Protecting abortion providers requires effective strategies to prevent harassment

Photo: SIM USA/Flickr (CC BY-SA 2.0)

Private abortion providers make it possible for people to exercise their rights to bodily autonomy, to health, and to decide if and when to form a family. But providers working in national contexts where the law is poorly understood and abortion is socially stigmatized face harassment by police, spurious charges, and occasionally arrest and prosecution. This combination of confusion and stigma leaves these providers—widely considered to be women’s human rights defenders—vulnerable to intimidation, fearful of fighting back, and, sometimes, resigned to the notion that enduring harassment is the “cost of doing business.”

Attacks on abortion providers are the manifestation less of state policy than of state practice, and of social and cultural norms that normalize patriarchy and the patrolling of women’s bodies. Eradicating police harassment and abuse demands the radical transformation of gender norms. But, as that work continues, persecution can be short-circuited in the immediate term. Abortion providers and lawyers throughout East Africa and Latin America have developed effective protection strategies implemented by national legal support networks. Refined together with Planned Parenthood Global, these networks have enabled providers to offer care—and clients to receive care—with dignity and without fear.

Attacks on abortion providers are the manifestation less of state policy than of state practice.

Abortion is completely illegal in very few countries. In most countries around the world, in fact, it is permitted to save the life or protect the health of a pregnant woman.

Because abortion is truly legal in many cases, and because a safe abortion—even if performed beyond the constraints of the law—is impossible to distinguish from a miscarriage, in countries with repressive abortion policies, police are generally unable to find grounds for legal action for the actual provision of care. As a result, harassment in these countries often takes the form of detecting failings in the administrative requirements for practice, such as authorizations, proper documentation, and employment contracts. The legal support networks follow protocols that ensure providers are in full compliance with these kinds of regulations. When a legal incident does arise, a network lawyer is also available to reduce the risk to the provider, staff, and clients, and mounts a defense against unwarranted charges when a case makes it to court.

A network lawyer is available to reduce the risk to the provider, staff, and clients, and mount a defense against unwarranted charges when a case makes it to court.

What do these “prevention protocols” look like? During periodic visits, a network lawyer and abortion provider work together to review and ensure the security of the clinic premises, staff, and documents (client registries, clinical records, financial data). They compile a complete and up-to-date file of credentials, authorizations, certificates, tax records, and any other documentation required to operate legally. They review contracts, to confirm compliance with all relevant labor laws, and establish procedures to follow in case of a medical or legal emergency.

Perhaps most importantly, all staff are trained in rights-based approaches to health care. The idea is to make sure that everyone—from the guard at the clinic door to the administrative staff managing the office to the clinical staff—understands the importance of the care provided at their clinic, and how abortion care protects and promotes women’s human rights. Training in rights-based health care also includes putting in place clear and comprehensive counseling and informed consent procedures. Apart from the obvious purpose of fulfilling patients’ rights to information and autonomy, solid informed consent protocols work to normalize abortion care and reduce shame and are fundamental to preventing police abuse.

Network lawyers must be well-versed in local law and regulations, not international law.

These legal support networks offer WHRDs additional protection measures, beyond the bureaucratic. They create cross-disciplinary national communities of practice and of solidarity between lawyers and healthcare providers, critically limiting the sense of isolation and stigma both may feel. They enhance the skills of both, as well as their commitment to sexual and reproductive rights. This is an important act of politicization for people—both providers and lawyers—who may be more likely to define themselves by their profession than as WHRDs, even as promoting women’s human rights is the thrust of their work. Through training, participation in conferences, and other gatherings, the national networks connect regionally and, through their relationship with Planned Parenthood Global, to international human rights organizations and movements across geographies.

Lessons about good practice have been learned in over ten years of trial and error developing legal support networks. Primary among them is that prevention must be at the heart of the networks’ work for them to be successful. (A prevention strategy also provides a useful complement to the social change, and legal and policy work, to advance the right to safe abortion underway in a given country.) Second, national lawyers with national expertise must lead. Early networks turned to international human rights lawyers whose knowledge was not entirely relevant: network lawyers must be well-versed in local law and regulations, not international law. Third, the network must proactively build relationships with providers so that they feel the impact of the prevention work, and so that they call skilled network lawyers in times of crisis, and not default to whomever they might find to take their case. Finally, the network must devise creative strategies to retain its volunteer lawyers, who are often busy with other work. Planned Parenthood’s networks have successfully engaged these lawyers through consistent, valuable professional development (e.g., training and networking).

The frequency of harassment, arrest, and prosecution of providers who work with the legal support networks has decreased substantially in both East Africa and Latin America, suggesting that women’s human rights defenders who perform abortions can protect themselves from rights violations through organizing, solidarity, and strategizing about practical interventions with peers and allies.