Morality that Kills, Legality that Saves

” There’s nothing altruistic, compassionate or noble in advocating for abortion.” These were the words of a forum participant on a pro-life website that featured a short article on abortion in Ethiopia. And I thought to myself: Yet there is righteousness in praying for the departed soul of a girl or woman who bleeds herself to death from back alley procedures? Well then, call me inhuman, unfeeling and undignified because I am unwaveringly pro-choice and will unendingly advocate for women and girls access to safe abortions.
The procurement of unsafe abortion is amongst the leading causes of death of women and girls in Ethiopia. According to IPAS, around 100 hundred women die in health facilities from abortion-related complications. And these figures only capture those that actually make it to health centers to follow-up on back-alley procedures gone wrong. In 2008 alone an estimated 52, 600 women received care at a health facility due to complications arising out of unsafe abortions. In desperation, women and girls self-induce abortions by thrusting metallic objects, sticks and other materials up into their uterus. Others utilize a leafy plant named abawela, pulling it out from the ground by its roots, trimming it and pushing it up their uterus to induce bleeding. Also, in a documentary film on abortion in Ethiopia titled Not Yet Rain by Lisa Russell, a mother who lost her daughter to an unsafe abortion speaks that the back alley abortionist used a catheter wrapped around an umbrella to perform the procedure on her daughter. Many health care professionals who now provide post-abortion care reiterate that the women and girls who come in to the health clinics show signs of infections and invasive injuries, most notably a perforated uterus.
Abortion Law in Ethiopia
Until 2004, the procurement and administration of abortion was a criminal offence and punishable by imprisonment according to Article 545 of the 1957 criminal code. The criminal code was revised in 2004 amending the articles on abortion. Now Article 551 of the FDRE penal code ” permits the procurement of abortion by a recognized medical institution under certain conditions”.   The following stipulations govern the legality of procuring an abortion:
a) the pregnancy is the result of rape or incest; or
b) the continuance of the pregnancy endangers the life of the mother or the child or the health of the mother or where the birth of the child is a risk to the life or health of the mother; or
c) where the child has an incurable and serious deformity; or
d) where the pregnant woman, owing to a physical or mental deficiency she suffers from or her minority, is physically as well as mentally unfit to bring up the child.
Following the revision of the abortion law, in 2006 the Ministry of Health released guidelines for safe abortion services which ensure that women and girls have access to safe abortions, permitting any woman eligible for an abortion to obtain the service within three working days.
Circumstances that Warrant an Abortion
I am of the belief that abortion services should be readily available to any woman or girl aside from the confines placed by the above-stated conditions. Yet I am still very glad that Ethiopia has not batted an eyelash in amending a moralistic law and adopting what is one of Africa’s most progressive and life saving abortion law.
Procurement of abortion is a taboo in a country that staunchly supports the Abrahamic tradition of multiplication. In addition, rape is also a taboo that leaves one readily disposed to stigmatization. As Lisa Russell states, ” a woman with an unwanted pregnancy due to rape gets stigmatized twice. That’s why providing access to safe and legal service is so important, because women in that stigmatized position will go to desperate means.”
While rape is one of the causes of unwanted pregnancies, lack of information and knowledge on contraceptives and family planning methods puts women and girls in Ethiopia, the majority of which live in rural areas, at a great disadvantage in controlling their reproductive capacities. Furthermore, even where the means to controlling pregnancies are readily available, a patriarchal culture that overvalues men makes it impossible for these women and girls to make decisions over their own bodies, where the husbands forbid their wives from using contraception.    
Despite the amendment of the law, it remains that many women and girls are uninformed about these changes and continue to procure dangerous back-alley abortion procedures. Notwithstanding the new law, almost 6 in 10 abortions are unsafe.
Safe Abortion Services

The following are a few facts from IPAS on abortion services in Ethiopia.

• ” About half of all health facilities in Ethiopia provide induced abortion services. However, the proportion is much higher for public hospitals (76%) and private or nongovernmental organization (NGO) facilities (63%) than for public health centers (41%). These proportions are likely changing rapidly, as efforts are being made to expand abortion services in public facilities. Currently, private and NGO facilities provide the most induced abortions.”
• ” Access to second-trimester abortions is severely limited. Only 9-10% of all facilities have a provider who can perform this service.”
• ” The majority of abortions obtained by relatively well-off women are performed by trained health professionals, such as physicians, clinical officers, nurses or midwives; poor women are far more likely to seek abortions from unskilled providers.”
• ” Government hospitals care for 35% of postabortion care patients; public health centers, which are more numerous, treat 40% of cases; and NGO and private facilities treat the remaining 25%.”
• ” A number of medication abortion products are being considered for official registration and government approval. Approval of one or more of these products could improve access to safe abortion, especially for rural women.”

Global Gag Rule

Earlier this year I blogged here about my concerns about the anti-choice gains in the US congress and how they impact reproductive rights in Ethiopia. Despite Ethiopia’s amendment of the abortion law, the successful implementation of the law was put to test by Bush’s global gag rule which prohibited U.S. financing to organizations that perform or counsel abortions or provide post-abortion counselling, even if they do not terminate pregnancies themselves. Although in true Democrat fashion Obama overturned the global gag rule, the threat of republican anti-choice sentiments severely impacts the Global Health Initiative (GHI) launched by the Obama administration as congressional leaders tried once again to reinstate the Global Gag Rule.
A Note to Anti-Abortionists
Restrictive abortion laws do not prevent abortion but only push it underground, increasing the risks to women and girls.
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Love & Light