Abortion in Tanzania

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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.

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It is estimated that there were 405,000 induced abortions in Tanzania in 2013. Due to fears of prosecution, women procure abortions clandestinely, often in conditions that are unsafe. Tanzania has one of the highest maternal mortality ratios in the world, with unsafe abortions being one of the leading causes of maternal death. The availability of the medication misoprostol has led to increased access to safe abortion.

While Tanzania is a signatory to the Maputo Protocol, it has not adopted legislation that would allow abortion in cases of pregnancy from rape, incest, or risk of harm to the mental and physical health of the mother. A Safe Motherhood Bill that would have aligned Tanzanian law with the Maputo Protocol was rejected by the National Assembly in 2012.

Legality

Tanzania has one of the most restrictive abortion laws in the world, with abortion only allowed to save the life of the mother. People convicted of performing abortions can be imprisoned for up to 14 years, while women convicted of procuring an abortion can be imprisoned for up to seven years. Other parties involved in an illegal abortion, such as those who supply medications or instruments, may be imprisoned for up to three years. [1]

Penal code

Tanzania's abortion laws originated with legal codes imposed during British colonial rule. In mainland Tanzania, Articles 150 to 152 of the penal code prohibit unlawful abortion, while Article 230 permits abortion to preserve the life of the mother. Chapter XV of the country's penal code regards abortion as an "offense against morality" [1] and Article 219 additionally prohibits "child destruction", meaning abortion after fetal viability, presumed at 28 weeks of pregnancy, unless it is done to preserve the life of the mother. [2] In Zanzibar, the penal act has equivalent articles 129 to 131, 213 and 200. [3]

The right to abortion due to risk to the health of the mother is not explicitly mentioned in Tanzanian law. The judicial decision in the 1938 British court case Rex v Bourne was affirmed by the East African Court of Appeal, which had jurisdiction over Tanganyika Territory, Tanzania's colonial predecessor. The decision interpreted preserving a woman's life as preserving both her physical and mental health. Sources state that the affirmation of this decision remains binding after independence. [4]

The penal code does not specify the type of healthcare provider who determines eligibility for abortions or require consultation with other healthcare professionals. Therefore, mid-level workers such as midwives may perform abortions without being required to consult others. [5]

International treaties and instruments

Tanzania is a signatory to the Convention on the Elimination of All Forms of Discrimination Against Women and the African Charter on Human and Peoples' Rights. [1] In 2007, Tanzania ratified the Maputo Protocol, which requires the government to "protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, [and] incest, and where the continued pregnancy endangers the mental and physical health of the [pregnant woman] or the life of the [pregnant woman] or the foetus." Despite ratification, provisions beyond those for preserving the life of the mother have not been incorporated into national law. [5]

Prevalence

Despite the illegality of abortion in Tanzania, clandestine abortion services are often accessible to those who can afford them, especially in urban areas such as Dar es Salaam. [5] Abortion-related prosecutions are not unheard of, but are rare. [6] In 2013, it is estimated that there were 405,000 induced abortions in Tanzania. [7]

As of 2017, the total fertility rate in Tanzania was 5.0 percent and contraceptive use stood at around 25 percent. [5] As of 2010, 26 percent of births in the country were from unintended pregnancies. [7]

According to statistics from Tanzanian hospitals, there are 36 induced abortions per 1000 women. Self-induced abortions in Tanzania have reportedly involved the insertion of sharp objects into the uterus, high doses of anti-microbial drugs, detergents, concentrated teas, cassava stems, or wood ashes. [6] Some women later experience infections, bleeding, complications during their later pregnancies, or death. Studies have suggested that nearly 60% of women who are admitted to hospitals for miscarriages have actually undergone abortions. [8]

Maternal deaths

Tanzania has one of the highest rates of maternal death in the world. The maternal mortality ratio was 398 per 100,000 live births in 2017. [5] Due to fears of prosecution, women seek to procure abortions clandestinely, often in conditions that are unsafe. [7] Unsafe abortions are estimated to be the second leading cause of maternal death in Tanzania. [1] A 2012 study by the Muhimbili University of Health and Allied Sciences found that one in three women who had abortions between the ages of 15 and 24 had the procedure done by a non-professional. [8] As of 2014, complications from abortions were responsible for around 16% of maternal deaths. [1]

The Ministry of Health and Social Welfare started a training program for post-abortion care in 2000. The ministry has also made efforts to address maternal death through its initiative, the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths. [7]

Availability of abortifacient medications

In 2007, the Tanzanian Food and Drugs Authority approved the medication misoprostol as a treatment for postpartum bleeding. [6] The medication was further approved for treating incomplete abortions in 2011. [5] While misoprostol is not approved for use as an abortifacient in Tanzania, it is commonly used to induce medical abortions. These usually occur outside of medical facilities and without medical supervision. [6]

Sentiment and advocacy

Politically and culturally, the people of Tanzania are largely anti-abortion. As of 2018, the majority of the population practices Christianity (60%) or Islam (35%). Public discourse in the country tends to frame abortion as a moral transgression or sin. [5]

A bill for a Safe Motherhood Act was introduced in the National Assembly in 2012. The bill proposed to align the country's laws with the Maputo Protocol by expanding abortion access to pregnancies resulting from rape or incest, where continuing the pregnancy would pose a substantial risk of the fetus having mental or physical abnormalities, or where a woman's mental or physical health would be threatened. The bill failed to pass. [5] During the mid-2010s Constitutional review process, the Women and the Constitution Coalition, a coalition of 50 Tanzanian women's rights groups, lobbied for the inclusion of sexual and reproductive health and rights in the Constitution. [1]

Efforts to liberalize the country's abortion laws have been supported by the Tanzania Women Lawyers Association (TAWLA), the East African Community, Care International, and the White Ribbon Alliance. [5] The organization Pro-Life Tanzania, operating under the auspices of the Catholic Church, was established in 1994. It receives funding from the U.S.-based Human Life International and actively counters initiatives that would allow for more permissive abortion policies in the country. [1]

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 reason women give for having an abortion is 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.

<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.

<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.

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 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.

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

Abortion in Namibia is restricted under the Abortion and Sterilisation Act of South Africa (1975), which Namibia inherited at the time of Independence from South Africa in March 1990. The act only allows for the termination of a pregnancy in cases of serious threat to the maternal or fetal health or when the pregnancy is a result of rape or incest. This law has not been updated since, and attempts to liberalise it have been met with fierce opposition from religious and women's groups.

Abortion in Turkey has been legal on request since May 27, 1983. Abortion is legal up to 10 weeks of pregnancy, and in special circumstances the time threshold can be extended if there is danger to the woman's life or the life of the fetus. During the ten weeks, an abortion is allowed for the following reasons: the pregnancy threatens the woman's mental and/or physical health, the fetus would be physically or mentally impaired, if the conception occurred through rape or incest, and economic or social reasons. The woman's consent is required. If the woman is under the age of 18, then parental consent is required. If the woman is married, the consent of the husband is also required. Single women over the age of 18 can choose to have an abortion on their own.

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.

Abortion in Zimbabwe is available under limited circumstances. Zimbabwe's current abortion law, the Termination of Pregnancy Act, was enacted by Rhodesia's white minority government in 1977. The law permits abortion if the pregnancy endangers the life of the woman or threatens to permanently impair her physical health, if the child may be born with serious physical or mental defects, or if the fetus was conceived as a result of rape or incest. Nevertheless, an estimated 70,000+ illegal abortions are performed in Zimbabwe each year, resulting in around 20,000 maternal deaths.

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 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 Samoa is only legal if the abortion will save the mother's life or preserve her physical or mental health and only when the gestation period is less than 20 weeks. In Samoa, if an abortion is performed on a woman for any other reason, or if a woman performs a self-induced abortion, the violator is subject to seven years in prison.

Abortion in Botswana is only legal if the abortion will save the woman's life, if the pregnancy gravely endangers the woman's physical or mental health, or if it is a result of rape or incest. In Botswana, abortions that meet these requirements must be performed within the first 16 weeks of pregnancy in a government hospital and must be approved by two physicians.

Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ 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 Ghana is legally permissible. 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 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. Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.

<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.

Abortion in Malaysia is generally legal to save the life of the mother or in cases where their physical or mental health is at risk, for the first 120 days of gestation, as regulated under Sections 312–316 of the Penal Code. However, specific legislation varies by state. Access to abortion in Malaysia has been hampered by religious, cultural and social stigmas against abortion, poor awareness of abortion legislation among health professionals and the high cost of abortion services in the private health sector. As a result, risky unsafe abortions are prevalent in Malaysia.

<span class="mw-page-title-main">Women in Zambia</span> Overview of the status of women in Zambia

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.

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

References

  1. 1 2 3 4 5 6 7 Sambaiga, Richard; Haukanes, Haldis; Moland, Karen Marie; Blystad, Astrid (December 2019). "Health, life and rights: a discourse analysis of a hybrid abortion regime in Tanzania". International Journal for Equity in Health. 18 (1). doi: 10.1186/s12939-019-1039-6 . PMC   6764130 . PMID   31558155.
  2. ↑ "The Penal Code, revised edition of 2019". Tanzania Legal Information Institute. Archived from the original on 4 December 2021.
  3. ↑ Penal Act, 2018, Zanzibar House of Representatives, 16 March 2018.
  4. ↑ A technical guide to understanding the legal and policy framework on termination of pregnancy in mainland Tanzania, Center for Reproductive Rights, 2012.
  5. 1 2 3 4 5 6 7 8 9 Blystad, Astrid; Haukanes, Haldis; Tadele, Getnet (December 2019). "The access paradox: abortion law, policy and practice in Ethiopia, Tanzania and Zambia". International Journal for Equity in Health. 18 (1): 126. doi: 10.1186/s12939-019-1024-0 . PMC   6764131 . PMID   31558147.
  6. 1 2 3 4 Solheim, I. H.; Moland, K. M.; Kahabuka, C.; Pembe, A. B.; Blystad, A. (1 January 2020). "Beyond the law: Misoprostol and medical abortion in Dar es Salaam, Tanzania". Social Science & Medicine. 245: 112676. doi: 10.1016/j.socscimed.2019.112676 . ISSN   0277-9536. PMID   31810016. S2CID   208812842.
  7. 1 2 3 4 Keogh, Sarah C.; Kimaro, Godfather; Muganyizi, Projestine (11 September 2015). "Incidence of Induced Abortion and Post-Abortion Care in Tanzania". PLOS ONE. 10 (9): e0133933. Bibcode:2015PLoSO..1033933K. doi: 10.1371/journal.pone.0133933 . PMC   4567065 . PMID   26361246.
  8. 1 2 Makoye, Kizito (13 January 2016). "Illegal abortions in Tanzania". DW.
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