Abort abortion law, ministry says

20 October 2021 | Health

JEMIMA BEUKES



WINDHOEK

The Abortion and Sterilisation Act 2 of 1975 is obsolete and must be discarded for more comprehensive legislation that speaks to the realities on the ground, including the effects of unsafe abortions on women, the ministry of health said yesterday.

The ministry’s executive director Ben Nangombe made this damning call at the public hearing on abortion in Namibia.

He emphasised that the new draft bill will look at the safety of women and the impact of unsafe abortions on public health, including the use of long-acting contraceptives.

According to him, the strong opposition to calls to liberalise abortion - which resulted in the stigmatising of women who have had an abortion - has bred a situation where backstreet and unsafe abortions continue unabated, putting women’s lives at risk.

A study by the Guttmacher Institute stated that about 121 million unplanned pregnancies occurred each year between 2015 and 2019, and about 61% of all unplanned pregnancies end in abortion.

“What about the situation in Namibia? The contribution of unsafe abortion to maternal deaths in Namibia is not fully known. According to available data, reporting on two separate surveys, the contribution of unsafe abortions ranges from 12% to 16%.

“In an assessment by the health ministry in 2006, 20% of obstetric complications were attributed to abortions,” Nangombe said.

Public health issue

In 2018, former health minister Dr Bernard Haufiku reported that - at the time - 7 335 illegal abortions were recorded at state facilities in 2017 alone, and he cautioned that the figure may reach 10 000.

Globally, there is ample evidence pointing to the significant and growing burden of unsafe abortions as a major cause of maternal mortality and morbidity, with increasing calls from the World Health Organisation (WHO) to address unsafe abortions as a major public health issue.

Nangombe said for Namibia, this reality, coupled with the fact that Namibia ratified the Convention on the Elimination of All Forms of Discrimination Against Women without any reservations in November 1992, calls for a review of the current law.

“It becomes important to look at some concepts as public health imperatives to inform public policy and in line with the precepts of the Namibian Constitution. “These concepts are: Autonomy and family planning, and the right to life as it relates to safe/unsafe abortion. A balance needs to be struck on these principles,” he said.

Nangombe also pointed out that the right to reproductive choice means that women have a right to choose whether or not to reproduce, including the right to decide whether to carry or terminate an unwanted pregnancy, and the right to choose their preferred method of family planning and contraception.

Mother comes first

Meanwhile, Dr David Emvula, who presented the position of the Medical Society of Namibia, explained that in clinician circles, they argue that there cannot be a baby if there is not a safe mother, which ultimately means the mother’s life comes first.

“If there is any serious threat to the mother’s life, then this is one of the indications where abortion can be considered. Also, when there is a serious risk to the child or the foetus, for example, if babies are born without a brain, picked up with an ultrasound. It is then also allowed to terminate the pregnancy.

“We know an X-Ray can be harmful to a foetus but we cannot withhold if it can help us to make a diagnosis to treat the mother to deliver a healthy baby. For us, the foetus is secondary,” he said.

Emvula also highlighted that pregnant women are not killed by the abortion process but rather the complications of these procedures, which includes profuse bleeding. Some women may even bleed to death, he said.

Effects of unsafe abortions

“These unskilled people [conducting unsafe abortions] are not even aware of the anatomy structure of a woman’s body and just poke, which makes a woman more likely to be injured and which can also potentially cause the death of these women.”

Then there’s blood incompatibility, which he explained as the foetus having a genetic make-up of its own. “If it starts bleeding and mixes with your blood, it may cause some complications, even to your future pregnancies,” Emvula warned.

“Unsafe abortions can also potentially lead to physical, mental or functional disability.

“We have seen patients who became critically ill; they were admitted to the intensive care unit [ICU] but never returned to their pre-procedure status,” he said.

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