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One of the great pro-life victories internationally over the past twenty years has been the defeat of the attempt to make abortion a universally recognized right through U.N. documents. Abortion is not mentioned in a single hard-law treaty and therefore has not risen to the legal level of a “human right.”

While abortion has not made any real progress through the U.N. rights-based approach, it has made serious advances through its promotion as a basic medical practice. The great engine for this has been the World Health Organization.

When national health ministers want advice about maternal mortality or reproductive health, they don’t turn to U.N. documents but to advice from the WHO. The official WHO definition of reproductive health includes “fertility regulation” and the definition of “fertility regulation” includes, first and foremost, abortion. Health ministers generally do not need any prodding when it comes to promoting abortion, but when they need ammunition to meet pro-life criticism at home, the WHO provides it.

In this vein, the WHO recently released the second edition of its Safe Abortion: Technical and Policy Guidance for Health Systems . The report contains abundant problems, which are examined by Dr. Susan Yoshihara and Dr. Rebecca Oas in “Eleven Problems with the 2012 WHO Technical Guidance on Abortion.”

The greatest issue of concern, they write, is that the WHO promotes “abortion practices for women in developing countries that have been rejected by medical experts in the developed world.”

For example, the WHO Technical Guidance endorses the more dangerous practice of using the abortion drug misoprostol alone without its companion drug mifepristone. The “Eleven Problems” report explains, “Mifepristone, also known as RU-486, is used to induce abortions by causing the softening and dilation of the cervix. Misoprostol, which was originally approved for the treatment of gastric ulcers, induces cervical contractions, and is therefore used in conjunction with mifepristone to cause the expulsion of the unborn child.” Though the use of these drugs for this purpose is morally repugnant, the use of one without the other prolongs the abortion process and puts the woman at greater risk. In fact, only a few years ago, in the first edition of this report, the WHO recommended against this practice.

One member of the American Association of Pro-Life OB/GYNs told Yoshihara that some of the practices advocated by the WHO would expose an American doctor to lawsuits.

Of equal concern is that the Technical Guidance places the onus for follow-up care on the patient. After the administration of the abortion drugs, the woman is sent home to self-diagnose any complications. In reality, follow-up care with a medical practitioner is “necessary to diagnose complications,” and “hemorrhaging and infection”potentially serious or fatal complications”are often misidentified as abortion’s usual symptoms of pain and bleeding.”

The Guidance recommends the use and even reuse of manual vacuum aspirators, which is a “hand-held, hand-activated pump” that evacuates the uterus and is often used by badly trained technicians or midwives in less than sanitary conditions. It also recommends sterilization techniques that are simply not available in remote areas.

Elsewhere, it acknowledges that the abortion drugs it suggests may not be effective in killing the child but therefore advises “commonly used pre-procedure regimens to effect fetal demise [which] include injection of potassium chloride (KCi) through the fetal umbilical cord or into the fetal cardiac chambers.” Of this recommendation the “Eleven Problems” report says the WHO “calls ‘effective’ a drug that admittedly causes ‘limb defects and skull and facial abnormalities in pregnancies that continued after failed attempts to induce abortion.’”

Moreover, the WHO says that “liquid waste, such as blood or other body fluids, should be poured down a drain connected to an adequately treated sewer or pit latrine,” practices that could pose serious threats to public health.

Besides questionable medical recommendations, the Guidance wanders into a faulty understanding of the law and human rights. As the “Eleven Problems” report states, “the WHO technical guidance advocates [overturning] all limits to abortion, for all nine months of pregnancy, for all ages including minors regardless of national laws, and in contravention of established human rights such as freedom of conscience and parental rights.”

The WHO document was presented to the U.N. General Assembly a few weeks ago. It is certain that most delegates have only a passing understanding of what this very technical report recommends. Health ministers, a highly suspect group when it comes to abortion anyway, will try to use the document to get around any domestic restrictions they may encounter on the question of abortion in their countries.

It is extremely difficult for laymen to counter the arguments made in such a document, difficult also for parliamentarians and other policymakers to counter the tyranny of “expert” recommendations coming from WHO headquarters in Geneva.

Where pro-lifers have generally won the argument about an alleged universal right to abortion, they are losing on practical ground where such dangerous documents hold great sway.

Yoshihara and Oas submitted their paper to the WHO, which to date has not responded.

Austin Ruse is president of C-FAM (Catholic Family & Human Rights Institute), a New York and Washington, D.C.-based research institute focusing exclusively on international legal and social policy .


Susan Yoshihara and Rebecca Oas, “ Eleven Problems with the 2012 WHO Technical Guidance on Abortion

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