights. Today, instruments such as the Convention of Elimination of All Forms of Discrimination Against Women approved by the UN in 1979 and ratified by all Latin American countries, have succeeded in establishing the concept of improvement of the status of women as a legislative right supported by international juridical principles. International recognition of human rights has meant that all restrictions against women in the public and private realms are to be regarded as discrimination. Previously, family law was based on traditional customs which accepted that the roles and obligations of men and women were different. Although most Latin American countries now have laws recognizing the equality of rights and obligations of men and women, women continue to be in a secondary position. Poverty, scarcity of resources, and the economic crisis not only impede improvement in the status of women but have led to increases in female unemployment. Another obstacle is the lack of a true political will to improve the status of women. The UN convention on elimination of discrimination obliges each ratifying nation to strive not just for equality or rights but for equality of enjoyment of these rights. Each government should adopt measures to overcome discrimination. Among measures adopted by governments to achieve equality have been incorporation of the principle of equality into the national constitution and creation of offices or ministries for women that are distinct from those for the family or youth. The Committee for Elimination of Discrimination Against Women established by the convention and composed of 23 expert members has had great difficulty in carrying out its mission due largely to the lack of acceptance of the goals of the convention. It will not be easy to modify a culture, acquire economic resources, and create political will. But almost all Latin American and Caribbean countries have used government programs to improve the status of women as smokescreens to hide their inaction. New strategies will be required that combine legal negotiation, political pressure, popular organization, and use of the mass media.^ieng