UGANDA: Should Abortion be a Woman's Right?

THE high number of maternal deaths is disturbing enough, but denying women reproductive health services worries them even more. And it becomes a bone of contention when women perceive such a health service to be their human right.

Women in developing countries like Uganda are on tenterhooks after research revealed that many of them are dying as a result of failing to access safe abortion services. This is because in many developing countries, abortion is illegal.

In Uganda, carrying out or procuring an abortion is a criminal offence contrary to Article 22 (2) of the Constitution.

The article says: “No person has a right to terminate the life of an unborn child except as may be authorised by law.” Therefore, a woman who aborts without authorisation has also committed an offence just like the person who has helped her abort. The penalty to the woman on conviction is 14 years imprisonment and whoever helps to procure an abortion is liable to three years' imprisonment upon conviction.

However, such laws have come under criticism by activists and reproductive health advocates who believe access to safe abortion is a fundamental human right that should be enjoyed by women at will.

Organisations like Reproductive Health Uganda (RHU), Uganda Women Network (UWONET), Ipas International and the US-based Guttmacher Institute have, therefore, stepped up the call for respecting safe abortion as a human right.

Jackie Asiimwe, the UWONET coordinator, says the Ugandan law on abortion contradicts international declarations on the right to health services like safe abortion, to which Uganda is a signatory.

“It is easy to pontificate those who abort but they still have a right to health,” Asiimwe told a dialogue on unsafe abortion from a health, human rights and policy perspective that RHU organised in Kampala recently.

Dr. Peter Ibembe, the RHU programmes director, notes that the UN Declaration on Human Rights considers reproductive health as a basic human right. Ibembe says since abortion is illegal in Uganda, women resort to crude ways of getting rid of unwanted pregnancies.

He cites drinking of turpentine, bleach, detergents or tea made with livestock manure, inserting herbal preparations into the vagina or cervix, placing foreign bodies such as sticks, coat hangers or chicken bones into the uterus and jumping from roof tops, as the crude methods women use to abort.

Ibembe says these result into complications like damage of the bladder or bowel, damage of the cervix, secondary infertility, tubal blockage, fistula, severe bleeding and sometimes death. As a solution, Ibembe says provision of high quality safe abortion services by trained service providers is crucial in reducing maternal mortality that currently stands at 435 per 100,000 live births.

Ntungamo district woman MP, Beatrice Rwakimari, says much as it might be a right for a woman to abort, the right of the unborn baby should not be overlooked. “We should not compromise the right of the mother and the baby,” she argues. “As policy makers, we need to focus on unwanted pregnancies as the first step in fighting unsafe abortion.”

Rwakimari suggests that Uganda should work on ensuring that the unmet need for contraceptive intake that stands at 41% be reduced by ensuring that more women use family planning methods to avoid unwanted pregnancies.

Unmet need refers to the percentage of women who would like to be able to either space their children or stop having children but are not using contraception. Besides reducing unsafe abortions, RHU says Uganda would save $112m (sh257.6b) by investing in contraceptive commodities and services to fill the entire unmet need.

Maxwell Ogwal, a student at Gulu Medical School, who was once arrested for helping a young woman get an abortion, says women need to access safe abortion as their right to get rid of unwanted pregnancies.

“What if a woman has been raped? Doesn't she have a right to get rid of such a pregnancy?

“I am preparing a petition that I will forward to Parliament next year on the need to legalise safe abortion in Uganda,” Ogwal told over 50 participants in a session on ‘Unsafe abortion and young women — their experiences, their dreams' at the college of physicians and surgeons in Accra, Ghana recently, where he was a presenter.

Besides local advocates, safe abortion activists from across Africa have drastically embraced the campaign. Queen Masaka Mbao, a programme officer for the Planned Parenthood Association of Zambia, says as much as abortion is taboo in many African countries, including her own, it is a violation of women's rights to deny them access to medical abortion.

“Medical abortion is part of reproductive health and should be respected just like any other form of reproductive health service.”

Mbao says outlawing safe abortion is an indirect way of encouraging unsafe abortion, thereby increasing maternal mortality, which is a violation of women's right to life.

Like Ogwal, Mbao also attended the one-week African conference on eliminating safe abortion in Africa in Accra recently.

Blain Rezene, a youth consultant from Ethiopia, notes that abortion remains a silent issue in many African countries, and urged community-based organisations to sensitise the masses about it.

Rezene specifically called for initiation of a youth dialogue arguing that: “Some male youth believe when a girl says no to sex, she means yes. This needs to be addressed because it also leads to unwanted pregnancies.”

Dr. Eunice Brookman-Amissah, the Ipas vice-president for Africa agrees that access to contraceptives is one of the issues that can stop unsafe abortion.

She, however, notes that the average contraceptive intake in Africa is still low. The medic from Ghana reveals that accessibility to contraceptives is at 15%, compared to countries like Thailand where it is at over 70%, and therefore stresses that legalising abortion is the way to go.