title: Why don't humanitarian organizations provide safe abortion services?
abstract: BACKGROUND
  Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'.
  
  
  CONCLUSIONS
  However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world's population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion.
  
  
  CONCLUSIONS
  As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women's right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women's health and human rights and save lives.
authors.affiliation: Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, NY 10032 USA.
authors.forename: Therese
authors.initials: T
authors.lastname: McGinn
authors.affiliation: Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, New York, NY 10032 USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Casey
keywords: Abortion-related maternal mortality; Humanitarian settings; Sexual violence; Unsafe abortion