December 15, 2011, 6:34 am


DAKAR, Senegal — Between heavy lunches and poolside cocktails, the doctors and health experts who gathered at a fancy hotel here early this month to talk about reproductive health often brought up cultural taboos. Cultural taboos that hinder open discussion of H.I.V., cultural taboos that prevent the availability of contraceptives, cultural taboos that make abortions illegal in many African countries.

Every sub-Saharan African state already allows pregnant women to abort when their lives are in danger, and in recent years Benin, Chad, Ethiopia, Ghana, Mali, Swaziland and Togo have been working at expanding their laws to allow abortions in more circumstances.

Still, in all of sub-Saharan Africa, abortion is legal only in Cape Verde and South Africa. And the number of unsafe abortions on the continent is staggeringly high: every year, there are over six million unsafe abortions conducted in Africa, and about 30,000 women die from the procedure. Unsafe abortions are among the leading causes of death for women admitted to hospitals around much of the continent.

The solution to this problem is clear. Just two years after abortion became legal in South Africa, the number of deaths among pregnant women who underwent the procedure fell precipitously: by 90 percent between 1998 and 2001, according to the South African Medical Journal. But legalizing abortion won’t be easy. Even since 45 African countries signed the 2005 Maputo Protocol, pledging to relax their abortion laws, local health-care providers throughout the continent have refused to provide safe procedures or counseling.

The root of this resistance is more complex than any one entrenched stigma. Take Eunice Brookman-Amissah, a doctor who attended the conference in Dakar. Twenty years ago, she was a gynecologist in Ghana. One day, the 14-year-old daughter of a family friend whom she’d treated since the girl was 10, walked in, scared and asking for an abortion. The father was a much older man. Brookman-Amissah said she was shocked and turned the girl away, telling her she didn’t perform that type of procedure because she thought it was sinful. A few days later, Brookman-Amissah found out that the man had sent the girl to a witch doctor in the countryside and that the girl had died from a botched abortion.

Edgar Kuchingale, a doctor in Malawi who also attended the conference, told me that to this day prejudice, especially about immoral sexual behavior, remains a major hurdle. But for Brookman-Amissah, now vice president for Africa of Ipas, a reproductive-health nongovernmental organization, the problem mostly lies elsewhere: “It is not as if it is by custom that Africans are against abortion. Rather, it is the colonial laws that we need to get rid of.”

Many restrictive abortion laws in Africa date back to colonial codes, and the bigotry of the law has trickled through society. Mali’s law is based on the Napoleonic Code from 1810, which forbade abortion. Nigeria’s, one of the world’s most restrictive, dates back to a British provision from 1861.

Brookman-Amissah told me that she was changed by her patient’s death. Soon she became known at Ghana’s health ministry as the “abortion lady.” Working with Ipas, she started passing out vacuum-aspiration kits for post-abortion care to women who had given themselves procedures outside of hospitals.

Brookman-Amissah, who was Ghana’s minister of health from 1996 to 1998, had some success in decentralizing reproductive care to rural outposts and clinics and in training midwives and natural-birth attendants in performing abortions. Ghana’s maternal death rate dropped as a result, if only slowly: there were 451 deaths for every 100,000 live births in 2008, down from 740 deaths in 1990, according to The Ghanaian Journal.

The current laws urgently need abolishing or amending. After so many years of women’s health in Africa being dictated by governments, both domestic and foreign, it’s time African women be allowed to take the matter of their bodies into their own hands.

Travel for this post was supported by a grant from the Pulitzer Center on Crisis Reporting.


Alexis Okeowo is a freelance journalist who has worked across Africa and in Cuba and Mexico.

Date: Monday, February 14, 2011

Source: Ghana News Agency

Cape Coast, Feb.12, GNA-Researchers on the trends of abortion in the country have suggested the inclusion of a comprehensive abortion care in the national health delivery to stem the increasing incidence of unsafe abortion and related “needless” deaths.


They revealed that the socio-economic cost of unsafe abortions was very high and therefore both its morbidity and mortality rates should be considered and policies formulated to address the situation.


These issues came to the fore at a dissemination forum organized by the University of Cape Coast (UCC’s), Department of Population and Health to disseminate results from studies on abortion in the country at UCC.


The study was done in collaboration with Guttmacher Institute in the United States and during the forum, other areas were identified for further research after the results were thoroughly discussed by participants.


They include the psychological trauma after abortion and how people understand the criminal law on abortion as well as the unmet needs of women on contraceptives.


Currently, deaths through unsafe abortion make up about 13% of all maternal deaths; a figure which the researchers said could be avoided if a concrete policy was put in place for women to access such services in the hands of qualified personnel.


According to them, if legalized, comprehensive service on abortion will be established with pre- and post counselling services attached to them to help stem the psychological trauma associated with it.


Dr. Joseph Teye Nuertey, the Cape Coast Metropolitan Director of Health Services, who presented a research on the “overview of abortion cases-The Cape Coast Perspective”, observed that though abortion was widespread particularly among the youth, accessing information on it was a challenge.


He said getting information or data during his study on abortion which was conducted in five facilities including two private ones in the Metropolis from 2008 to 2010, was virtually inaccessible as most health personnel were reluctant to divulge information because of perceived illegalities associated with it.


Dr. Nuertey gave total statistics on abortions in the five facilities during the period as 1,233 and indicated that the figures might have been under declared adding that the quality of data was not the best and seems to be shrouded in secrecy even though the GHS has some protocols on abortion.


He said: “it was painful as practitioner to see young women die needlessly due to abortions carried out by quacks or through self medication” and was of the view that the country found a remedy to unsafe abortions which was major a contributing factor to the rate of maternal mortality in Ghana.


The Head of Department of Population and Health of UCC, Dr. Akwasi Kumi Kyereh, said in Ghana, 17 of out every 1,000 women have had abortions and that the higher the level of education the more likely a woman would have an abortion.


Professor Harold Amonoo Kuofie, Dean of the UCC School of Medical Science, who chaired the function, stressed the need for women who have had abortions to be treated with empathy.


He commended the Department for coming out with the study since it would help identify pertinent issues on abortion and find means to erase the stigma attached to it.



Lack of Awareness of Abortion Law Is a Barrier to Better Health

More than one in 10 pregnancy-related deaths in Ghana are the result of unsafe abortions. In addition, 13% of Ghanaian women who have had an abortion experience complications resulting from unsafe procedures, and fewer than half of them received the needed follow-up care. These statistics are all the more remarkable because Ghana is one of the few African countries where abortion is legal under fairly broad grounds, and abortion performed by a qualified professional under proper conditions is an extremely safe procedure.

Abortion in Ghana,” a new report released today by the New York-based Guttmacher Institute brings together data from various studies, including the 2007 Ghana Maternal Health Survey (GMHS), to present what is known about abortion in Ghana, including information on incidence, abortion providers and the procedures they use, and the characteristics of women having abortions.

A major factor contributing to unsafe abortion in Ghana is that only 4% of women surveyed in 2007 were aware that abortion is legal under fairly broad grounds. Unaware that they can legally obtain a safe abortion procedure, many women turn to unsafe providers. Women also face other barriers to accessing safe abortion services, including high cost, a limited number of qualified abortion providers and concerns about social stigma.