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Reproductive rights and reproductive behavior. Clash or convergence of private values and public policies?

Using a rational scientific approach upholding public health values, this article notes experience gained from 25 years of cooperative transnational research on reproductive behavior. An overview of world population trends is followed by discussions of reproductive rights as a human right, the utility of acceptability studies of modern methods of fertility regulation, and findings from research on psychological responses to abortion, long-term developmental effects of compulsory pregnancy, and the use of incentives and disincentives to influence family size. There is also consideration of the clash between private values and public policy on reproductive behavior in the United States and the convergence achieved in Denmark and the Netherlands, where rates of unintended pregnancy are among the world's lowest.

Abortion, Legal↗

Reproductive rights and the state in Serbia and Croatia.

The global reproductive rights movement arose in the late 1980s and early 1990s as a challenge to the population control paradigm that has dominated family planning policy for almost half a century. The essence of the challenge is to place women into the center of population discussions as subjects, not objects of policy, and to reorient family planning and health programs toward meeting the broad reproductive health needs of individuals, rather than the narrow population control objectives of states. Reproductive rights advocates argue that the use of family planning programs for developmentalist-oriented population control objectives is illegimate, and inevitably relegates women to the status of depersonalized policy "targets". The cases of Croatia and Serbia, the two dominant partners in the former Federal Republic of Yugoslavia, offer interesting twists on these reproductive rights issues. In Croatia and Serbia, unlike in many nations, the governments are deliberately seeking to increase rather than decrease fertility levels. Moreover, the objective concerns identity politics, more so than development: the governments have encouraged increased fertility to safeguard the survival of their nations and to strengthen national power amidst threatening internal and external environments of ethnic conflict. In this paper, we examine the dynamics of pro-natalist fertility policy in Croatia and Serbia. We do so with a view to explaining why, despite similarities, the two have followed divergent paths. While reproductive rights violations have occurred in both nations, they have been markedly higher in Serbia than Croatia. To explain this divergence we look at a series of sociopolitical factors, including the space available for groups to mobilize in each political system; the degree of nationalistic extremism present in the discourse of central political leaders; and perceptions of threats and opportunities in external geopolitical environments. In conducting this analysis we seek to drive home the point that a nation's reproductive rights situation and prospects cannot be understood divorced from its sociopolitical context. We also raise an additional impetus for promoting the reproductive rights agenda--one largely unexplored in the family planning literature-that emerges from low fertility nations facing identity issues. Women's bodies must be protected not only against those states seeking to use their reproductive capacities for developmentalist-oriented fertility control, but also against those wanting their bodies for nationalistic-oriented fertility promotion.

Authoritarianism↗

Reproductive rights of Egyptian women: issues for debate.

Because the definitions of reproductive health and reproductive rights are so broad, it has been possible in Egypt and elsewhere for one or other issue on the reproductive health agenda to be prioritised to the detriment or exclusion of others, and a comprehensive approach avoided. Reproductive health and rights language was introduced in Egypt around the time of the International Conference on Population and Development in Cairo in 1994. From the moment these concepts were translated into Arabic, activists, scholars and women themselves discussed and debated their meanings and questioned whether Egyptian culture permitted a rights approach of this kind and whether reproductive rights were actually perceived as such by Egyptian women. This paper discusses the language of reproductive rights in relation to cultural specificity in the Egyptian context, Egyptian women's perceptions of reproductive rights, the role of tradition and religion, and the ways in which reproductive rights are taken up under Egyptian law. It analyses some of the arguments used against reproductive rights on these grounds.

Arabs↗

IPPF Charter on Sexual and Reproductive Rights. International Planned Parenthood Federation.

For most of human existence and in most societies, women have been considered to be property and subject to men. Throughout history, with such notable exceptions as Queen Boadicea, Eleanor of Aquitaine, Elizabeth I of England, and Catherine the Great of Russia, women had little or no power until early in the 20th century when the women's suffrage movement was successful in the United States and in some European countries. As women have gained political rights, groups of women have sought sexual and reproductive rights, as exemplified by the feminist movement of the past few decades in the United States. Although marked strides toward achievement of reproductive choice have been taken in high-income countries, there remain major strictures to reproductive freedom for women in low-income countries. This area, which is replete with ethical and moral issues, has been addressed by the International Planned Parenthood Foundation (IPPF), which has worked to improve the sexual and reproductive health of women throughout the world. The IPPF Charter on Sexual and Reproductive Rights is a paradigm for both women's rights and human rights. Karen Newman is policy adviser with the IPPF and has codrafted the IPPF Charter on Sexual and Reproductive Rights together with two lawyers. She has held several positions within the IPPF, including medical researcher, press officer, and programme adviser in Europe, where she had responsibility for working with new family planning associations (FPAs) in the Czech Republic and Slovakia. At present, she is working to increase the capacity of IPPF member FPAs to undertake human rights-based advocacy for sexual and reproductive health and rights. Judith F. Helzner is director of Sexual and Reproductive Health at International Planned Parenthood Federation/Western Hemisphere Region, Inc., where she has worked since 1987. She holds M.A. degrees from the University of Pennsylvania in International Relations and Demography. Her previous employment includes the Pathfinder Fund and the International Women's Health Coalition.

Family Planning Services↗

Reproductive rights in Hungarian law: a new right to assisted procreation?

Hungary has a mixed record in terms of fulfilling reproductive rights as a whole, but in the context of artificially assisted procreation, it provides reproductive health services far beyond those offered by its neighbors, beyond what is stipulated by the ICPD Programme of Action, and, arguably, beyond the internationally accepted parameters of reproductive rights. Recent legislation on assisted procreation has established important new regulations and formulated a new "right to continuation of infertility treatment" applicable to women who have been widowed or divorced. The new legislation is examined in the context of the international reproductive rights movement, with comparisons to other European countries and with reference to Hungarian attitudes and laws on abortion and surrogacy.

Abortion, Legal↗

The FIGO study group on women's sexual and reproductive rights. International Federation of Gynecology and Obstetrics.

In October 1998, the FIGO Executive Board established a Study Group on Women's Sexual and Reproductive Rights to develop specific details regarding observance, enforcement and advancement. At its inaugural meeting in April 1999 the Study Group reviewed international and national progress in respect of such rights. International initiatives had achieved considerable progress towards specification and monitoring of rights, particularly through the committee receiving reports of national compliance under the Convention on the Elimination of All Forms of Discrimination Against Women. National progress was more mixed. While some countries had improved women's sexual and reproductive rights, many had not, and rights in some had regressed. The Study Group considered actions available to FIGO member societies to advance rights in their countries, how advancement of rights might be pursued in countries in general, and initiatives that FIGO itself might undertake and facilitate to protect and promote women's sexual and reproductive rights.

Female↗

[Breast feeding: instinctive? Natural? The biological paragon X the reproductive rights in debate].

The objective of this essay was to reflect about the naturalization of the breastfeeding, inserting the field of the breastfeeding in the range of the women rights, seeking to destroy the paragon that biologizes the female body to the maternal functions, in special to the breastfeeding in the range of the reproductive rights. In discussion we protrude the importance of the actions which estimulate the breastfeeding are embrased in the notion of the reproductives rights, which will allow the health professionals to comprehend the meaning of the breastfeeding in the women's mark of life and their everyday. By the end, we propose that the reproductive rights drive the actions of breastfeeding incentive developed by the health professionals, in the perspective of to redeem the view of the women while the main subject of this practice.

Breast Feeding↗

Assisted reproduction and reproductive rights: the case of in vitro fertilization.

In vitro fertilization (IVF) and other assisted reproduction technologies (ARTs) have become widely accepted as therapy for a wide array of fertility problems and accompanied by the rapid expansion of clinics that provide full range of ARTs. Although these technologies undoubtedly offer benefits for some individuals, they raise important questions over reproductive rights to safe and effective treatment as well as access. This article analyzes current data concerning the safety, effectiveness, and cost of IVF. It concludes that IVF and related techniques have been transformed too rapidly and easily from experimental to therapy status, despite evidence that suggests considerable caution is warranted. Unfortunately, the widespread diffusion of IVF has preceded rather than followed firm evidence of its value in extending the reproductive rights of women and couples. Resources might better be directed toward prevention of fertility problems and discovering the causes of infertility.

Cost-Benefit Analysis↗

Sexual but not reproductive: exploring the junction and disjunction of sexual and reproductive rights.

Although the term "sexual rights" has gained widespread currency, its concrete scope and content have not yet been fully defined. The need for definition is critical not only for promoting governmental accountability but also for ensuring that sexual rights can be claimed by diverse persons around the world. Ironically, the concept of "sexual and reproductive rights" poses a challenge to this effort; practices and people not traditionally addressed by reproductive rights work must be explicitly named and protected. This article considers how international norms have contributed to a gendered regulation of sexuality and of contemporary theories of "socially constructed sexuality," and it proposes a focus on the conditions that contribute to the ability to choose and on the links between sexuality, conduct, identity, social structures, and reproduction. Given the probable politically charged responses, global coalition-building is needed.

Human Rights↗

Post-communist limitations on reproductive rights: the German and the Romanian examples.

This article examines legislative changes affecting reproductive rights that have taken place in two Central European countries since the dissolution of the Soviet bloc. Although some of these changes have been progressive, not all of them have been. Both countries will have to make further changes to be in full compliance with their international human rights obligations to accord women and men reproductive choice.

Abortion, Legal↗

Transforming family planning programmes: towards a framework for advancing the reproductive rights agenda.

Recent international agreements call for the transformation of family planning programmes from a focus on demographic goals to the promotion of health and rights objectives. But the practical implications of this agenda for current and future programmes remain unclear. Public health resources are devoted to preventing illness and reducing the prevalence and incidence of disease across a population. Human rights methodologies focus on protecting the rights of individuals, and on the right to health and health care. Both of these approaches need to be re-thought and reconciled on a practical level to promote rights-based health programmes. Applying a rights framework to reproductive health programmes means, among other things, focusing as much on the process as on the outcome, incorporating efforts to address the gender and power dimensions of reproductive and sexual decision-making into every level of programme, and focusing on building a sense of entitlement among both the seekers and the providers of services. It also means moving beyond a focus only on the technical quality of clinic-based services to incorporate the ethos of a rights perspective at every level. Political, institutional, and technical barriers to the realisation of the reproductive health and rights agenda include national level politics, lack of capacity within civil society, and lack of transparency of institutional actors.

Family Planning Policy↗

Sexual and reproductive rights: statements, rhetoric and responsibilities.

The current international movement for the promotion of reproductive health has great potential for improving sexual and reproductive rights. Health professionals should play a major role in applying international human rights instruments at the country level. Being at the front line of service delivery, health professionals have a duty to ensure that those rights are articulated in routine care by empowering individuals, lobbying for legislation, promoting policies and reporting violations of human rights treaties.

Contraception↗

Women's health and reproductive rights: Romanian experience.

One of the most dramatic chapters in the history of women's reproductive rights ended in Romania in 1989. For over 23 years, Romania had pursued a rigidly enforced pronatalist policy, banning the importation of contraceptives, strictly prohibiting most abortions, and imposing a tax on childless couples. The aim of this study was to explore, through individual in-depth interviews, psychosocial antecedents and consequences of the Romanian policy. The study group consisted of 50 women, aged between 18 and 55 years, with diverse sociodemographic and educational characteristics. The interviews focused on sexuality education, sexual experiences, reproductive events, and partner relations. The results show that women's private behavior and efforts to regulate their fertility prevailed over public policies, regardless of personal risks or costs to health. Concluding observations summarize major findings, results from a 1993 national household survey on reproductive health, and a commentary on the need for ongoing sexuality and contraceptive education and counseling.

Adolescent↗

Reproductive rights and the medical care system: a plea for rational health policy.

Recently, there have been many challenges to women's reproductive rights and freedoms: court-ordered cesarean sections; criminal cases against women for prenatal child abuse; and attempts to limit the practice of mid-wifery, home birth, and the operation of alternative birth centers. In these cases, medicine has been complicit or proactive in attempts to control the behavior or health care options of pregnant women. We discuss medicine's role as an agent of social control, the medical reconstruction of problems that are social in nature, and the need for a more coherent policy framework to guide physician practices.

Abortion, Legal↗