Ads for abortion clinics in East London, South Africa
Algeria is the most restricted country in the region regarding abortion. There are many laws and punishments regarding abortion. If there are posters, publicity, public meetings, group meetings that have to do with abortion, anyone involved can be punished.
The 3 grounds
A government bill on health issues proposed to make abortions legal on three grounds. One being that a woman could have an abortion if they were psychologically and or mentally at risk. The second one being non-viable or severe fetal abnormality or disease. The third ground being that the health or the life of the woman will be at risk if the pregnancy was to continue. When the woman is to see the doctor, the doctor must get the consent of that woman and inform her of the whole situation.
This is the text that was published when the bill was passed, “Therapeutic termination of pregnancy is intended to preserve the health of the mother and when her life or psychological and mental balance is seriously threatened by pregnancy. The detailed rules for the application of this article are laid down by regulation.”
Before August 14, 2018
This new law for abortion was being debated for way too long in the National Assembly. Before this, Algerians only option for abortion was to go to clinics or “Tunisia”. These clinics did not have any safety or good hygiene environments. The clinics did not meet any of the standards therefore would be risking the woman’s life.
There have been many cases of death of a pregnant woman and where there have beem fetuses’ and newborns found in dumpsters and trash cans. This shows that there has been a huge distress of a woman seeking an abortion.
Secret abortion clinics
There have been secret abortion clinics in Algeria. Many of the clients were young girls who made a mistake and wanted it to go away. Other clients were women who were housewives and when the husband found out about the babies, the mothers were forced to give them up. One common reason why these women go to the secret abortion clinics is because they don’t want to be pushed away from their families. Another reason being that they are truly not ready to care to a child. These women do a lot to get these illegal abortions done for example saving money for long periods of time and selling jewelry.
Abortion and Rape
In 1998, there was a big uproar about abortion in Algeria’s laws because of women being raped by Islamic Rebels. There were obvious ground rules, but women wanted a change. Women wanted to have the right to get an abortion if they had been raped. While the decisions were being made for four long years, 1,600 young women had been abducted by roving bands of the Armed Islamic Group.
The ground of rape was no included in the three grounds for the new law on abortion. A journalist made the point that the three group points and the ground point of rape used to be included when Algeria was fighting for independence but is not anymore. This is implying that the country has gone backwards since then in terms of abortion.
International Campaign for Women’s Right to Safe Abortion
This is a campaign that supports Women’s rights and protects so they can live in a safe environment. On the website they talk about many problems that are going on all over the world that involve women. One of the important topics they talk about on this website and campaign is Abortion in Algeria. This campaign works with many people and protest with the women to get women the support they need with abortion. The campaign keeps people up to date and gives money to make a difference in theses women’s lives.
Abortion in Angola
Abortion in Angola is only legal if the abortion will save the woman's life. In Angola, any abortion performed under different conditions subjects the woman and the person who performs the procedure to up to three years in prison. If the woman dies as a result of the abortion, the criminal charges are increased by one-third.
Barriers to legal reform
Angolan measures to reduce the number of unsafe illegal abortions by making legal abortions more accessible have been difficult to pass because of the conservative populace.
Unsafe abortion
Unsafe abortions are one of the leading causes of maternal death in the developing world. In many African countries, abortions are considered taboo. Women who get abortions often are associated with negative stereotypes due to cultural beliefs. Many of these cultural issues force women to seek abortions in unsafe ways. According to the Women's international Network News, these "back-alley" abortions are the cause of thousands of deaths every year.
More political attention has been given to the issue of abortions in Angola due to the unsafe procedures and the health effects on young women. Justice Minister Guilhermina Prata recently presented legislation with the intent to help decrease the number of illegal abortions done in Angola. In the region of Sub-Sahara Africa, the majority, if not all, of illegal abortions are unsafe. It is believed that 40 percent of women who have an illegal abortion die due to complications of the surgery. Information on unsafe abortions in Angola is difficult to obtain. However, due to the nature of the health care system and the prevalence of unofficial fees, the number of illegal abortions is potentially much higher than is reported. The debate regarding unsafe abortions in Angola is not new and is highly affected by the cultural and religious atmosphere in the country.
Abortion in Benin
Abortion in Benin is only legal if the abortion will save the woman's life. A select list of experts are allowed to examine a pregnancy to determine whether the only option for saving the woman's life is to induce abortion.
Impact of strict abortion laws
Self-induced abortions have been growing in Benin, especially among students in high school or university, and the average age of abortion recipients is 19.
Abortion in Botswana
Abortion in Botswana is only legal if the abortion will save the woman's life, if the pregnancy gravely endangers the woman's physical or mental health, or if it is a result of rape or incest. In Botswana, abortions that meet these requirements must be performed within the first 16 weeks of pregnancy in a government hospital and must be approved by two physicians.
Impact of restrictive abortion laws
Though women in Botswana are recognized as having some of the best access to abortions in Sub-Saharan Africa because of these exceptions, many women are still resorting to unsafe abortions and self-induced abortions, commonly leading to maternal death.
Socio-cultural impacts on abortion
In Botswana, many families still follow the lobolo custom where men pay a woman's family in order to take her as a bride. This has established an expectation that husbands have paid for and own their wives' bodies, including their reproductive rights. Even though this sentiment may lead to pregnancy that is a result of rape, hospitals and clinics are unlikely to approve marital rape cases as justifying abortion, as cultural norms suggest husbands are entitled to their wives' bodies.
Abortion in Burkina Faso
Abortion in Burkina Faso is only legal if the abortion will save the woman's life, the pregnancy gravely endangers the woman's physical or mental health, the child will potentially be born with an incurable disease, or in cases where the pregnancy is a result of rape or incest, so long as it is proven by a state prosecutor. Even these abortions are limited to the first ten weeks of pregnancy.
In Burkina Faso, any abortion performed under other conditions subjects the person who performs the procedure subject to one to five years’ imprisonment and imposition of a fine of 300,000 to 1,500,000 CFA francs.
Impact of restricted abortion laws
In the early 1990s, at least 5% of women admitted into healthcare facilities for maternal health concerns had life-threatening complications from unsafe abortions, and 70% of these women were between 16 and 24 years of age. During the same time period, 35% of women who sought medical treatment for infertility had previously been recipients of an illegal abortion.
Abortion in Burundi
It has been suggested that this article be merged into Abortion law#National laws. (Discuss) Proposed since March 2019.
Abortion in Burundi is only legal if the abortion will save the woman's life or if the pregnancy gravely endangers the woman's physical, or potentially mental, health. In Burundi, two certified physicians must agree that the pregnancy is threatening before giving medical assistance. Even in cases in which an abortion practitioner has deemed that the pregnancy has endangered the woman, both the physician and woman may be subject to prison time and fines.
Abortion in Cameroon
It has been suggested that this article be merged into Abortion law#National laws. (Discuss) Proposed since March 2019.
Abortion in Cameroon is only legal if the abortion will save the woman's life, the pregnancy gravely endangers the woman's physical or mental health, or the pregnancy is a result of rape.
Statistics
In 1997, a survey in Yaoundé found 20 percent of women aged 20–29 had had at least one abortion. 80 percent of these procedures took place in a medical facility, but they were not always safe, and women often faced complications. The odds that a pregnant woman would seek an abortion were increased if they were educated or had children. Of women reporting past abortions, 40% had two or more. The survey found that 35% of all reported pregnancies in the capital city ended in abortion.
Access to reproductive health care
In 1990, the Cameroon government passed Act No. 90/035 to prohibit birth control education. Reports found that abortion and secretive reproductive health services were widespread and made up 40 percent of OB/GYN emergency admissions. However, most access to abortion clinics were limited to urban centers within the country.
Abortion in the Central African Republic
It has been suggested that this article be merged into Abortion law#National laws. (Discuss) Proposed since March 2019.
Abortion in the Central African Republic is prohibited by law unless the pregnancy is the result of rape. According to general medical practice, the medical procedure is only legal if the abortion will save the woman's life, though this is not explicitly stated in any law. Anyone who performs an abortion faces up to five years in prison and a fine, and physicians risk losing their medical licenses for up to five years.
History
Prior to 2006, law in the Central African Republic explicitly outlawed abortion. In 2006, the National Assembly legalized abortion care in cases of rape, as women regularly faced sexual violence, rape, and gang rape in the war-ravaged country.
Women's health implications
Women with unwanted pregnancies in the Central African Republic do not have legal access to medical care. They still seek reproductive health care, but experts believe they often resort to conditions that are not sterile or medically safe.
Abortion in Chad
It has been suggested that this article be merged into Abortion law#National laws. (Discuss) Proposed since March 2019.
Abortion in Chad is prohibited by law. According to general medical practice, the medical procedure is only legal if the abortion will save the woman's life, though this is not explicitly stated in any law. Anyone who performs an abortion faces up to five years in prison and a fine, and physicians risk losing their medical licenses for at least five years and possibly indefinitely. Someone charged for regularly performing abortions faces up to ten years in prison. According to local experts, women and their physicians are rarely prosecuted for receiving or giving illegal abortions.
Abortion in Egypt
Abortion in Egypt is prohibited by Articles 260–264 of the Penal Code of 1937. However, under Article 61 of the Penal Code, exceptions may be granted in cases of necessity, which has typically been interpreted to permit an abortion necessary to save the life of the pregnant woman. In some cases, this exception has been extended to cases where the pregnancy poses dangers to the pregnant woman's health, and to cases of foetal impairment. A physician can only perform an abortion in such cases when two specialists approve, unless the woman's life is in imminent danger.
Any person who induces an abortion may be imprisoned, and physicians who do so may be sentenced to prison. Convictions are uncommon, because the prosecution must prove that the woman was pregnant and the means by which the pregnancy was interrupted.
In 1998, Muhammad Sayyid Tantawy, the Grand Imam of al-Azhar, issued a fatwa calling for access to abortion for unmarried women who had been raped. In 2004 he approved a draft bill that would permit abortion in the case of rape; the bill was unsuccessful.
Despite legal restrictions, abortions are common. In a 2000 study of 1025 women from six villages in Upper Egypt, 416 were found to have had at least one abortion; among this group, there were 265 abortions per 1000 live births. Abortions are carried out by indigenous methods, at clandestine clinics, or at great expense by private gynecologists.
In addition, unsafe abortions are common: a 1998 study found that about 20% of obstetric hospital admissions were for post-abortion treatment. One study estimated that between 1995 and 2000, there were 2,079,216 abortions, and 2,542 maternal deaths due to unsafe abortions.
Abortion in Ghana
Abortion in Ghana is illegal. Abortions are criminal offenses subject to at most five years in prison for the pregnant woman who induced said abortion, as well as for any doctor or other person who assisted this pregnant woman in accessing, or carrying out, an abortion. Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.
Terminology
The definition of abortion is quite wide. According to Act 29, section 58, article 3, of the Criminal code of 1960, “Abortion or miscarriage means premature expulsion or removal of conception from the uterus or womb before the period of gestation is completed.” Thus, both words, abortion and miscarriage, can be used interchangeably to refer to the same phenomenon. The law would seem to cover induced abortions, where the pregnant woman willfully expels a viable fetus, and also spontaneous abortions, or miscarriages, which may be encouraged by the pregnant woman through various means. Medically, there have been attempts to clearly distinguish between the two, but the laws in Ghana concerning this matter do not make this distinction.
Exceptions
In some situations, abortions are legal. The laws of Ghana allow abortions where (1) the pregnancy was as a result of rape, defilement, or incest, which are themselves all crimes in Ghana, and (2) where the pregnant woman requests the abortion. The pregnant woman's next of kin may request the abortion if the woman lacks the capacity to request it. For instance, if she is unconscious and in need of immediate medical attention that may entail abortion; if she is mentally incapable of making medical decisions (for example has an Intellectual disability); or if she is a minor according to the law. In Ghana, the age of minority is below eighteen years, although the legal age for marriage is sixteen years of age.
Law
Abortion is a criminal offence pursuant to Act 29, section 58 of the Criminal code of 1960, amended by PNDCL 102 of 1985, which states that:
Subject to the provisions of subsection (2) of this section
any woman who with intent to cause abortion or miscarriage administers to herself or consent to be administered to her any poison, drug or other noxious thing or uses any instrument or other means whatsoever; or
any person who—
administers to a woman any poison, drug or other noxious thing or uses any instrument or other means whatsoever with intent to cause abortion or miscarriage, whether or not the woman is pregnant or has given her consent
induces a woman to cause or consent to causing abortion or miscarriage;
aids and abets a woman to cause abortion or miscarriage;
attempts to cause abortion or miscarriage; or
supplies or procures any poison, drug, instrument or other thing knowing that it is intended to be used or employed to cause abortion or miscarriage; shall be guilty of an offence and liable on conviction to imprisonment for a term not exceeding five years.
It is not an offense under section (1) if an abortion or miscarriage is caused in any of the following circumstances by a registered medical practitioner specializing in Gynaecology or any other registered medical practitioner in a government hospital or a private hospital or clinic registered under the Private Hospital and Maternity Home Act, 1958 (No. 9) or in a place approved for the purpose by legislative instrument made by the Secretary:
where pregnancy is the result of rape or defilement of a female idiot or incest and the abortion or miscarriage is requested by the victim or her next of kin or the person in loco parentis, if she lacks the capacity to make such request;
where the continuance of the pregnancy would involve risk to the life of the pregnant woman or injury to her physical or mental health and such a woman consents to it or if she lacks the capacity to give such consent it is given on her behalf by her next of kin or the person in loco parentis;
where there is substantial risk that if the child were born it may suffer from or later develop a serious physical abnormality or disease.
For the purposes of this section, abortion or miscarriage means premature expulsion or removal of conception from the uterus or womb before the period of gestation is completed.
Statistics
According to national statistical data from 2009, 7% of all pregnancies are aborted. Within the population of women between 15 and 49, 15% have had abortions. For every 1,000 women in Ghana of childbearing age of 15 to 44, 15 abortions are performed. Another study carried out in the 1990s suggested that in southern Ghana, the number is marginally higher, at 17 abortions for every 1,000 women. This number is lower than the statistics available for West Africa as a whole: abortions rates are at 28 per 1,000 women
Ghanaian women of the following demographics are more likely to have abortions: women who have never been married; women in their twenties; women with no children; wealthy women; and women from urban areas. Never-married women are twice as likely to seek the procedure as those who are married. The tendency to seek abortion decreases with number of children: women with no children are seven times more likely to seek an abortion than women with three or more children. For these women, the most prominent reason for seeking the abortion was the stigma associated with having a child out of wedlock. Women who have had previous abortions are far more likely to seek the procedure. Researchers peg this to the possibility that these women may have more knowledge, both of the legal status of abortions, and more likely, where to obtain the procedure. Women in the top 40% of the wealth distribution in the country are 67% - 80% more likely to have abortions that their poorer counterparts. Younger women are more likely to seek abortions, with women between 20 and 24 years being most likely, at 25 abortions per 1,000 women, and the frequency decreasing with every successive age group. Urban women are far more likely to have abortions, with 34 abortions per 1,000 women. Overall, urbanites are 110% more likely to seek abortions than their rural counterparts, at 21 abortions per 1,000 women versus 10 abortions per 1,000 women.
The reasons that Ghanaian women give for seeking abortions include: the financial inability to care for a child; the pregnancy interfering with their occupation or schooling; and wanting to space out their childbearing or to limit family size. Also due to limited number of legal practitioners to perform safe abortion, it is expensive therefore lots of women cannot afford it and they turn to have unsafe abortion by unskilled practitioners
Approximately 45% of abortions in Ghana are unsafe. 11% of Ghanaian maternal deaths are due to unsafe abortions, and maternal mortality is the second leading cause of death among Ghanaian women. Some women experience complications from these experiences. Because so few women know that abortions are legal on many grounds in Ghana, they do not seek, or demand post abortion care, even when they have legitimate reasons to obtain legal abortions. According to a 2007 survey, only 3% of pregnant women, and 6% of women actively seeking abortions, knew the laws surrounding the procedure.
These numbers are relatively unreliable, because of how stigmatized abortions are in Ghana. Much of this data was collected based on face-to-face interviews, rendering it unlikely that they will reveal an accurate estimate of the occurrence of abortions. According to a paper, the number of abortions in Ghana is more likely to be closer to the West African rate of 28 per 1,000 women.
Abortion and Contraceptives
The low rate of contraceptive use is part of the driver for abortions. According to national statistical data, contraceptive use has increased over the decades, but from 13% use by married women in 1988, to just 25% by this demographic in 2003 followed by a slight decline to 24% in 2008. A much higher proportion of sexually active unmarried women use modern contraceptives, but in 2008, this number was just 28% of the population. As such, 35% of married women, and 20% of sexually active unmarried married fall in the pool of people who are not seeking children, and yet are not using any modern contraceptive methods.
As a consequence of this dearth, upwards of 37% of pregnancies in Ghana are unintended. A further 23% are mistimed, that is to say, do not occur at a time preferred by the individuals. 14% of all pregnancies are not wanted by the individuals pregnant. This translates to more than 300,000 children being products of unwanted pregnancies.
Overall, the average number of children Ghanaian women have has decreased from 6.4 to 4.0 between 1988 and 2008. Nonetheless, this does not match the recorded desire of women, who wish to have less than four children. For more than a third of these women who are not looking for children nor are on contraceptives, the reason they give for not doing so are often health related, or a fear of the side effects and the risks associated with the use of contraceptives. The proportion of women in this pool rises with education and urbanity. Poorer women are overall more likely to have unplanned births, and less likely to use modern contraceptives, than their wealthier counterparts.
Abortion in Kenya
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Abortion in Kenya is prohibited by article 26(IV) of the constitution unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law. Unsafe abortions are a leading cause of maternal morbidity and mortality in Kenya.
The 2010 Kenyan constitutional referendum that introduced article 26 broadened access to abortion by allowing it for maternal health reasons. Christian churches, who feared it would lead to the legalisation of abortion, opposed the amendment.
A survey of 2012 by the Kenyan Ministry of Health, African Population & Health Research Center and IPSAS found that there were 464,000 abortions induced that year, which translates to an abortion rate of 48 per 1,000 women aged 15-49; and an abortion ratio of 30 per 100 live births. About half (49 %) of all pregnancies in Kenya were unintended and 41 % of unintended pregnancies ended in an abortion. Marie Stopes International estimates that 2,600 women die from unsafe abortions annually, an average seven deaths a day.Nearly 120,000 women are hospitalized each year due to abortion-related complications.
The publication these statistics in 2018 and the death of activist Caroline Mwatha in February of 2019 following an unsafe abortion has brought the debate on abortion to the forefront in recent times.
Abortion in Namibia
Abortion in Namibia is restricted under the Abortion and Sterilisation Act of South Africa (1975), which Namibia inherited at the time of Independence from South Africa in March 1990. The act only allows for the termination of a pregnancy in cases of serious threat to the maternal or fetal health or when the pregnancy is a result of rape or incest.
Legal position
Abortion is only allowed when continuing the pregnancy will "endanger the woman’s life or constitute a serious threat to her physical or mental health or there must be a serious risk that the child to be born will suffer from a physical or mental defect so as to be irreparably seriously handicapped, when the foetus is alleged to have been conceived in consequence of unlawful carnal intercourse (rape or incest); or when the foetus has been conceived in consequence of illegitimate carnal intercourse and the woman is, owing to a permanent mental handicap or defect, unable to comprehend the implications of or bear the parental responsibility for the “fruit of coitus”."
In addition to the woman’s doctor, two other doctors are required to certify the existence of grounds for an abortion, and the operation must be performed by a medical practitioner in a State hospital or an approved medical facility."
In a statement at the 1994 International Conference on Population and Development in Cairo, then Minister of Health and Social Services Nickey Iyambo stated:
On the question of abortion, the position of Namibia is that it can only be performed under strict medical supervision within the confines of the laws, which state that consent to abortion can only be given in cases of rape, incest and when the life of the mother is in danger. Mr. President, ladies and gentlemen it must be clearly understood that Namibia does not promote abortion as a means of family planning but as a public health issue.
Impact of abortion restrictions
The lack of emergency contraceptive use and access to safe legal abortions are contributing factors to the problem of abandonment of newborns, which is acknowledged to be a serious problem in the country.
Medical Practice
For abortion to be as safe as possible for a woman , the procedure needs to be performed as early in pregnancy as her decision about continuing the pregnancy permits .
Health Implications involved
If the process is not done accordingly and by a professional, it might lead to infertility, death or one might end up paralyzed
Abortion in Nigeria
Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by The Penal Code and southern Nigeria is governed by The Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother's life in danger.
Nigerian Law
Nigeria’s abortion laws make it one of the most restrictive countries regarding abortion. Nigeria's criminal law system is divided between the northern and southern states of Nigeria.
The Criminal Code is currently enforced in southern states. The abortion laws of the Criminal Code are expressed within sections 228, 229, and 230. Section 228 states that any person providing a miscarriage to a woman is guilty of a felony and up to 14 years of imprisonment. Section 229 states that any woman obtaining a miscarriage is guilty of a felony and up to imprisonment for 7 years. Section 230 states that anyone supplying anything intended for a woman's miscarriage is also guilty of a felony and up to 3 years of imprisonment.
The Penal Code operates in northern states, with abortion laws contained in sections 232, 233, and 234. The sections of the Penal Code parallel the Criminal Code, besides the exception for abortion with the purpose of saving the life of the mother. The Penal Code's punishments include imprisonment, fine, or both. The offenses of these codes are punishable regardless of whether the miscarriage was successful. No provisions have been made to the Criminal Code making exceptions for the preservations of the mother's life. However, the cases of Rex vs Edgar and Rex vs Bourne have made it generally accepted that abortion performed to preserve the mother's life is not an appropriate transgression of the Criminal Code.
Statistics
Since abortion is illegal in Nigeria, many women resort to unsafe abortion methods, leading to abortion-related complications and increasing mortality and morbidity rates in the country. According to research done by the Guttmacher Institute, an estimated 456,000 unsafe abortions are done in Nigeria every year. In a joint study carried out by the Society of Gynecologists and Obstetricians of Nigeria and Nigeria's Ministry of Health, estimates of women who engage in unsafe abortion were put at about 20,000 each year. Research has revealed that only 40% of abortions are performed by physicians with improved health facilities while the remaining percentage are performed by non-physicians.
History
Throughout history, Nigeria's abortion laws have mobilized several groups and movements with opposing missions regarding the liberalization of abortion laws and promotion of women's rights. In the 1972 conference of the Nigerian Medical Association (NMA), the first attempts were made to reform abortion laws in Nigeria. However, a lack of support caused no revisions to result from this attempt. In 1975, the National Population Council further advocated for women's access to safe and legal abortion on the basis of promoting health and well-being of the mother. Defended by the Nigerian Medical Association (NMA) and the Society of Gynecologists and Obstetricians of Nigeria (SOGON), this sparked a controversy in 1976. At the yearly SOGON convention, the Prime Minister of Health gave a speech noting the possibility for national reform of abortion laws.
In 1981, the National Council of Women's Societies countered the SOGON's proposed bill regarding termination of pregnancy, preventing it from reaching the House of Representatives. The National Council of Women's Societies expressed that more efforts should be put towards family planning education and prevention of pregnancy outside of marriage. They expected parents of the House to enforce strong moral values for the country. In 1998, the Women's Health Research Network of Nigeria emerged with the purpose of promoting research and encouraging other groups to advocate and unite around women's health issues.
The Campaign Against Unwanted Pregnancy (CAUP) was created in 1991 with the mission of defending women's sexual and reproductive rights and eliminating unsafe abortion. In 1992, CAUP organized a reform meeting in which the Minister of Health and NMA president reviewed legislation regarding abortion. However, this reform was met with much opposition and was not successful. An important goal of the CAUP is public health education. In 1997, they established the Action Group for Adolescent Health (AGAH), in which they trained medical students to become public educators on sexual and reproductive health. From 1999 to 2004, CAUP organized many workshops and lectures on sexual health and women's rights with the hope of empowering Nigerian citizens with the knowledge to lead a healthy lifestyle and advocate for change. The focus of CAUP since 2002 has been abortion bill reform. A group of experts collaborated to outline changes in 2003. As of 2004, the bill was in its eighth stage of revision.
In 2015 The Violence Against Persons Prohibition Act (VAPP) was passed into law. This act is meant to provide sexual assault and relationship violence survivors with aid. This act is helping women get the contraceptives they need to prevent unwanted pregnancy, the leading cause for abortions.
Despite the combined and continued efforts of various Nigerian and International advocacy groups, only a woman whose life is endangered can undergo a legally performed abortion today.
Practices and Consequences
Many regions in Africa are known for their unsafe practices in health care and disease, specifically when it comes to young pregnant women and abortion. A major problem in these regions is that access to adequate health care is limited, meaning that options for safe health care practices are not easily accessible and some turn to unsafe methods of handling their pregnancies. Abortion accounts for 40% of maternal deaths in Nigeria, making it the second leading cause of maternal mortality in the country.
Health care systems in African countries have failed to make the proper changes to ensure a better future for their citizens. The government has either failed to make these issues a priority or they have attempted to introduce policies that had an opposite result of what was desired. Specifically in Nigeria, religious and cultural factors are major reasons behind the failure to address certain abortion issues.
Many of the issues surrounding unsafe abortion focus on adolescents. Although unsafe abortion practices do affect most of the sexually active women in the country, it is believed that adolescents may require special circumstances and could be a reason for change in this area. Adolescents are the most in need of these services, if they adopt safe practices to avoid unplanned pregnancy, these problems could start to decline. A major issue with teens in Nigeria, is that they are the most likely not to use contraceptives to avoid pregnancy and the most likely to turn to unsafe abortion practices.
Contraceptive use is a common issue for teens in Nigeria and there are no services to support this. Contraceptives are an important resource in a community where abortion and high fertility is an issue.
The need for increased access to safe abortion practices in Nigeria is very apparent. There are several different methods used to try and ensure a healthy and safe approach to abortions, but Nigeria hasn't always been able to keep up with the costs of these medical advances. In Nigeria, there are three first-trimester safe practices that are utilized to compare costs and effectiveness. Hospital-based dilatation and curettage, hospital-and clinic-based manual vacuum aspiration, and medical abortion using misoprostol are all considered to be a huge cost savings and ultimately puts the mother in its best interest.
Prior to women practicing these medically safer and more cost-effective methods, the rate of self-induced abortions was extremely high relative to other countries and regions. The side effects of using other methods have proved to be damaging to the mothers, resulting in high fevers, urinary tract infections, and genital trauma.
There are also issues where the women who did induce their own abortions did so incorrectly and could have caused other complications by overdosing on misoprostol - a method that is most commonly used safely and cost effectively. An important aspect to take into consideration is that Nigeria is a region where there are low health system requirements and where they strive to use non-surgical options.
Causes for Abortion
Unwanted pregnancy is the leading cause for abortion in Nigeria. Unwanted pregnancies have many causes. Nigeria's growing economy and increasing urbanization is making the price of living higher. This is making it more necessary for women to be working, as well as the men, to help support the family. When there are more children it makes it harder for the women to focus on work because they are expected to take care of the family first, thus women would rather be working, than pregnant or taking care of a child.
Another reason for the high rates of unwanted pregnancy in Nigeria is low contraceptive use and lack of family planning. Much of this is a result of lack of education on the use of contraceptives, as well as a lack of access to health care and contraceptive products in Nigeria. Due to the lack of contraceptive use, there is a trend of uneducated, young, childless women, and women with many children who end up with unwanted pregnancies. Both of these groups of women live in rural areas, where healthcare is spread out, hard to find, and government campaigns to help educate the public on family planning and contraceptives don't get as much advertisement.
Nigerian women want around 6.7 children. They have 25 years from the ages of 20-45 where they are mostly likely to get pregnant. They spend around 15 of those years pregnant, trying to get pregnant, and not having sex immediately after pregnancy, as accustomed in Nigerian culture. This equates to them having around ten childbearing years where they don't want to be pregnant Nigerian women have a long span of their life where an unwanted pregnancy can take place, thus these women need contraceptives to make sure an unwanted pregnancy will not occur.
Abortion in South Africa
Abortion in South Africa was legal only under very limited circumstances until 1 February 1997, when the Choice on Termination of Pregnancy Act (Act 92 of 1996) came into force, providing abortion on demand for a variety of cases.
Legal position
In South Africa, any woman of any age can get an abortion by simply requesting with no reasons given if she is less than 13 weeks pregnant. If she is between 13 and 20 weeks pregnant, she can get the abortion if (a) her own physical or mental health is at stake, (b) the baby will have severe mental or physical abnormalities, (c) she is pregnant because of incest, (d) she is pregnant because of rape, or (e) she is of the personal opinion that her economic or social situation is sufficient reason for the termination of pregnancy. If she is more than 20 weeks pregnant, she can get the abortion only if her or the fetus' life is in danger or there are likely to be serious birth defects.
A woman under the age of 18 will be advised to consult her parents, but she can decide not to inform or consult them if she so chooses. A woman who is married or in a life-partner relationship will be advised to consult her partner, but again she can decide not to inform or consult him/her. An exception is that if the woman is severely mentally ill or has been unconscious for a long time, where consent of a life-partner, parent or legal guardian is required.
The Constitution does not explicitly mention abortion, but two sections of the Bill of Rights mention reproductive rights. Section 12(2)(a) states that, "Everyone has the right to bodily and psychological integrity, which includes the right to make decisions concerning reproduction," while section 27(1)(a) states "Everyone has the right to have access to health care services, including reproductive health care." In the case of Christian Lawyers Association v Minister of Health an anti-abortion organisation challenged the validity of the Choice on Termination of Pregnancy Act on the basis that it violated the right to life in section 11 of the Bill of Rights; the Transvaal Provincial Division of the High Court dismissed their argument, ruling that constitutional rights only apply to born people and not to fetuses.
In general, only medical doctors may perform abortions. Nurses who have received special training may also perform abortions up to the 12th week of pregnancy. A medicine-induced abortion can be performed by any medical doctor at his/her premises up to 7 weeks from the first day of the last menstrual period. The usual method is a dose of an antiprogestin, followed by a dose of a prostaglandin analogue two days later.
Health workers are under no obligation to perform or take active part in an abortion if they do not wish to, however they are obligated by law to assist if it is required to save the life of the patient, even if the emergency is related to an abortion. A health worker who is approached by a woman for an abortion may decline if they choose to do so, but are obligated by law to inform the woman of her rights and refer her to another health worker or facility where she can get the abortion.
Abortion can be had for free at certain state hospitals or clinics, although sometimes only if the woman is referred by a health worker. Most abortion centres will insist on providing pre- and post-abortion counselling, and the woman can legally demand it, but it is not a legal requirement that abortion centres provide it.
Statistics
There has since the legalisation of abortion on demand been a decrease in deaths from backstreet abortions, but the number of deaths following abortions are still quite high according to statistics gathered in Gauteng province—5% of maternal deaths following childbirth are abortion related, and 57% of these are related to illegal abortions.
A recent study in Soweto showed the following: the rate of abortions for women older than 20 years decreased from 15,2% in 1999 to 13,2% in 2001, the rate for women aged 16–20 decreased from 21% to 14,9%, and the rate for women aged 13–16 decreased from 28% to 23%. In 2001, 27% of abortions were second-trimester.
Abortion in Uganda
Abortion in Uganda is illegal unless performed by a doctor who believes pregnancy places the woman's life at risk. The Ugandan Ministry of Health estimates that as of 2008, 26% of all maternal deaths result from abortion complications. This is aggravated by legal, socioeconomic, and geographical barriers to safe abortion, which compel women to use unsafe abortion methods and deter them from seeking post-abortion medical care. Contraception is not commonly used, leading to Uganda’s need for family planning.
Laws on women's sexual reproduction and abortion
The legal status of abortion in Uganda is unclear because it provides for some exceptions while criminalizing the procedure in most cases. The Ugandan Constitution, in Article 22, item 2 states: "No person has the right to terminate the life of an unborn child except as may be authorised by law." However, what is authorized by law remains poorly understood.
The Penal Code of 1950, Article 141 on "Attempts to procure abortion" states:
Any person who, with intent to procure the miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means, commits a felony and is liable to imprisonment for fourteen years.
Article 142 lays out a punishment of seven years for an attempt to procure a miscarriage.
Nonetheless, under other provisions of the Penal Code an abortion may be performed to save the life of a pregnant woman. Section 217 of the Code provides that a person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon an unborn child for the preservation of the mother’s life if the performance of the operation is reasonable, having regard to the patient’s state at the time and to all the circumstances of the case. In addition, Section 205 of the Code provides that no person shall be guilty of the offence of causing by willful act a child to die before it has an independent existence from its mother if the act was carried out in good faith for the purpose of preserving the mother’s life.
Uganda, like a number of Commonwealth countries, whose legal systems are based the English common law, follows the holding of the 1938 English Rex v. Bourne decision in determining whether an abortion performed for health reasons is lawful. In the Bourne decision, a physician was acquitted of the offence of performing an abortion in the case of a woman who had been raped. The court ruled that the abortion was lawful because it had been performed to prevent the woman from becoming “a physical and mental wreck”, thus setting a precedent for future abortion cases performed on the grounds of preserving the pregnant woman’s physical and mental health. The liberalization and legality of abortion in Uganda has been complicated by the use of rape as a weapon of war and terror by rebel groups in the region."
In Uganda, an abortion is permitted to save a woman's life, preserve the physical health of the woman, and to preserve the mental health of the woman. An abortion is not permitted in terms of rape or incest, fetal impairment, economic or social reasons, or by request. A legal abortion has to be performed by a licensed and registered physician with the consent of two physicians prior to the medical procedure.
Government family planning
In 1988, the Ugandan government launched a comprehensive program in response to the country's high fertility and growth rates, which adversely affected per capita incomes and threatened the sustainability of social services. The major goal was to increase the contraceptive rate from 5 percent to 20 percent by 2000. The services for birth control in Uganda are now accessible at clinics and are operated by the Family Planning Association of Uganda. Contraceptives like condoms helped to reduce the rate of HIV/AIDS in Uganda, but there are still a significant number of unwanted pregnancies leading to abortion.
There was direct support provided in the government's policy on contraceptive use, and since 1995, 8 percent of married women aged 15 to 49 use contraception. The total fertility rate from 1995 to 2000 was 7.1, and the age specific fertility rate per 1,000 women aged 15 to 19 from 1995 to 2000 was 180. The government has shown a lot of concern for the morbidity and mortality resulting from induced abortion, but there has been a number of complications in childbearing and child birth. In Uganda, the female life expectancy at birth from 1995 to 2000 was 40.4 percent.
Movements
Movements such as Pro-Life Uganda (Pro-Life Uganda) and Pro-Choice Uganda (Pro Abortion) fight for their belief that either a woman has the right to choose what happens to her and her body (Pro-Choice Uganda), or the fetus' life is sacred and everyone deserves to live (Pro-Life Uganda). There was a movement that took place that involved the Pro-Life organization, Christian founded anti-abortion that advocates against abortion. This group was joined by 100 delegates from the U.S., United Kingdom, Uganda and Spain in a three-day workshop to help the young women of Uganda understand the preciousness of life, and to counsel the young women against the practice of abortion.
Abortion in Zimbabwe
Abortion in Zimbabwe is available under limited circumstances. Zimbabwe's current abortion law, the Termination of Pregnancy Act, was enacted by Rhodesia's white minority government in 1977. The law permits abortion if the pregnancy endangers the life of the woman or threatens to permanently impair her physical health, if the child may be born with serious physical or mental defects, or if the fetus was conceived as a result of rape or incest. Nevertheless, an estimated 70,000+ illegal abortions are performed in Zimbabwe each year, resulting in around 20,000 maternal deaths.
Terminology
The Termination of Pregnancy Act defines abortion as "the termination of a pregnancy otherwise than with the intention of delivering a live child."
History
Before 1977, abortion in Zimbabwe (then Rhodesia) was governed Roman-Dutch common law and English case law, namely the 1861 Offences Against the Person Act, which permitted abortion only to save the life of the pregnant woman. This principle was clarified in the 1938 case Rex v. Bourne, in which Justice Malcolm Macnaghten ruled that abortion could be legally performed to save the mother's life. At the time, Bulawayo was the "abortion centre" of Rhodesia, with most abortion procedures being performed by gynaecologists at Bulawayo Central Hospital.
With the advent of the women's liberation movement in Rhodesia in the early 1970s, debate over the country's abortion law increased. In July 1976, the government's Commission of Inquiry into the Termination of Pregnancy in Rhodesia published its recommendations that some restrictions on abortion be loosened. In the report, the commission acknowledged that "perhaps the majority of younger Rhodesians wish to see abortion laws liberalized." The commission recommended that abortion be permitted under the following conditions:
"Where the continuation of the pregnancy constitutes a danger to the life of the mother and termination is necessary to ensure her life;
"where the continuation of the pregnancy constitutes a serious threat to the physical health of the mother and termination is necessary to ensure her continued health;
"where the continuation of pregnancy creates a great danger of serious and permanent damage to the mother's mental health and termination is necessary to avoid such danger;
"where there exists a serious risk on scientific grounds that the child to be born will suffer from a mental or physical defect so that he will be seriously handicapped;
"where the child is conceived as a result of rape or incest;
"where the mother is an idiot or imbecile."
The commission's report, and the proposed legislation in Parliament that followed, sparked public debate on the issue, and in the months that followed, The Rhodesia Herald regularly published letters from white Rhodesians on what it described as "a key social issue in Rhodesian society."
In the journal Zambezia, Diana Seager, a sociology lecturer at the University of Rhodesia, expressed dissatisfaction with the commission's finding, writing that while they made a "seemingly liberal gesture... in substance reccomendations are no different from previous legislation." Jacquie Stafford, president of the National Organisation for Women, wrote to The Herald that "the reccomendations of the Commission... were quite conservative... not going as far as many women would have liked." Political activist Diana Mitchell asked in a letter, "why are the women of Rhodesia not consulted on this controversial subject?" She opined that abortion "should be left to the individuals concerned." At the same time, other letters to The Herald expressed opposition to liberalized abortion laws. Roy Buckle, a Salisbury resident, argued that expanded access to legal abortion represented the "thin end of the wedge and that further liberalization will follow." None of the writers were black Rhodesians, and none of the letters addressed how black women might be affected.
As much as abortion was a social and moral issue, it was also a racial issue in Rhodesia. Many on the far-right of the white population viewed abortion primarily as a means to combat the rapid growth of the black population. As a result, liberalized abortion laws might be viewed by black Rhodesians as a means for genocide of their race.
In December 1976, acting on the commission's findings, the Parliament introduced legislation addressing abortion. The Termination of Pregnancy Act (No. 29 of 1977), which took effect on 1 January 1978, expanded abortion access, allowing the procedure under three conditions: if the pregnancy endangers the life of the woman or threatens to permanently impair her physical health, if the child may be born with serious physical or mental defects, or if the fetus was conceived as a result of rape or incest. Under the former law, the latter two conditions were not circumstances under which a legal abortion could be obtained. Although the new law expanded abortion access, it did not go far enough for some: Jacquie Stafford, president of the National Organisation for Women, wrote in a letter to The Herald that the law "showed nothing but contempt for the women of this country, and makes me wonder at the sanity of our parliamentary representatives."
After Zimbabwe's independence in 1980, the new black government retained the Termination of Pregnancy Act.
In recent years, there has been growing vocal support to amend the law and expand legal abortion access. Many support expanded legal abortion access in order to end unsafe illegal abortions which often threatens the health of the mother, or results in maternal death. Zimbabwean women are 200 times more likely to die from an abortion procedure than women in South Africa, where obtaining an abortion is easier. And Zimbabwe's maternal mortality rate is three times higher than South Africa. One abortion-rights group active in Zimbabwe is Right Here Right Now (RHRN), which advocates for a review of the Termination of Pregnancy Act, which they consider "archaic". Other calls to expand access to legal abortion came from the organization Zimbabwe Doctors for Human Rights, as well as former Minister of Finance Tendai Biti.
Current legal status
Abortion is legally permitted under limited circumstances. In accordance with the Termination of Pregnancy Act, an abortion may be legally performed if the pregnancy seriously endangers the mother's life or threatens to permanently impair her physical health, if there is a significant risk that the child would be born with serious physical or mental defects, or if the fetus was conceived as a result unlawful intercourse, defined as rape, incest, or intercourse with a mentally handicapped woman (other sexual offenses, like statutory rape, are not legal grounds for an abortion).
An abortion may only be performed by a medical practitioner in an institution designated by the Ministry of Health and Child Care, with the written permission of the hospital superintendent or administrator. In order for the abortion procedure to be performed, two medical practitioners who are not from the same medical partnership or institution must certify that the requisite conditions indeed exist. In cases of unlawful intercourse, (rape, incest, or intercourse with a mentally handicapped woman), a court magistrate of the jurisdiction in which the abortion would take place must issue a certificate certifying that the pregnancy was probably that the result of unlawful intercourse as defined in the Act. Abortion services are provided by the Ministry of Health and Child Care, and are free to low-income and unemployed women.
Illegal abortion carries a penalty of imprisonment up to five years and/or a fine. The Termination of Pregnancy Act set the fine at Z$5,000 (approx. US$563 in 1997). However, Zimbabwe no longer uses the Zimbabwean dollar. Under section 60 of the Criminal Law and Codification Reform Act, illegal abortion is punishable by up to five years in prison and/or a fine not exceeding level 10.
Statistics
Illegal abortions
A UNICEF report in 2005 estimated that around 70,000 illegal abortions take place in Zimbabwe each year. Government estimates indicate that more than 80,000 illegal abortions happen every year, resulting in around 20,000 maternal deaths. In 2017, Ministry of Health and Child Care official Dr. Bernard Madzima estimated that illegal abortions causes 16% of maternal deaths, half of whom were adolescents. Most illegal abortions obtained by adolescent mothers occur in rural areas. Illegal abortions are also often performed illegally by city doctors. In 2014, over 2,000 young women ages 17 to 25 sought post-abortion care at Harare Hospital, and at Parirenyatwa Hospital treats over 100 women per month seeking post-abortion care.
Public opinion
A 2018 survey on the Constitution of Zimbabwe found that that 40% of respondents favored full constitutional abortion rights, 39% supported abortion rights in certain instances, and 19% were completely opposed to any constitutional abortion rights. The survey results showed that Zimbabwean men were more supportive of abortion rights than women, with 46% of men supporting full rights for women to an abortion, compared to 39% of women holding the same view.
2018 survey, question on whether the Constitution should protect abortion rights
Full abortion rights (40%)
In some instances (39%)
No legal abortion (19%)
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