The abortion question has recently made headlines with the Executive Order released by the new United States President prohibiting any aid from the US going to organisations, which provide services or even information on abortion. This is the ‘global gag-rule’ which will have devastating consequences for women and girls in lower and middle income countries across the globe, including Uganda, as funding for organisations which provide family planning services and information will be cut. This may seem like good news to the majority of Ugandans who are reportedly against any exceptions to the abortion prohibition, but we need to pay more attention to what this will mean in practice for many of our women and girls, who usually pay the price for such populist policies in the currency of life and disability.
We already gag discussions on abortion through the criminalisation of abortion, and therefore what the ‘global gag rule’ will do is to worsen an already bad situation. It is a well-known fact that the criminalisation of abortion in Uganda has not been effective in preventing abortions. The Guttmacher Institute this month launched a report that found that an estimated 314,304 abortions took place during 2013, up by 7% from 293,804 in 2003. There are 438 maternal deaths for every 100,000 live births in Uganda, of which an estimated 26% can be attributed to unsafe abortions. Human Rights Awareness and Promotion Forum (HRAPF) in a 2016 study found that the criminal status of abortion causes the majority of abortions to be carried out in unhygienic conditions or without the assistance of a skilled medical worker, leading to extortion, disability, infertility and in many cases death.
The majority of Ugandans seems to be of the view that abortion goes against our values as a country. That Uganda values human life and is willing to protect it right from inception. This is such an admirable value. However, we must be willing to live up to it to its logical conclusion, which is that, we need to protect the lives of both unborn children and women.
To do this, we incidentally need to un-gag our women in a rather literal sense by opening up the conversation around abortion, including discussions on decriminalisation of abortion as criminalisation has so far failed. The fact that more than 300,000 women a year are willing to risk their lives, break the law and perhaps act contrary to even their own moral standards in order to get rid of unwanted pregnancies begs us to look at this issue in more detail. The silence around a ‘taboo’ breeds stigma, which isolates women with unwanted pregnancies; dilutes the prospects of a support-network through which alternatives could be weighed; and encourages panicked solutions.
Through open discussion, we shall be able to address the most common reasons why women decide to undergo abortions. We shall be able to contemplate the quality and availability of sex education in schools as well as the accessibility to contraception and family planning services. We shall see the debilitating effect of sexual violence and exploitation against women and girls that is rife in this country, and we shall consider the viability of letting girls stay in school after giving birth. We cannot see the underlying challenges that cause abortions, if we do not open up the discussion around sex and around abortions.
Finally, we need to recognise that the prohibition on abortion in Uganda is not absolute, and have open discussions with health workers and the police on the exceptions. The Constitution recognises exceptions to the prohibition on abortion if they are authorised by law. The Penal Code Act provides an exception as it allows for a skilled person to end pregnancy by a surgical operation for the preservation of the life of a mother. The HRAPF study found that even health workers do not have clarity on whether this exception should also apply when it is the mental and physical health of the mother that is at stake. Life is not simply about the ability to breath in and out, but also about the quality of life. The 2015 Ministry of Health Guidelines, which provided for more analogous grounds upon which abortions could be done, and which were stayed for more consultations, need to be reinstated.
We need to acknowledge that the more we remain silent about abortion, the more it happens, and it happens in unsafe conditions which in many cases lead to the death of women. Society cannot simply look on as this happens. If we accept that human life is indeed sacred, let’s protect our women and girls from suffering unnecessary and undignified deaths.
By: Adrian Jjuuko, Executive Director of HRAPF
This article appeared in The Observer on 17 March 2017 http://observer.ug/viewpoint/51814-the-more-we-remain-silent-about-abortion-the-more-it-happens.html