(See also “Reproductive Health,” “Reproductive Health Care and/or Services,” “Reproductive Rights,” “Reproductive Rights, Context of Girls, Children, Youth, or Adolescents,” “Sexual and Reproductive Health,” “Sexual and Reproductive Health Rights”)
Overview
Note: For an extensive overview of the term “sexual and reproductive health,” including its history, how the term has been used, negotiating strategies, and talking points, see “Sexual and Reproductive Health (SRH)” section.
Despite its controversial nature, “sexual and reproductive health” (SRH) language has been adopted in a number of UN documents, including the Sustainable Development Goals (SDGs), because many pro-family UN delegations were not aware that SRH language is often used as code language for abortion and sexual rights. However, just because SRH language has been accepted in previous documents does not mean governments are under any obligation to accept it again. There has been pushback on troublesome language before (see “Various Forms of the Family” section), and there can be and should be pushback again, even if the term has been used often in the past. (See the “Sexual and Reproductive Health (SRH)” section for many strategies for doing this.) In fact, many nations have changed their positions on SRH issues, especially the United States, which often changes positions depending on who is sitting in the White House.
Moreover, because UN agencies and donor countries all agree that SRH issues encompass an “evolving set of standards,” which include standards many Member States have not agreed to and would never willingly accept, it is even more imperative to back away from ambiguous SRH terms that are often used in harmful ways. In addition, adding terms such as “care,” “services,” or “care services” to SRH language (see examples below), can add new layers of meaning and enable the terms to be more easily used to promote controversial medical procedures, such as abortion or even “sex-change” operations.
Ultimately, it is the UN agencies, donor countries, and powerful and well-funded NGOS who decide how SRH terms will be understood, as they are the ones with the funding and are in control of implementing SRH programs on the ground in countries around the world. We know from the publications that these entities publish and support (e.g., Sexual Health, Human Rights and the Law, and the 2018 revised “International Guidance on Sexuality Education”) that their SRH agenda is harmful indeed.
Common SRH Add-ons:
- “Services”
- “Care-Services”
- “In accordance with”
Common SRH Language:
- “Reproductive Health Care”
- “Reproductive Health Care Services”
- “Reproductive Health Services”
- “Sexual and Reproductive Health Care”
- “Sexual and Reproductive Health Care Services”
- “Sexual and Reproductive Health Service
UN Member States and NGOs alike often argue over which are the best SRH language formulations. For example, they debate on whether SRH or RH should be modified by “care” or “care services,” or qualified with Beijing or ICPD or the “outcome documents of their review conferences.” The truth is, however, that all of the SRH-related terms are highly problematic. And these terms are only getting worse as their meanings evolve over time. To buy into this game of choosing the best add-on is to buy into a game that has already been won by the other side.
Indeed, UN agencies and donor countries now openly assert in multiple documents that many, if not all of the SRH-related terms encompass radical sexual and abortion rights, even for children (See “Sexual and Reproductive Health.”) For example, with respect to sexual health, one UN committee has even claimed that “the right to life” encompasses a right to abortion.
To put it bluntly, the situation with respect to SRH is completely out of control. Therefore, UN Member States will need to stop doing business as usual and stand up and simply say no to all of these SRH-related terms, which continue to be proposed over and over again in UN documents, regardless of the topic at hand.
In addition, delegations should insist on definitions or qualifying phrases that make it impossible for these terms to be interpreted for bad purposes. This is another way to take back the definitions of these terms. (See “Negotiating Strategies” in “Sexual and Reproductive Health” for multiple strategies and talking points for deleting, defining, qualifying, or diluting SRH terms, and for using standard arguments often used at the UN to delete any controversial term.)
It is one thing to have these terms in your own SRH-related national policies where your government can control the interpretation and implementation. It is another thing to agree to SRH language in UN documents that other powerful outside entities will take as mandates or permission to implement their radical agendas in your country.
REPRODUCTIVE HEALTH CARE
As is clearly outlined in the other “reproductive health”-related sections of this Guide, “reproductive health,” (RH) is a term that is used to promote abortion. “Reproductive health care” is the euphemism used to promote abortion services provided by abortion clinics.
For example, a search for “reproductive health care” in the U.S. Westlaw database brought up at least 235 cases. A number of these cases concerned pro-life protestors outside abortion clinics. In these cases, the terms “reproductive health care facility” or “reproductive health care clinic” were used as euphemisms to describe the abortion clinic. So, in American law, “reproductive health care” means, precisely, “abortion.”
ICPD and the Beijing Platform for Action define “reproductive health care” as follows:
“In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health.” [Warning: “reproductive health” and “reproductive health care” are defined to also include sexual health, yet sexual health is not defined!]
REPRODUCTIVE HEALTH CARE SERVICES – Defined to include abortion
ICPD 7.5. provides that “reproductive health care services” include, for women, “methods of their choice for regulation of fertility which are not against the law.” As also explained in the SRH section, “regulation of fertility” is a common euphemism for abortion. (An article in the peer-reviewed journal, The Lancet, stated “for the foreseeable future abortion will remain an important element of fertility regulation.”[1]) For example, consider the “World Health Organization Task Force on Post-ovulatory Methods for Fertility Regulation” (which may be the most creative euphemism for abortion to date). The sordid work of this task force was “to test the efficacy of lower doses of mifepristone and gemeprost for medical induction of early abortion,” by experimenting on “1,224 healthy pregnant women,” lowering the dose to see the effect.[2]
They reported the results of this experiment as follows, “Incidence of complete abortion … included side effects such as vomiting and fall in haemoglobin, as well as the need for emergency curettage and blood transfusion.” After causing all of these serious side effects to their female test subjects, they concluded that “[a] single dose of mifepristone 50 mg followed by gemeprost is inadequate for early medical abortion.” In other words, the World Health Organization compromised the health of over 1,000 women by actually performing experimental chemical abortions on them under the guise of “fertility regulation.”
REPRODUCTIVE HEALTH SERVICES – defined to include abortion
UNFPA’s publication, “Interagency Reproductive Health Kits for Crisis Situations,”[3] lists UNFPA’s suggestions for “the provision of appropriate reproductive health services in emergency and refugee situations.” In their recommended list for what to include in “reproductive health kits” to be used by humanitarian agencies, UNFPA lists the following: the “Ipas EasyGrip®,” a hand-operated abortion vacuum suction; an abortion kit called a “[g]ynecological aspiration system, for uterine aspiration/uterine evacuation in obstetrics and gynecology patients;” and a “Manual Vacuum Aspiration (MVA) Set (adapted from IPAS set 2 x IA18).” Although this list is included in the section for dealing with incomplete miscarriage, these aspirators are commonly also used for first trimester abortion and IPAS is one of the largest providers of abortions in the world.
UNFPA’s “reproductive health kit” list also includes an “Emergency contraception patient information leaflet” and lists the pill “Levonorgestrel, tablet, 1.5 mg, (emergency contraception).” Used shortly before egg release, Levonorgestrel works to prevent the ovary from producing sufficient amounts of progesterone to sustain a pregnancy. This mechanism kills embryos.
In other words, in practice, these UN agencies consider “reproductive health services” to include abortion kits and emergency contraception, which kills embryos and unborn children.
Furthermore, during negotiations at the UN World Summit on Children in New York in 2002, the Canadian delegation was asked explicitly on the UN floor if “reproductive health services” included abortion. To the shock of many in the room, he responded that it did.
“SEXUAL AND REPRODUCTIVE HEALTH CARE”—Defined to include abortion
ICPD defines “sexual and reproductive health care” (SRHC) to include abortion with some caveats. In addition, as you will see in the SRH section, the terms “reproductive health” and “sexual health” on their own, with no qualifiers or add-ons, are often interpreted to include abortion and controversial sexual rights. Thus, quibbling over whether SRHC or SRHCS include abortion and sexual rights because of the nuanced and convoluted language in ICPD is pointless because according to many governments and implementing agencies, both terms now certainly do.
A 2006 World Health Organization publication titled “Sexual and Reproductive Health, A Matter of Life and Death” illustrates how the term “sexual and reproductive health care” has been used to advance abortion. To begin with, it states that one of the “five core components of sexual and reproductive health care” is “elimination of unsafe abortions.” It also claims that “the frequency of unsafe abortion in a country is affected by… the abortion legislation and its implementation, and the availability and quality of legal abortion services. Legal obstacles to safe abortion services force women to resort to unsafe abortion when faced with an unwanted pregnancy…. Restrictive legislation is usually associated with a high incidence of unsafe abortion.” (See “Abortion, Safe/Unsafe” and “Abortion, Legal/Illegal” to see how they come to these erroneous conclusions.) Similarly, the WHO definition of “safe abortions” is “abortions which meet legal requirements in countries where abortions are not legally restricted.”
In other words, the WHO definitions of “unsafe abortion” and “safe abortion” are based on legality, not medical definitions, and thus such abortions are really only “safe” for the abortionist.
Eliminating “unsafe abortion,” according to WHO, thus means eliminating legal restrictions on abortion.
The same WHO SRH report also claims that another component of “sexual and reproductive health care” is “promotion of healthy sexuality.” WHO then defines sexuality as encompassing “gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction… thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles, and relationships.” So, by definition, according to WHO, “sexual and reproductive health care” includes “services” related to fantasies, desires, sexual orientation, pleasure, eroticism, and more.
Thus, the term “sexual and reproductive health care” is not only used to promote abortion but is also used to promote the sexual rights agenda.
“SEXUAL AND REPRODUCTIVE HEALTH CARE SERVICES”—Defined to include abortion
Because ICPD and WHO define “sexual and reproductive health care” (SRHC) to include abortion (although with some caveats), it only makes sense that “sexual and reproductive health care services” would encompass services for abortion as well.
Thus, SRHC and SRHCS should both be avoided.
“SEXUAL AND REPRODUCTIVE HEALTH SERVICES”—Defined to include abortion
According to the report released by the Special Rapporteur on the Rights of Persons with Disabilities, titled “Sexual and Reproductive Health and Rights of Girls and Young Women with Disabilities,” “[s]exual and reproductive health services include, inter alia, … safe abortion services.”
NEGOTIATING STRATEGIES
As mentioned in the note at the beginning of this section, the “Sexual and Reproductive Health” section of this guide has extensive negotiation suggestions and talking points for negotiating SRH language.
With regard to SRH for children (i.e., girls, adolescents, teens, youth, etc.), certainly, any medical, sexual, or reproductive health services, sexual information, or counseling provided to children of minor age should be given only with the knowledge, involvement, and consent of their parents. (See “Reproductive Rights, Context of ‘Girls,’ ‘Children,’ ‘Youth,’ or ‘Adolescents,’” for talking points that could also be adapted for negotiating SRH in the context of children, and “Parents” for good language for modifying SRH to recognize parental rights.)
Proposing parental rights language and refusing to back down has been known to cause backers of SRH (and CSE) language to withdraw their proposals because they refuse to allow any precedence to be set for requiring parental involvement in sexual and reproductive health information, education or services. Parental rights language foils their plans to get SRH information or services to children without parental consent. (See “Barriers” and some of the sections on youth for more on this.)
Also note that “Sexual and Reproductive Health” and “Reproductive Rights” language in the SDGs is qualified by “in accordance with” ICPD and Beijing and “the outcome documents of their review conferences.” (See “Outcome Documents of Their Review Conferences” section to understand the serious problems with these qualifiers.) As pointed out in the overview above, any of the SRH terms, whether modified by services, care, care services, ICPD, Beijing, or outcome documents, should be deleted or modified with additional clarifying language as specified in the Negotiating Strategies section of the “Sexual and Reproductive Health” section of this guide.
Another way to safeguard this term if you can’t delete it is to propose adding the following language from Beijing, which ensures it cannot be interpreted to encompass abortion: “the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.” – Beijing (1994), 97.
[1] Kulczycki, A. et al. (1996). Abortion and Fertility Regulation. The Lancet, 347, 1663-1668.
[2] See https://www.ncbi.nlm.nih.gov/pubmed/11467701
[3] UNFPA. (2011). Interagency Reproductive Health Kits for Crisis Situations. Retrieved from https://www.unfpa.org/sites/default/files/resource-pdf/RH%20kits%20manual_EN_0.pdf Retrieved from https://www.unfpa.org/sites/default/files/resource-pdf/RH%20kits%20manual_EN_0.pdf