Accessing Abortion Across Africa

By Helen Walker
Abortion is one of those topics that people usually go out of their way to avoid talking about; the type of thing that people see as too sensitive and personal for it to enter the realm of public discussion.   Yet arguably, deciding if and when to have a child is one of the most important decisions a woman can make during her lifetime. Why then do we feel that we can’t talk about it? How has this attitude actually helped women? How has ‘keeping quiet’ furthered women’s reproductive rights? It is the 21st century but many women around the world still don’t have control over their bodies and their reproductive choices. Surely this shows that it is time for abortion to be discussed by everyone, in the same way as the right to education or the right for women to vote. As Terry O’Neill recently wrote, ‘Abortion Rights Are Human Rights’ (http://www.huffingtonpost.com/terry-oneill/abortion-rights-are-human_b_6431462.html). This is how we should view access to abortion, not as something we find too difficult to discuss, but as a right that needs to be fought for and defended in the same way that all other human rights are.

Although women’s reproductive rights vary around the world, accessing abortion across Africa can be particularly problematic for women, depending on which country they live in. As the above photo shows, the majority of African countries are represented by either red or orange, meaning the procedure is completely prohibited or women can only access abortion if their health or life is at risk. Some people may see the fact that abortions are available when a woman’s life is at risk as sufficient. But how can this be seen as acceptable? How can this current position be satisfactory when women are unable to have an abortion simply because they are not at risk of dying? The simple fact of the matter is that where safe, legal abortions are prohibited, women use unsafe, illegal abortion methods instead; a horrible truth demonstrated by the 4 million unsafe abortions taking place each and every year in Africa, with over 40% of women dying from the procedure. (http://globalmedicine.nl/issues/issue-2/unsafe-abortion-in-africa/) If these women lived in countries where abortion could be legally and safely accessed, they would not be forced to risk their lives having the procedure in dangerous conditions.

Problems surrounding abortion in Africa have persisted despite worldwide women’s rights movements and abortion developments elsewhere in the world. Indeed, many saw the Maputo Protocol as the answer to Africa’s abortion problems. More formally known as the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa, it specifically provides women with access to safe, legal abortion and family planning services under Article 14 (http://www.achpr.org/files/instruments/women-protocol/achpr_instr_proto_women_eng.pdf). 2015 marks the 10 year anniversary since it came into effect, and at first glance the situation seems very simple; once a country has signed and ratified the Protocol (indicating their consent to be bound by the document), then women should receive the services listed within the article (http://www.achpr.org/files/instruments/women protocol/achpr_instr_proto_women_eng.pdf):

1. States Parties shall ensure that the right to health of women, including sexual and reproductive health is respected and promoted.

This includes:

a) the right to control their fertility;

b) the right to decide whether to have children, the number of children and the spacing of children;

c) the right to choose any method of contraception;

d) the right to self-protection and to be protected against sexually transmitted infections, including HIV/AIDS;

e) the right to be informed on one’s health status and on the health status of one’s partner, particularly if affected with sexually transmitted infections, including HIV/AIDS, in accordance with internationally recognised standards and best practices;

g) the right to have family planning education.

The right to have an abortion does not get much clearer than ‘the right to decide whether to have children, the number of children and the spacing of children’. Yet despite the Protocol being widely ratified within Africa, women still encounter barriers when trying to have an abortion. Many countries have failed to implement the Protocol’s provisions, effectively making the document worthless and little more than a group of empty promises. Angola, Democratic Republic of Congo, Guinea-Bissau and Senegal are just a few of the countries that have ratified the Protocol (http://www.maputoprotocol.com/the-countries-that-have-ratified-it), yet women are still only able to have a legal abortion in these countries if their life is at risk (http://www.guttmacher.org/pubs/IB_AWW-Africa.pdf). Not because of rape or incest; not because of a foetal impairment; not because they choose to. Why then did these countries ratify the Protocol? What is the point in having a document that countries agree to implement if there are no repercussions when they fail to keep their promises?

Adverts for procedures posted on a street in South Africa. Abortion is illegal in Kenya except when a mother’s health is in danger. Photograph: Miran Hojnik

Adverts for procedures posted on a street in South Africa. Abortion is illegal in Kenya except when a mother’s health is in danger. Photograph: Miran Hojnik

Abortion is a complex topic to discuss, that can’t be denied. But so are FGM and domestic violence, yet these are discussed far more freely by people and by the media. Why is it acceptable to fight for freedom from FGM, but at the same time ignore the plight of millions of African women who also don’t have control over their bodies when they are denied safe abortion services? The Protocol that could have changed so much seems little more that an empty promise by African countries; a document that lifted the hopes of women across Africa and then shattered those hopes when reproductive freedom never materialised.

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