Many were aghast at Nancy Ruth's strategic advice this week to maternal-health advocates to "shut the f--k up" about abortion. The Liberals instantly seized on the Conservative senator's remarks by sending out a fundraising letter. Even Transport Minister John Baird called her language unacceptable.
But the senator, a United Church minister by training who is known for her feminist views, may have a point. As aid groups fixate on Canada's decision not to fund abortion as part of its signature G8 initiative on child and maternal health, other key issues central to reducing maternal mortality in the developing world have been ignored.
Every year, between 350,000 and 500,000 women around the world die as a result of pregnancy and childbirth. According to the World Health Organization, unsafe abortions cause 13 per cent of these deaths. But hemorrhage causes 24 per cent, infection per cent, and HIV/AIDS and other infectious diseases 28 per cent
Access to abortion, therefore, should be part of the conversation around how to reduce maternal mortality rates, but it shouldn't be the only conversation.
The more subsumed we become in the abortion debate, the less time is spent lobbying for other critical health services for women and children. The issues are many and include: ways to stop mothers from transmitting HIV to their babies; vaccine programs and nutrition; access to medical care before, during and after labour; and access to contraception, which would help women plan pregnancy and avoid the need for abortion.
Canada could help in the provision of the essential drug Misoprostol, an ulcer medication which helps stop post-partum bleeding.
Drug trials are also under way for anti-retroviral drug-based microbicides that can prevent the sexual transmission of HIV infection. Women can apply these microbicides without their partner's knowledge. Another innovation worth supporting is a DNA test allowing for more precise and earlier screening of cervical cancer. This wholly preventable disease still kills 225,000 women a year, most of them in poor countries.
Even advocates say it is time to broaden the discussion. By lobbying for women's rights, including the right to delay marriage and inherit land, Canada can help women in developing countries become agents of change, says Katherine McDonald, executive director of Action Canada for Population and Development. A full debate about women's reproductive lives should include access to abortion. But it isn't the only conversation worth having.