In 2005, the Ethiopian Parliament liberalised the abortion law to grant safe abortions to women in specific circumstances.
Currently, abortion is legal in Ethiopia in cases of rape, incest, or maternal problems relating to foetal impairment.
Since 2008, Ethiopia has witnessed a rapid increase in healthcare facilities which provide legal abortion services. Abortions services in Ethiopian facilities includes medical abortion using misoprostol and Mifepristone, surgical abortion, manual vacuum aspiration and dilation and curettage.
In 2008, estimated 382,500 induced abortions were performed in Ethiopia, for annual rate of 23 abortions per 1,000 women aged 15–44. This has been doubled the proportion in 2014, with rate of 53% (some 326,000) in all health facilities. Most abortions occur in non-governmental organization and private hospitals within Ethiopia.
Ethiopia is the second most populated country in Sub-Saharan Africa (SSA). A central issue concerning the safety of its population is the access to health care including abortion services.
Historically, access to abortion in Sub-Saharan Africa has created controversy amongst some members of the public and its healthcare professionals, due to the existing religious practices and traditional beliefs. There exists a lack of medical knowledge and a cultural stigma surrounding the process of abortion.
From 1980 to 1999, the main cause of maternal mortality in Ethiopia at 31% was the unsafe nature or complications regarding abortion. [1]
In 1994, the International Conference on Population and Development (ICPD), organised by the United Nations, remarked the urge to reduce unsafe abortions in order to tackle these maternal mortality rates. Following this conference, African nations began to encourage the liberalisation of abortion laws. [2] African leaders put this in motion by updating national laws and policies, providing service-delivery rules and regulations, medical training programmes and community outreach programmes. [3]
The journey to safe abortions gained relevance within Ethiopia's political agenda throughout the 1990s. However, the various religious practices in Ethiopia soon expressed their resistance to these plans. The 2007 census demonstrates that 43.5% of citizens identified as Orthodox Christian, 33.9% identified as Muslim and 18.5% identified as Protestant Christian. [2] A study conducted in the same year proves that a high 67% considered induced abortion as 'never justifiable'. [2]
However, with Ethiopia's rapidly growing population, a Population Policy goal was implemented in 1993 to stabilise the rate of population alongside the economic growth. This Policy came to existence during a transition from the Imperial and Military regimes in Ethiopia, during which population and the reproductive health movement had largely been neglected as a national concern. [4] The policy's crucial goals were to reduce the fertility rate from 7.7 to 4, and promote the use of modern contraception among married women who were of child-bearing age from less than 5% to 44%. [4] Before 1993, the Ethiopian Government played a role in actively discouraging the administration and use of contraception. Hence, with this Population Policy, Ethiopia adopted the principle of providing safe abortions and seeking planned pregnancy.
Three years after the legalisation of abortion in Ethiopia, the WHO found that unsafe abortions contributed to 18% of maternal mortality in East Africa, a significant improvement from the previous 31%. [5] By 2014, the maternal mortality caused by unsafe abortions in Ethiopia had declined to 10%. [1]
In 2005, Ethiopia legalized abortion in cases of rape, incest, or foetal impairment. [6] [7] [8] [9] Woman can legally terminate her child life if the pregnancy or childbirth endanger her life. Although abortion is prohibited by Criminal Code, the Ethiopian Parliament approved it in the following circumstances: [10] [11]
A woman can terminate the child upon a difficulty of giving birth owing to minor or physical disability. [12] However, the law engendered almost six in ten unsafe abortions in Ethiopia. In 2006, the government started national standard for safe abortion guideline that utilizes medications such as misoprostol with or without mifepristone) to terminate pregnancies, in accordance with World Health Organization (WHO) clinical recommendations on safe abortion. [13] Available abortion services are: [14]
In 2008, an estimated 382,500 induced abortions were performed in Ethiopia, for annual rate of 23 abortions per 1,000 women aged 15–44. [15] [16] The abortion rate in Ethiopia was lower than to African and Eastern African countries which has 29% and 39% respectively according to WHO estimates. [17] In urban areas, abortions rates is higher than in national average, such as Addis Ababa, Dire Dawa and Harar. Factors for these conditions include greater social and healthcare provision attracting women in these areas. [12]
Some of 35% women tend to undergo induced abortion whereas 27% of those obtaining post-abortion care report having had a previous abortion. [18] In 2014, about 620,300 abortions were performed in Ethiopia, corresponding to annual rate of 28 abortions per 1,000 women aged 15–49, an increase from 22 per 1,000 in 2008. [19] [20]
In 2008, about 27% women induced abortions were safe performed by health facilities. [5] However, 15% (58,000 abortions) reported safe despite lack of clear survey from private and public hospitals. Some of these practices were legal and mostly performed by private and small facilities; about half of all health facilities provided induced abortions in Ethiopia. The proportion is higher than for public hospitals (76%) and private or non-governmental facilities (63%) than for public health centers (41%). [12]
This proportion is likely fluctuating, as there are abortion services in public facilities. Currently, private and NGO facilities mostly provide induced abortion aboard. Access to second trimester abortions is severely limited, in which 9–10% of all facilities only provide these services. [12]
In 2014, legally performed induced abortions were reached 53% (some 326,200) in all health facilities, nearly double the proportion in 2008 (27%). Between 2008 and 2014, shared abortion rate increased from zero to more than one-third. [13]
Modern contraceptive absorption is much higher than in Addis Ababa (57% among women aged 15–44) than in Ethiopia as whole (14%), while in rural areas is below national average (3–16%). One of root causes of abortion is the low level of contraceptive methods, which leads to unintended pregnancy. [12] 13% of unintended pregnancy ended in 2014, up slightly from 10% in 2008. [13]
Despite the legalisation of abortion in 2005, many women in Ethiopia demonstrate little knowledge when it comes to the abortion process. This is due to a combination of factors including religious practices, cultural barriers, public stigma and moral beliefs that inherently values the life of the foetus.
A survey of women between the ages of 15-49 from Bahir Dar in North-Eastern Ethiopia shows that two-thirds were aware of the 2005 law, but 57% remained under-educated as to its purposes. [21]
A community-based cross-sectional survey from 2017 found that a woman's age can determine the level of knowledge held regarding the abortion law. Similarly, the woman's occupation can determine the attitude towards the abortion law. Overall, those with a lack of knowledge towards the abortion law are found likely to possess a conservative attitude towards abortion. [21] This highlights the nation's need for further education across all ages to break down the stigma and conservative attitudes concerning abortion in Ethiopia.
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The most common reasons women give for having an abortion are for birth-timing and limiting family size. Other reasons reported include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.
A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.
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.
Sexual and reproductive health (SRH) is a field of research, health care, and social activism that explores the health of an individual's reproductive system and sexual well-being during all stages of their life. Sexual and reproductive health is more commonly defined as sexual and reproductive health and rights, to encompass individual agency to make choices about their sexual and reproductive lives.
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.
A medical abortion, also known as medication abortion or non-surgical abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage. Medical abortions are more common than surgical abortions in most places around the world.
Latin America is home to some of the few countries of the world with a complete ban on abortion and minimal policies on reproductive rights, but it also contains some of the most progressive reproductive rights movements in the world. With roots in indigenous groups, the issues of reproductive rights include abortion, sexual autonomy, reproductive healthcare, and access to contraceptive measures. Modern reproductive rights movements most notably include Marea Verde, which has led to much reproductive legislation reform. Cuba has acted as a trail-blazer towards more liberal reproductive laws for the rest of Latin America, while other countries like El Salvador and Honduras have tightened restrictions on reproductive rights.
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.
In Benin, abortion is legal on broad socioeconomic grounds up to twelve weeks of pregnancy.
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.
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.
The status of women in Zambia has improved in recent years. Among other things, the maternal mortality rate has dropped and the National Assembly of Zambia has enacted multiple policies aimed at decreasing violence against women. However, progress is still needed. Most women have limited access to reproductive healthcare, and the total number of women infected with HIV in the country continues to rise. Moreover, violence against women in Zambia remains common. Child marriage rates in Zambia are some of the highest in the world, and women continue to experience high levels of physical and sexual violence.
Post-abortion care (PAC) is treatment and counseling for post-abortion women. It includes curative care, such as treating abortion complications, as well as preventative care, such as providing birth control to prevent future unwanted pregnancies. Post-abortion care reduces morbidity and mortality associated with abortion.
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 Sierra Leone, abortion is a criminal offence. Its abortion law does not specify any grounds for legal abortion, but abortion might be permitted to save the life of the mother.
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.
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 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.
In Lesotho, abortion is illegal unless the pregnancy poses a risk to life or health.
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