Abortion: a social taboo
Life as we know it is the most sacred trust God has placed in mankind. And the lack of respect for life is a most heinous crime. However, there are many dilemmas one is faced with in terms of social sayings, and abortion is a significant problem. Ending a life in a woman’s body seems like a difficult situation, and it has turned into one of the greatest moral debates the world has seen. Moral judgment has made its way into state legislatures and the practice has been banned in many parts of the world.
We need to understand what abortion is and why women in Pakistan perform it when they know it is abhorred by society. There are two types of abortions that take place in Pakistan: safe and unsafe. The former are conducted in a clinical environment with all medical protocols in place, while the latter are performed in non-clinical facilities by untrained midwives, alley doctors and charlatans – putting women’s health at risk and resulting in horrific deaths. A national survey conducted by the Population Council in 2002 estimated that at least one in five pregnancies is terminated. Maternal deaths account for 20.3% of women of reproductive age, and deaths from unsafe abortions are around 5.6%. These are huge numbers.
Abortion, however, should not be defined as the use of contraceptives, as most clergy interpret it in their sermons, thus discouraging couples from using it. This trend has had serious repercussions on family planning and population control initiatives, but there are very symbolic efforts undertaken by the government to confront clerical teachings. In addition, since the transfer of responsibilities, no concrete measures have been taken at the provincial level for birth control initiatives.
In Pakistan, since 1997, abortion has been allowed within the first 120 days of conception in cases of rape, physical disability or threat to a woman’s life, but this law is largely unknown to most. practitioners, which leaves women in danger when seeking an abortion. In 1997, the Commission of Inquiry on Women made three recommendations. These were: 1) Allocations to the health and population sectors should be increased by 6% of GDP; 2) Regulations should be changed to ensure the right of women to have tubal ligation without the permission of their husbands; and 3) The right of women to have an abortion of their choice within 120 days of pregnancy be unambiguously declared their absolute right. These recommendations presented by Judge Nasir Aslam Zahid have never been legislated for clarity in the law.
Social factors play a central role in abortion cases. Sometimes abortion is performed without the will of women, forcing her to have an abortion if the child she is carrying is a woman. Sometimes she is forced to keep the child against her will. Whether women should have control over their bodies remains a heated debate, as religious injunctions are introduced to separate the dimension of control from that of women.
Most of the women seeking abortions belong to poorer social strata. Because of their lack of resources, they are unable to afford the private costs for safe abortions. The services they seek through traditional Daya are risky business, but women are powerless to seek safer options.
The inaccessibility of health services and the refusal to provide them to women remain the greatest challenge of maternal health services. Most cases that arrive at the hospital are usually complicated due to incomplete abortions that were performed by midwives and doctors in the background. Most of the cases treated are from private sector health care providers who reach about 70% of the population that the public service sector cannot reach. However, in the private sector, the income matrix of women seeking help is detrimental to the acquisition of quality of care.
There are a number of reasons why women seek an abortion; most often, due to rape. Another reason is low household income and the inability of women to support their unborn children. In fact, most women who wish to have an abortion live below the poverty line. The circumstances in which abortion is requested should not be ignored and facilities should be tailor-made to be better in sync with the local needs of women who wish to undergo the procedure.
The government should take into consideration the various recommendations presented to it on this subject. The fact that the female morbidity rate is on the rise means that swift action must be taken to address the grievances of women at risk. The situation needs to be monitored objectively, taking into account whether women will get an abortion whether or not there is a ban. The stigma of abortions must first be removed, before reaching an agreement with a woman who wishes to terminate her pregnancy. Postabortion care should be more systematized and streamlined to provide easy, accessible and essential care for those seeking an abortion. All of this cannot be done until the consent and will of women has become the deep basis for the conduct of abortion, and that of no one else.
The writer is a freelance columnist.