Abortion Around the World

Abortion in Zambia

Abortion has been legal in Zambia since 1972. The official Government policy on abortion in Zambia is as follows:

Grounds on which abortion is permitted:

Yes - To save the life of the woman
Yes - To preserve physical health
Yes - To preserve mental health
No - Rape or incest
Yes - Fetal impairment
Yes - Economic or social reasons
No - Available on request

Additional requirements: An abortion requires the consent of three physicians, one of whom must be a specialist in the branch of medicine related to the woman’s reason for seeking an abortion. However, the requirement may be waived if the abortion is immediately necessary to save the life or prevent grave permanent injury to the physical or mental health of the woman. A legal abortion must be performed by a registered physician in a government hospital or other approved institution unless the patient’s life is in danger.

While abortion is legal, physicians are still reluctant to schedule appointments , and junior physicians are often the ones who perform the abortions in the operating room. Some private physicians insert an IUD to induce abortion and tell the women to go to the gynecology ward at the hospital when bleeding begins. Other private doctors insert a plastic cannula and tell the women to go to the hospital ward. Most women go to traditional healers or midwives who insert roots soaked in water into the cervix which act as an irritant/dilator. Traditional healers also provide herbs claimed to be abortifacients which are taken in tea or eaten. Other women attempt to induce abortion themselves by inserting plants or twigs into the cervix. Desperate and often the youngest women drink gasoline or detergents or take large overdoses of chloroquine, aspirin, or other toxic substances. Many women die as a result of poorly performed abortions.

Our Centre in Kitwe, Zambia is thriving under the leadership of Barbra Mwansa.  She and her husband have also started an orphanage, a maternity home, and a boy's ranch. You can learn all about what they do the Heartbeat International website:  https://www.heartbeatinternational.org/afla-lrg

News from Zambia - February 2015

“My name is Tamara. My mom was married to a Nigerian who came to work in Zambia as a teacher. She died when I was 6 years old. Dad decided to go back to Nigeria but my grandmother refused him to take me. I stayed with my grandmother until when I was 9 years my uncle came to pick me so that I could start going to school since my grandmother had no means to support me. In the City where I went, my uncle was married and at one time my aunt travelled to visit to some place for a period of time. But to my surprise, while I was sleeping, I saw my uncle enter my room. He told me not to shout while holding a knife and a rope. He then tied me and started having sex with me. He did this every night before my aunt could come back. I started feeling weak, sick and sometimes I could fell down. I later found out that I was pregnant. When my aunt came back, I could not hesitate to tell her even though it was scarily. She was angry but could not report the case to the Police but asked me to report for fear that the husband would harm her. My uncle was caught and has remained in custody.

The government withdrew me and took me to Silent Voices Maternity home being operated by Sara rose Children foundation. My blood level was only 4 mills, I had no strength. In the maternity home, I have been taken good care off and I have delivered a baby boy. I have named the baby Michael resembling to the Arc angel that fought the powers of darkness. My baby is two weeks old. Aim happy to see this baby besides the pain and the suffering. I thank the government and the Sara Rose foundation for their love and support.”

1. PMID: 2219228 [PubMed - indexed for MEDLINE], “Observations on abortion in Zambia.”

Abortion in India

"According to the first national study of the incidence of abortion and unintended pregnancy in India, an estimated 15.6 million abortions were performed in the country in 2015. This translates to an abortion rate of 47 per 1,000 women aged 15–49,"

The Medical Termination of Pregnancy Act was enacted by the Indian Parliament in 1971 and came into force on April 1, 1972. The MTP act was again revised in 1975. The MTP Act lays down the condition under which a pregnancy can be terminated, as well as the persons who are qualified to perform terminations, and the places where they may be performed. The reasons for which MTP is done, as interpreted from the Indian MTP Act, are:

1. Where a pregnant woman has a serious medical disease and continuation of pregnancy could endanger her life, such as: heart diseases, severe rise in blood pressure, uncontrolled vomiting during pregnancy, cervical/ breast cancer, diabetes mellitus with eye complication (retinopathy), epilepsy, psychiatric illness.
2. Where the continuation of pregnancy could lead to substantial risk to the newborn leading to serious physical / mental handicaps (ie. chromosomal abnormalities, Rubella (German measles) viral infection to mother in first three months, if previous children have congenital abnormalities, Rh iso-immunization, o exposure of the fetus to irradiation.)
3. Pregnancy resulting from rape.
4. Conditions where the socio-economic status of the mother (family) hampers the progress of a healthy pregnancy and the birth of a healthy child.
5.  

Consent:
If married--- her own written consent. Husband’s consent not required.
If unmarried and above 18years ---her own written consent.
If below 18 years ---written consent of her guardian.
If mentally unstable --- written consent of her guardian.
A consent assures the clinician performing the abortion that she:
Has been informed of all her options.
Has been counseled about the procedure, its risks and how to care for herself after she has chosen the abortion of her own free will.

Person or persons who can perform MTP: Any qualified registered medical practitioner who has assisted in 25 MTPs; a house surgeon who has completed a six months post in Obstetrics and Gynecology; a person who has a diploma /degree in Obstetrics and Gynecology; 3 years of practice in Obstetrics and Gynecology for those doctors registered before the 1971 MTP Act was passed, 1 year of practice in Obstetrics and Gynecology for those doctors registered on or after the date of commencement of the Act; whenever the pregnancy exceeds 12 weeks but is below 20 weeks opinion of two registered medical practitioners is necessary.

Place where MTP can be performed: any institutions licensed by the Government to perform MTP. The certificate issued by the Government should be conspicuously displayed at a place easily visible to persons visiting the place.

Methods of Induced Abortion: abortion can be induced by different methods depending on the weeks of pregnancy completed.

First trimester, medical methods:
(i) Methotrexate - misoprostol (a suppository inserted into cervix)
(ii) Mifepristone (RU486) - misoprostol

First trimester abortion, surgical methods:
(i) Cervical dilatation followed by evacuation of uterus by: curettage /suction evacuation / vacuum aspiration / dilatation and evacuation
(ii) Menstrual aspiration (MR)

Second Trimester Abortions (13 - 20 weeks):
Medical methods using drugs like: Ethacridine lactate and prostaglandin.

Surgical methods include aspirotomy, hysterotomy, and hysterectomy.

Sadly, in this country, baby girls are frequently the target of abortion because male offspring is "more desirable."  A documentary
It's a Girl - documents the practice of aborting babies simply because they are girls.

Abortion in Uganda

From Wikipedia -

Law on abortion in Uganda is unclear in that it provides for some exceptions while condemning the procedure in most cases. The Ugandan Constitution, in Article 22, item 2 states: "No person has the right to terminate the life of an unborn child except as may be authorized by law."[4] However, what is authorized by law remains poorly understood.

The Penal Code of 1950, Article 141 on "Attempts to procure abortion" states:

Any person who, with intent to procure the miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means, commits a felony and is liable to imprisonment for fourteen years.[5]

Article 142 lays out a punishment of seven years for an attempt to procure a miscarriage.

Nonetheless, under other provisions of the Penal Code an abortion may be performed to save the life of a pregnant woman. Section 217 of the Code provides that a person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon an unborn child for the preservation of the mother’s life if the performance of the operation is reasonable, having regard to the patient’s state at the time and to all the circumstances of the case. In addition, Section 205 of the Code provides that no person shall be guilty of the offence of causing by willful act a child to die before it has an independent existence from its mother if the act was carried out in good faith for the purpose of preserving the mother’s life.

Moreover, Uganda, like a number of Commonwealth countries, whose legal systems are based the English common law, follows the holding of the 1938 English Rex v. Bourne decision in determining whether an abortion performed for health reasons is lawful. In the Bourne decision, a physician was acquitted of the offence of performing an abortion in the case of a woman who had been raped. The court ruled that the abortion was lawful because it had been performed to prevent the woman from becoming “a physical and mental wreck”, thus setting a precedent for future abortion cases performed on the grounds of preserving the pregnant woman’s physical and mental health. The liberalization and legality of abortion in Uganda has been complicated by the use of rape as a weapon of war and terror by rebel groups in the region."[6]

The grounds on which abortion is permitted: An abortion is permitted to save a woman's life, the preserve the physical health of the woman, and to preserve the mental health of the woman. However, an abortion is no permitted in terms of rape or incest, fetal impairment, economic or social reasons, or just simply by request. A legal abortion has to be done by a licensed and registered physician, and the law does not now need the approval of any kind of council or committee, only the consent of two physicians before the abortion can take place.[7]

The Government's Part

In 1988, the Ugandan government launched a comprehensive program in response to the country's high fertility and growth rates, which adversely affected per capita incomes and threatened the sustainability of social services. The goal of the major goal was to increase the contraceptive rate from 5 percent to 20 percent by 2000. The services for birth control in Uganda are now accessible at clinics and are operated by the Family Planning Association of Uganda. Contraceptives like condoms helped to reduce the rate of HIV/AIDS in Uganda, but there are still a significant number of unwanted pregnancies leading to abortion.[8]

Movements

Movements such as Pro-Life Uganda (Pro-Life Uganda) and Pro-Choice Uganda (Pro Abortion) fight for their belief that either a woman has the right to choose what happens to her and her baby (Pro-Choice Uganda), or the life is sacred and everyone deserves to live (Pro-Life Uganda).[9] There was a movement that took place that involved the Pro-Life organization, Christian founded anti-abortion that advocates against abortion. This group was joined by 100 delegates from the U.S., United Kingdom, Uganda and Spain in a three-day workshop to help the young women of Uganda understand the preciousness of life, and to counsel the young women against the practice of abortion.[10]

References

1.Moore, Ann M, Richard Kibombo, and Deva Cats-Baril. "Ugandan opinion-leaders’ knowledge and perceptions of unsafe abortion." ' 'Health Policy Plan.' ' 2014 29: 893-901.
2. Abortion in Uganda. (2013). Retrieved June 16, 2016, from https://www.guttmacher.org/fact-sheet/abortion-uganda#6
3. Migiro, Katy. "Uganda women unable to get contraception, dying from unsafe abortions." Thomas Reuters Foundation. 21 Nov. 2013.
4. Constitution of the Republic of Uganda, 1995. http://www.parliament.go.ug/new/images/stories/constitution/Constitution_of_Uganda_1995.pdf
5. The Penal Code Act. Chapter 120. http://www.wipo.int/wipolex/en/text.jsp?file_id=170005 (WIPO Lex)
6."Population Policy Data Bank." United Nations. The Population Division of the Department of Economic and Social Affairs of the United Nations Secretariay, n.d. Web. 25 Oct. 2014.
7. "Population Policy Data Bank." United Nations. The Population Division of the Department of Economic and Social Affairs of the United Nations Secretariay, n.d. Web. 25 Oct. 2014.
8. "Population Policy Data Bank." United Nations. The Population Division of the Department of Economic and Social Affairs of the United Nations Secretariay, n.d. Web. 25 Oct. 2014.
9. "Pro Life Uganda." Pro Life Uganda. N.p., n.d. Web. 25 Oct. 2014.
10. ukwago, Juliet. "Uganda: World Workshop Against Abortion Opens At Namugongo." AllAfrica.com. Allafrica, 1 Sept. 2013. Web. 25 Oct. 2014.

Silent Voices in Uganda

A Silent Voices' office opened in Uganda, with Maggie Nambela Alemu as the Director. Maggie used family resources to open the office, and continues to run the ministry without assistance from other sources (which we hope will change soon!). Maggie has a huge heart for the unborn and pregnant women in her country! According to Maggie, the government of Uganda is currently trying to legalize abortion. She believes that she must "continue to fight this vice and evil that is consuming the lives of babies, and also the lives of the mothers."

Here are some of the women Maggie has helped -

Deborah is a girl who was a student at one of the secondary schools. When her mother visited her at the school she discovered that Deborah was pregnant. Her mother had come to pay the school fees, but once she learned of the pregnancy she wanted to use the money to procure an abortion instead. Thankfully, Deborah and her mother met one of Maggie's volunteers who is a midwife they had contacted to see about an abortion. Maggie and the midwife talked to them, and encouraged them not to have the abortion - and were able to persuade them to give this child life. The baby girl (named Mary Nambela) was born, and is now three years old! Deborah initially had to live with Maggie because her father chased her away from home. With additional counseling from Maggie and her team, he agreed to allow Deborah to come home and has accepted the child into the family. Maggie continues to work with Deborah, and is encouraging her to go back to school, or to take a skills course so she can support herself and her child.

Grace was pregnant and the mother of five children when her husband drowned in a lake while fishing. Grace was under a great deal of pressure - and traumatized by the death of her husband - and went to the hospital expecting to have an abortion. Maggie and her team were able to counsel with her to keep the pregnancy, and she had a baby boy who was named Francis Alemu - after Maggie's husband.

Agnes found out she was pregnant in her last year of High School - right before she was to do her final exams. The school expelled her, and her mother refused to let her come home, so Maggie took Agnes into her home until she finished her examinations. She has had her baby, and is now finishing her first degree in education - but has a vision of becoming a lawyer to help fight for the rights of the voiceless - like the innocent babies who lose their lives to abortion.

Barbra is a very young girl who was raped by her brother-in-law. When the family found out, they chased her away. Maggie's team counseled her, and encouraged her to return to school after delivering her baby. They helped her with scholastic materials, such as books, uniforms and other necessities.

Irene was in High School when she found out she was pregnant - her parents also rejected her and chased her away from home. She was able to go live with her Aunt, and went back to school. She delivered a baby girl - Amanda Abigal. Irene is unable to complete her education because she lacks the school fees - Maggie is praying that God provides what Irene needs so she can graduate.

Maggie and her team also go to schools to talk to boys and girls about the sanctity of human life, as well as the physical dangers and complications of abortion.  They are always looking for ways to share the truth - to save a life - to make a difference!