Last week, the United Nations Third Committee wrapped up the work of the 67th Session of the General Assembly. Delegates scrambled to finalize documents that had been in the works since September. The inclusion of the phrase “reproductive rights” in two of these documents resulted in several months of tense negotiations. Until now, only two GA resolutions have included “reproductive rights” (in 1999 and 2000). Now, two additional resolutions, “Supporting efforts to end obstetric fistula” (A/C.3/67/L.22/Rev.1) and “Intensification of efforts to eliminate all forms of violence against women” (A/C.3/67/L.19) have been added to this list—paving the way for the term to become entrenched in the body of UN language.
The problem with “reproductive rights” is that it could be understood to mean the right to abortion, which does not exist under international law. The phrase “in accordance with the Programme of Action of the International Conference on Population and Development” was inserted immediately following “reproductive rights” in both resolutions. The reference to the ICPD was introduced as a compromise in order to highlight the fact that States have the prerogative to determine their policy on abortion (ICPD paragraph 8.25).
At the adoption of the Fistula text, several Member States delivered statements affirming the right to life. The delegate from Peru made note of the fact that the Peruvian constitution “recognizes the right to life from the moment of conception and abortion is a crime in Peru.” Similarly, Chile’s delegate stated that “in Chile’s constitution, life is clearly protected from conception to natural death [and] no part of this resolution can be taken or interpreted as direct or indirect exceptions to abortion.” In contrast, the United States stated that “it is only by protecting sexual and reproductive health and reproductive rights” that obstetric fistula can be eliminated.
Myriad factors contribute to the prevalence of obstetric fistula in poor countries around the world. As the delegate from Kenya explained, obstetric fistula is a result of “lack of health facilities, inadequacy of birth attendants, lack of trained medical personal, unavailability of necessary expertise to deal with complications in childbearing especially in the rural areas.” These factors often are exacerbated by persistent violence against women and girls, which manifests in the form of forced and child marriages in addition to other harmful practices.
Obstetric fistula does not stem from the act of giving life, but from the problems of poverty and the lack of adequate healthcare to ensure that new life can be brought safely into the world. As evidenced by the absence of obstetric fistula in the developed world, ending poverty will result in the end of obstetric fistula. At the most fundamental level, the solution to ending obstetric fistula resides in the challenge of poverty eradication.