Abortion in Africa

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Flyers advertising illegal abortion clinics in Bloemfontein, South Africa Abortion.jpg
Flyers advertising illegal abortion clinics in Bloemfontein, South Africa

In Africa, abortion is subject to various national abortion laws. Most women in Africa live in countries with restrictive laws. Most countries in Africa are parties to the African Union's Maputo Protocol, the only international treaty that defines a right to abortion. Sub-Saharan Africa is the world region with the highest rates of unsafe abortions and abortion mortality. Most abortions in the region are unsafe. The region has the highest rate of unintended pregnancy, the primary motive for abortion. The most likely women to have abortions are young, unmarried, or urban. Post-abortion care is widely available.

Contents

Abortion-rights movements emphasize public health arguments about the maternal mortality rate. Anti-abortion movements argue that the practice of abortion was imposed upon Africa by foreign powers.

Many women keep abortions secret due to stigma. Medical abortion using misoprostol is available from health providers and pharmacies, and is usually safe. Surgical abortion is regulated by national guidelines in countries with legal abortion. Self-induced abortion is often unsafe. Traditional methods are common.

Abortion has existed in Africa since ancient times. Many bans on abortions were implemented during the colonial era. Since then, reproductive health laws, constitutional amendments, and judicial decisions have been passed to permit abortion under varying grounds. International treaties have influenced reform. United States policy has influenced the abortion debate.

Legality of abortion by country or territory
Legal on request:
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No gestational limit
Gestational limit after the first 17 weeks
Gestational limit in the first 17 weeks
Unclear gestational limit
Legally restricted to cases of:
Risk to woman's life, to her health*, rape*, fetal impairment*, or socioeconomic factors
Risk to woman's life, to her health*, rape, or fetal impairment
Risk to woman's life, to her health*, or fetal impairment
Risk to woman's life*, to her health*, or rape
Risk to woman's life or to her health
Risk to woman's life
Illegal with no exceptions
No information
* Does not apply to some countries or territories in that category Abortion Laws in Africa.svg
Legality of abortion by country or territory
Legal on request:
 No gestational limit
 Gestational limit after the first 17 weeks
 Gestational limit in the first 17 weeks
 Unclear gestational limit
Legally restricted to cases of:
  Risk to woman's life, to her health*, rape*, fetal impairment*, or socioeconomic factors
 Risk to woman's life, to her health*, rape, or fetal impairment
 Risk to woman's life, to her health*, or fetal impairment
 Risk to woman's life*, to her health*, or rape
 Risk to woman's life or to her health
 Risk to woman's life
 Illegal with no exceptions
 No information
* Does not apply to some countries or territories in that category

Constitutions, judicial decisions, health codes, and laws may mention abortion. Many countries' reproductive health laws specify legal grounds for abortion, often following the terms of international laws. Guidelines and codes of medical ethics may describe implementation of the law or may be contradicted by the law. Most African countries where abortion is legal do not implement them in a way that makes abortion broadly available. [1]

Abortion is unconditionally legal in Benin, Guinea-Bissau, Cape Verde, São Tomé and Príncipe, South Africa, and Tunisia. [2] Zambia allows abortion for any health or socioeconomic reason. [1] As of 2019, 45% of women of reproductive age in Sub-Saharan Africa live in countries with highly restrictive laws, 47% are under moderately restrictive laws, and 8% in countries where abortion is broadly legal. [1] Some countries with restrictive laws apply them inclusively. Ethiopia uses a broad interpretation of its law. Ghana states that no evidence is needed to prove grounds for legal abortion. [1]

In countries where abortion is conditionally legal, abortion is not accessible in practice due to complicated legal processes. [3] Many women think abortion is illegal, regardless of whether it is. Those who think abortion is illegal are more likely to undergo unsafe treatments, fearing legal issues of seeking professional care. [4] In Ghana, Zambia, and Kenya, most women do not know the laws legalising abortion. [1] [5] Medical providers may be uncomfortable providing abortions out of fear of anti-abortion backlash. [6] In some countries, unclear laws deter them from providing abortion. [7]

International law

The African Union's Maputo Protocol secures the right to abortion in the cases of rape, incest, or threat to the life or health of the pregnant woman. As of 2022, 42 out of 55 countries in Africa have signed it. Most countries in Africa have ratified the United Nations Convention on the Rights of the Child and African Charter on the Rights and Welfare of the Child, which provide a right to sexual and reproductive healthcare for minors. [8] The Southern African Development Community has written policy frameworks to decriminalise abortion. Article 5 of its SADC Sexual and Reproductive Health Rights Strategy (2019–2030) aims to reduce unsafe abortion and teenage pregnancy rates. [9]

History

Pre-colonial era

From Ancient Egypt until the 15th century, women would consult a pharmacopoeia about herbs that worked as contraceptives or abortifacients. [10] Abortion was practiced by over 400 cultures in pre-colonial Africa. The Malagasy people used it to limit the sizes of families. The Maasai people used it when women were impregnated by men who could not provide for the child. The Maasai and the Owambo people used it in cases of teenage pregnancy. The Efik people used it if they predicted birth defects. In South Africa, Cape Malays used red geraniums, Khoekhoe people used thorn bushes, and Zulu people used a shrub called uhlungughlungu. [10]

Colonial era

Laws banning abortion are inherited from colonial powers. All of the countries that colonised Africa have since decriminalised abortion. [1] Colonial abortion laws were based on laws developed by European governments in the 18th century—civil law of France, Belgium, and Portugal, common law of England, and, in the case of South Africa's law, the Roman-Dutch law system. [11] Laws were influenced by Christian and Islamic law. [10] Islamic societies often practiced abortion. Islamic schools had differing opinions of it. [12]

Post-independence era

In 1985, Ghana legalised abortion under certain grounds. It reviewed the law in 2003 to develop a plan for implementation. [11] In the 1990s, nearly three-quarters of emergency gynecological admissions in Africa were due to unsafe abortion. The rate of abortions resulting in hospitalisation was over two-thirds in Egypt and nearly one-quarter in Nigeria. [11] Parties to the 1994 International Conference on Population and Development pledged to increase access to family planning services, safe and legal abortion, and post-abortion care, which influenced reforms in Africa. [5] Before the conference, African governments had avoided the stigmatised topic of unsafe abortion. [11]

In the late 1990s and early 2000s, post-abortion care (PAC) services were introduced in Egypt, Ethiopia, Ghana, Kenya, Malawi, Nigeria, Senegal, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe. Ipas led the Woman-Centred Abortion Care program, which addressed the use of MVA and the availability of providers. [11] South Africa decriminalised abortion in 1996 through a political coalition. The African National Congress noted that unsafe abortion had a disproportionate impact on Black South Africans. [1] Between 1996 and 2003, Burkina Faso, Mali, Guinea, Niger, Chad, and Benin revised their strict abortion bans from the Napoleonic Code to allow abortion in the cases of rape, incest, and fetal impairment. In 2004, lawmakers debated abortion in Kenya. [11] Senegal and Madagascar are the only Sub-Saharan countries that have passed reproductive health laws without specifying legal grounds for abortion, as of 2020. [1]

Maputo Protocol

Participation in the Maputo Protocol
.mw-parser-output .col-begin{border-collapse:collapse;padding:0;color:inherit;width:100%;border:0;margin:0}.mw-parser-output .col-begin-small{font-size:90%}.mw-parser-output .col-break{vertical-align:top;text-align:left}.mw-parser-output .col-break-2{width:50%}.mw-parser-output .col-break-3{width:33.3%}.mw-parser-output .col-break-4{width:25%}.mw-parser-output .col-break-5{width:20%}@media(max-width:720px){.mw-parser-output .col-begin,.mw-parser-output .col-begin>tbody,.mw-parser-output .col-begin>tbody>tr,.mw-parser-output .col-begin>tbody>tr>td{display:block!important;width:100%!important}.mw-parser-output .col-break{padding-left:0!important}}
Signed and ratified
Acceded or succeeded
Only signed
Not signed
Territories of non-AU states Maputo Protocol participation map.svg
Participation in the Maputo Protocol

The African Union's 2003 Maputo Protocol is the only human rights treaty that provides criteria for abortion. Article 14(2)(c) of the Protocol says: [1]

2. States Parties shall take all appropriate measures to...
c) protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.

Article 14 of the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa

The Maputo Plan of Action calls to "compile and disseminate data on the magnitude and consequences of unsafe abortion." [1] Since the Maputo Protocol, 21 African countries have expanded their legal grounds for abortion. As of 2023, 44 member states have ratified the it, 8 have signed but not ratified it, and 3 have not signed it. Of those that have ratified it, 12 exceed its provisions, 11 fully comply with the provisions, 16 partially comply, and 4 do not comply. [13] Few countries in North Africa signed the protocol until the 2010s. [12]

Some legal scholars have criticized the Maputo Protocol for listing specific grounds to allow abortion. Others have argued that the continent's human rights guidelines provide for the complete legalisation of abortion. The African Commission on Human and Peoples' Rights (ACHPR) has said, "Women must not be subjected to criminal proceedings and should not incur any legal sanctions for having benefited from health services reserved to them, such as abortion and post-abortion care," and has called for countries to "immediately place a moratorium on the prosecution and detention of women who have illegal abortions." The ACHPR interprets that Articles 3 and 4 of the Protocol, which guarantee rights to respect and dignity, includes the right to make personal decisions without government involvement. [14]

In the Democratic Republic of the Congo, Article 14 was enacted after a 2018 ruling by the Constitutional Court invoked an article saying national treaties take precedence over national law. It was the first country in Francophone Africa to expand legal abortion. [15] In 2019, Rwanda, which had removed its reservation to the Maputo Protocol in 2012, implemented the WHO's definition of health, which provides for the terms of Article 14. [1]

21st century

Abortion laws were liberalised in Ethiopia in 2006 and Ghana in 2006 and 2012. [16] In 2008, the ACHPR decided in Institute for Human Rights and Development in Africa v. Angola that the ban on cruel punishment extends to "lack of access to medicine or medical care." [14] The following year, Nigeria became the first country in the world to include misoprostol for PAC in its essential medicines list. [17]

In the Gambia, the Women's Act 2010 provides for safe abortion if there is a risk to the life of the mother or fetus. Kenya's 2010 constitution, passed by a referendum, permits abortion if there is risk to life or health. In 2012, São Tomé and Príncipe changed its penal code from completely banning abortion to allowing it without restriction, and Somalia authorised abortion in emergencies in its new constitution. The same year, Mauritius reformed its law, influenced by a Mauritian member of the Convention on the Elimination of All Forms of Discrimination against Women. [1]

Planned Parenthood created legal networks to advocate for safe abortion in East Africa. The program began in 2011; in the following decade, it trained 75 lawyers and brought seven cases to court, all of which succeeded. [18] The International Federation of Gynaecology and Obstetrics's Advocacy for Safe Abortion project, launched in 2019, has partnered with OB/GYN societies of African countries. [19] The MAMA network has worked to expand access to self-managed abortion. [14] Malawi proposed the Termination of Pregnancy Bill in July 2015, but legislators have not yet debated it, as of 2020. Sierra Leone's Safe Abortion Act was passed by its parliament in 2015 and 2016, but the president refused to sign it. [1] In a 2015 joint statement, the United Nations, the Inter-American Commission on Human Rights, and the ACHPR said that criminalizing abortion is a form of gender discrimination. The ACHPR began a campaign for African governments to decriminalize abortion in 2016 and reiterated this goal in 2021. [14]

The COVID-19 pandemic led to disruption in the supply chains of medical abortion and contraceptives. DKT International, a major provider of such products, ran low on its stock after manufacturing disruptions in Asia. MSI Reproductive Choices suspended its programs in Kenya and Uganda. Health workers predicted a rise in unsafe abortion cases. [20]

Influence of United States policy

Several Presidents of the United States have instated the Mexico City policy, which bans federal funding for NGOs operating abroad from performing or advocating for abortion as family planning. It was introduced in 1984 by the administration of Ronald Reagan. Since then, Democratic presidents have rescinded the policy and Republican presidents have reinstated it. Organisations such as Planned Parenthood and Marie Stopes International have chosen to lose federal funding when it is in effect. The instatement of the policy by George W. Bush was strongly correlated with higher abortion rates in Sub-Saharan African countries affected by it. Countries that had lost more aid funding had higher pregnancy rates and lower contraceptive use than those less affected. [21] [22]

The United States overturned its right to abortion in the 2022 case Dobbs v. Jackson Women's Health Organization , which impacted the abortion debate in Africa. Abortion providers faced an increase in threats. American groups provided funding for anti-abortion activists. [6] Anti-abortion groups in Kenya challenged the country's recent ruling that abortion is a constitutional right, which had cited Roe v. Wade. The governor of Lagos State, Nigeria, suspended guidelines for therapeutic abortion. Ethiopian groups such as the U.S.-based Family Watch International challenged its law legalizing abortion, and protestors gathered in Hawassa and Addis Ababa. [23] Family Watch International held a meeting at Uganda's presidential office with delegates from 20 African countries. Its leader said in a speech in Malawi that it was combatting a "sexual social recolonization of Africa". [24] Days after the ruling, Sierra Leone's president Julius Maada Bio announced his plan to protect abortion. Benin implemented one of Africa's most permissive abortion laws. [25]

In 2023, Republican members of the United States House of Representatives defunded PEPFAR, a foreign aid plan that lowered rates of HIV/AIDS in Africa. It had previously had bipartisan support despite concerns about abortion. African aid recipients who lost funding included many abortion opponents. [26] In September, 350 African religious leaders wrote that PEPFAR should be re-implemented and denied that it led to abortions. [27]

According to reporting by the Center for Countering Digital Hate and MSI Reproductive Choices in March 2024, Meta and Google restricted abortion information in Africa, Latin America and Asia. MSI said that Google flagged the term "pregnancy options" and Facebook deleted its advertisements while allowing advertisements including misinformation related to abortion. Meta said it would review the claims and Google said it did not restrict the subject. [28] Online barriers to information contributed to women in Africa not knowing about the legality of abortion. [6]

Prevalence

As of 2010–2014, Africa has an annual average of 8.2 million abortions, a rate of 34 per 1,000 women of reproductive age equating to a total of 41 million. [29] The rate varies from 31 per 1,000 in Western Africa to 34 per 1,000 in Northern Africa. The ratio of pregnancies resulting in abortion is 15%. This percentage varies from 12% in Western Africa to 24% in Southern Africa. [30] The abortion rate is the same in places where abortion is or is not permitted. [1] Sub-Saharan Africa is the region with the most unsafe abortions. As of 2024, 77% of abortions are unsafe and nearly half are least safe, as classified by the World Health Organization (WHO). [1] Doctors Without Borders estimated in 2023 that abortions in hospitals in poor or conflict-affected places are five to seven times more likely to lead to serious complications. [31] [32]

As of 2014, 9% of maternal deaths in Africa (16,000 deaths) were caused by abortions. [30] Sub-Saharan Africa has the highest rate of abortions resulting in deaths, at 185 per 100,000, as of 2019. The rate has gone down from 315 per 100,000 in 2010. The highest fatality rate is in Middle Africa and the lowest is in Southern Africa, where most abortions are legal. [1] The most commonly treated complication of abortion is haemorrhage. [33] About 10% of women treated for abortion complications have infections. The abortion mortality rate is higher among women who have infections. [34]

Societal factors

Unintended pregnancies cause the overwhelming majority of abortions. Sub-Saharan Africa has the world's highest unintended pregnancy rate. [1] As of 2017, the continent's unintended pregnancy rate is 89 per 1,000 women of reproductive age. Of the 21.6 million unintended pregnancies annually, 38% result in abortion. About 58 million women have an unmet need for contraception. [30] As of 2019, the rate of use of modern contraceptives is 29% among married women, which has tripled since 1990. Though Sub-Saharan Africa has the highest average desired fertility, the desire for large families is declining. Sexually active unmarried women have higher-than-average rates of modern contraceptive use than married women, but are more likely to not want to be pregnant, so they have more unmet need for contraception. [1]

Demographics of women who are more likely to receive abortions are those who are young, are unmarried, are in school, do not have children, live in cities, are better educated, and are wealthier. Reasons for seeking abortions include wanting to delay being a mother, being unmarried, family honor, financial pressure, and wanting to continue education. [1] Women who have experienced intimate partner violence are more likely to have abortions. [35]

The abortion rate is 26 per 1,000 for married women and 36 per 1,000 for unmarried women. [30] Premarital pregnancy is stigmatised, so unmarried women often want to terminate their pregnancies. Sexually active adolescents have much higher rates of abortion than the average. Unmet need for contraception causes 86% of unintended pregnancies among Sub-Saharan adolescents. Some adolescents cannot afford birth control or fear stigma from providers. [1] Adolescents have higher rates of abortion in all African regions. Adolescents, especially students, have knowledge of abortion services but do not use them due to the cost and stigma. [33] Though international treaties guarantee the medical autonomy of minors, many African countries' laws do not guarantee access to abortion for minors. [8]

Abortion rates are higher in cities, where services and providers are concentrated. Urban women have lower rates of unintended pregnancy, due to higher contraceptive use; however, they are more likely to want fewer children or to have higher agency. [1] Sub-Saharan Africa has few trained medical professionals, especially in rural areas, where 60% of the population lives. Laws requiring abortion to be authorised by medical professionals are difficult to adhere to. The option for conscientious objection limits the number of doctors who can perform abortions. [1] Male partners of women who have abortions may be involved through financial or emotional support. Some men avoid involvement due to denial of responsibility or suspicion of promiscuity, and some women do not tell their partners as they fear lack of support. [1] Those who are involved may decide the method of abortion. [4]

Debate

Pro-abortion

Feminist activists advocate for more permissive abortion laws. Public health frameworks, emphasising the rates of morbidity and mortality from unsafe abortion, are effective. These frameworks often do not address psychological effects of unsafe abortion. [16] The "pro-choice" argument is popular in the Western world, but less effective in Africa. African feminists criticise this stance for focusing on choice regarding abortion rather than other factors of women's sexual and reproductive experiences. The framework of reproductive justice has been proposed to be relevant to African experiences. [10] International organisations such as the Center for Reproductive Rights work to establish safe, legal abortion in Africa. [36]

Anti-abortion

An anti-abortion sculpture in Nigeria (Statue) Stop Abortion. University of Ilorin.jpg
An anti-abortion sculpture in Nigeria

A 2024 survey found that over half of people in South Africa and about 90% in Kenya and Nigeria oppose legal abortion. [37] People in rural South Africa view abortion as a form of killing that violated traditional values. Men in Kenya view abortion as a way for women to hide culturally deviant behavior. [10] A decolonisation framework is common, which argues that abortion has been imposed on Africa by colonial powers. The argument is based on the fact that American organisations lead advocacy efforts for legal abortion in Africa. Postcolonial theorists have criticised this philosophy for presenting a homogenous view of African culture. [10]

Methods

Little data exists on methods of abortion. Some abortion patients do not know what methods they use. [1] Lack of knowledge causes women to obtain unsafe abortions or face delays that limit their options. Women who are older, less educated, in rural areas, or do not know health workers are less likely to have adequate knowledge of abortion. Social networks influence women's decisions about abortion. [4] Many women make multiple attempts at abortions, as they seek out professional services after inexpensive methods often fail. This delays the final procedure, which leads to higher risk. Women often keep abortions secret. They may opt for folk remedies over formal services. [1] Women and girls in rural areas are more likely to more likely to use traditional methods. [33] Abortions outside of the formal health system are more likely to cause complications. [38] Though women wish for safe abortions, fears of legal and social repercussions may lead to more unsafe abortions. Some women who know about safe methods cannot afford them. [4]

Countries with legal abortion have implemented guidelines from international medical standards and offer abortions in public facilities. Post-abortion care is always legal and obligated by medical ethics. [1] Abortion providers use coded language in their advertising to avoid objections. [6] Religious NGOs are a major source of abortion care but are more likely to choose conscientious objection. [1] Many surgical abortions use dilation and curettage, a method that is not recommended by the WHO. [1]

Legal restrictions and social stigma lead to women getting clandestine abortions or self-induced abortions. Methods of ineffective abortions include ingesting herbal remedies, caustics, or store-bought products falsely believed to induce abortions; using over-the-counter drugs in large quantities; or inserting cassava sticks, metal objects, or branches into the vagina. [1] Safe self-managed abortion is considered a possible safe option by the WHO. In Africa, people who receive or provide self-managed abortions may face prosecution or stigma. [14]

Medical abortion

The widespread use of misoprostol for medical abortions has made abortions safer. It has been available in the region since 2005, when the WHO added it to its list of its list of essential medicines, off of which many African countries base their guidelines. The WHO recommends a procedure of mifepristone followed by misoprostol, or use of only the latter if the former is unavailable. Mifepristone is more expensive and has fewer uses than misoprostol, so it is not widely available. [1]

Many women purchase misoprostol without prescriptions. Pharmacies are a preferred source for healthcare as they are accessible and affordable. Some providers clandestinely offer misoprostol pills which may be expired or adulterated or not contain enough of the active ingredient to be effective. Many women lack information about how to use misoprostol. [1] Knowledge of mifepristone and misoprostol is higher in younger women. [4] Providers and clients in several countries widely approve of medical abortion as it can be done privately, is more accessible and affordable than other methods, and is considered safe and painless. Access to medical abortion may lessen the stigma of abortion. [7] Implementing misoprostol at lower-level health centers has been shown to be effective. It may lead to lower rates of unsafe abortion with a lower need for physicians and resources. [17]

Post-abortion care

In Sub-Saharan Africa, an average of 1.7 million women per year receive post-abortion care (PAC). National average annual rates range from 4–7 per 1,000 women in Nigeria to about 15 per 1,000 women in Uganda. [5] PAC patients may be treated as inpatients or outpatients depending on the severity of their cases and national guidelines. PAC is provided by varied professionals at public and private providers. In some countries, nurses and clinical officers have been shown to treat abortion as well as physicians. PAC services are concentrated in urban facilities owned by the government or NGOs and referral hospitals. [5] In countries where abortion is illegal, many patients have their abortions recorded as miscarriages. [1]

About 44% of abortions require care for complications or incompleteness. Of women who require treatment, 43% do not receive it. These rates are highest among poor rural women and lowest among non-poor urban women. Severe complications are more likely to occur in later stages of pregnancy. [1] In Southern Africa, where abortion is widely legal, there are fewer cases of treatment of abortion complications. [9] Young and unmarried women comprise large proportions of PAC patients in Sub-Saharan Africa. Statistics vary by country. [5] PAC patients comprise large proportions of adolescents receiving gynecological care. [5]

Delayed or deficient PAC is a major factor in abortion mortality. Many women delay PAC because they expect the problem to be go away, lack the money or transportation, or fear social consequences or arrest. Most arrests for abortion are initiated by healthcare providers. Some PAC providers refuse care or demand bribes. Delays occur after women seek treatment, as local health centers lack the training or equipment and must make referrals to higher-level facilities. [1] Patients in rural areas face delays since services are more available in cities. Many providers lack adequate training in PAC methods, violate standards, and perform unsafe procedures. Some national abortion laws are unclear about PAC. [5]

WHO standards recommend manual vacuum aspiration (MVA) or misoprostol for PAC. Use of misoprostol leads to higher safety, as misoprostol can be easily purchased, stored, and used, and it can be stocked in primary care facilities. Many places continue to use dilation and curettage (D&C), a surgical method not recommended by WHO. [1] Sublingual administration of misoprostol is effective and accepted in many African countries. [5] Post-abortion family planning services effectively inform patients of options such as long-acting reversible contraceptives. These services increase the use of effective contraception. The most common contraceptives offered are injectables, oral contraceptive pills, condoms, and intrauterine devices. Many PAC providers do not offer family planning services. [5]

The annual spending on PAC in Sub-Saharan Africa is $228 million, as of 2019. Costs to national health systems vary based on population, unsafe abortion rate, and provisions for care in primary and secondary facilities. Less expensive abortions result in more expensive PAC. The costs to the healthcare systems of PAC are greater than the costs of safe abortion. [1] Stigma about abortion and unawareness of PAC among medical workers contribute to low availability. As of 2018, PAC is offered by fewer than 10% of primary care facilities in Kenya, Namibia, Rwanda, Tanzania and Uganda. [39] Training and intervention programs are effective in expanding access, reducing delays, and improving midwives' and nurses' willingness and ability to provide PAC. Rollout of misoprostol, community health education, and community partnerships have been shown to increase access to PAC in many countries. [5] PAC is less available in countries where abortion is illegal. [1] Scholars have criticized metrics of PAC use for overlooking the harm caused by illegal abortion. [5]

Abortion laws by jurisdiction

Legend
permittedIn many cases, abortion is permitted only up to a certain gestational age.
If this limit is known and does not vary by subdivision, it is shown instead of "permitted".
permitted, with complex legality or practice
varies by subdivision
prohibited, with complex legality or practice
prohibited
unknown or unclear

Countries

The table below summarises the legal grounds for abortion in all African Member states of the United Nations. This table is mostly based on data compiled by the United Nations up to 2019, [40] with some updates, additions and clarifications citing other sources.

Legal grounds on which abortion is permitted in independent countries
CountryRisk to lifeRisk to healthRapeFetal impairmentEconomic or socialOn request
Flag of Algeria.svg  Algeria [41] permittedpermittedprohibitedprohibitedprohibitedprohibited
Flag of Angola.svg  Angola [a] permittedpermitted16 weekspermittedprohibitedprohibited
Flag of Benin.svg  Benin [44] permittedpermittedpermittedpermitted12 weeksprohibited
Flag of Botswana.svg  Botswana [45] 16 weeks16 weeks16 weeks16 weeksprohibitedprohibited
Flag of Burkina Faso.svg  Burkina Faso [46] no limitno limit14 weeksno limitprohibitedprohibited
Flag of Burundi.svg  Burundi permittedpermittedprohibitedprohibitedprohibited [b] prohibited
Flag of Cameroon.svg  Cameroon [48] permitted28 weeks28 weeksprohibitedprohibitedprohibited
Flag of Cape Verde.svg  Cape Verde [49] no limitno limit12 weekspermitted12 weeks12 weeks
Flag of the Central African Republic.svg  Central African Republic 8 weeksprohibited [c] 8 weeks8 weeksprohibitedprohibited
Flag of Chad.svg  Chad permittedpermittedpermittedpermittedprohibitedprohibited
Flag of the Comoros.svg  Comoros [51] permittedpermittedprohibitedprohibitedprohibitedprohibited
Flag of the Republic of the Congo.svg  Republic of the Congo permitted [d] prohibited [d] prohibitedprohibitedprohibitedprohibited
Flag of the Democratic Republic of the Congo.svg  Democratic Republic of the Congo permitted [e] permitted [f] permitted [f] permitted [f] prohibitedprohibited
Flag of Djibouti.svg  Djibouti [58] [59] [60] permittedpermitted [g] prohibitedprohibitedprohibitedprohibited
Flag of Egypt.svg  Egypt [61] [62] permittedpermittedprohibitedprohibitedprohibitedprohibited
Flag of Equatorial Guinea.svg  Equatorial Guinea [63] 12 weeks12 weeks12 weeks12 weeksprohibitedprohibited
Flag of Eritrea.svg  Eritrea [64] permittedpermittedpermittedprohibited [h] prohibited [h] prohibited [h]
Flag of Eswatini.svg  Eswatini [65] permittedpermittedpermittedpermittedprohibitedprohibited
CountryRisk to lifeRisk to healthRapeFetal impairmentEconomic or socialOn request
Flag of Ethiopia.svg  Ethiopia [66] [67] [68] 28 weeks28 weeks28 weeks28 weeksprohibited [i] prohibited
Flag of Gabon.svg  Gabon [69] 10 weeksprohibited [j] 10 weeks10 weeksprohibitedprohibited
Flag of The Gambia.svg  Gambia [70] [71] [72] permittedprohibitedprohibitedpermittedprohibitedprohibited
Flag of Ghana.svg  Ghana 28 weeks28 weeks28 weeks28 weeksprohibitedprohibited
Flag of Guinea.svg  Guinea permittedpermittedpermittedpermittedprohibitedprohibited
Flag of Guinea-Bissau.svg  Guinea-Bissau [73] [74] permittedpermittedpermittedpermittedpermittedpermitted
Flag of Cote d'Ivoire.svg  Ivory Coast permittedprohibited [k] permittedprohibited [k] prohibitedprohibited
Flag of Kenya.svg  Kenya [77] [78] permittedpermittedpermitted [l] prohibitedprohibitedprohibited
Flag of Lesotho.svg  Lesotho [81] permittedpermittedpermittedpermittedprohibitedprohibited
Flag of Liberia.svg  Liberia [82] 24 weeks24 weeks24 weeks24 weeksprohibitedprohibited
Flag of Libya.svg  Libya [83] [84] permittedprohibitedprohibitedprohibitedprohibitedprohibited
Flag of Madagascar.svg  Madagascar prohibited [m] prohibitedprohibitedprohibitedprohibitedprohibited
Flag of Malawi.svg  Malawi [88] permittedprohibitedprohibitedprohibitedprohibitedprohibited
Flag of Mali.svg  Mali [89] [90] permittedpermitted [g] permittedprohibitedprohibitedprohibited
Flag of Mauritania.svg  Mauritania permitted [n] prohibited [n] prohibitedprohibitedprohibitedprohibited
Flag of Mauritius.svg  Mauritius [95] no limitno limit14 weeksno limitprohibitedprohibited
Flag of Morocco.svg  Morocco [o] no limitpermittedprohibitedprohibitedprohibitedprohibited
Flag of Mozambique.svg  Mozambique no limitno limit16 weeks24 weeks [p] 12 weeks12 weeks
CountryRisk to lifeRisk to healthRapeFetal impairmentEconomic or socialOn request
Flag of Namibia.svg  Namibia permittedpermittedpermittedpermittedprohibitedprohibited
Flag of Niger.svg  Niger permittedpermittedprohibitedpermittedprohibitedprohibited
Flag of Nigeria.svg  Nigeria permittedprohibited [q] prohibitedprohibitedprohibitedprohibited
Flag of Rwanda.svg  Rwanda [103] no limitno limit22 weeksno limitprohibitedprohibited
Flag of Sao Tome and Principe.svg  São Tomé and Príncipe [104] no limitno limitno limit16 weeks12 weeks12 weeks
Flag of Senegal.svg  Senegal permitted [r] prohibited [r] prohibitedprohibitedprohibitedprohibited
Flag of Seychelles.svg  Seychelles 12 weeks [s] 12 weeks [s] 12 weeks [s] 12 weeks [s] prohibitedprohibited
Flag of Sierra Leone.svg  Sierra Leone permitted [t] permitted [t] prohibitedprohibitedprohibitedprohibited
Flag of Somalia.svg  Somalia [117] [118] permitted [u] prohibitedprohibitedprohibitedprohibitedprohibited
Flag of South Africa.svg  South Africa no limit20 weeks20 weeksno limit20 weeks12 weeks
Flag of South Sudan.svg  South Sudan [119] permittedprohibitedprohibitedprohibitedprohibitedprohibited
Flag of Sudan.svg  Sudan [120] no limitprohibited90 days [v] prohibitedprohibitedprohibited
Flag of Tanzania.svg  Tanzania [w] no limitpermitted [x] prohibitedprohibitedprohibitedprohibited
Flag of Togo (3-2).svg  Togo [124] permittedpermittedpermittedpermittedprohibitedprohibited
Flag of Tunisia.svg  Tunisia [125] no limitno limit3 monthsno limit3 months3 months
Flag of Uganda.svg  Uganda 28 weeks28 weeks28 weeks28 weeksprohibitedprohibited
Flag of Zambia.svg  Zambia [126] permittedpermittedpermittedpermittedpermittedprohibited
Flag of Zimbabwe.svg  Zimbabwe [127] [128] 22 weeks22 weeks22 weeks [y] 22 weeksprohibited [z] prohibited [z]

Partially recognised states

The table below summarises the legal grounds for abortion in African states with limited recognition.

Legal grounds on which abortion is permitted in partially recognised states
CountryRisk to lifeRisk to healthRapeFetal impairmentEconomic or socialOn request
Flag of the Sahrawi Arab Democratic Republic.svg  Western Sahara [13] Un­knownUn­knownUn­knownUn­knownUn­knownUn­known
Flag of Somaliland.svg  Somaliland [131] [132] permittedprohibitedprohibitedprohibitedprohibitedprohibited

Autonomous jurisdictions

The table below summarizes the legal grounds for abortion in African dependent territories of countries outside of Africa.

Legal grounds on which abortion is permitted in other autonomous jurisdictions
JurisdictionRisk to lifeRisk to healthRapeFetal impairmentEconomic or socialOn request
Flag of France.svg  Mayotte / Flag of France.svg  Réunion [133] [134] no limitno limit16 weeks [aa] no limit16 weeks [aa] 16 weeks [aa]
Flag of the United Kingdom.svg  Saint Helena, Ascension and Tristan da Cunha [ab] no limitno limitpermitted [ac] no limit24 weeks [ac] prohibited

See also

Notes

  1. The UN source incorrectly shows Angola as allowing abortion on request, citing a penal code draft from 2014 that did not become law. [42] The version of the penal code enacted in 2020 and entered into force in 2021 allows abortion only in certain circumstances. [43]
  2. The penal code says that social demands are taken into account in a conviction for abortion. [47] It is unclear if this circumstance reduces the penalty or may remove it.
  3. The penal code says that abortion may be permitted to an underage woman in a state of grave distress up to 8 weeks. [50]
  4. 1 2 This ground is not explicitly mentioned in the law. [52] The Charter of Rights and Freedoms, which is declared to be an integral part of the constitution, says that "Abortion, other than therapeutic, is prohibited and punishable by law." [53] It is unclear whether the therapeutic ground means only to save the woman's life or also to preserve her health. The UN source says that only the ground to save the woman's life is accepted as a general legal principle. [54]
  5. This ground is not explicitly mentioned in the law but it is accepted as a general legal principle, allowed by regulation and established by treaty. [55] [56]
  6. 1 2 3 This ground is not explicitly mentioned in the law but it is established by treaty, whose application is requested by the Constitutional Court. [55] [57]
  7. 1 2 The penal code says that abortion is permitted for therapeutic purposes but is unclear whether it means only to save the woman's life or also to preserve her health. The UN source marks it as a permitted ground.
  8. 1 2 3 Abortion is permitted if the woman is under age 18.
  9. Permitted up to 28 weeks of gestation if the woman is unfit to raise the child due to a physical or mental disability or for being under age 18. The penalty for abortion may be mitigated in case of extreme poverty. [66] [67]
  10. The penal code says that abortion may be permitted to an underage woman in a state of grave distress up to 10 weeks.
  11. 1 2 The UN source marks it as a legal ground but it is only established by treaty, not by law and not implemented as of 2020. [75] [76]
  12. This ground is not explicitly mentioned in the law but it is established by judicial decision. [79] It is also mentioned in the National Guidelines on Management of Sexual Violence. [80]
  13. This ground is not explicitly mentioned in the law. [85] The UN source says that it is accepted as a general legal principle, [54] but other sources say that abortion is not legally allowed under any circumstance in Madagascar. [86] [87]
  14. 1 2 The penal code prohibits abortion without any explicit exception, [91] but the UN source says that abortion to save the woman's life is permitted as a general legal principle. [54] The law on child protection prohibits abortion except for a "proven medical need", [92] and the law on reproductive health prohibits abortion except in case of risk to the woman's life. [93] The government has stated that the law of the country permits abortion on therapeutic grounds. [94]
  15. In 2016, the government of Morocco proposed allowing abortion in cases of rape, incest, mental disability and fetal impairment. However, the parliament did not approve the proposal, [96] [97] and as of 2021 the abortion articles in the penal code remain unchanged. [98] [99]
  16. May be permitted with no gestational limit in case the fetus is not viable. [100]
  17. The Criminal Code of the predecessor of Nigeria prohibited abortion except to save the woman's life. A judicial decision on a similar law in the parent country allowed abortion also to preserve the woman's health, but the West African Court of Appeal, despite applying the reasoning of the parent country's decision, affirmed only the ground to save the woman's life in Nigerian law. The Criminal Code and its judicial precedent remain in force in the southern states of Nigeria. In the states corresponding to the former Northern Region, the Penal Code replaced the Criminal Code and its judicial precedent, and it also prohibits abortion except to save the woman's life. [101] [102]
  18. 1 2 The penal code prohibits abortion without any explicit exception, [105] but the code of medical ethics permits abortion to save the woman's life. [106] [54] [107] The government has stated that abortion is authorised in case of risk to the woman's health. [108]
  19. 1 2 3 4 In some cases, abortion may be allowed up to fetal viability or 26 weeks of gestation. [109] [110]
  20. 1 2 Sierra Leone established that the laws in force in England in 1880 would be in force in Sierra Leone from 1965. [111] One of these laws prohibited abortion done "unlawfully" without defining it. [112] A judicial decision in England in 1938 clarified that this law always implicitly allowed abortion at least to save the woman's life, and the decision allowed it also to preserve her health. It is unclear whether Sierra Leone applies only the original legal principle or also the judicial decision. [113] [114] In 2015 the parliament of Sierra Leone passed a law allowing abortion on request but it was not signed by the president so it did not come into force. [115] [116]
  21. This ground is not explicitly mentioned in the law but it is accepted as a general legal principle.
  22. From conception.
  23. In mainland Tanzania, articles 150 to 152 of the penal code prohibit abortion done "unlawfully", and article 230 of the same law permits abortion to preserve the woman's life. Article 219 additionally prohibits "child destruction", meaning abortion after fetal viability, presumed at 28 weeks of pregnancy, but still permits it to preserve the woman's life. [121] In Zanzibar, the penal act has equivalent articles 129 to 131, 213 and 200. [122]
  24. This ground is not explicitly mentioned in the law. A judicial decision by the East African Court of Appeal, with jurisdiction over the predecessors of Tanzania, allowed abortion also to preserve the woman's health, and sources state that this decision remains binding after independence. [123]
  25. Abortion is not permitted for rape within marriage. [129]
  26. 1 2 The 2014 Guidelines for Comprehensive Abortion Care says "In Zimbabwe termination of pregnancy may be permitted for HIV-positive women if they choose to do so." [130]
  27. 1 2 3 Defined as 14 weeks of pregnancy, considered as 16 weeks from the last menstrual period. [135]
  28. Applies English law in force on 1 January 2006 unless locally modified, in each part of the territory. [136] Tristan da Cunha explicitly applies the abortion law of the United Kingdom with minor modifications. [137]
  29. 1 2 This ground is not explicitly mentioned in the law but it is considered to be included in a ground for preserving physical or mental health. [138] [139] [140]

Related Research Articles

<span class="mw-page-title-main">Abortion law</span> Laws that allow, prohibit, or regulate abortion

Abortion laws vary widely among countries and territories, and have changed over time. Such laws range from abortion being freely available on request, to regulation or restrictions of various kinds, to outright prohibition in all circumstances. Many countries and territories that allow abortion have gestational limits for the procedure depending on the reason; with the majority being up to 12 weeks for abortion on request, up to 24 weeks for rape, incest, or socioeconomic reasons, and more for fetal impairment or risk to the woman's health or life. As of 2022, countries that legally allow abortion on request or for socioeconomic reasons comprise about 60% of the world's population. In 2024, France became the first country to explicitly protect abortion rights in its constitution, while Yugoslavia implicitly inscribed abortion rights in its constitution in 1974.

<span class="mw-page-title-main">Unsafe abortion</span> Termination of a pregnancy by using unsafe methods

An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, abortions in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention. About 25 million unsafe abortions occur a year, of which most occur in the developing world.

Abortion in Venezuela is currently illegal except in some specific cases outlined in the Venezuelan Constitution, and the country has one of Latin America's most restrictive laws.

Abortion in Costa Rica is severely restricted by criminal law. Currently, abortions are allowed in Costa Rica only in order to preserve the life or physical health of the woman. Abortions are illegal in almost all cases, including when the pregnancy is a result of rape or incest and when the foetus suffers from medical problems or birth defects. Both social and economic factors have led to this legal status. It remains unclear whether abortions are legal to preserve the mental health of the woman, though the 2013 United Nations abortion report says Costa Rica does allow abortions concerning the mental health of a woman.

Abortion is illegal in Bangladesh under most situations, but menstrual regulation is often used as a substitute. Bangladesh is still governed by the penal code from 1860, where induced abortion is illegal unless the woman is in danger.

Abortion in Uganda is illegal unless performed by a licensed medical doctor in a situation where the woman's life is deemed to be at risk.

Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by the two laws that differs greatly depending on geographical location. Northern Nigeria is governed by The Penal Code and Southern Nigeria is governed by The Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother's life in danger. However, sex-selective abortion has long had acceptance in Nigeria.

In Yemen, abortions are only “permitted to save the life of a pregnant woman”, making it one of the strictest abortion laws in the Middle East and the world. Abortion is not widely accepted in Yemeni society. However, because of the recent conflict in Yemen, rape, honor killings, and unsafe abortions have increased in Yemen. According to a study conducted by Canadian Studies in Population, the number of unsafe and illegal abortions are high in Yemen, which can lead to fatal health risks for women.

<span class="mw-page-title-main">Abortion in Kenya</span>

Abortion in Kenya is prohibited with the exception of certain circumstances including danger to the life and health of the expectant mother, and rape. Unsafe abortions are a major cause of deaths and health complications for women in Kenya.

In 2005, the Ethiopian Parliament liberalised the abortion law to grant safe abortions to women in specific circumstances.

Abortion is illegal in Tanzania except to preserve the life of the mother. Under the Tanzanian penal code, health practitioners who perform illegal abortions may receive sentences of up to 14 years in prison, while those who procure abortions for themselves may be sentenced to up to seven years in prison.

In Zambia, abortion is legal if the pregnancy would threaten the mother's life or physical or mental health or those of existing children, or if it would cause a birth defect. Zambia has one of the most permissive abortion laws in Africa, though its restrictions limit access. The Termination of Pregnancy Act, passed in 1972, legalizes abortion if approved by medical professionals. It requires signatures from three doctors, including one specialist. Amendments to the bill and medical guidelines clarify that the law allows the consideration of situations such as pregnancy from rape, as well as socioeconomic factors.

In Malawi, abortion is only legal to save the life of the mother. Abortion is a felony punishable by prison. Malawi's abortion law is one of the strictest in the world.

In Madagascar, abortion is illegal in all circumstances. The abortion law punishes receiving or assisting in an abortion with imprisonment or fines. It is one of the only countries with a total abortion ban. Abortion has been illegal since the French colonial era, influenced by attitudes favoring increased births. In 2017, the government rejected a proposal to legalize therapeutic abortion. A bill allowing abortion in the case of rape was proposed by Member of Parliament Masy Goulamaly in November 2021 but was withdrawn by the parliament.

In Senegal, abortion is illegal unless the life of the mother is in danger. A medical exception requires a medical certificate. Senegal is one of the only countries whose criminal code completely bans abortion. Receiving an abortion is punishable by fines and prison. Abortion was banned in the colonial era. In 1967, an exception was made in the case of threat to life. In 2005, the National Assembly declared that women have a right to post-abortion care. Activists wanted this law to legalize abortion in the cases of rape or incest, but failed. In 2013, a group of NGOs called the Task Force formed with the goal of aligning Senegal's abortion law with the Maputo Protocol, which it had signed in 2004. The National Assembly considered a bill in 2024 that would guarantee legal access to medical abortion. International organizations have called for abortion law reform. Domestically, religious families and organizations influence widespread opposition to abortion due to Islamic beliefs.

In the Gambia, abortion is illegal except to save the life of the mother or to prevent birth defects. Abortions in the Gambia have high rates of mortality and complications. Abortions are common among adolescents. There is a stigma surrounding extramarital pregnancy and abortion.

In Togo, abortion is only legal in the cases of pregnancy from rape or incest, risk to the mother's health or life, or risk of birth defects. The law requires abortion to be performed by a doctor.

In Lesotho, abortion is illegal unless the pregnancy poses a risk to life or health.

In Guinea, abortion is illegal unless the pregnancy poses a threat to the life or health of the pregnant woman or fetus, if it resulted from rape, or if the pregnant woman is a minor. Illegal abortions are punishable by fines and prison. Legal abortions require approval from doctors in the case of therapeutic abortion or ethics committees in the case of abortion from rape. The conditions for legal abortion are debated. Women's rights activists and journalists have advocated for reform.

In Gabon, abortion is only legal in the cases of risk to the mother's life, risk of birth defects, pregnancy from rape or incest, or if the mother is a minor in distress, up to ten weeks of pregnancy. Illegal abortions are punishable by prison or fines. Gabon has one of the highest rates of abortion in Sub-Saharan Africa.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Bankole, Akinrinola; Remez, Lisa; Owolabi, Onikepe; Philbin, Jesse; Williams, Patrice (December 2020). "From Unsafe to Safe Abortion in Sub-Saharan Africa: Slow but Steady Progress". Guttmacher Institute . doi: 10.1363/2020.32446 .
  2. "The World's Abortion Laws". Center for Reproductive Rights. Retrieved 11 August 2024.
  3. Ajayi, Anthony Iwodu; Ouedraogo, Ramatou; Juma, Kenneth; Kibunja, Grace; Cheruiyot, Collins; Mwoka, Meggie; Igonya, Emmy Kageha; Opondo, Winnie; Otukpa, Emmanuel; Kabiru, Caroline W.; Ushie, Boniface Ayanbekongshie (15 February 2021). "Research priorities to support evidence-informed policies and advocacy for access to safe abortion care in sub-Saharan Africa". Sexual and Reproductive Health Matters . 29 (1): 5–8. doi: 10.1080/26410397.2021.1881207 . PMC   8009017 . PMID   33587020.
  4. 1 2 3 4 5 Hinson, Laura; Bhatti, Anam M.; Sebany, Meroji; Bell, Suzanne O.; Steinhaus, Mara; Twose, Claire; Izugbara, Chimaraoke (10 October 2022). "How, when and where? A systematic review on abortion decision making in legally restricted settings in sub-Saharan Africa, Latin America, and the Caribbean". BMC Women's Health . 22 (1): 415. doi: 10.1186/s12905-022-01962-0 . PMC   9552475 . PMID   36217197.
  5. 1 2 3 4 5 6 7 8 9 10 11 Izugbara, Chimaraoke; Murunga Wekesah, Frederick; Sebany, Meroji; Echoka, Elizabeth; Amo-Adjei, Joshua; Muga, Winstoun (1 July 2020). "Availability, accessibility and utilization of post-abortion care in Sub-Saharan Africa: A systematic review". Health Care for Women International . 41 (7): 732–760. doi:10.1080/07399332.2019.1703991. PMID   31855511.
  6. 1 2 3 4 Cheng, Maria; Apawu, Misper (2 April 2024). "Abortions are legal in much of Africa. But few women may be aware, and providers don't advertise it". Associated Press . Retrieved 6 August 2024.
  7. 1 2 Bornstein, Marta; Young, Yves-Yvette; Berro Pizzarossa, Lucia; Cohen, Margot Jeanne; Maina, Jade (January 2023). "Documenting activism and advocacy around medication abortion in Central, East, and West Africa". African Journal of Reproductive Health . 27 (1): 84–94. doi:10.29063/ajrh2023/v27i1.8 (inactive 1 November 2024). JSTOR   27231870. PMID   37584960.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  8. 1 2 Kangaude, Godfrey Dalitso; Macleod, Catriona; Coast, Ernestina; Fetters, Tamara (17 October 2022). "Integrating child rights standards in contraceptive and abortion care for minors in Africa". International Journal of Gynecology & Obstetrics . 159 (3): 998–1004. doi: 10.1002/ijgo.14502 . PMC   7616402 . PMID   36209475.
  9. 1 2 Matshalaga, N; Mehlo, M (August 2022). "Safe abortion policy provisions in the SADC region: Country responses, key barriers, main recommendations". Southern African Journal of Public Health. 5 (3): 68–76. doi: 10.7196/SAJPH.2022.v5.i3.133 .
  10. 1 2 3 4 5 6 Malvern, Chiweshe; Macleod, Catriona (June 2018). "Cultural De-colonization versus Liberal Approaches to Abortion in Africa: The Politics of Representation and Voice". African Journal of Reproductive Health . 22 (2): 49–59. doi:10.29063/ajrh2018/v22i2.5 (inactive 1 November 2024). PMID   30052333.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  11. 1 2 3 4 5 6 Brookman-Amissah, Eunice; Moyo, Josephine Banda (November 2004). "Abortion Law Reform in Sub-Saharan Africa: No Turning Back". Reproductive Health Matters. 12 (24): 227–234. doi:10.1016/s0968-8080(04)24026-5. PMID   15938178.
  12. 1 2 Maffi, Irene; Tønnessen, Liv (December 2019). "The Limits of the Law: Abortion in the Middle East and North Africa". Health and Human Rights . 21 (2): 1–6. PMC   6927385 . PMID   31885431.
  13. 1 2 "Maputo Protocol at 20: Progress on Abortion Rights in Africa". Center for Reproductive Rights . 29 June 2023. Retrieved 4 August 2024.
  14. 1 2 3 4 5 Berro Pizzarossa, Lucía; Maziwisa, Michelle; Durojaye, Ebenezer (June 2023). "Self-Managed Abortion in Africa: The Decriminalization Imperative in Regional Human Rights Standards". Health & Human Rights . 25 (1): 171–183. PMC   10309143 . PMID   37397422.
  15. "The Democratic Republic of the Congo Leads the Way on Abortion Access: A Pathway for Reproductive Rights Advocates in Francophone Africa". Population Reference Bureau . 28 October 2021. Retrieved 6 August 2024.
  16. 1 2 Macleod, Catriona; Chiweshe, Malvern (22 April 2016). "A critical review of sanctioned knowledge production concerning abortion in Africa: Implications for feminist health psychology". Journal of Health Psychology . 23 (8): 1096–1109. doi:10.1177/1359105316644294. PMID   27106087.
  17. 1 2 Kulczyski, Andrzej (September 2016). "The Imperative to Expand Provision, Access and Use of Misoprostol for Post-Abortion Care in sub-Saharan Africa". African Journal of Reproductive Health . 20 (3): 22–25. doi: 10.29063/ajrh2016/v20i3.3 . ISSN   1118-4841. PMID   29553188 via African Journals OnLine.
  18. Casas, Ximena; Kimathi-Osiemo, Mitchelle; Redwine, Dee; Tebbets, Claire; Plafker, Karen (February 2024). "Preventing State Harassment of Abortion Providers: The Work of the Legal Support Network in Latin America and East Africa". Health & Human Rights . 21 (2): 181–187. PMC   6927384 . PMID   31885447.
  19. Morris, Jessica L.; Armitage, Sinéad; Davis, Jema; Kaur, Jameen; Pretty, Matthew; Ea, Sophie; Seok, Jane; de Vries, Irene (February 2024). "Professional societies of obstetrics and gynecology as agents of change in sexual and reproductive health: FIGO's 10-country safe abortion advocacy project in Africa and Latin America". International Journal of Gynecology & Obstetrics . 164 (Suppl 1): 31–41. doi: 10.1002/ijgo.15334 . PMID   38360034.
  20. Wadekar, Neha (4 May 2020). "The Coronavirus Is Cutting Off Africa's Abortion Access". Foreign Policy . Retrieved 6 August 2024.
  21. Bendavid, Eran; Avila, Patrick; Miller, Grant (2011). "United States aid policy and induced abortion in sub-Saharan Africa". Bulletin of the World Health Organization . 89 (12): 873–880. doi: 10.2471/BLT.11.091660 (inactive 18 November 2024). PMC   3260902 . PMID   22271944.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  22. Brooks, Nina; Bendavid, Eran; Miller, Grant (27 June 2019). "USA aid policy and induced abortion in sub-Saharan Africa: an analysis of the Mexico City Policy". The Lancet . 7 (8): E1046–E1053. doi: 10.1016/S2214-109X(19)30267-0 . PMID   31257094.
  23. Hellerstein, Erica (19 September 2023). "Roe's repeal has energized Africa's anti-abortion movement". Coda Media . Retrieved 6 August 2024.
  24. Anna, Cara (1 July 2023). "After the fall of Roe, emboldened religious conservatives lobby to restrict abortion in Africa". Associated Press . Retrieved 6 August 2024.
  25. Ferragamo, Mariel (5 February 2024). "Roe's Repeal Inspires Abortion Rollbacks in Other Countries". Think Global Health. Retrieved 6 August 2024.
  26. Musambi, Evelyne; Amiri, Farnoush; Anna, Cara; Knickmeyer, Ellen (11 September 2023). "Republican opposition to abortion threatens global HIV/AIDS program that has saved 25 million lives". Associated Press . Retrieved 6 August 2024.
  27. Gbadamosi, Nosmot (1 November 2023). "Will U.S. Abortion Wars End a Successful Foreign Policy in Africa?". Foreign Policy . Retrieved 6 August 2024.
  28. Strzyżyńska, Weronika (27 March 2024). "Meta and Google accused of restricting reproductive health information". The Guardian . Retrieved 6 August 2024.
  29. Fokazi, Sipokazi (13 May 2016). "African women more likely to have abortions". IOL. Retrieved 10 November 2024.
  30. 1 2 3 4 "Abortion in Africa". Guttmacher Institute . March 2018. Retrieved 4 August 2024.
  31. Lecumberri, Beatriz (11 September 2023). "Fatal abortion in sub-Saharan Africa: 'She dilated my cervix with a cassava root and the fetus fell out'". El País . Retrieved 6 August 2024.
  32. Pasquier, Estelle; Owolabi, Onikepe O.; Fetters, Tamara; Ngbale, Richard Norbert; Adame Gbanzi, Mariette Claudia; Williams, Timothy; Chen, Huiwu; Fotheringham, Claire; Lagrou, Daphne; Schulte-Hillen, Catrin; Powell, Bill; Baudin, Elisabeth; Filippi, Veronique; Benova, Lenka (4 March 2023). "High severity of abortion complications in fragile and conflict-affected settings: a cross-sectional study in two referral hospitals in sub-Saharan Africa (AMoCo study)". BMC Pregnancy and Childbirth . 23 (1): 143. doi: 10.1186/s12884-023-05427-6 . PMC   9985077 . PMID   36871004.
  33. 1 2 3 Atuhaire, Shallon (9 July 2019). "Abortion among adolescents in Africa: A review of practices, consequences, and control strategies". International Journal of Health Planning and Management . 34 (4): e1378–e1386. doi:10.1002/hpm.2842. PMID   31290183.
  34. Baguiya, Adama; Mehrtash, Hedieh; Bonet, Mercedes; Adu-Bonsaffoh, Kwame; Compaoré, Rachidatou; Bello, Folasade Adenike; Govule, Philip; Msusa, Ausbert Thoko; Kim, Caron R.; Kouanda, Séni (January 2022). "Abortion-related infections across 11 countries in Sub-Saharan Africa: Prevalence, severity, and managemen". International Journal of Gynecology & Obstetrics . 156 (S1): 36–43. doi: 10.1002/ijgo.14032 . PMID   35060617.
  35. Arthur-Holmes, Francis; Aboagye, Richard Gyan; Dadzie, Louis Kobina; Agbaglo, Ebenezer; Okyere, Joshua; Seidu, Abdul-Aziz; Ahinkorah, Bright Opoku (January 2023). "Intimate Partner Violence and Pregnancy Termination Among Women in Sub-Saharan Africa". Journal of Interpersonal Violence . 38 (1–2): 2092–2111. doi: 10.1177/08862605221098405 . PMID   35585757.
  36. Cascais, Antonio (16 July 2022). "Abortion: Is Africa becoming more liberal?". Deutsche Welle . Retrieved 6 August 2024.
  37. Fetterolf, Janell; Clancy, Laura (15 May 2024). "Support for legal abortion is widespread in many places, especially in Europe". Pew Research Center . Retrieved 6 August 2024.
  38. Moseson, Heidi; Shaw, Jessica; Chandrasekaran, Sruti; Kimai, Esther; Maina, Jedidiah; Malisau, Pearson; Musa, Yiga; Nmezi, Sybil; Philipo, Kitungano; Bonnefoy Borjas, Eva; Young, Yves-Yvette; Janssen, Kantjil (1 August 2019). "Contextualizing medication abortion in seven African nations: A literature review". Health Care for Women International . 40 (7–9): 950–980. doi:10.1080/07399332.2019.1608207. PMID   31158324.
  39. Adams, Patrick (9 March 2021). "In Hospitals Across Africa, A Lack Of Post-Abortion Care". NPR . Retrieved 6 August 2024.
  40. Table 2: Countries by legal grounds for abortion (recoded), United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Policies 2017: Abortion laws and policies.
  41. Collection of Regulatory Texts relative to the Management of Health Establishments, Med Ould-Kada, December 2020. Law 85-05 of 16 February 1985 regarding the protection and promotion of health. Article 72 (in French).
  42. Penal code draft, Global Abortion Policies Database, World Health Organization (in Portuguese).
  43. Law that approves the Angolan Penal Code, Journal of the Republic of Angola, 11 November 2020. Articles 154–158 (in Portuguese).
  44. Law no. 2012-12 of 20 December 2021, General Secretariat of the Government of Benin (in French). Published on 7 January 2022.
  45. Penal Code, Government of Botswana. Article 160.
  46. Law no. 025-018/AN bearing the penal code, Police Academy of Burkina Faso. Articles 513-10 to 513–19 (in French).
  47. Law no. 1/27 of 29 December 2017 bearing revision of the penal code, President of the Republic of Burundi. Article 534 (in French).
  48. Norms and Standards in Reproductive Health-Family Planning in Cameroon, Ministry of Health of Cameroon, 2018 (in French).
  49. https://abortion-policies.srhr.org/documents/countries/01-Cape-Verde-Law-and-Regulation-on-Voluntary-Interruption-of-Pregnancy-1987.pdf law no. 9/iii/86 & decree no. 7/87 https://abortion-policies.srhr.org/documents/countries/15-Cabo-Verde-Resolution-ratifying-Maputo-Protocol-2005.pdf resolution no. 131/vi/2005 https://www.parlamento.cv/GDRevisoesContitucionais.aspx?ImagemId=30
  50. Penal Code, 2010. Article 79 (in French).
  51. Penal Code, University of Alicante Intellectual Property and Information Technologyart. Article 304 (in French).
  52. Penal Code, Ministry of Justice of the Republic of the Congo. Article 317 (in French).
  53. Consideration of reports submitted by States parties under article 19 of the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, The Republic of the Congo, United Nations, 1 May 2014.
  54. 1 2 3 4 World Population Policies 2017: Abortion Laws and Policies, United Nations Department of Economic and Social Affairs, 2020.
  55. 1 2 Is the abortion of a rape victim permitted in Congolese law?, Leganews.cd, 29 October 2019. (in French)
  56. Ordinance 70–158 of 30 April 1970 determining the rules of medical deontology, Leganet.cd. (in French)
  57. Memorandum no. 04/SPCSM/CFLS/EER/2018 of 6 April 2018 regarding the execution of the provisions of article 14 of the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa, Official Journal of the Democratic Republic of the Congo, 5 June 2008. (in French)
  58. Law 59/AN/94 of 5 January 1995 bearing the Penal Code, VERTIC (in French).
  59. Decree no. 2008-0098/PR/MS regarding the Code of Medical Deontology, National Order of Medical Professions of Djibouti (in French).
  60. Abortion in Djibouti, Human Village, April 2015 (in French).
  61. "قانون العقوبات" [Penal Code]. Article 61 and Chapter 3, Law 58 of 1937 (in Arabic). Parliament of Egypt. With amendments as 15 August 2021.
  62. Profession Ethics Regulations. Archived from the original on 3 November 2021.
  63. Chapter 3, Section 1, Law No. 4 of 5 November 2020 (in Spanish). Parliament of Equatorial Guinea.
  64. Andemariam, Senai W. (2015). "PENAL CODE OF THE STATE OF ERITREA" (PDF). Ref World. Archived (PDF) from the original on 18 September 2015.
  65. "Swaziland National Policy on Sexual and Reproductive Health and Rights" (PDF). Researchgate.net. Retrieved 2 March 2022.
  66. 1 2 "The Criminal Code of the Federal Democratic Republic of Ethiopia" (PDF). World Intellectual Property Organization. Articles 545 to 552.
  67. 1 2 Dr. Yirgu Gebrehiwoth (2020). "Federal Ministry of Health - National Norms & Guidelines for Safe Abortion Services in Ethiopia second edition - original 2013/2014 modified 2018" (PDF). St. Paul's Hospital, Addis Ababa. Archived (PDF) from the original on 1 November 2021.
  68. "Standard Treatment Guidelines for General Hospitals" (PDF). Food, Medicine and Healthcare Administration and Control Authority of Ethiopia. 2014.
  69. Penal Code, Official Journal of the Gabonese Republic, 30 June 2020. Title X (in French).
  70. The Gambia's Political Transition to Democracy: Is Abortion Reform Possible?, Satang Nabaneh, Health and Human Rights, 9 December 2019.
  71. Criminal Code (Act No. 25 of 1933), Gambia, International Labour Organization. Chapter XV, sections 140–142, and chapter XX, sections 198–199.
  72. Women's Act, 2010, Office of the Vice President and Ministry for Women Affairs of Gambia, July 2010. Section 30.
  73. Penal Code of Guinea-Bissau, Judicial Police of Guinea-Bissau, 20 May 2019. Article 112 (in Portuguese).
  74. Report on the Right to Health in Guinea-Bissau, Office of the United Nations High Commissioner for Human Rights, April 2017, pages 14–15.
  75. Ivory Coast: advocacy for medical abortions as in the case of rapes, Abidjan.net, 19 July 2020 (in French).
  76. Law no. 2019-574 carrying the Penal Code, Official Journal of the Republic of Ivory Coast, 10 July 2019 (in French).
  77. Penal Code, revised edition of 2012, National Council for Law Reporting. Articles 158–160 and 240.
  78. The Constitution of Kenya, National Council for Law Reporting, 2010. Article 26(4).
  79. FIDA-Kenya and Others v. Attorney General and Others, Kenyalaw.org, 12 June 2019.
  80. National Guidelines on Management of Sexual Violence in Kenya, 3rd edition, Ministry of Health of Kenya, 2014. Pages 15, 25, 78.
  81. "Penal Code Act, 2012 | Lesotho Legal Information Institute". lesotholii.org. Archived from the original on 26 January 2019. Retrieved 23 October 2021.
  82. Offenses Against the Family, Chapter 16: Penal Law – Title 26 – Liberian Code of Laws Revised, Legal Information Institute.
  83. "Law No. 106 of 1973 Promulgating the Health Law" (in Arabic). Ministry of Justice of Libya. 13 December 1978. Archived from the original on 31 January 2023.
  84. "Law No. 17 of 1986 on Medical Liability" (in Arabic). Ministry of Justice of Libya. 4 November 1986. Archived from the original on 6 February 2023.
  85. Penal code, Ministry of Justice of Madagascar, updated 31 March 2005. Article 317 (in French).
  86. Legalization of abortion in Madagascar – The revision of the law again on the parliamentarians' carpet, La Vérité, 9 February 2021 (in French).
  87. In Madagascar, clandestine abortions are the second cause of maternal deaths, Radio France Internationale, 1 October 2021 (in French).
  88. "Penal Code. Article 243" (PDF). Malawi Legal Information Institute. Archived from the original (PDF) on 8 July 2021.
  89. Law no. 2001-79 of 20 August 2001 bearing the Penal Code, Droit Afrique. Article 211 (in French).
  90. Law no. 02-044 of 24 June 2002 relative to reproduction health, President of the Republic of Mali. Article 13 (in French).
  91. Penal Code, Official Journal of the Islamic Republic of Mauritania, 9 July 1983. Article 293 (in French).
  92. Ordinance no. 2005-015 bearing the penal protection of the child, Military Council for Justice and Democracy of Mauritania, 5 December 2005 (in French). Article 33.
  93. Law no. 2017-025 regarding reproductive health, Official Journal of the Islamic Republic of Mauritania, 27 December 2017. Article 21 (in French).
  94. List of issues and questions in relation to the combined second and third periodic reports of Mauritania, Addendum, Replies of Mauritania, Convention on the Elimination of All Forms of Discrimination against Women, 17 March 2014. Page 20.
  95. The Criminal Code (Amendment) Act 2012, Official Gazette of Mauritius, 23 June 2012.
  96. Moroccan women are still waiting for the abortion reform wanted by Mohammed VI, Le Monde, 18 March 2018 (in French).
  97. In Morocco, the Hajar Raissouni case revives the debate on abortion, France 24, 24 September 2019 (in French).
  98. Penal code, consolidated version of 5 July 2018, Ministry of Justice of Morocco (in French).
  99. Penal code, consolidated version of 14 June 2021, Ministry of Justice of Morocco (in Arabic).
  100. Law of Revision of the Penal Code, Bulletin of the Republic of Mozambique, 24 December 2019 (in Portuguese).
  101. Re-characterizing abortion in Nigeria: an appraisal of the necessity test, Victor Nnamdi Opara, International Law Students' Association Journal of International & Comparative Law, vol. 11, issue 1, article 8, March 2005.
  102. Penal Code (Northern States) Federal Provisions Act, 30 September 1960. Police and Human Rights Resources, Amnesty International.
  103. Ministerial Order no. 002/MoH/2019 of 08/04/2019 determining conditions to be satisfied for a medical doctor to perform an abortion, Official Gazette of Rwanda, no. 14, 8 April 2019 (in Kinyarwanda, English, and French).
  104. Penal Code, Government of São Tomé and Príncipe, 2012. Book II, title I, chapter II (in Portuguese).
  105. Penal Code of Senegal, 21 July 1965, with amendments up to 29 January 1999. Article 305 (in French).
  106. Code of Medical Ethics, National Order of Physicians of Senegal, 10 February 1967. Article 35 (in French).
  107. Sénégal – Marième N'Diaye on the decriminalization of abortion: "the debate is open", Le Point, 11 April 2019 (in French).
  108. Combined third to seventh periodic reports due in 2010, Senegal, Convention on the Elimination of All Forms of Discrimination against Women, 13 December 2013. Page 55.
  109. Termination of Pregnancy Act, consolidated to 30 June 2012, Seychelles Legal Information Institute.
  110. Reproductive health policy for Seychelles, Ministry of Health of Seychelles, January 2012.
  111. Courts Act, 1965, Government of Sierra Leone. Article 74.
  112. Offences Against the Person Act 1861, Legislation.gov.uk. Articles 58–59.
  113. Supplementary Information on Sierra Leone, scheduled for review by the U.N. Committee on the Elimination of Discrimination against Women during its 57th Session (February 2014), Center for Reproductive Rights, 24 January 2014. "This interpretation of the Offences Against the Person Act has not been tested in case law in Sierra Leone and therefore it remains unclear whether women terminating a pregnancy on such grounds would be criminally liable."
  114. Understanding Abortion Access in Africa, Catholics for Choice, 19 February 2014. "Sierra Leone is one of several Commonwealth countries to model its abortion policy after England's 1938 Rex v. Bourne decision, which established necessity that is, threats to a woman's mental and physical health as grounds for legal abortion."
  115. Sierra Leone abortion bill blocked by President Bai Koroma again, BBC News, 12 March 2016.
  116. Fighting Unsafe Abortion and Abortion Stigma in Sierra Leone, Women's Health and Reproductive Rights Organization, 20 April 2021.
  117. Provisional Constitution, University of Minnesota: Human Rights Library, 7 September 2012. Article 15.5.
  118. Penal Code, Global Abortion Policies Database, 6 December 1962. Article 36 and part X.
  119. "Penal Code Act. Article 216" (PDF). Sudantribune.com. Archived from the original (PDF) on 16 October 2021. Retrieved 2 March 2022.
  120. Penal Code, European Country of Origin Information Network, 1991.
  121. "The Penal Code, revised edition of 2019". Tanzania Legal Information Institute. Archived from the original on 4 December 2021.
  122. Penal Act, 2018, Zanzibar House of Representatives, 16 March 2018.
  123. A technical guide to understanding the legal and policy framework on termination of pregnancy in mainland Tanzania, Center for Reproductive Rights, 2012.
  124. Law No. 2007-005, On Reproductive Health, Official Journal of the Togolese Republic, 10 January 2007 (in French).
  125. Penal Code, 2012. Article 214 (in French).
  126. The Termination of Pregnancy Act, National Assembly of Zambia.
  127. Ministry of Health and Child Welfare (2001). National Guidelines for Post Abortion Care (PDF) (1st ed.). Harare: Hunyani Printopak. ISBN   1-779-09-010-2.
  128. "Induced Abortion and Postabortion Care in Zimbabwe". Guttmacher Institute. October 2018. In practice, it is extremely difficult to obtain a legal abortion; as a result, most abortions are clandestine and potentially unsafe. Updated as of 16 July 2019.
  129. "Termination Of Pregnancy Act [Chapter 15:10] – law.co.zw".
  130. "National Guidelines for Comprehensive Abortion care in Zimbabwe - 2014" (PDF). Ministry of Health and Child Care. Archived (PDF) from the original on 18 October 2021.
  131. Penal Code, Somalilandlaw.com.
  132. Jama, Ibrahim Hashi (30 January 2012). "THE 2000 CONSTITUTION OF THE REPUBLIC OF SOMALILAND - english translation" (PDF). Somaliland law. Archived (PDF) from the original on 18 May 2012.
  133. Voluntary interruption of pregnancy, Public Health Code articles L2211-1 to L2223-2, Légifrance (in French).
  134. Mayotte, Wallis and Futuna Islands and French Southern and Antarctic Lands, New Caledonia and French Polynesia, Public Health Code articles L2421-1 to L2446-3, Légifrance (in French).
  135. What are the deadlines to abort?, Ministry of Health and of Prevention of France, 21 July 2022 (in French).
  136. General Introduction to Legislation, Saint Helena Government.
  137. Abortion Act (UK) (Tristan da Cunha) Ordinance, 1967, Saint Helena Government, 2017.
  138. Rape and abortion, EFC.
  139. Britain's abortion law, British Pregnancy Advisory Service.
  140. Know Your Abortion Rights in the UK, 123 Healthwise.