Abortion in Ghana

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Abortion in Ghana is banned except when there is a valid exemption. The abortion should also be conducted only at a government hospital; registered private hospital, clinics registered under the Private Hospitals and Maternity Homes Act, 1958 (No. 8) and a place approved by the Minister of Health by a Legislative Instrument. Illegal abortions are criminal offenses subject to at most five years in prison for the pregnant woman who induced said abortion, as well as for any doctor or other person who assisted this pregnant woman in accessing, or carrying out, an abortion. [1] Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.

Contents

Terminology

The definition of abortion is quite wide. According to Act 29, section 58, article 3, of the Criminal code of 1960, "Abortion or miscarriage means premature expulsion or removal of conception from the uterus or womb before the period of gestation is completed." [1] Thus, both words, abortion and miscarriage, can be used interchangeably to refer to the same phenomenon. The law would seem to cover induced abortions, where the pregnant woman willfully expels a viable fetus, and also spontaneous abortions, or miscarriages, which may be encouraged by the pregnant woman through various means. Medically, there have been attempts to clearly distinguish between the two, [2] but the laws in Ghana concerning this matter do not make this distinction.

Exceptions

In some situations, abortions are legal. The laws of Ghana allow abortions where (1) the pregnancy was as a result of rape, defilement, or incest, which are themselves all crimes in Ghana, and (2) where the pregnant woman requests the abortion. The pregnant woman's next of kin may request the abortion if the woman lacks the capacity to request it. For instance, if she is unconscious and in need of immediate medical attention that may entail abortion; if she is mentally incapable of making medical decisions (for example has an Intellectual disability); or if she is a minor according to the law. In Ghana, the age of minority is below eighteen years, although the legal age for consent is 16 years of age.

Law

Abortion is a criminal offence pursuant to Act 29, section 58 of the Criminal code of 1960, [1] amended by PNDCL 102 of 1985, which states that:

  1. Subject to the provisions of subsection (2) of this section
    1. any woman who with intent to cause abortion or miscarriage administers to herself or consent to be administered to her any poison, drug or other noxious thing or uses any instrument or other means whatsoever; or
    2. any person who—
      1. administers to a woman any poison, drug or other noxious thing or uses any instrument or other means whatsoever with intent to cause abortion or miscarriage, whether or not the woman is pregnant or has given her consent
      2. induces a woman to cause or consent to causing abortion or miscarriage;
      3. aids and abets a woman to cause abortion or miscarriage;
      4. attempts to cause abortion or miscarriage; or
      5. supplies or procures any poison, drug, instrument or other thing knowing that it is intended to be used or employed to cause abortion or miscarriage; shall be guilty of an offence and liable on conviction to imprisonment for a term not exceeding five years.
  2. It is not an offense under section (1) if an abortion or miscarriage is caused in any of the following circumstances by a registered medical practitioner specializing in Gynaecology or any other registered medical practitioner in a government hospital or a private hospital or clinic registered under the Private Hospital and Maternity Home Act, 1958 (No. 9) or in a place approved for the purpose by legislative instrument made by the Secretary:
    1. where pregnancy is the result of rape or defilement of a female idiot or incest and the abortion or miscarriage is requested by the victim or her next of kin or the person in loco parentis, if she lacks the capacity to make such request;
    2. where the continuance of the pregnancy would involve risk to the life of the pregnant woman or injury to her physical or mental health and such a woman consents to it or if she lacks the capacity to give such consent it is given on her behalf by her next of kin or the person in loco parentis;
    3. where there is substantial risk that if the child were born it may suffer from or later develop a serious physical abnormality or disease.
  3. For the purposes of this section, abortion or miscarriage means premature expulsion or removal of conception from the uterus or womb before the period of gestation is completed.

Statistics

According to national statistical data from 2009, 7% of all pregnancies are aborted. Within the population of women between 15 and 49, 15% have had abortions. [3] For every 1,000 women in Ghana of childbearing age of 15 to 44, 15 abortions are performed. Another study carried out in the 1990s suggested that in southern Ghana, the number is marginally higher, at 17 abortions for every 1,000 women. [4] This number is lower than the statistics available for West Africa as a whole: abortions rates are at 28 per 1,000 women [5]

Ghanaian women of the following demographics are more likely to have abortions: women who have never been married; women in their twenties; women with no children; wealthy women; and women from urban areas. Never-married women are twice as likely to seek the procedure as those who are married. The tendency to seek abortion decreases with number of children: women with no children are seven times more likely to seek an abortion than women with three or more children. For these women, the most prominent reason for seeking the abortion was the stigma associated with having a child out of wedlock. Women who have had previous abortions are far more likely to seek the procedure. Researchers peg this to the possibility that these women may have more knowledge, both of the legal status of abortions, and more likely, where to obtain the procedure. Women in the top 40% of the wealth distribution in the country are 67%–80% more likely to have abortions that their poorer counterparts. [6] Younger women are more likely to seek abortions, with women between 20 and 24 years being most likely, at 25 abortions per 1,000 women, and the frequency decreasing with every successive age group. [3] Urban women are far more likely to have abortions, with 34 abortions per 1,000 women. Overall, urbanites are 110% more likely to seek abortions than their rural counterparts, at 21 abortions per 1,000 women versus 10 abortions per 1,000 women.

The reasons that Ghanaian women give for seeking abortions include: the financial inability to care for a child, the pregnancy interfering with their occupation or schooling, and wanting to space out their childbearing or to limit family size. [7] [8] [9] Due to limited number of legal practitioners who perform safe abortion, it is expensive; therefore many women cannot afford it and they turn to unsafe abortion by unskilled practitioners. [10]

Approximately 45% of abortions in Ghana are unsafe. [6] 11% of Ghanaian maternal deaths are due to unsafe abortions, [3] and maternal mortality is the second leading cause of death among Ghanaian women. Some women experience complications from these experiences. Because so few women know that abortions are legal on many grounds in Ghana, they do not seek, or demand post abortion care, even when they have legitimate reasons to obtain legal abortions. [3] According to a 2007 survey, only 3% of pregnant women, and 6% of women actively seeking abortions, knew the laws surrounding the procedure. [6]

These numbers are relatively unreliable, because of how stigmatized abortions are in Ghana. Much of this data was collected based on face-to-face interviews, rendering it unlikely that they will reveal an accurate estimate of the occurrence of abortions. According to a paper, the number of abortions in Ghana is more likely to be closer to the West African rate of 28 per 1,000 women. [6]

Abortion and Contraceptives

The low rate of contraceptive use is part of the driver for abortions. [6] According to national statistical data, contraceptive use has increased over the decades, but from 13% use by married women in 1988, to just 25% by this demographic in 2003 followed by a slight decline to 24% in 2008. [8] A much higher proportion of sexually active unmarried women use modern contraceptives, but in 2008, this number was just 28% of the population. As such, 35% of married women, and 20% of sexually active unmarried married fall in the pool of people who are not seeking children, and yet are not using any modern contraceptive methods.

As a consequence of this dearth, upwards of 37% of pregnancies in Ghana are unintended. A further 23% are mistimed, that is to say, do not occur at a time preferred by the individuals. 14% of all pregnancies are not wanted by the individuals pregnant. This translates to more than 300,000 children being products of unwanted pregnancies. [7]

Overall, the average number of children Ghanaian women have has decreased from 6.4 to 4.0 between 1988 and 2008. [8] Nonetheless, this does not match the recorded desire of women, who wish to have fewer than four children. For more than a third of these women who are not looking for children nor are on contraceptives, the reason they give for not doing so are often health related, or a fear of the side effects and the risks associated with the use of contraceptives. The proportion of women in this pool rises with education and urbanity. Poorer women are overall more likely to have unplanned births, and less likely to use modern contraceptives, than their wealthier counterparts. [6]

Related Research Articles

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.

Therapeutic abortion committees were committees established under the Canadian Criminal Code. Each committee consisted of three medical doctors who would decide whether a request for an abortion fit within the exception to the criminal offence of procuring a miscarriage, i.e. performing an abortion. The Criminal Code only permitted lawful abortion if continuation of a pregnancy would cause a woman medical harm, as certified by a TAC. The TACs were almost always composed of men, due to fewer women practicing medicine and even fewer having these types of high level positions. These restrictions on abortion were struck down as unconstitutional by the Supreme Court of Canada in its decision in R v Morgentaler in 1988.

<span class="mw-page-title-main">Self-induced abortion</span> Abortion performed by a pregnant person themselves outside the recognized medical system

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.

<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 is illegal in El Salvador. The law formerly permitted an abortion to be performed under some limited circumstances, but in 1998 all exceptions were removed when a new abortion law went into effect.

Abortion has been legal in India under various circumstances with the introduction of the Medical Termination of Pregnancy (MTP) Act, 1971. The Medical Termination of Pregnancy Regulations, 2003 were issued under the Act to enable women to access safe and legal abortion services.

Abortion in Japan is allowed under a term limit of 22 weeks for endangerment to the health of the pregnant woman, economic hardship, or rape. Chapter XXIX of the Penal Code of Japan makes abortion de jure illegal in the country, but exceptions to the law are broad enough that it is widely accepted and practiced. Exceptions to the prohibition of abortion are regulated by the Maternal Health Protection Law that allows approved doctors to practice abortion on a woman if the pregnancy was the result of rape or if the continuation of the pregnancy endangers the maternal health because of physical or economic reasons. Anyone trying to practice abortion without the consent of the woman will be prosecuted, including the doctors. If a woman is married, consent from her spouse is also needed to approve abortions for socioeconomic reasons, although the rule doesn't apply if she is in a broken marriage, suffering abuse, or other domestic issues. Despite the partner's consent not being necessary for unmarried women and women who were impregnated by abusive partners or through rape, many doctors and medical institutions seek a signature from the man believed to have made the woman pregnant for fear of getting into legal trouble, rights advocates say.

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.

Unintended pregnancies are pregnancies that are mistimed or unwanted at the time of conception, also known as unplanned pregnancies.

The Dominican Republic is one of 24 countries in the world and one of six in Latin America that has a complete ban on abortion. This complete ban includes situations in which a pregnant person’s life is at risk.

Foeticide, or feticide, is the act of killing a fetus, or causing a miscarriage. Definitions differ between legal and medical applications, whereas in law, feticide frequently refers to a criminal offense, in medicine the term generally refers to a part of an abortion procedure in which a provider intentionally induces fetal demise to avoid the chance of an unintended live birth, or as a standalone procedure in the case of selective reduction.

Pregnancy is a potential result of rape. It has been studied in the context of war, particularly as a tool for genocide, as well as in other unrelated contexts, such as rape by a stranger, statutory rape, incest, and underage pregnancy. The current scientific consensus is that rape is at least as likely to lead to pregnancy as consensual sexual intercourse, with some studies suggesting rape may actually result in higher rates of pregnancy than consensual intercourse.

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 in Azerbaijan is legal on request up to 12 weeks of pregnancy, and in specific circumstances between 12 and 28 weeks. The current abortion law of Azerbaijan is based on the abortion law of the Soviet Union of 1955 when Azerbaijan was a Republic of the Soviet Union, and no changes were made after Azerbaijan became independent in 1991. Between 1965 and 1987 the abortion rate used to be very high. Since independence, the abortion rate has almost halved and relatively stabilized after 2000. In the 2014, 13.8% of pregnancies in Azerbaijan ended in abortion, a slight rise from the all-time low recorded in 2005 (12.1%).

Childbirth in Ghana is often seen as a joyous occasion in Ghanaian society, as children represent wealth, status, and the continuation of a lineage. Pregnant women are often given special privileges and are considered to be beautiful, fragile, and vulnerable to evil spirits. Therefore, women may seek guidance from a religious or spiritual diviner to protect their fetus or to increase their chances of conceiving. For example, the Akan may carry akuaba dolls, a fertility symbol, during pregnancy to ensure that they will birth a healthy and beautiful baby that resembles the doll's exaggerated features.

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 Guatemala is illegal, except when needed to save the woman's life. Abortion was illegal without exception prior to 1973. Congressional Decree 17-73 altered the penal code to allow abortion in cases in which the pregnant woman's life is endangered in September 1973. The procedure must be done by a physician and approved by a second doctor.

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> Termination of pregnancy in Kenya

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.

References

  1. 1 2 3 Abortion or miscarriage. Consolidation of Criminal Code of Ghana, 1960. Act 29. Section 58. 1999. Dec 10, pp. 37–38
  2. ↑ Moscrop, Andrew (2013-02-21). "'Miscarriage or abortion?' Understanding the medical language of pregnancy loss in Britain; a historical perspective". Medical Humanities. 39 (2): 98–104. doi:10.1136/medhum-2012-010284. ISSN   1468-215X. PMC   3841747 . PMID   23429567.
  3. 1 2 3 4 Ghana Statistical Service (GSS), Ghana Health Service (GHS) and Macro International, Ghana Maternal Health Survey 2007, Accra, Ghana: GSS and GHS; and Calverton, MD, USA: Macro International, 2009.
  4. ↑ Ahiadeke, Clement (June 2001). "Incidence of Induced Abortion in Southern Ghana". International Family Planning Perspectives. 27 (2): 96–108. doi:10.2307/2673822. ISSN   0190-3187. JSTOR   2673822.
  5. ↑ World Health Organization (WHO), Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2003, fifth ed., Geneva: WHO, 2007
  6. 1 2 3 4 5 6 Sedgh, Gilda (2010). "Abortion in Ghana" (PDF). Guttmacher Institute (2): 1–4. PMID   20653094.
  7. 1 2 Aboagye PK et al., An Assessment of the Readiness to Offer Contraceptives and Comprehensive Abortion Care in the Greater Accra, Eastern, and Ashanti Regions of Ghana, Chapel Hill, NC, USA: Ipas, 2007.
  8. 1 2 3 Blanc AK and Grey S, Greater than expected fertility decline in Ghana: untangling a puzzle, Journal of Biosocial Science, 2002, 34(4):475-495.
  9. ↑ Baiden FK et al., Unmet need for essential obstetric services in a rural district in Northern Ghana: complications of unsafe abortions remain a major cause of mortality, Journal of the Royal Institute of Public Health, 2006, 120(5):421–426.
  10. ↑ Morhee RAS and Morhee ESK, "Overview of the law and availability of abortion services in Ghana", Ghana Medical Journal, September 2006, 40(3): 80-86
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