Greater access to safe abortions and revision of abortion laws became the rallying points among activists and researchers in the recent Regional Consultation on Unsafe Abortion in Africa held in Ethiopia on  March 21-23.
The meeting discussed ways to liberalise attitudes, laws and accessibility to safe abortions in Africa. More than 140 researchers, key government officials, health practitioners, advocates, and journalists from 16 African countries gathered in the Ethiopian capital of Addis Ababa to attend the consultation.

A silent war waged on women

Unsafe abortion continues to exert a heavy and negative impact on womens lives in Africa, said Eunice Brookman-Amissah, vice-president for Africa of Ipas, an international non-government organisation which co-organised the forum.

Most African countries prohibit abortion except in cases where the mothers life is in danger. This leaves women who are desperate to end unwanted pregnancies with nowhere to turn to but backstreet abortionists, placing their health and lives at risk in the process.

Some 4.2 million unsafe abortions take place in Africa every year, according to World Health Organisation (WHO) estimates. This results in about 30,000 deaths yearly, comprising 44% of the worlds abortion-related deaths. The WHO says virtually all these deaths are preventable, as are most of the unintended pregnancies that lead to abortion.

"There is a silent war waged against women, mostly in the developing world, and their right to reproductive health--especially to safe abortion. This war is fuelled byarchaic abortion laws," said Brookman-Amissah. "We need to ask ourselves whether we will allow old laws to kill women. If we have a law that kills people, we need to review it," she added.

Laws make a difference

Experience shows that changing laws does make a difference. South Africa--one of the few African states to have legalised abortion on demand--has drastically reduced the number of deaths related to termination of pregnancy.

"The number of women dying from abortion has plummeted. Initially, before the new law was established [in 1997], there were 425 deaths arising from abortion every year. Now the number is less than 20," said Roland Edgar Mhlanga, head of the Department of Obstetrics and Gynaecology at the University of KwaZulu-Natal in South Africa.

However, the forum noted that relaxation of abortion laws does not automatically translate to putting a stop to unsafe abortions. "Having the laws is one thing, and having the laws work for everyone is another thing. Laws must also be in place to ensure that these services are available to the poorest of the poor," argued Mhlanga.

We need to look at the accessibility of our services, he added. African women are 100 times more likely to die from unsafe abortions than European women.

Taking other factors into consideration

The conference likewise emphasised the importance of providing women with contraception to prevent unwanted pregnancies. According to Ethiopia Health Minister Tedros Adhanom, the low level of contraceptive usage in Ethiopia (just 14% of married women used this family planning method in 2005) has shown the need for more community health workers to provide counseling and distribute contraceptives.

Another factor to contend with in countries like Ethiopia, Kenya, and Nigeria are long-standing, religious codes, which carry powerful social weight.

Beyond these, making progress in reducing maternal mortality and making safe abortions available to women is complicated as well by American policy. Foreign-based organisations receiving US funding for family planning are forbidden from advocating abortion, according to Dr. Sharon Camp of the Guttmacher Institute, a co-organiser of the forum. The policy, often called Global Gag Rule, forbids as well provision of abortion services and counselling.

The meeting likewise called for more policy-oriented research with the goal of reducing maternal mortality and unsafe abortion, and pledged to form a new partnership to advance this. It is the initial phase of a larger effort aimed at bringing attention to unsafe abortions worldwide.

Sources:

Mulama, J. (2006). Health-Africa: Anti-abortion laws a "silent war waged against women." Retrieved on March 26, 2006 from Inter Press News Service <www.ipsnews.net/news.asp?idnews=32586>.

Neuhaus, L. (2006). Womens rights coalition calls for more research and greater access to abortions in Africa. In Push Journal. Associated Press. Retrieved March 27, 2006 from <www.pushjournal.com>.