Women’s Lives: National & International Perspectives


            The issues related to women’s health have been widely discussed in the academic literature and the mass media sources. It is not a secret that women throughout the world have succeeded in protection of equal rights in almost every sphere of human activity. Yet, a number of problems are still prevalent, such as poor access to reproductive health services, lack of effective sexuality education and contraception prevention opportunities. These problems affect women’s health and do not permit enjoying citizen rights (Northup & Shifter, 2015). In order to have a good understanding of the significance of global policies in social sphere and the need for national action, it is necessary to explore abortion policies and reproductive health policies, making reference on two countries.  These policies have a strong impact on women’s health and women’s rights. The Programme of Action of the 1994 International Conference on Population and Development (ICPD) provides definition of the term reproductive health, including all relevant issues related to the women’s health, the processes of the reproductive system and its major functions (Mishra et al., 2014). It provides that “sexual interaction should be free of coercion and infection, every pregnancy should be intended, and every delivery and childbirth should be healthy” (Mishra et al., 2014, p. 2). Unfortunately, abortion policies and reproductive health policies vary across the world. This fact means that some governments permit abortion, while others do not permit abortion under any circumstances. The major reasons that support abortion policy are saving women’s lives, when the physical or mental health of the pregnant women is damaged; termination of the pregnancy that results from rape and other crisis cases; and economic and social factors. It has been found that Chile, the Dominican Republic, El Salvador, the Holy See, Malta and Nicaragua do not permit termination of pregnancy under any circumstances. Recent research findings show that “the growing number of countries have expanded the legal grounds for abortion, but abortion policies remain restrictive in many countries” (Mishra et al., 2014, p. 6).

            The major goal of this paper is to discuss the policies concerning women’s health that have tended to ignore women’s wider health needs, instead focussing on reproduction and sexuality. Due attention is paid to the discussion on abortion policies and their effects on women’s health and the discussion on the reproductive health policies in three countries, namely the United States, China and Chile. These countries have different levels of economic development.  As a result, there will be differences in addressing the identifies issues by the governments. The analysis of the approaches selected by these countries will help to draw relevant conclusions on women’s health. 

Discussion on abortion policies and their effects on women’s health

            Abortion policies are the policies that concern women’s health because in some situations women’s wider health needs are ignored by the governments instead focussing on reproduction and sexuality. According to recent report, “Governments in developing regions are more than four times as likely to have restrictive abortion policies as those in developed regions” (Mishra et al., 2014, p.1).

            In the United States, there are certain medication abortion restrictions that have a negative impact on women’s health.  In many states, it is prohibited to use evidence-based standards by health care providers to administer medication. Besides, it is prohibited to use technology (e.g. telemedicine) to provide the most effective and reliable care.  These laws were passed by many states of the US, although this is a developed country. According to researchers, “these laws restrict a patient’s ability to access appropriate, effective care that fits her needs in a timely manner and in the most appropriate setting, undermining quality care” (Bad Medicine: How a Political Agenda is Undermining Women’s Health Care, 2016, p. 10). It is necessary to understand that medication abortion is considered to be the safest abortion method, which is based on the use of new medications to terminate a pregnancy. There is much evidence that well-trained health care providers are successful in prescription of the medications that can help to terminate a pregnancy. According to experts, “this method is medically indicated for certain women, and others may choose it because it provides more control and privacy” (Bad Medicine: How a Political Agenda is Undermining Women’s Health Care, 2016, p. 10). Besides, this method is the best option for survivors of sexual assault and those who want to avoid abortion procedures. 

            In China, one-child family policy has had an enormous success in providing control over the population growth. The policy was initiated in 1979, when the Chinese government accepted the short-term approach to strengthen a voluntary small-family culture. The policy was based on several regulations that controlled the size of families in China. Among these regulations were “restrictions on family size, late marriage and childbearing, and the spacing of children (in cases in which second children are permitted)” (Hesketh et al., 2005, p. 1171). The major reason for the policy implementation was to improve living standards and facilitate economic reforms. Actually, the policy required universal access to contraception and abortion.  According to researchers, the policy implementation led to “heavy reliance on long-term contraception, with intrauterine devices and sterilizations together accounting for more than 90 percent of contraceptive methods used since the mid-1980s” (Hesketh et al., 2005, p. 1171). As a result, the increased rate of abortions and other methods of contraception made many Chinese women dependent on family planning centres. They had no chance to choose what they wanted because they were forced to accept the method of contraception recommended by the family-planning centres. Women who violated the one-child policy had fines and abortion. Recent study shows that “many deliveries of babies that have not been officially sanctioned occurred at home without trained personnel, a practice associated with the risk of maternal or neonatal mortality” (Hesketh et al., 2005, p. 1171). Hence, the policy led to violation of women’s rights because many Chinese women wanted to have several children. Besides, there is much evidence that the policy  reduced population growth, increased sex ratio, contributed to the growth of the elderly people, and increased the health risks caused by the refusal of accepting medical care by Chinese women with unapproved pregnancies. Further relaxation of the one-child policy would help to strengthen women’s rights in China.

            In Chile, abortion policies are strict because the country does not permit abortions  under any circumstances. In 2016, the law was offered to be amended by the President to allow abortion in cases of rape. According to experts, “Abortion is not legal in Chile even to save the woman’s life or health” (Shepard & Becerra, 2007). It has been found that Chile’s abortion policies create considerable implications and ethical dilemmas not only for women, but also for health care practitioners. The rate of illegal abortion has decreased since 1990 due to the usage of various types of contraception. Nevertheless,  Chilean health care practitioners are required by law to report illegal abortions to the authorities ( Shepard & Becerra, 2007). These facts mean that in Chile, women’s rights are restricted. According to researchers, “with the often restricted availability and use of contraception, it is not surprisingly that unsafe abortions are commonplace, resulting in high maternal mortality and HIV/AIDS rates” (Molyneux, 2007, p. 93). Undoubtedly unsafe abortions in Chile is one of the serious threats to women’s lives. Statistics show that  approximately 6.000 women die annually from severe complications caused by clandestine abortion procedures in Chile and other countries of Latin America (Molyneux, 2007).

Discussion on reproductive health policies

            The Centre for Reproductive Rights is focused on promoting the laws aimed at advancing reproductive freedom of women as a “fundamental human right that all governments are legally obligated to protect, respect, and fulfil” (Northup & Shifter, 2015, p. 11). Reproductive health care helps women to maintain their reproductive health rights, as well as improve their reproductive health (Kaining, 2011). Currently, many governments  across the world have adopted reproductive health policies aimed at raising fertility levels. Nevertheless, there are certain concerns regarding high levels of adolescent fertility in developing countries. According to researchers, “early childbearing is associated with low educational attainment and poverty, increase in the risk of maternal death or physical impairment and children born to young mothers tend to have higher levels of morbidity and mortality” (Northup & Shifter, 2015, p.10). Reproduction health policies are targeted at providing a wide range of services aimed at improving reproductive health of women, including screening diagnosis and rehabilitation procedures, family planning services, as well as maternal and child health care services and relevant clinical services (Kaining, 2011).

            Moreover, many governments have developed the policies that are aimed at reduction of violence against women. These policies affect reproduction health of women to some extent. According to experts, “Violence against women not only violates human rights, but also has a direct impact on the mental and physical health of women, including reproductive health” (Northup & Shifter, 2015, p.12). As a rule, women face violence in household settings and in the workplace. Domestic violence is associated with intimate partner abuse. Making changes in legal frameworks contributes to adoption of the policies that help to prevent the spread of domestic violence. In fact, many policies are aimed at providing care and support to the victims of domestic violence.

            In fact, it becomes clear that assessment of social factors, social structures and public behaviours regarding women’s reproductive health helps to have a good understanding of the problems faced by developing and developed countries. The common reproductive health issues include pregnancy related issues and contraceptive and reproductive technologies (Wingood et al., 2013). Although the issues regarding women’s reproductive health have gained greater recognition since the 1970s, there are many inequalities in this area because of the different approaches used by the governments across the world ( Glasier & Gebbie, 2011).

            In the United States, due attention is paid to reproductive health of women. There are many public programs and private health insurance that provide payments for contraceptive services and ensures the proper supplies for women. Under the Affordable Care Act, it is required that private health insurance plans should provide coverage of a number of preventive services without any patient cost-sharing (Women’s Health Policy, 2017). According to research findings provided by a group of scientists from Guttmacher Institute, “during the 2015 state legislative session, lawmakers considered 514 provisions related to abortion; the vast majority of these measures—396 in 46 states—sought to restrict access to abortion services” (Nash ate al., 2015). These changes in policies are caused by the changing politics of abortion targeted as effective family planning practices. The issues covered in new policies include improved sexual education on violence prevention, provision of free or low-cost pregnancy-related care, provision of anti-discrimination policy in the workplace that protects reproductive health of employees, expansion Medicaid eligibility for family planning services, provision of insurance coverage of contraceptives, and others. However, there are certain improvement in the policy implementation. In 2006, the US policies provided restrictions on the access of  of Latina or African-American women with low incomes to reproduction health care, including contraception, abortion, and others. There were certain barriers caused by the government’s decisions that impeded women’s access to new types of contraceptives, which are “more safe and effective” (Women’s Reproductive Rights in the United States: a Shadow Report, 2006, p. 6). In addition, there were certain restrictions on insurance coverage for reproductive health care and access to emergency contraception.  As a result, in 2006, “49% of all pregnancies in the United States were unintended; half of those pregnancies resulted in abortion” (Women’s Reproductive Rights in the United States: a Shadow Report, 2006, p. 6). In 2017, the US polices are more effective because the needs of women are addressed without any discriminations. Statistical data show that  about 86% of women in the USA use  some form of contraception to avoid pregnancy, among them 30% of women prefer to use hormonal form of contraception (Yu & Hu, 2013). In general, American women enjoy more freedom in reproductive health decision making deciding than women from other countries of the world (Rosser, 2002; Yu & Hu, 2013).

            In China,  the government pays due attention to reproductive health policies, which guarantee healthy nation and happy families. Accessibility to reproductive health services has been improved  since 1990s, when the Population Research Institute of Beijing University has launched a wide range of communality-based initiatives aimed at enhancing women’s reproductive health (Kaining, 2011). In China, reproduction health policies are related to family planning that has become a major national health policy since 1979. This policy highlights “population control, fertility rate, and its determinants, a focus on women’s reproductive behaviour and contraceptive technologies and use” (Kaining, 2011, p. 72).  Undoubtedly, assessment of China’s approach to maintenance of reproductive health shows that “women’s health beyond reproductive age and their  reproductive health rights were never seen as priorities”(Kaining, 2011, p. 72). Nevertheless, there is much evidence that the Chinese health system has achieved success in health care, which led to reduction of infant mortality. The research findings show that “mortality rates for neonates from 1990 to 2008 decreased by 70% (from 34.0 to 10.2

per 1000 live births)” (Liu, 2015, p. 14). There are many factors that played an important role in improvement of health status of people, including nutrition options, hygiene, educational opportunities, living standards, and even cultural modifications (Liu, 2015). Since the years 1980s, many new governmental policies on reproduction health led to the fundamental societal transformation of Chinese society. The Regulations Concerning the Labor Protection of Female Staff and Workers (1988) policy and the Regulations on Work Prohibited for Female Staff and Workers (1990) policy helped to address a wide range of challenges associated with reproductive health of women. During the menstrual period,  women employed by the Units are not engaged in “Labour at high altitudes, in low temperatures or involving contact with cold water, or Labour involving physical Labour of the third (3rd) degree of intensity as specified by the state” (Liu, 2015, p. 16).  In 2009, the adoption of Maternal and Child Health Care and Community Health Work Focus policy was aimed at the delivery of premarital health services to married couples. In addition, in 2007, the Regulations on Pregnancy Health Care Services

(Trial) policy issued by the Ministry of Health of China was focused on the preconception period beyond the point of obtaining a marriage certificate with the goal of improving women’s health (Liu. 2015). Besides, the Regulations on the Management of Family Planning Services policy of 2001 and 2004 was aimed at reduction of birth defects and improvement of the health status of newborns (Liu, 2015).

            In Chile, the issue regarding family planning and reproductive rights of women have been discussed since the 1960s. Chilean health care practitioners were focused on to reduction of maternal mortality through self-induced abortions. According to researchers, “Chilean women’s mobilization for rights surged in the 1970s, and the concept of reproductive rights became the focus within health policy debates only by the 1990s” (Mooney, 2017, p.1). Due to a wide range of political developments, Chile’s government addressed the issue of fertility regulation, through generation of new policies related to reproductive health rights of women. The major goal was to prevent abortions and reduce maternal mortality, providing adequate control over the size of population and protection of families. Many new family planning programs were developed in the 1960s. Chile’s health care practitioners work collaboratively with the International Planned Parenthood Federation (IPPF). The establishment of the  the Chilean family planning institution, the Association for the Protection of the Family led to addressing family planning challenges faced by women in Chile. Recent studies show that due to advancements  in contraceptive technologies, as well as changes in women’s reproductive health rights,  Chile’s government provides no choices to women on their pregnancy-related problems. Currently, the abortion policies and reproductive health policies in Chile are considered to be the most restrictive in the world. There are many challenges posed to women’s reproductive health rights. Illegal abortions lead to the increased rate of maternal mortality.  There is much evidence taken from research studies that the majority of people in Chile are against the abortion policy. Many politicians and feminist groups demand “legal reforms and the de-criminalization of abortion” (Mooney, 2017, p.1). The introduction of the new legislation that allows performing therapeutic abortions in the following cases:  if the life of a mother is in danger, if there are the signs of malformation of the fetus, and in cases of rape, is still not adopted by the Congress (Mooney, 2017) Moreover, in Chile, there is a problem of teenage pregnancy that requires finding the proper solutions to protect women’s rights to health and reproductive freedom. The proposition to legalize emergency contraception was  accepted by the government in 2010. The policy was aimed at improvement of  reproductive health of women. According to researchers, “women above the age of fourteen can now get emergency contraception free of charge in public health centres, without parental consent” (Mooney, 2017, p.1). Actually, this new policy provides access to free emergency contraception, as well as helps in reduction of the risk of unwanted pregnancy (Mooney, 2017). According to recent studies, Chile is one of Latin American countries that have introduced effective policies to ensure integration of health, social, and economic practices in order to develop a new health care system (De Andrade et al., 2015).

            All in all, the International Conference on Population and Development (ICPD) and other international conferences and meetings are focused on developing and implementing the proper strategies to improve women’s reproductive health. Due attention is paid to improved access to family planning and other reproductive health services; reduction of the recourse to abortion and improvement of current abortion services; response to the needs of young couples; prevention and treatment of reproductive tract diseases (The WHO Strategic Approach to strengthening sexual and reproductive health policies and programmes, 2017).


            Thus, it is necessary to conclude that the rights of women are violated in many regions of the world because of the implementation of abortion policies and reproductive health policies that deny women’s rights to safe termination of pregnancy, placing the lives of women at risk. This paper explores the policies concerning women’s health that have tended to ignore women’s wider health needs, instead focussing on reproduction and sexuality. The key findings show that there is a need for advancement of gender justice through overcoming of current social and structural inequalities and promoting women’s participation in movements aimed at making changes in the law. Besides, it is necessary to reduce maternal deaths and improve reproductive health policies in developing countries. Reproductive choices should remain the most private decisions; therefore, governments should not restrict abortions. In other words, reproductive decision making should be voluntary. Nevertheless, governments should provide the proper support to couples in order to improve the health status of the nations. Any political, ideological, socio-economic and health care concerns should not affect reproductive choices of women. Generally speaking, the International Conference on Population and Development (ICPD) and other international summits contribute to improvement of reproductive health of women across the would.


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