Slipped into the middle of a 200-page report, this directive from the World Health Organization (WHO) could have gone unnoticed. The report in question, published on 8 March, on the occasion of International Women’s Rights Day, is an update of a series of health recommendations regarding the practice of abortion.
The WHO therefore urges the abolition of any law or regulation that limits access to voluntary termination of pregnancy (IVG) ” based on gestational age limits. Understand: WHO calls for abortion to be possible at any time during the nine months of pregnancy.
A recommendation that the United Nations public health agency makes in the name of the right to abortion and the dangers associated with clandestine abortions. ” It was found that the [délais d’accès à l’avortement liés aux] gestational age limits have been associated with increased maternal mortality rates and poor health outcomes “, we can therefore read at the end of chapter 2 of the report. Bela Ganatra, head of the WHO unit for the prevention of unsafe abortions, believes that the limits of access to abortion based on gestational age are ” arbitrary “And therefore constitute” medically unnecessary obstacles “, who “It shouldn’t be enshrined in law “.
In France, for example, the law of 2 March 2022 aimed at strengthening the right to abortion already extends the legal deadline for resorting to abortion by two weeks, thus passing from 12 to 14 weeks of pregnancy. A measure already highly controversial, but far from the total abolition of access times suggested by the WHO. If the country of human rights does not seem ready to take this step, can the new WHO recommendations influence French legislation in the long term?
Deep reluctance on the part of gynecologists
The former president of the National College of French Gynecologists and Obstetricians Israel Nisand practices abortions in the Strasbourg University Hospital, where he practices. ” I understand that the WHO wants to liberalize abortion. WHO combats women’s mortality, which is huge in countries where abortion is not legal, he advances, but there comes a time when a viable baby is killed if it were out of the womb! ” There is therefore no risk, according to him, that the French medical profession will be in tune with the recommendations of the WHO.
If in France medical termination of pregnancy (IMG) – not to be confused with abortion – can be performed regardless of gestational age, in case of severe fetal abnormality or when pregnancy endangers the woman’s life, the gynecologist it’s formal: “Doctors agree to do it when it is impossible to cure the baby, but for a normal fetus, no one wants to do such a thing. ” And for good reason, the process is far from trivial for a caregiver: “We aim the fetus to make him fall asleep, because it hurts, then we inject him with a product that blocks his heart before carrying out the abortion”, specific.
While the WHO assures in its report that “Gestational age limits are not evidence based”, Israel Nisand, who claims to be an atheist and pro-abortion, objects: Although some feminists believe that there is nothing in a woman’s stomach when she doesn’t want to not of the child, the human fetus is not a thing, it is a human being who feels, feels, perceives. There comes a time when this fetus acquires rights, even if full human rights are only obtained at birth. Doctors also have rights, including the right not to make gestures that no one could look at. “
Because that’s how it is. Surgical abortion, now possible up to 14 weeks of pregnancy in France, is already very difficult to perform, so asking a doctor to do it beyond 14 weeks of pregnancy is to risk disaffection among doctors in the practice of abortion. Israel Nisand: ” The same doctors cannot be asked to resuscitate a 24-week-old baby (in the case of premature babies, ed) and kill a 27-week-old baby.. “
“The later the abortion, the greater the risk for the mother”
And this medical act is far from trivial for women, she continues. Despite the WHO’s claim that ” a pregnancy can be safely terminated regardless of gestational age “Israel Nisand is formal: ” The later the abortion, the greater the risk to the mother. “
As proof of this, he points to women in France who are returning from an abortion abroad, where they have suffered a late abortion, who “comes home with a badly torn cervix “warns. “Doctors see it; the public doesn’t know, he complains. Also, if WHO’s goal is to make abortion more accessible to women, particularly in developing countries, it is to forget about all the costs associated with this type of medical intervention and pain management, warns the doctor. “Countries that do not already have the means to guarantee safe births certainly do not have the means to do soTo allow this type of procedure to take place safely! “
If the gynecologist is not at the moment concerned about the scope of this WHO recommendation, alarming as it may be, it is because he knows he is protected by his conscience clause, but also because he believes that the Agency is not an authority. prescriber on the subject. At least not in France, where neither he nor his colleagues had heard of this report. ” Abortion during the survival period on a normal fetus, which requires a previous fetishide, otherwise the child must be killed at birth, will never take place in France, because no one will authorize it. And even so no one would do it, except on a case-by-case basis in situations of rape or incest, which fortunately remain exceptional. “concludes the doctor.
However, WHO’s Bela Ganatra rightly defines the Public Health Agency’s mandate as that of ” collaborate with all countries to inform them in the decision-making process about their national policies and approaches to abortion Active gear in organizing the global coronavirus response, WHO has also distinguished itself as a particularly prescriptive public health agent during the past two years of the pandemic. And if the medical profession surrounding Israel Nisand doesn’t feel worried about it. recommendation in question, however, finds a plebiscite claimed with Family Planning in France. Already in October 2020, the latter assured that he would continue to ” they initially ask for alignment with the more progressive European countries and the abolition of delays in access to abortion “in a statement posted on its website.
A directive that reflects a new radicalization by the WHO
This is why the Alliance Vita movement said it was ” surprised “on reading the WHO report” the radicality of the recommendation “, Explains its deputy general manager, Caroline Roux. She recalls that while the WHO regularly makes recommendations in this area, the latest ones, dating back to 2012, have recognized, for example, that the risks for women associated with abortion increase with gestational age. But today this is no longer the case. ” WHO detaches itself from any ethics concerning human life before birth “, sums up Caroline Roux, and if it’s just simple directives,” this can still be influential, especially for developing countries “he complains.
But what above all raises fears within Alliance Vita is the ” lack of reliability and rigor of the figures put forward by the WHO to justify its position, continues Caroline Roux. The debate thus inevitably becomes distorted and this presents significant risks for the continuation of medical debates on a global scale. ” The credibility of the WHO is thus undermined “, Insists the deputy director general of the movement. For this reason Alliance Vita, in an analytical note, examines the links that the WHO establishes in its relationship between the legal restrictions related to abortion (including gestational age limits) and women’s health, to justify their cancellation.
To support this recommendation, WHO draws on a study published in American Journal of Preventive Medicine in February 2020, which ends it “in states that have established gestational age limits, maternal mortality increases by 38% compared to states that have not.” This conclusion is taken as such on page 130 of the WHO report Additional material 1.
However, this study, conducted in the United States, presents several problems that are highlighted by the analysis note from Alliance Vita. To begin with, maternal mortality is assessed by including all possible causes (haemorrhage, hypertension, sepsis), and therefore not only those related to abortion. Secondly, the data collected concerns only 39 states out of 50, which prompts Alliance Vita to question itself “What were the assumptions that led to the exclusion of 11 out of 50 states, including California, which represents 40 million out of 330 million people? ” Finally, the quantified conclusions are false, Alliance Vita warns: ” Of the 12 states that have enacted time constraints for abortion, the maternal mortality rate (including all causes, not just abortion) is 19% higher than the remaining 27, not 38%, a figure cited by the WHO. “
Caroline Roux wants to ask WHO to ” a little caution ” on a sensitive subject such as abortion. “It is legitimate to make estimates and take care of women’s health. But the WHO never publishes a study on the causes, on who are abortion women, for example. Only in France do we realize that it is the most precarious women who have more abortions than others. WHO does not take the problem as a whole, this is what worries us “Complains Caroline Roux.
While it could be argued that the movement it leads does not hide its pro-life commitment, and must therefore be aware of its own potential analytical biases, the fact remains that the quantitative conclusions advanced by the WHO on this specific objectively questionable point remain.