A paper presented by Kato Mukasa at the Open Talk Debate on 10 October at Fair Way Hotel
Abortion is one of the most sensitive and controversial topics today. MANY women and girls continue to get rid of unwanted pregnancies in unsafe ways and get serious medical and psychological complications and many equally lose their lives. Many Women and girls use abortion as the illegal method of family planning.
KEY FACTS ABOUT ABORTION
Except under special circumstances accorded to some women, abortion is illegal in Uganda but common due to rampant unintended pregnancies. Over 775,000 women in Uganda become pregnant unintentionally every year. Over 297,000 illegal abortions are carried out in Uganda annually. Over 150,000 women in Uganda suffer from abortion-related complications annually. Many fear to go to hospital thinking they might be arrested. The above figure is just the number which is recorded in the health facilities, there are many cases that undergo abortions and have died in the villages silently because they fear to be stigmatized and victimised by the colonial law that condemns abortion. Thus, there are high numbers of unregistered abortions.
Every day Mulago Hospital receives 10-15 women suffering from abortion-related complications. Abortion is the fourth killer of women in Uganda and a total of 297,000 abortions are done every year, the United Nations Population Fund country representative. About 7,200 mothers die yearly and more than 144,000 survive death but develop serious complication in the process of giving life including obstetrics fistula according to UNFPA. In Uganda, every year about one million teenagers get pregnant and 40 per cent of these abort because they did not plan to have the children.
LEGAL FRAME WORK ON ABORTION
Ugandan law allows abortion under some circumstances, but laws and policies on abortion are unclear and are often interpreted inconsistently, making it difficult for women and the medical community to understand what is legally permitted.
The Ugandan Constitution states in article 22 on protection of life that no person has the right to terminate the life of an unborn child except as may be authorized by law, this means that abortion is permitted if the procedure is authorised by law, but many of the medical workers cannot perform abortions because of failure to interpret the law,
Under the 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights, pregnancy termination is permissible in cases of fetal anomaly, rape and incest, or if the woman has HIV.
According to the Penal Code, a doctor who thinks that an abortion is justified to save the life of the mother, must write to the director general of medical services in the health ministry, seeking approval to terminate the pregnancy who also convenes a medical team to scrutinise the case. This process is bureaucratic and life in danger may be lost as a medical doctor waits for an approval from the director general of medical services.
FUNDAMENTAL QUESTIONS TO THINK ABOUT
When does a human being regarded to have rights? Does a fetus qualify to be a human being or does it have rights just like a new born baby? At what months would a fetus qualify as a human being and does it have special rights over and above the rights of its mother? Putting the ingredients of murder in perspective, does an abortion truly amount to murder? Why does the law leave out young people (girls) even in the extreme cases where women are allowed to abort?
MEDICAL EFFECTS OF UNSAFE ABORTION
Many young girls suffer from obstetric fistula and obstructed labour often due to small size of the birth canal amongst these children. Many other young girls are suffering from sepsis Gangrene, pyometia, pelvic inflammatory diseases, infertility, obstetric fistula, embolism, ectopic pregnancy, incomplete cervix and incomplete removal of products just because government has failed to legalise abortion to be performed in hospitals by qualified medical workers.
Teenagers are at the forefront of carrying out abortions and HALEA has established that teenagers fear pregnancies because teenage pregnancy contributes to loss of economic potential due to foreshortened education lost opportunities and constrained life options.
Medical figures from Mulago Hospital (2014) indicate that in Uganda six women suffer severe morbidities- anaemia, infertility, pelvic pain and obstetric fistulas that lead to ill health caused partly by deliveries and unsafe abortions carried out in rural areas. Recent studies have shown that the cost to the healthcare system of treating complications from unsafe abortion is $130 (Shs330,000) per patient.
Part of my way forward is a call to reason through the proposals I am making:
Aware that abortion results from unplanned pregnancy, it therefore follows that preventing unintended pregnancy is a major step is preventing unsafe abortions. Can we therefore have condoms and other contraceptives readily available to young people in and outside school? Will the government and faith based schools allow teens and students access contraceptives?
Can we think of legalizing safe abortion and thereby allowing qualified and certified medical practioners to operate abortion clinics through which women will be given a choice to have safe abortions?
Can we give freedom to the man and woman (and girls) responsible for the fetus in question have a right to decide on whether or not to keep the yet to be born rather than having a law in place that make them make unwanted choices?
If we chose to save lives as many people have proposed, do we have foster families that will take care of the many unwanted babies in Uganda? Will the government be financially ready to start a welfare system in which the needy can be helped? Why should countries will welfare system allow abortion clinics to exist? We have many already born children, unloved and uncared for, it is not important that we started taking care of the already born than the yet to be born?
For one to assume that he or she has rights to tell another human being what they can or cannot do with their bodies is a violation of a woman’s individual rights granted by our constitution. It is only fair that women should be allowed to have control over their bodies. Men and women need to be empowered to make the best choices, to access contraceptives and to be able and ready to use them. They should also have the freedom to raise babies they can love and can take care of. Condom use and contraceptives is not a woman thing, men need to be empowered too and girls and boys below 18 should be allowed to access and use contraceptives once they start to be sexually active.
Let abortion be a choice and not a crime. Let young people be given a choice. Abortion is the best choice in cases where a woman ( a girl) is raped, defiled, conceives through incest, she is still in school, or pursuing a career that cannot allow her carry a pregnancy, when she is medically un able to have the child or financially incapable of taking care of a pregnancy and a baby. Several drug addicts do not want to have children and equally so, many mentally sick individuals do not want to have children; it is only safer if women were given a chance to decide whether or not to keep a pregnancy and a safe abortion offers a remedy.
Kato Mukasa is a Humanist,Human Rights Activist and Lawyer based in Kampala, Uganda. He is the Executive Director of HALEA and currently the Chair of the African Working Group under IHEYO.