At today’s United Nations Security Council debate, member states will discuss the secretary-general’s annual report on sexual violence in conflict. In this year’s annual report, the secretary-general recognizes sexual and reproductive health care as “lifesaving interventions.” Indeed, they are.
Writing about the Central African Republic, the secretary-general noted, “A large number of rape victims resort to unsafe abortion, which is the leading cause of maternal mortality.” During research on sexual violence by armed groups in the current conflict, Central African doctors repeatedly told me the same thing – that harm from self-induced or underground abortions now accounts for more deaths than, for example, childbirth-related hemorrhages.
Abortion is legal for rape victims in the Central African Republic but, as in many countries, that doesn’t mean it is readily available. Confusion about when abortion is legal deters some doctors from performing the procedure. Poor access to post-rape medical care – due to lack of services, fear of stigma, and insecurity, among other factors – prevents many women and girls from getting critical treatment that can prevent unwanted pregnancy and HIV transmission if administered quickly.
A 50-year-old survivor told me how, in 2014, she explained to medical staff at a displacement camp that members of an armed group had raped her and her two daughters. “They said, ‘We don’t have injections to stop diseases in the body,” she recalled. “They only gave [us] medicine for malaria.”
Survivors who become pregnant from rape report facing additional stigma, emotional distress, and economic strain. A 23-year-old survivor told me that, realizing she was pregnant after escaping from sexual slavery by an armed group, “I said to myself, if I had medicine I would abort the pregnancy. But since I don’t have anything, I have to stay like this until I give birth.” She said she struggles to support her daughter, then around 12 months old, both financially and emotionally.
At today’s meeting, states should urgently heed the secretary-general’s call and commit to ensuring that all women – including but not limited to those who become pregnant from rape – can get comprehensive post-rape medical care, including information about and access to safe abortion. States should also ensure psychosocial and socioeconomic support and legal aid for survivors, to help them rebuild their lives.
Rape in conflict can have deadly consequences, but the harm can be mitigated. Prioritizing access to services – including safe abortion – should be one of the first things governments do to help women and girls survive.