Are restrictive abortion laws good for women’s reproductive health?

File pic: Abortion pills

This article is a two-part series looking with some relative depth into illegal abortions in relation to women’s reproductive health, reproductive rights and their perceptions of the impact of the current legislation on backyard or illegal abortions in Zimbabwe.

The issue of abortion is both contentious and emotive. It is an issue that significantly impacts on both women’s reproductive health and reproductive rights.

Anthropological studies have shown that women always used abortion to control fertility and this was widespread even in ancient and pre-industrial societies.

The Population Reference Bureau in a report titled Abortion Facts and Figures, estimates that 210 million women become pregnant every year and of these pregnancies an estimated 46 million result in induced abortions with 19 million of these performed in unsafe conditions and or by unskilled people resulting in the deaths of at least 68 000 girls and women annually.

The irony is that while abortion impacts on women’s reproductive health and rights, in most cases women’s voices are relegated to the periphery because abortion is connected to women’s sexuality.

Rusere N in a research called Justice delayed is justice denied: The experiences of applicants for the termination of pregnancy in rape situations under the Termination of pregnancy Act in Zimbabwe reveals that women’s voices are silenced in sexuality matters because culturally their sexuality is not regarded as their own, but their parents’ and husbands’. Such cultural restrictions are enforced through legislation.

In Zimbabwe abortion is a crime unless sanctioned by the state and certified by health personnel. Studies have shown that due to such restrictions women resort to illegal or backyard abortions putting their health and subsequently their lives at risk.

The UN in a report titled: Abortion policies and reproductive health around the world, says in Zimbabwe an average of 70 000 cases of illegal or backyard abortion are recorded every year and these are conservative estimates recorded when women suffer post-natal complications and seek medical help in the formal system.

There are many cases that go unreported. The UN further notes that the number of induced abortions is difficult to obtain particularly in countries such as Zimbabwe where policies are restrictive.

The World Health Organisation (WHO) in the article titled Unsafe abortions: The preventable pandemic, reports that all unsafe abortions take place in developing countries (where restrictions are severe) and this is where 99% of abortion-related deaths occur.

Research has also shown that the 82 countries in the world with the toughest abortion-related legislative frameworks have the highest number of unsafe abortions and the highest number of abortion-related deaths.

Statistics reveal that the 60 000 to 70 000 cases of illegal abortions in Zimbabwe that occur annually are some of the leading causes of maternal morbidity and mortality. Many women with unplanned pregnancies seek unsafe abortions because of the legal implications associated with abortion, social and cultural factors and failure to recognize the concomitant risks.

Why is society so polarised on the abortion issue if it impacts on the reproductive health and rights of individual women? The answer largely lies on the perspectives of relative societies in relation to abortion. Two perspectives are important in this regard — the pro-life perspective and the pro-choice perspective.

The Alabama Alliance Against Abortion in a work titled Abortion Debate says that the crux of the pro-life proponents’ argument is that policies and laws should preserve the lives of all, including foetuses. They argue that the government has the obligation to preserve human life regardless of intent, viability or quality of life concerns.

The pre-born child has a heartbeat by the end of the third week and when surgical operations are carried out in the mid- to late trimester the foetus has arms, legs and feet among other human organs.

Consequently, the pro-life proponents believe that abortion policies should be prohibitive; the government can dictate what happens to a woman’s body when a human being is involved. This perspective is mostly found among religious groups such as Christians and moralists.

On the other hand, pro-choice advocates are more concerned with the woman’s mental, physical and psychological health and reproductive rights. The pro-choice argument hinges on two issues — that the foetus is not a human being and that the woman has the right to choose what to do with her body. From this perspective, individuals should have unlimited autonomy with respect to their own reproductive systems as long as they do not breach the autonomy of others.

The Pro-choice Network in the article titled Abortion Information argues that there is no scientific consensus on when life begins; it is just a matter of philosophical opinion or religious belief.

Human life is a continuum — sperms and eggs are also alive and represent potential human beings, but most sperms and eggs are wasted and virtually two-thirds of human conceptions are aborted by nature.

The pro-choice proponents argue that if abortions were to be made illegal, thousands of women would end up with back-alley abortions and die. The government has no business in legislating against abortion because it is a moral issue and moreover, laws have never stopped abortion, but only made it unsafe for women since abortion is a universal practice that has been with us since the beginning of time, whether legal or illegal.

Thus, these two schools of thought have shaped legislation in all countries in the world and in Zimbabwe legislation that governs abortion is pro-life, hence its restrictive nature.

If the law is restrictive, why is it not deterring enough and why then do we have 70 000 abortions that put women’s health at risk every year in Zimbabwe? Research around the issue in Zimbabwe revealed interesting factors.

Culture

Cultural beliefs were cited by respondents in various studies as triggers for backyard abortions. A study by Nhundu R: Criminalizing abortion does not prevent women from procuring abortionswhere women revealed that in Zimbabwe, culturally, pregnancy is associated with marriage.

If an unmarried woman or girl gets pregnant society frowns on her and she may resort to backyard abortion to hide the fact especially if the man responsible denies paternity. Widows said they quietly terminated pregnancies because it was culturally unacceptable that they fall pregnant when they no longer had husbands.

Christianity

Zimbabwe is a country in which Christianity is dominant and it is well known that the Christian doctrine is pro-life and hence does not condone abortion at all. Ndarukwa P in a paper presented at the Inaugural Commonwealth Nurses Conference in London titled Factors contributing to abortion at Chitungwiza Population Service: Zimbabwe reproductive health, notes that all the respondents in his study were Christians and those who terminated pregnancy did so deliberately against the Christian doctrine. Unmarried women and girls said they feared being frowned upon in church if they carried the pregnancies. They also did not want people in church to ever know that they fell pregnant at one time so they resorted to secret, backyard abortion.

Lack of knowledge about sexuality

In Rusere N’s research titled Justice delayed is justice denied: The experiences of applicants for the termination of pregnancy in rape situations under the Termination of pregnancy Act in Zimbabwe, it was noted that because of the myths and silence around women’s sexuality one of the women said she thought she could not get pregnant during her first sexual contact and this led to unwanted pregnancy and subsequently illegal abortion because the law does not allow termination of pregnancy. In such cases lack of knowledge about sexuality becomes the precursor to backyard abortion.

Unwanted pregnancies

 Seventy-seven percent of women in a study stated that their initial abortion was a result of unwanted pregnancies. Women interviewed said that if women have unwanted pregnancies it is good for both the child and mother for the pregnancy to be terminated because forced motherhood does not help them both and since the law does not permit they can only resort to backyard abortion. They argued that in severe cases, forced motherhood results in ills such as baby dumping and infanticide.

Economic factors

Studies unearthed that economic factors played a huge role in triggering backyard abortions in a restrictive environment. Sex workers said pregnancy and child care dented their chances of servicing their clients while women seeking employment said that a bulging tummy would reduce their chances of getting employed to zero.

Abortion stigma

Research also revealed that abortion stigma is generated through popular and medical discourses, government and political structures, institutions, communities and personal interactions. Abortion has been stigmatized in communities through various discourses and actions such as anathematisation and this has led women, even in instances where abortion is permitted, to seek backstreet abortion for fear of being exposed to society’s backlash. Negative attitudes of some health personnel (especially from the pro-life perspective), engendered by stigma, also push women into backstreet abortion.

In all this, what are some of the women’s perceptions on the legislative framework in Zimbabwe vis a viz abortion? Do they feel by being restrictive the law is good for women’s reproductive health? We will hear the women’s voices in the second part of this article.

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