Reproductive Health in Australia
Discuss about the National Characteristics in Antiretroviral Treatment.
Reproductive health not only implies absence of infirmity or disease but it encompasses an overall mental, physical and social well-being of a woman from the reproductive system, its functions and procedures at all stages of her life. In other words, reproductive health implies entitlement of a woman to a satisfying responsible and safe sex life having the capability and freedom to make decisions regarding reproduction. This right inherently includes the accessibility right and right to be informed of effective, safe, acceptable and affordable reproductive health services. They must be entitled to have accessibility to health care services to ensure a healthy and safe pregnancy and childbirth, thus, having the opportunity to have a healthy infant. Every woman is entitled to the right to attain highest standard of mental and physical health (Sifris and Belton 2017).
In Australia, the legal framework related to reproductive health ensures that women have accessibility to health care services that are effective, safe and affordable. It also ensures to provide adequate decision to women to assist her in making appropriate decisions. Although the legal framework of the country regulates various aspects of reproductive health such as reproductive rights, surrogacy, cross-border reproduction, the essay shall entail discussion about reproductive rights as one such specific area of regulation of reproductive health (Sifris and Belton 2017). Further, it has been often observed that several socio-economic factors influence the decisions related to reproduction, such as the prevailing cultural norms and values of family of woman. It shall further explain how the reproductive health regulations in Australia rely only on the ability of woman to make decisions regarding her reproductive health and the prevalence of effective health care services.
According to Szirom (2017), sexual and reproductive health which includes maternal health is a priority for every woman and Australian women is no exception. This can be achieved if both the reproductive and sexual health is taken into consideration within cultural and social lives of women. As mentioned earlier that reproductive health does not merely imply that absence of diseases but an overall well-being of the women. The reproductive health is influenced by various cultural, political and socio-economic environmental factors. Amongst such factors, the women’s position in the society in terms of their control over their bodies, reproductive lifestyles and choices, significantly influences the reproductive health of women. However, Thomas and Aggleton (2016) states how other issues like family cultural norms and values, structural issues related to health services equally affects the reproductive health of a woman.
Cultural Norms and Reproductive Health
Zimmerman (2015) argues that while sexual health is completely biological, however, the perception related to reproduction and sexuality have become cultural trend that is shaped by cultural as well as social structures like gender roles, religious values and most importantly, family expectations. In regards to the role played by cultural norms and dominant narratives of family, many consider educating their children about sex as inappropriate because either they themselves lack sufficient knowledge about reproductive health or they are concerned about how much information must be disseminated and at what age. This is based on the belief that the provision of information shall encourage young people to engage in sexual activities.
Zimmerman (2015) asserts that usually family members are influential sources of attitudes, beliefs and values for youth and children. They are perceived as role models who are responsible for shaping the concept of gender roles for the young people, thus, enabling them to make appropriate choices regarding their sexual conduct. The parents and other family members must provide adequate information about the prevailing cultural norms and values regarding reproductive health may be by narrating their personal experiences. On the contrary, Thomas and Aggleton (2016) states that since the family members themselves lack appropriate information about reproductive health and the prevailing reproductive rights often feel reluctant to discuss about the topics. At times, they themselves fear about the consequences that arose from their own negative sexual experiences. Consequently, Thomas and Aggleton (2016) agrees that due to lack of adequate information availability, especially, young people use other sources to seek their answers like peers, media and their observation of other adults. This often results in misinformation which further enhances the probability of damaging the myths and making the young people more vulnerable to unprotected sexual experiences than they would have, if they were properly guided and adequately informed about the consequences.
As understood, family plays an important role in providing early knowledge about reproduction, reproductive health and the reproductive rights, which further prevents unwanted pregnancies and other sexual related issues, however, the role of family does not ends here. In regards to decisions to be made by women in terms of her reproduction, her decision is often influenced by the familial experiences, values and norms. In other words, Szirom (2017) states that whether the decision is pertaining to family planning or terminating the pregnancy, the ability of the woman to decide is influenced by several socio-economic and cultural factors. The lack of inadequate information regarding reproductive rights is another factor that impedes the ability of women to take decisions regarding her reproductive health, which enables the above mentioned factors to influence such decision.
The Principle of Autonomy in Reproductive Health Decision Making
Szirom (2017) states that the Australian legal framework recognizes the importance of the decision taken by the woman in terms of her reproductive health and therefore, have introduced the principle of autonomy in the context of health care which entitles a woman to make her own decision regarding her reproduction or reproductive health. The ability of women or her competency to participate in any decision-making process equally that is related to her reproductive health has been upheld in the case of Planned Parenthood of Southeastern Pennsylvania v Casey. In this case, the Supreme Court held that the ability of women to take part in the social and economic life of the nation equally can only be made possible by enabling them to exercise control over their reproductive lives.
Starrs et al. (2018) further explains that the reproductive rights are part of the basic human rights to which every woman is entitled and denial of such right shall violate her human rights. Reproductive rights include the right to accessibility to contraception, affordable abortion, sex education and medical services that are essential to ensure a good health, altogether. Sifris and Belton (2017) agrees that every woman must have the ability to plan their pregnancies considering their future decisions and leaving scope to make better decisions about their career, education and work. This will not only prevent unwanted pregnancies but shall also ensure good reproductive health of women.
In the contemporary era, reproductive rights had given rise to several ethical, moral and legal controversies pertaining to family planning, abortion, health care services accessibility and birth control. At present, the subject of reproductive rights persists to be a politically as well as emotionally charged issue, particularly, with the advent of recent legal provisions and technologies. Savulescu and Schuklenk (2017) states that while the Australian human right laws regarding reproductive health of woman recognizes the consent and ability of the women to make decision, at the same time, such decisions are often influenced by the dominating societal culture norms and values. For instance, the right to sex education and right to plan as well as terminate pregnancy is mostly influenced by societal norms and values. This is because as observed earlier those most family members are reluctant to discuss about sexual activities and related information, hence, they do not encourage sex education as well. Further, while planning a pregnancy, lack of sex education and insufficient information often results in unwanted pregnancies.
Reproductive Rights and Human Rights
Furthermore, the laws regulating reproductive rights of the minors have restricted them from exercising control over their bodies and have relied on the parents of the minors for making decisions regarding their reproductive rights on their behalf. Similarly, the decision related to abortion rights taken by adult women are also restricted or are influenced especially by societal norms like aborting the baby is a sin and should be prohibited. Further, Rowlands et al. (2015) several arguments have been made in this respect where the pro-life advocates argue that a fetus being a living beings at the time of contraception should be safeguarded and the act of abortion should be criminalized. On the other hand, the pro-choice contends that abortion falls within a constitutional right to privacy, as they believe that such choice to terminate pregnancy must exist between the doctor and the individual.
The reproductive rights include the rights to accessibility to health care especially primary health care such as appointment with general practitioners and obtaining professional guidance from other health care providers (Ouellette 2015). The accessibility to such reproductive services amounts to a fundamental reproductive right as it shall prevent the occurrence of any chronic health condition that might arise due to reproduction. Besides preventing the occurrence of chronic health conditions, the reproductive rights to adequate health care also enables early detection of any such issues, which results in timely treatment of such chronic health diseases or at least, assists women in dealing with such chronic health condition arising from reproduction.
In the past twenty five years, the incline in the accessibility to contraception including adequate information about abortions family planning and contraception have been an essential element to a health care package that has assisted millions of women from dying due to poor reproductive health conditions (O’Rourke 2016). The Australian government has committed to continue with the International Planned Parenthood Foundation.
The right to terminate pregnancy is one of the significant reproductive rights, which have been restricted due to ineffective implementation of policies related to abortion rights, thus, compelling women to rely on the decision of territory and state governments regarding their reproductive right to abortion. Apart from the restrictions on reproductive rights of the women to terminate their pregnancy, they are subjected to restriction with respect to the accessibility to private and public funded health care services as well (Narasimhan et al. 2016).
Legro (2016) argues that in the Australian state of Victoria, where the women are permitted to exercise their reproductive rights to abortion, any women who seeks to obtain adequate information about reproduction or any related information are provided with sufficient knowledge about contraception which are reliable and successfully reduces the risk of planning an unplanned pregnancy in the future.
The primary argument that arises here is whether the inclusion of ability of women and availability of health care services within the Australian legal framework ensures good reproductive health. Legro (2016) states that the Australian legal framework supports ability and health care services relating to reproductive rights is further evident from the various legislations and regulations that includes rights to Assisted Reproductive Treatment (ART) procedures that have been developed to ensure a sound reproductive health. Such ART legislations have been implemented throughout the Australian territories and states. However, Huang et al. (2018) sates that presently, there are no Commonwealth legislation that shall regulate such technology assisted reproductive treatment. Nevertheless, the enactment of the Family Law Act 1975 (Cth), Research Involving Human Embryos Act 2002 (Cth) and the Prohibition of Human Cloning for Reproduction Act 2002 (Cth) usually regulates the ART procedures. Further, the Reproductive Technology Accreditation Committee (RTAC) ensures that ART clinics must comply with ART laws.
However, in New South Wales, the significance of reproductive rights of women to private and safe accessibility to reproductive health service has been recognized as is evident from the passing of the Public Health Amendment (Safe Access to Reproductive Health Clinics) Bill. Helmer et al. (2018) states that this marks a positive initiative towards ensuring women towards safe reproductive health services reaffirming dignity, well-being and safety of women that is in need of such services. The bill was passed to prevent women from undergoing violence and other forms of abuses for obtaining health care services from the medical professionals. Similarly, other Australian states like the Northern Territory, the ACT, and Victoria, Tasmania have also ensured that reproductive rights like abortion rights, accessibility to health care services are upheld. This initiative signifies that the Parliament is against all such acts or omissions that amount to violence against women, and ultimately, contravening their reproductive rights (Helmer et al. 2018).
According to Emanuel (2018), despite such a commendable initiative, the reproductive rights to terminate pregnancy remains a criminal act as per NSW legal provisions. Despite ensuring that women are entitled to exercise their reproductive rights and may abort the unborn under certain exceptional circumstances such as life threatening of the mother, etc, the ultimate decision lies with the doctors. The health care professionals must undertake decision whether such termination fall within the exceptions regardless of the choice of the mother. This is because the Bill although encourages exercising of reproductive rights but does not decriminalize the act of abortion unless it falls within the category of exceptions. Eager (2017) argues that in the present era, the doctors as well as women are subjected to the risk of being prosecuted for undergoing any safe procedure to terminate pregnancy or access any health care services. It is a complete contravention of the basic human rights of women in Australia.
Eager (2017) states while some Australian states have legalized abortion rights, women continue to experience impediments with respect to their accessibility to the health care services. Doran and Hornibrook (2016) states that it is already established that obtaining health care services from medical professionals or health care providers is essential to ensure a good reproductive health, the absence of such services often gives rise to complications resulting in death of the mother or the child or both.
Dobson and Ringrose (2016) agrees that despite significant improvements made in the health sector with respect to Australian women in the past decades, the entire community has not been able to enjoy such improvements as certain groups of Australian women, particularly, the aboriginals and Torres islanders women experience worse health than the general population. For the aboriginals and Torres Islanders women are subjected to social factors mostly, that affects the health services as well as sexual health resources and information. Dobson and Ringrose (2016) states that while exploring reproductive health demonstrates the need to provide health education, prevention strategies and health promotion especially for the marginalize population group like the Torres islander women, older and young women, bisexual and lesbian women and women with disabilities. For instance, women with disability are subjected to myths in relation to their sexuality and imparting the concept that they are non-sexual, hence they do not require any sex education.
Although the legal framework supports ability of the women to undertake decisions regarding the reproductive health and has enacted legislations that provided accessibilities to health care services, but, it ultimately leaves the final decisions regarding reproductive decisions pre-dominantly with the medical professionals. Despite legal regulations, Dix (2018) states that certain politicians and federal legislators have made such reproductive health issues a political issue instead of ensuring that the ultimate decision regarding availing of health care services or termination of pregnancies lies with the women instead of the doctors. This is because it has made the right to exercise control over their reproductive health for women misleading, especially the aboriginals and the marginalized group of women.
There are certain ethical considerations that may originate from reproduction control with respect to women health as well. De Moel-Mandel and Shelley (2017) states that the health of women may be enhanced if women are provided with the opportunity to make choices regarding contraception, abortion, application of reproductive technologies. The other ethical dilemmas that may arise from the legislations regarding ART include right to reproduce or whether it is morally acceptable to intervene with the reproduction procedure. Furthermore, de Costa and Douglas (2015) states that in regards to induced abortion may give rise to ethical dilemmas regarding safeguarding the life of mother versus safeguarding the life of the embryo. () argues that where the legislations that support women’s ability to terminate the pregnancy and have permitted them to exercise their right to pregnancy, it might face issues like impact of such abortion on the lives of women or whether termination of pregnancy is necessary and falls within the exceptions that validates abortion.
Although the Australian legislations, regulations have enhanced accessibility of women to health care services, which permits the women to exercise their reproductive rights, the legislations are not sufficient to ensure overall wellbeing of woman including a safe and healthy reproductive health. Further, in order to uphold the statement of the court in Pennsylvania’s case that ability of women to equally participate in the social and economic life of the nation is possible only if she becomes the ultimate decider of her reproductive life. de Costa and Douglas (2015) states that a strong reproductive health can only be achieved if women are able to exercise her reproductive rights as it will help her to plan her pregnancy after considering all options for her work, career and other responsibilities.
The reproductive regulatory framework only ensures that women may be have access to health services though are not the ultimate decider, but such legal framework fail to give more emphasis on the main element of ensuring reproductive health which is sex education. The lack of adequate information is the ultimate cause, which results in unwanted pregnancies affecting the health of the woman or young females. The most essential element of reproductive health is to provide sexual education for teenagers. The young people who are often misled by inadequate information about their sexual health are likely to become pregnant which ultimately affects their career and life. Chambers et al. (2017) states that for these teenagers, when it comes to exercise their other reproductive rights such as right to terminate their pregnancy, such rights are restricted to either their parents or doctors. The fear that often holds back families from disseminating information about sexual activities is that such information might induce them to be involved in one, could be avoided by imparting information that is not only age-appropriate but also medically accurate.
From the above discussion, it can be inferred that despite the ethical or legal dilemma that may arise with respect to technological advancements in reproductive health, it cannot be denied that such development in terms of introduction of parental education programs and sex education programs has reduced mortality rate of women and child. This is because such programs provide detailed information about contraception and outcomes of unprotected sexual activities along with its impact on the health. The present scenario where the reproductive health regulations supports ability of women in taking decisions regarding reproduction is acceptable but it is also necessary to fill in the gaps that exist which hold back women from being the ultimate decider regarding her reproductive health (Botfield, Newman and Zwi 2017).
It has become imperative to strike a balance between human rights of women to exercise her reproductive rights and the human right of a fetus, which has a right to life. The only way to balance between the two is to enable women an opportunity to make family planning considering her personal career and other responsibilities. The socio-cultural norms have always acted as impediment for the women and have restricted her to exercise her reproductive rights either on the grounds of incompetency to decide (teenagers and young people, disability) or by burdening her with her ethical obligations towards the fetus, disregarding her own physical health.
This requires stringent policies that will ensure that every woman is entitled to all the reproductive rights including the right to sex education, right to abortion, accessibility to family planning services and other health care services that will assure a good reproductive health (Bennett 2017). As the legal framework has enabled women to have access to the reproductive related health care activities, the only change that should be brought within such legal framework is that it must ensure that women especially young people are encouraged to learn sex education where they should be provided with adequate knowledge about contraceptive methods. This will not only improve health of the children and women by reducing mortality rate and enabling women to plan their pregnancies without affecting their career or life.
Therefore, if a woman is deprived of her right to plan her pregnancies, it will have an adverse impact on her life as well as on her security, given that childbirth by girls aged 15 to 19 is a significant reason of death. Bennett (2017) states that it is important that girls and women must complete education and take part in paid employment as it would establish empowerment of women as it will not only enable the women to take part in the social but also in the political economy of the country. Further, it is important to ensure women exercise their reproductive health rights as it shall not only be beneficial for the women but for the community altogether.
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