Abortion raises fundamental questions about human existence, such as when life begins and what it is that makes us human. Abortion is at the heart of contentious issues such as the right of women to control their own bodies; the nature of the Government’s duty to protect the unborn; the tension between secular and religious views of human life, and between the individual and society; the rights of spouses and parents to be involved in the abortion decision; and the conflicting rights of the mother and the foetus. Also central to the subject of abortion is one of the most highly controversial social issues of all – sexuality. Any discussion of abortion almost inevitably leads to a consideration of how a pregnancy came about and ways that the pregnancy could have been prevented by the use of contraceptive methods.
The debate about abortion centres mainly on moral and religious grounds; whether it is right to ever terminate a life, and just when life begins. It is argued that society should protect its weakest and most vulnerable members, including the unborn. This anti-abortion (pro-life) movement is led by citizens of western countries and its effects have been most acutely felt in Africa, where abortion is severely restricted.
A safe abortion as defined by the World Health Organisation (WHO) is performed by skilled and trained clinical practitioners in sterile clinical settings, with complete post-abortion care provision (United Nations, 2002). Unsafe abortions are those terminations performed either by unskilled practitioners or in non-medical settings, or both.
According to the WHO, an estimated 4.2 million African women resort to dangerous practices each year to abort, and 30,000 die as a result. Although only 10% of the global total number of abortions happen in Africa, the continent accounts for almost half of the world’s deaths from unsafe abortions, with one in 12 women dying. Besides the heavy toll on deaths due to unsafe abortions, for every death, 20 to 30 women suffer permanent damage to their uterus, cervix, fallopian tubes, intestines or bladder. In addition, it has been established that treatment of large numbers of women with complications of unsafe abortion is a major problem in the health care systems in Africa.
Although the number of deaths related to unsafe abortions across the globe has declined, it still hovers around 13% of all maternal deaths, according to the most recent data from the World Health Organisation (2011). But there are fears that the number of deaths could increase with a continued spike in risky abortions unless policies are put in place to ensure access to safe practices and contraception, including a woman's freedom to choose if, or when, to have a child.
Concern over adolescent pregnancies and adolescent abortions has moved the overall issue of adolescent sexual and reproductive behaviour to the top of the international agenda. Pregnancy in adolescence is generally unwanted and unplanned, and the social consequences frequently lead to the choice to terminate using any available method. Hospital and clinic-based surveys suggest that in some African countries abortion has become common among adolescent girls, particularly schoolgirls living in urban areas.
At the African Union Summit in 2009, there was consensus that the issue of abortion should be addressed within the laws of each country with a focus on providing comprehensive contraception and family planning services to prevent unwanted pregnancies. At global level, a consensus was reached during the 1995 International Conference on Population and Development that unsafe abortion is a “major public health concern”. It was agreed that dealing with the health impact of unsafe abortions and reducing the risk of recourse to abortion through expanded and improved family planning services was integral to the commitment to women’s health.
- AMREF concurs with the fact that restrictive abortion laws violate women's human rights based on agreements made at the UN International Conference on Population and Development in Cairo, the Fourth World Conference on Women in Beijing and the Universal Declaration of Human Rights (Articles 1, 3, 12, 19 & 27.1).
- Thus, AMREF promotes reproductive health rights, including those that help women make informed choices about family planning. In addition, the organisation is promoting access to and use of maternal/reproductive health services, including obstetric care, family planning, and management of pregnancy and abortion complications.
- AMREF is convinced that knowledge about the correct use of contraceptives, as well as having a variety of methods to choose from, would greatly reduce the chances of unwanted or ill-timed pregnancies and therefore the need for abortions. Sexual and reproductive health education must be disseminated to adolescents to prepare them to make informed choices about their sexual health.
- AMREF is convinced that effective contraception services would enable women and families to avoid unwanted and too many pregnancies which often lead to unsafe abortions, besides the complications associated with too many births.
- AMREF strives to provide education on family planning options and advocate for availability of contraceptive methods at community and health facility levels.
- AMREF believes that legalisation of abortion can prevent the unnecessary suffering and death of women. Therefore, AMREF should engage in advocacy to remove real and perceived barriers to obtaining legal abortions.
- AMREF promotes and provides care for post-abortion complications within emergency obstetric care packages, irrespective of the legal status of the induced abortion.
- AMREF must engage moralising and idealistic groups in discussions about the impact of unsafe abortions in Africa.
There’s no reason why African women should die, fall ill or become infertile because of unsafe abortions when the knowledge and the means to prevent such deaths exist.