Abortion in Uganda

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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. [1] [2]

Contents

With women lacking access to safe and legal abortions, many of them turn to unsafe abortion practices, such as self-induced abortions. The Ugandan Ministry of Health in the Annual Health Sector Performance Report of 2017-2018 estimates that as of 2018, 5.3% of all maternal deaths result from abortion complications. [3]

There are many legal and socioeconomic barriers to safe abortion and other family planning services, which often results in women using unsafe abortion methods and being deterred from seeking post-abortion medical care. [4] [5] Contraception is also not commonly used or easily accessible, which leads to Ugandan women having more children than they desire and increases the number of women resorting to unsafe abortions. [6] [7]

The Ugandan Constitution, in Article 22, item 2 states: "No person has the right to terminate the life of an unborn child except as may be authorised by law." [8] Abortion is thus criminalized in Uganda unless it is done by a licensed and registered physician to save a woman's life or preserve the physical or mental health of the woman. [9] [10]

The Ugandan Ministry of Health's 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights lays out a number of specific cases in which women have the right to seek an abortion, including rape, sexual violence or incest, or when the woman has pre-existing conditions such as HIV or cervical cancer. [11] However, many healthcare providers remain unaware of the expansiveness of cases when abortion is allowed, resulting in legal abortion access still being difficult. [7]

Laws on abortion

The Penal Code of 1950 states in Section 141, "Attempts to procure abortion":

Any person who, with intent to procure the miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means, commits a felony and is liable to imprisonment for fourteen years. [12]

Section 142 deems an attempt to procure an unlawful abortion is punishable by imprisonment of seven years, and Section 143 states that anyone who aids a woman in performing an unlawful abortion can be imprisoned up to three years. [13]

Nonetheless, Section 224 of the Code provides that a person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon an unborn child for the preservation of the mother's life. [14] In addition, Section 205 of the Code provides that no person shall be guilty of the offence of causing by willful act a child to die before it has an independent existence from its mother if the act was carried out in good faith for the purpose of preserving the mother's life.

Common law applications to Ugandan abortion law

Uganda, like a number of Commonwealth countries whose legal systems are based the English common law, follows the holding of the 1938 English Rex v Bourne decision in determining whether an abortion performed for health reasons is lawful. [11] In the Bourne decision, a physician was acquitted of the offence of performing an abortion in the case of a 15 year-old girl who had been raped. [15] The English Court ruled that the abortion was lawful because it had been performed to prevent the woman from becoming "a physical and mental wreck", thus setting a precedent for future abortion cases performed on the grounds of preserving the pregnant woman's physical and mental health.

Government family planning

Unintended pregnancy is the most commonly cited reason that Ugandan women seek abortions. [16] Thus, family planning programs are one way to lower the prevalence of illegal and/or unsafe abortions.

In 1988, the Ugandan government launched a comprehensive program in response to the country's high fertility and growth rates, which adversely affected per capita incomes and threatened the sustainability of social services. [17] The major goal was to increase the contraceptive rate from 5% to 20% by 2000. For instance, the program made birth control accessible at clinics across the country operated by the Family Planning Association of Uganda. [17] There was direct support provided in the government's policy on contraceptive use, and since 1995, 8% of married women aged 15 to 49 use contraception. [17] The total fertility rate from 1995 to 2000 was 7.1, and the age specific fertility rate per 1,000 women aged 15 to 19 from 1995 to 2000 was 180. [18] As of 2018, Uganda's total fertility rate stands at 5.5 children born per 1,000 women. [18]

However, the demand for modern contraception—especially emergency contraception—is still unmet. [19] Many Ugandan women cite a lack of access to family planning services or information as an explanation for not using contraceptives. [19]

In 2014, the Ministry of Health launched the Family Planning Costed Implementation Plan (CIP) with a goal of increasing education and access to family planning for Ugandans. [20] This commitment to increasing access to family planning has had tremendous impact, with a study revealing that the contraceptive prevalence rate has jumped to 39% as of 2016, while maternal mortality ratios have dropped by around 25%. [21]

Post-abortion care

Post-abortion care is not explicitly criminalized in Uganda. [22] In fact, healthcare providers who treat women for bleeding, infections, or other post-abortion complications are forbidden by law from interrogating their patients or reporting them to the authorities. [23] However, the police often does not care to differentiate between abortion and post-abortion care, leading to healthcare workers who provide either being punished just the same. [22]

In Uganda, 89% of healthcare facilities with the capacity to provide post-abortion care actively treat post-abortion complications. [24] However, according to Uganda's Minister of State for Health for General Duties, Sarah Opendi, an annual loss of 25 billion Uganda shillings occurred as a result of post-abortion care and treatment from unsafe abortions. [25] Additionally, it was found that on average, three quarters of women who utilized unsafe abortion methods suffered from a loss of productivity and more than a third of women ended up worse off economically. [26] As such, the argument for increasing access to safe abortion services and family planning services, which leads to reduced unsafe abortions and reduced need for costly post-abortion care, is often framed in economic terms. [26]

Discourse on abortion in Ugandan society

Abortion rights and anti-abortion movements exist in Uganda. [23] As a Christian majority country, much of the discourse on abortion is shaped by strong conservative religious forces, which argue that abortion is akin to murder and which influence anti-abortion policies. [27] Along these lines, the Pro-Life Organisation, a global Christian movement, has gained popularity in Uganda in recent years. [28] In 2013, Pro-Life was joined by over 100 delegates from the U.S., United Kingdom, Uganda, and Spain in a three-day workshop that advocated against abortion. [29]

At the same time, there have been increasing calls for the liberalization of Uganda's abortion laws. [23] Abortion rights discourse often centers around human rights arguments, specifically that a pregnant woman has the right to health, life, and choice. [27] Medical arguments also support this, saying that liberalized abortion laws and expanded access to safe abortions have led to improved women's health. [27]

See also

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.

<span class="mw-page-title-main">Family planning</span> Planning when to have children

Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marital situation, career or work considerations, financial situations. If sexually active, family planning may involve the use of contraception and other techniques to control the timing of reproduction.

Reproductive rights are legal rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world. The World Health Organization defines reproductive rights as follows:

Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence.

<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.

<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 in Iran, as can be expected of many government policies, changed drastically between governments.

Abortion is illegal in the Philippines.

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.

<span class="mw-page-title-main">Birth control in the United States</span> History of birth control in the United States

Birth control in the United States is available in many forms. Some of the forms available at drugstores and some retail stores are male condoms, female condoms, sponges, spermicides, over-the-counter progestin-only contraceptive pills, and over-the-counter emergency contraception. Forms available at pharmacies with a doctor's prescription or at doctor's offices are oral contraceptive pills, patches, vaginal rings, diaphragms, shots/injections, cervical caps, implantable rods, and intrauterine devices (IUDs). Sterilization procedures, including tubal ligations and vasectomies, are also performed.

Reproductive coercion is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and control related to reproductive health by a current, former, or hopeful intimate or romantic partner, but they can also be perpetrated by parents or in-laws. Coercive behaviors infringe on individuals' reproductive rights and reduce their reproductive autonomy.

Abortion in Cuba is legal and available upon request, which is rare in Latin America because of widespread Catholic influence.

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

Access to safe and adequate sexual and reproductive healthcare constitutes part of the Universal Declaration of Human Rights, as upheld by the United Nations.

<span class="mw-page-title-main">Prevalence of birth control</span> Overview article

Globally approximately 45% of those who are married and able to have children use contraception. As of 2007, IUDs were used by about 17% of women of child bearing age in developing countries and 9% in developed countries or more than 180 million women worldwide. Avoiding sex when fertile is used by about 3.6% of women of childbearing age, with usage as high as 20% in areas of South America. As of 2005, 12% of couples are using a male form of contraception with rates of up to 30% in the developed world.

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 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">International Family Planning and Development</span>

International family planning programs aim to provide women around the world, especially in developing countries, with contraceptive and reproductive services that allow them to avoid unintended pregnancies and control their reproductive choices.

<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.

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

References

  1. ↑ "HEALTH SECTOR DEVELOPMENT PLAN 2015/16 - 2019/20" (PDF).
  2. ↑ Moore, Ann M.; Kibombo, Richard; Cats-Baril, Deva (2014). "Ugandan opinion-leaders' knowledge and perceptions of unsafe abortion". Health Policy and Planning. 29 (7): 893–901. doi: 10.1093/heapol/czt070 . PMID   24064047.
  3. ↑ "Annual Health Sector Performance Report 2017/18 | Ministry of Health Knowledge Management Portal". library.health.go.ug. Retrieved 2019-07-23.
  4. ↑ Abortion in Uganda. (2013). Retrieved June 16, 2016, from https://www.guttmacher.org/fact-sheet/abortion-uganda#6
  5. ↑ Olson, Rose Mckeon; Kamurari, Solomon (2017). "Barriers to safe abortion access: Uterine rupture as complication of unsafe abortion in a Ugandan girl". BMJ Case Reports. 2017: bcr-2017-222360. doi:10.1136/bcr-2017-222360. PMC   5665318 . PMID   29054903.
  6. ↑ Migiro, Katy (21 November 2013). "Uganda women unable to get contraception, dying from unsafe abortions". Thomas Reuters Foundation.
  7. 1 2 Prada, Elena; Atuyambe, Lynn M.; Blades, Nakeisha M.; Bukenya, Justine N.; Orach, Christopher Garimoi; Bankole, Akinrinola (2016-11-01). "Incidence of Induced Abortion in Uganda, 2013: New Estimates Since 2003". PLOS ONE. 11 (11): e0165812. Bibcode:2016PLoSO..1165812P. doi: 10.1371/journal.pone.0165812 . ISSN   1932-6203. PMC   5089684 . PMID   27802338.
  8. ↑ Constitution of the Republic of Uganda, 1995. http://www.parliament.go.ug/new/images/stories/constitution/Constitution_of_Uganda_1995.pdf
  9. ↑ Larsson, Sofia; Eliasson, Miriam; Klingberg Allvin, Marie; Faxelid, Elisabeth; Atuyambe, Lynn; Fritzell, Sara (2015-06-25). "The discourses on induced abortion in Ugandan daily newspapers: a discourse analysis". Reproductive Health. 12 (1): 58. doi: 10.1186/s12978-015-0049-0 . ISSN   1742-4755. PMC   4481262 . PMID   26108479.
  10. ↑ "Population Policy Data Bank." United Nations. The Population Division of the Department of Economic and Social Affairs of the United Nations Secretariay, n.d. Web. 25 Oct. 2014.
  11. 1 2 "10 Key Points About Uganda's Laws and Policies on Termination of Pregnancy" (PDF). Center for Reproductive Rights . November 2011.
  12. ↑ The Penal Code Act. Chapter 120. http://www.wipo.int/wipolex/en/text.jsp?file_id=170005 (WIPO Lex)
  13. ↑ Prada, Elena, et al. "Incidence of induced abortion in Uganda, 2013: new estimates since 2003." PLOS ONE 11.11 (2016).
  14. ↑ "New Report Exposes Impact of Uganda's Abortion Law Through Personal Stories | Center for Reproductive Rights". reproductiverights.org. 28 July 2016. Retrieved 2020-03-29.
  15. ↑ "Rex v. Bourne". msu.edu. Retrieved 2020-03-29.
  16. ↑ "Contraception and Unintended Pregnancy in Uganda". Guttmacher Institute. 2016-02-14. Retrieved 2020-03-30.
  17. 1 2 3 Use, National Research Council (US) Working Group on Factors Affecting Contraceptive (1993). Family Planning Programs and Policies. National Academies Press (US).
  18. 1 2 "Fertility rate, total (births per woman) | Data". data.worldbank.org. Retrieved 2019-09-05.
  19. 1 2 "Contraception and Unintended Pregnancy in Uganda". Guttmacher Institute. 2016-02-14. Retrieved 2020-03-29.
  20. ↑ "Family Planning in Uganda" (PDF). Reproductive Health Uganda. June 2018. Retrieved 2020-03-29.
  21. ↑ "Uganda Makes Strides In The Family Planning Reproductive Health Indicators | JHU - Advance Family Planning". www.advancefamilyplanning.org. Retrieved 2020-03-30.
  22. 1 2 "Facing Uganda's Law on Abortion" (PDF). Center for Reproductive Rights. July 2016. Retrieved 2020-03-29.
  23. 1 2 3 Scheier, Rachel (27 August 2007). "Pro-Choice Ugandans Steer a Gradual Course". Women's eNews. Retrieved 2020-03-29.
  24. ↑ "Abortion and Postabortion Care in Uganda" (PDF).
  25. ↑ "Uganda loses sh25b in post-abortion care-Opendi". www.newvision.co.ug. Retrieved 2019-07-24.
  26. 1 2 Coast, Ernestina; Lattof, Samantha R.; Rodgers, Yana van der Meulen; Moore, Brittany (2019-07-01). "Economics of abortion: a scoping review protocol". BMJ Open. 9 (7): e029939. doi: 10.1136/bmjopen-2019-029939 . ISSN   2044-6055. PMC   6678010 . PMID   31366662.
  27. 1 2 3 Larsson, Sofia; Eliasson, Miriam; Klingberg-Allvin, Marie; Faxelid, Elisabeth; Atuyambe, Lynn; Fritzell, Sara (2015-06-26). "The discourses on induced abortion in Ugandan daily newspapers: A discourse analysis". Reproductive Health. 12: 58. doi: 10.1186/s12978-015-0049-0 . PMC   4481262 . PMID   26108479.
  28. ↑ Lukwago, Juliet (2013-09-01). "Uganda: World Workshop Against Abortion Opens At Namugongo". AllAfrica. Retrieved 2020-03-29.
  29. ↑ Lukwago, Juliet (1 September 2013). "Uganda: World Workshop Against Abortion Opens At Namugongo". AllAfrica.com.
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