January 6^th , 2004

Abortion: foetus, mother, and society.

Is it a moral, legal, religious or social issue?

By Fitsum Getachew

The Penal Code of Ethiopia, still in vigour, (although there are currently extensive reforms under scrutiny, in view of the changing realities in five decades), prescribes at Art 528 : (1)The deliberate termination of pregnancy, at whatever stage or however effected, is punishable.... The nature and extent of the punishment awarded for intentional abortion shall be determined according to whether it is procured by the pregnant woman herself or by another, and in the latter case according to whether or not the pregnant woman gave her consent.

Art 530: Whosoever performs an abortion on another, or assists in the commission of the offence, is punishable with rigorous imprisonment not exceeding five years.

Art 531: Where the offender has acted for gain, or where he has habitually made a profession of abortion within the meaning of Art 90,(making business of a crime as aggravating circumstance) the punishment prescribed in the preceding article shall apply and a fine shall be imposed in addition.(emphasis added)

A

few days ago, a friend of mine came to me, filled with rage and fury, and asked : “did you know that here in Addis there is a hospital, run under a foreign umbrella, that without scruples, trades on the skin of our sisters?”! For a moment, I was bewildered by the grave accusation, and asked him if he could be more specific and substantiate. I was not very appreciative of his ideas. He wondered, ‘how can you be ignorant of a fact that almost every one in Addis knows? I can take you tomorrow morning and show you the lines that our sisters are making to obtain an abortion! The only thing that they are required to do, is pay a certain fee (around 300 birr) and put down a signature, (acknowledging that the hospital, is exempted from any responsibility (legal or otherwise) about the matter. The signature would testify to the full awareness and voluntariness of the act.’ He told me that among the ‘clients’ were women, from teenage group to adults, to married ones as well as singles, every day, in search of this ‘prompt and easy service’. At times, the pregnancy could even be six months old, and there are no moral or legal issues raised by the hospital medics!

Naturally, I was surprised and could not believe his words. I would never have thought that abortion was so simple to carry out in a public place such as a hospital! My friend was so emotional and angry about the whole subject that I began to suspect that he had a personal score to settle with the hospital. So I insisted with my questions and asked for more reliable and convincing substance, to which he was more than delighted to add. He said he was sure that authorities such as the Ministry of Health, the Ministry of Justice or any pertinent body were aware of it, but never took the scruples to intervene. Here in Ethiopia, certain things are and remain concealed unless some body airs the scandal, and the private press gets hold of it. His words were like an overflowing river, and his emotions transpired overtly underlining his narration. He said, what is even more infuriating is that this hospital has close association with the Red Cross and benefits from certain privileges in pacifically carrying out such horrendous deeds! It can import equipments, including medicines, duty free. Therefore, it is committing two wrongs at once! He said it was very sad that such hospital was capitalizing on the tragic plight of a society that has little alternatives, with out any one inquiring and demanding transparent accounts about it. There are other medical establishments who carry out similar illegal abortions at the request of the woman in need, and this adds up to the thousands of other backstreet amateur abortionists who are engaged in killing, (because there is no better word to define such act), he went on. How can we tolerate such state of affairs, in plain daylight? he asked, in apparent despair, and laconically.

If you doubt my words, I can take you to this establishment some time in the morning. You find ladies queuing, at times short of the necessary fees, not refraining from resorting to pure begging. The hospital tries to make even more money by ordering superfluous or irrelevant exams, such as endoscopy, x-rays and other tests, thus making the costs even more burdensome for the modest resources of the women. Many young ladies find themselves caught in shortage of money due to these unforeseen charges, thus resorting to begging!

My friend would not spare even the rest of medical establishment in the country, counting all the incidents he experienced, (such as the wrong and negligent diagnosis, and mistaken therapies that physicians prescribe, both in the public and private sector, with virtually no accountability and consequent action taken by government bodies with the relative legal mandate). The stakes are evidently very high! He said clinics and hospitals were big business and managed to get away with any wrong at the cost of poor patients ( the death during delivery of the cousin of my sister-in-law came to my mind; it was attributed to medical negligence!) and professional ethics is a rare commodity, he lambasted. He said abortionists are breaching the laws of our land, and get away with it. At the same time, they are making a lot of money, tax free! No one has the courage to challenge them. No one has dared to stop them. Imagine an average of 70 ladies going every day to that institution and obtaining very costly abortions! Not only are they encouraging the massacre of lives, but in so doing they are also carrying out a usury-type business! taking advantage of inertness of our authorities! Our laws do not admit abortion, (see Penal Code provisions above), why are they allowed to continue with such horrendous activity, and for decades, my friend asks? Are they really doing this as a humanitarian act? A Red Cross service? If so, why don’t they do it gratis? Who is to put order in the entire medicare system in Ethiopia? Please shed some light on this issue, he implored.

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Already, I was preparing an article on ‘abortion’, because it is now becoming a hot issue in our country, I comforted my friend. A new law is being drafted in our House, and members are deliberating on it. Abortion is not a totally resolved issue even in the West, where there is presumably a better awareness and protection of human rights, the sensitivities and the interests that go with it are more complex and extensive, the advancement in science and technology is much more sophisticated. The debate is still ongoing and there are no simple hard and fast rules applicable to all cases and circumstances. I remember there was the case of an ‘erroneous abortion’ carried out by French doctors on a Vietnamese lady in a French hospital recently (error of person due to namesakes!) and the lady who was actually seeking the abortion had been confused with another one with the same name, but who just came for a check up of her progressing pregnancy! And some how a grave error had been committed on a six-month old foetus! A huge controversy and a fierce legal battle are still unfolding. Many sensitive issues pertaining to abortion and its legalisation are being debated in many states in Europe.

In certain societies, abortion had remained taboo owing to strong religious convictions, whereas in others, the civil interests and women lobbies are so strong that it has been left to the choice of the concerned lady, (leaving the right to her). At others, it is left to the choice of the doctors, after a study that they would conduct on the lady that requests it. I remember in the seventies, when Italian women activists were demonstrating against the ‘oppressive laws’ of the country. They had banners saying “ l’utero e mio et me lo gestisco io” (the womb is mine, and I manage it the way I like”!

In any case, abortion is normally considered for delivery only in the first twelve weeks of pregnancy, (unless exceptional events would dictate to the contrary) as carrying it out much later would involve more risks for the mother. In most countries, abortion is outright admitted where the eventual birth would be ‘useless’, where the life of mothers is to be compromised, and it is therefore ‘justified’ to save a life. It is also considered when the pregnancy is proved the result of a crime such as rape.

However, the question of sacrificing a life to save another has often been put under question mark by religious authorities and their congregation. Who has the right to decide on such delicate and ultra sensitive issue? Can any one posture as a God or some extra might to decide on the fate of another person? Ever since the first day of conception, these people assert, the foetus should be seen as a life worthy of its name, and should be granted every right, while others consider this too far fetched to be put into practice. The relative repercussions would seriously put at jeopardy many values associated with this. In many legislations, the child’s rights are considered only after a viable birth. The child acquires rights at birth, and only if born alive. This has obvious repercussions on the succession of property rights. Because a child already born alive and registered as such would be a beneficiary of a ‘succession right’ and up on its death would be given the right to ‘transfer’ its succession rights whereas such would not be the case if it was born lifeless. Even our legislation is explicit about this issue. Hence, there are arguments that considering a conceived child, even before assuming the contours of a living ‘human’ being, cannot be taken as a child.

These arguments are often passionate and interminably controversial, involving the beliefs and values of people. Some people are offended that any kind of termination of pregnancy be accepted or admitted/encouraged as long as we admit that conception is the beginning of life for every being. Others argue, better to abort a foetus, before it is too late, and expose both mother and child to a life long calvary. Many could be prompted by economic motives, but the most convincing verge on ‘products’ of violence, rape, incest and other extramarital or illegal relations determining the pregnancy. If the pregnancy is of such origin, there should be no story in admitting abortion, they say. But the counter argument goes, all mothers should be able to face the consequences of their actions, their relations, and should not be let to commit an ‘easy crime’, under any pretext. Otherwise, they assert, any pregnancy could very easily be qualified as a result of an ‘unwanted’ relation, a forced relation or a crime, (rape/violence/abduction) and that the cycle would never end, resulting in the ‘legal massacre’ of innocent children. This is inadmissible morally and legally, socially, and ethically. This is inadmissible religion wise.

So how should we go about tackling one of the most sensitive and controversial of social issues? An issue that is even more debated and sensed than whether or not to abolish capital punishment, divorce, or the admission or not of homosexual ‘marriage’ and homosexual families to be taken as normal heterosexual families?

The polemics on abortion has often created fierce fractures in many societies being a very sensitive issue. Beside its moral/religious facets, it has economic, social and medical implications. It contains physical and psychological reflexes, as well, particularly to the aborting mother.

Should abortion be legalized and if so, under what circumstances/conditions? The views naturally vary depending on the social and educational exposure one has gone through, the religious values. Add to that the detached views of those who regard it as only the pregnant woman’s affair.

Why is there the need for abortion in the first place, and what are the circumstances under which one would resort to it? Is the foetus a human being with full rights or is it just something that one could do away with without much moral and physical pain? What causes unwanted pregnancy? To what extent does the protection and guarantees of the rights of women go? This has to do with how mature and up to date our laws, our legislators, our leaders and the entire population are. It embraces virtually every one.

In Ethiopia, several women organizations, most notably the Ethiopian Women Lawyers Association, (EWLA) has (for the last six years) been campaigning for the legalization of abortion. Their point is that abortion is mainly the concern of the pregnant woman. EWLA President Meaza Ashenafi said very recently that she was hopeful and confident that the parliament, (which is now considering the draft law on abortion), will crown with success the battle of EWLA for the legalization of abortion. She said she was convinced that the House has recognized that thousands of lives are lost due to illegal/clandestine abortion every year, and such drama must halt.

However, at a public rally held some weeks ago against the legalization of abortion, the promoters alleged that the law legalizing abortion under the pretext of ‘unwanted pregnancy’ and the ‘consent of the mother’, will be cause to the ‘legal killing’ of thousands. These people, mainly members of religious congregations, allege that such law would encourage more abortion. Such assertion infuriates me, counters W/ro Meaza, because a woman would resort to abortion only when she is ‘obliged’ by certain adverse circumstances, and not voluntarily. She never undergoes such painful choice easily. After all, it is her baby we are talking about, not something extraneous!

Meaza says what we are demanding is that women who had to undergo and tolerate serious constraints of various sorts, such as incest, rape, abduction, or even cases in which the woman would be too poor to have a baby. They should be given the chance to choose. This can also happen when the fate of the foetus is too bleak. The lack of a law regulating abortion has resulted in the suffering and death of thousands of mothers who resort to backstreet abortions and their exploitation by ruthless profiteers.

According to a research conducted on the matter, the Ministry of Health says, we find that abortion is the second cause of death after TB, whereas research conducted by gynaecologists indicates that 58 % of the women who abort are aged between 20-29 of whom 53 % are married. 27% are not educated, 28% have finished high school. Of all these abortions, 60% are unplanned, and 50% are unwanted. However, 28% of the abortion would have been avoided if only contraceptives were available to the ladies. Meaza says 36% of all women who would need family guidance consultancy do not have access to it. The majority of those who are against abortion are religious organizations, but this right has nothing to do with religion, she asserts. It is a constitutional right that stands for the protection of women’s rights. It is the responsibility of the government to entitle women to exercise such right. She thus welcomes the participation of all groups and associations in the passionate debate.