Abortion in Guinea

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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.

Contents

The use of contraceptives is low, which leads to unwanted pregnancies and abortions, especially among adolescents. Rape is a frequent cause of abortion. Post-abortion care has been available in Guinea since the 1990s and is available at public facilities across the country. Nearly all of these facilities use manual vacuum aspiration, and most offer post-abortion family planning.

Legislation

Articles 262 and 263 of the penal code of Guinea prohibit abortion without a legal defense. The sentence for an illegal abortion is one to two years of prison and a fine of 500,000 to 5 million Guinean francs for first-time offenders. Repeat offenders may face 2 to 5 years in prison or a fine of 10 million francs. [1] The abortion ban is defined in a reproductive health law passed on 10 July 2000. [2] The country previously had a total abortion ban based on the Napoleonic Code. [3]

Legal therapeutic abortions require a diagnosis from a group of doctors that the woman cannot carry the pregnancy or the fetus would have defects. In the case of pregnancy from rape, an ethics committee may approve that the abortion is acceptable. [1] Minors can legally have abortions. [4]

Some lawyers say a woman can be imprisoned for receiving a non-therapeutic abortion even in the case of rape. Others believe that the ethical risks of pregnancy from rape are a ground for abortion under the penal code. [1] One legal interpretation says that the law does not penalize a woman who receives an abortion, but only the provider. [5]

Advocacy

Today's Women International Network, a women's rights group founded in Guinea, advocates for sexual and reproductive healthcare, including family planning and post-abortion care. [6] On 18–19 March, 2020, twenty journalists met in Conakry for a discussion on sexual and reproductive rights and abortion. They recommended that the government revise the 2000 law and introduce sexual education programs. [2] On 25 March 2021, le Réseau des Médias Africains pour la Promotion de la Santé et l’Environnement (transl. African Media Network for the Promotion of Health and Environment) held a forum to inform journalists about illegal abortions. Its coordinator urged the government to bring its abortion law in line with the Maputo Protocol. [7]

Prevalence

In 2015–2019, the annual number of pregnancies was 631,000, of which 204,000 were unwanted and 77,000 resulted in abortion. Between 1990–1994 and 2015–2019, the abortion rate increased 48% while the unintended pregnancy rate remained steady. [8] Guinea has a strong stigma about abortion. [9]

Guinea's rates of unsafe abortion and maternal mortality are among the highest in the world. [10] Safe abortion is only available in cases of fetal deformity or life-threatening pregnancy. The maternal mortality rate is 550 per 100,000 births. [11]

The low rate of contraceptive use contributes to unwanted pregnancies and unsafe abortions. [6] As of 1995, most girls aged 15-24 do not use birth control, and 25% have been pregnant, of which 22% resulted in abortion. [12] As of 2018, in Matoto sub-prefecture, 32.1% of sexually active secondary school girls have been pregnant, of which 30.8% had abortions. [13] Frequent rapes in the country lead to unwanted pregnancies and abortions. [1] Victims of sexual violence often face difficulty accessing emergency contraception, which may lead to unsafe abortions. [14]

Post-abortion care

As of 2014, 38 of the 456 public facilities in Guinea provide post-abortion care (PAC). National policy requires 122 of them to provide PAC. PAC is available at all but one national hospital, all regional hospitals, three-quarters of prefectural and municipal hospitals, and 3.8% of urban health centers. [15] The price of PAC is legally fixed. [11] As of 2015, 34.5% of PAC patients have severe complications. [10]

As of 2014, 31 of the 38 prefectures of Guinea have PAC facilities. There are 416 trained PAC providers, of which the most are in Conakry and Boké Prefecture and the fewest are in Labé Prefecture and Faranah Prefecture. Only 16% of providers are in rural areas, where 62% of Guineans live. [15] As of 2015, all regions have comprehensive PAC, with the highest coverage in Nzérékoré Region and the best performance in Boké Region. [10]

As of 2014, 94.7% of PAC facilities offer 24/7 care. Manual vacuum aspiration (MVA) is used at 99% of providers and long-acting reversible contraceptives (LARC) are available at 95%. As of 2013, 95.2% of patients receive post-abortion counseling and 73.0% get post-abortion family planning, of which 29.6% were LARC. The use of modern contraception is significantly higher among PAC patients than the national average of 7.0%. [15] In two hospitals in Conakry from April to August 2014, there were 426 PAC patients, all of which were treated with MVA. Of these patients, 92.5% were satisfied with their care. They reported low waiting times, satisfactory pain management, confidentiality, and access to their desired birth control. [11]

History

The 1994 International Conference on Population and Development led the government of Guinea to improve PAC services. [15] PAC was introduced to Guinea in 1998, following successful initiatives in Senegal and in Burkina Faso. The program debuted at Donka Hospital and Ignace Deen Hospital. The program was later introduced in 38 other public hospitals. [11]

The Ministry of Health's 2008–2012 Family Planning Repositioning Strategic Plan aimed to strengthen contraceptive use and PAC. In 2013, post-abortion contraceptive use was the highest in West Africa. [15] The frequency of PAC procedures went down during the COVID-19 pandemic. [16]

See also

Related Research Articles

<span class="mw-page-title-main">Sexual and reproductive health</span> State of the reproductive system without evidence of disease, disorders, or deficiencies

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 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.

In Trinidad and Tobago, abortion is illegal save for few exceptions. The respective laws are in place since 1925.

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

<span class="mw-page-title-main">Reproductive rights in Latin America</span>

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 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.

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.

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

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 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 Eswatini, abortion is a criminal offence. The 2005 Constitution of Eswatini allows exceptions if approved by a doctor. Providing or receiving an illegal abortion is punishable by life imprisonment.

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

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.

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

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 Zézé Guilavogui, Elisabeth (3 April 2022). "Avortement en cas de viol ou d'inceste : ce que dit la loi guinéenne…" [Abortion in the case of rape or incest: here's what the Guinean law says]. Le Djely (in French). Retrieved 14 August 2024.
  2. 1 2 Bah, Alhassane (21 March 2020). "Conakry : Des journalistes formés sur la santé sexuelle de reproduction". Guinéenews . Retrieved 14 August 2024.
  3. ↑ 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.
  4. ↑ 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 .
  5. ↑ Ibrahima, Olladi (9 March 2024). "«La loi guinéenne ne condamne pas une femme qui se fait avorter», Kalil Camara" ["The Guinean law does not condemn a woman who has an abortion", Kalil Camara]. Kale News (in French). Retrieved 14 August 2024.
  6. 1 2 "Today's Women International Network (TWIN) s'implique pour l'accès à la santé sexuelle et reproductive en Guinée" [Today’s Women International Network (TWIN) gets involved in access to sexual and reproductive health in Guinea]. Population Reference Bureau (in French). 7 September 2021. Retrieved 14 August 2024.
  7. ↑ Keita, Youssouf (26 March 2021). "Guinée : des acteurs de la société civile et médias imprégnés en DSSR" [Guinea: Civil society and media personnel imbued with SRH]. Mediaguinee (in French). Retrieved 14 August 2024.
  8. ↑ "Guinea country profile". Guttmacher Institute . 2022. Retrieved 14 August 2024.
  9. ↑ Assignon, Carole (7 April 2022). "L'avortement, un sujet délicat aussi en Afrique". Deutsche Welle (in French). Retrieved 14 August 2024.
  10. 1 2 3 Compaore, Rachidatou; Ouedraogo, Adja Mariam; Baguiya, Adama; Kpebo, Denise Olga; Sidibe, Sidikiba; Kouanda, Seni (19 April 2022). "Availability and Utilization of Postabortion Care Services in Burkina Faso, Côte d'Ivoire, and Guinea: A Secondary Analysis of Emergency Obstetric and Neonatal Care Needs Assessments (EmONC)". Health Services Insights. 15. doi: 10.1177/11786329221092625 . PMC   9021517 . PMID   35464819.
  11. 1 2 3 4 Millimouno, Tamba M.; Leno, Jean P.; Sidibé, Sidikiba; Bah, Oumou H.; Delamou, Alexandre; Hyjazi, Yolande (June 2020). "Assessment of Post-abortion Care Services in Two Health Facilities in Conakry, Guinea". African Journal of Reproductive Health . 24 (2): 96–105. doi:10.29063/ajrh2020/v24i2.9 (inactive 1 November 2024). PMID   34077095.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  12. ↑ Görgen, Regina; Yansané, Mohamed L.; Marx, Michael; Millimounou, Dominique (June 1998). "Sexual Behavior and Attitudes Among Unmarried Urban Youths in Guinea". International Family Planning Perspectives . 24 (2): 69. doi: 10.2307/2991927 . JSTOR   2991927.
  13. ↑ Diallo, Abdourahamane; Diallo, Yaya; Magassouba, Aboubacar Sidiki; Bah, Ibrahima Koussy; Sy, Telly (13 April 2020). "Rapports sexuels chez les élèves de la commune de Matoto à Conakry en Guinée" [Sexual intercourse among students in Matoto, Conakry, Guinea]. Pan-African Medical Journal . 35 (113): 113. doi: 10.11604/pamj.2020.35.113.20733 . PMC   7320788 . PMID   32637011.
  14. ↑ Kane, Coumba (29 September 2022). "Impunity for sex crimes is commonplace in Guinea". Le Monde . Retrieved 14 August 2024.
  15. 1 2 3 4 5 Pfitzer, Anne; Hyjazi, Yolande; Arnold, Bethany; Aribot, Jacqueline; Hobson, Reeti D.; Pleah, Tsigue G.; Turke, Shani; O'Colmain, Benita; Arscott-Mills, Sharon (22 August 2019). "Findings and Lessons Learned From Strengthening the Provision of Voluntary Long-Acting Reversible Contraceptives With Postabortion Care in Guinea". Global Health: Science and Practice. 7 (Supplement 2): S278–S284. doi:10.9745/GHSP-D-18-00344. PMC   6711623 . PMID   31455624.
  16. ↑ Millimouno, Tamba Mina; Dioubaté, Nafissatou; Nianou, Harissatou; Cellou Diallo, Mamadou; Maomou, Cécé; Sy, Telly; Diallo, Ibrahima Sory; Semaan, Aline; Delveaux, Thérèse; Beňová, Lenka; Delamou, Alexandre (25 March 2023). "Effect of the COVID-19 pandemic on maternal and neonatal health services in three referral hospitals in Guinea: an interrupted time-series analysis". Reproductive Health . 20 (1): 50. doi: 10.1186/s12978-023-01599-8 . PMC   10039677 . PMID   36966343.
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