The unending debate

Is abortion right or wrong? There is still no end to this old debate in most parts of the world.

It has remained an unresolved argument. Is abortion right or wrong? The debate has for long pitted the pro-choice movement against the pro-life movement. While the pro-choice movement contends that a woman’s right to abortion is absolute, the pro-life movement insists that the right of the foetus (baby in the womb) to life is indisputable.

But then, what exactly is abortion? David Oseyemwen, a resident doctor at the University of Benin Teaching Hospital, UBTH, describes it as the termination of an already implanted embryo within the womb of human. It is also the termination of pregnancy before the age of viability. The age of viability according to the standard of the World Health Organisation, WHO, is 24 weeks or if the foetus weighs less than 500 grams.

An abortion can occur spontaneously due to complications during pregnancy or can be induced in humans. An abortion that is induced to preserve the health of the pregnant female is termed a therapeutic abortion; while an abortion induced for any other reason is termed an elective abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages.

People give different reasons for terminating pregnancies. It is either they are too young, single or married but uninterested in having more children. Another circumstance under which abortion could be the only option is when the life of the mother is at risk either physically or mentally or conditions that put the unborn child at risk.

Maybe a doctor foresees that a child is going to be handicapped and it is going to be a burden to the parents and to the nation generally. At this stage, if the doctor knows that the chances of survival of the unborn baby are very slim, he could carry out abortion.

As far as Nigeria’s laws are concerned, induced abortion is legal only if it is done to save the woman’s life. And before abortion can take place on medical grounds, the doctor must seek the second opinion of another doctor. Jerry Osa Uwaifo, a gynaecologist, and chief medical director, Central Hospital, Benin City, has identified different kinds of abortion.

There is complete abortion which is a situation whereby the woman starts bleeding and she loses the pregnancy completely. Then, there is incomplete abortion where the woman starts bleeding, loses part of the pregnancy and some parts are retained before it is eventually evacuated.

There is the inevitable abortion. In this case, the woman is already on the verge of losing the pregnancy but it has reached a point where the doctor cannot save it and so it is inevitable. There is also what is called missed abortion.

Missed abortion is a situation whereby, the baby is no longer viable. And then there is septic abortion which occurs either from a missed abortion or the spontaneous abortion. Septic abortion means that the woman has been infected because of the abortion process.

The World Health Organisation, WHO, posits that safe and legal abortion is a fundamental right of women, irrespective of where they live. It, however, cautioned that unsafe abortion is a “silent pandemic.” According to the world health body, nearly 42 million women faced with unintended pregnancies have abortions yearly.

A 2007 study conducted by the WHO and Guttmacher Institute says 20 million unsafe abortions take place each year, mostly in countries where abortion is illegal.

Both bodies claim abortion is safe in countries where it’s legal, but dangerous in countries where it’s outlawed and performed clandestinely. According to WHO, nearly all abortions (92 percent) are safe in developed countries, whereas in developing countries, more than half (55 percent) are unsafe.

Complications arising from unsafe abortions, according to doctors, could be either immediate or prolonged. These, include severe blood loss leading to death; infections leading to infertility; uterus perforation; cervical laceration; renal failure; damage to the bladder and intestine perforation. Other effects of unsafe abortion include infertility and chronic pelvic inflammatory disease.

According to medical experts, grounds on which abortion is permitted include, to save the life of the woman, to preserve physical health, and to preserve mental health. In addition, two physicians are required to certify that the pregnancy poses a serious threat to the life of the woman.

Due to the dangers posed to the health of women by unsafe abortion, many developed countries have legalised it. Some of the countries that have legalised abortion are the United Kingdom, Poland, Spain, Denmark, Germany, Italy and South Africa.

Abortion laws vary from country to country. In South Africa, the Choice on Termination of Pregnancy Act 92 of 1996, permits any woman of any age to get an abortion by simply requesting with no reasons given if she is less than 34 weeks pregnant.

If she is between 13 and 20 weeks pregnant, she can get the abortion if her own physical or mental health is at stake, the baby will have severe mental or physical abnormalities, she is pregnant because of incest, she is pregnant because of rape, or she is of the personal opinion that her economic or social situation is sufficient reason for the termination of pregnancy.

If she is more than 20 weeks pregnant, she can get the abortion only if she or the foetus’ life is in danger or there are likely to be serious birth defects.

A woman under the age of 18 will be advised to consult her parents, but she can decide not to inform or consult them if she so chooses. A woman who is married or in a life-partner relationship will be advised to consult her partner, but again, she can decide not to inform or consult him.

According to the Associated Press and Ultimate Pro-Life Resource, abortion in Italy became legal in May 1978, when Italian women were granted the right to terminate a pregnancy on demand during the first 90 days.

Although a proposal to repeal the law was considered in a 1981 national referendum, it was rejected by nearly 68 percent of voters. Italian women are eligible to request an abortion for health, economic or social reasons, including the circumstances under which conception occurred.

In Poland, abortion was legal under the communist government. The post-communist democratic government enacted the present law in 1993. In 1996, it passed a more liberal law, allowing abortion up to 12 weeks for various reasons, including financial hardship and emotional problems, but the high court declared this law unconstitutional.

In Spain, abortion is legal up to 12 weeks in cases of rape, deformed baby, or danger to the mother’s life or mental health. The law was passed in 1985, but in practice, the “mental health” clause has resulted in abortion on demand (up to 12 weeks) as psychiatrists will routinely certify that a woman’s mental health is endangered.

In Germany, abortion is legal, but the mother must present a certificate showing that she has consulted a counsellor first. The counsellor may be from a church group, the Red Cross, or the government.

While pro-abortion groups argue that legalising abortion will reduce the number of deaths from backstreet abortion, those against it say it is wrong to legalise procedures that kill the innocent just to make the killing process less hazardous.

From the child’s point of view, the post-life movement claim there is no such thing as a safe, legal abortion. According to them, it is always deadly. “For every two people who enter an abortion clinic, only one comes out alive. Typically, those appealing to the emotion through the use of this argument completely avoid the real issue, since it is easier to talk about coat hangers than dead children,” they argue.

In Nigeria, abortion is governed by two different laws. In the predominantly Muslim states of Northern Nigeria, the Penal Code, Law No. 18 of 1959, is in effect. In the southern part of the country, which is predominantly made up of Christians, the Criminal Code of 1916 is in effect.

While both codes generally prohibit the performance of abortion, differences in the wordings of the codes, as well as in their interpretation, have resulted in two slightly different treatments of the offence of abortion.

In the southern states, the law also allows abortion to be performed for physical and mental health reasons. The fact, however, remains that in Nigeria, it is criminal to carry out the act of abortion and the persons who perpetuate it are liable. The patient, the doctor and any person that is an aid to the act are all liable. And the penalty for the offence is as long as six years imprisonment.

A 1982 attempt to liberalise abortion law in Nigeria was defeated. A termination of pregnancy bill, sponsored by the Society of Gynaecologists and Obstetricians of Nigeria, was presented to the National Assembly.

The bill would have permitted abortion if two physicians certified that the continuation of a pregnancy would involve risk to the life of a pregnant woman, or of injury to her physical and mental health or to any existing children in her family greater than if the pregnancy were terminated. The bill would also have allowed abortion if “there was a substantial risk that the child, if born, would suffer such physical and mental abnormalities as to be seriously handicapped.”

Abortions performed on these expanded grounds could have been carried out only in the first 12 weeks of pregnancy, except to save the life of the woman.

The bill also would have permitted physicians to refuse to perform an abortion on grounds of conscience. The bill was strongly opposed by religious leaders and by the National Council of Women’s Societies of Nigeria who feared that its passage would promote sexual promiscuity.

Nearly all religious groups in Nigeria frown at abortion. Gabriel Osu, director of communication, Catholic Archdiocese of Lagos, said that the church is against abortion because it “is tantamount to bloodshed and for no reason should a Catholic woman have abortion.’’

Adewale Martins, the bishop of Catholic Diocese of Abeokuta, said the opposition to abortion by the church was rooted in the law of God, which forbids a man from taking the life which only God could provide.

“The position of the Catholic Church is that each human person at all stages of life (from the moment of conception to natural death) is precious and is a gift of God, which no one has a right to terminate at will. It is really part of the commandments of God when he said ‘thou shall not kill,” he said.

Even when a woman becomes pregnant as a result of rape, the cleric said, the child should not bear the consequence of the action against the woman or the mother. But he admits that rape is a traumatic experience. “Rape is traumatic and an unspeakable evil.

It is more traumatic when it results in pregnancy. It is not the child; however, that deserves the death penalty. Even rapists will not be put to death if convicted. The unfortunate woman should be assisted and supported but not to kill the innocent child who has no fault in the sad event,” the bishop said.

Lateef Adegbite, secretary-general, Nigerian Supreme Council of Islamic Affairs, said that the Islamic faith does not allow abortion. He explained that abortion is only permitted on medical grounds. “A Muslim woman can only seek abortion when she is in clear danger and a medical report is issued to confirm this,” he said.

According to him, to avoid cases of abortion, Islamic clerics advise people to practice safe, protected sex, or have sex during their safe period or embrace medical ways of family planning.

But in spite of legal restriction, abortion rate is still high in Nigeria. Recent studies show that in Nigeria, about 25 out of 1,000 pregnancies are aborted, compared to western countries where abortion is legal and done liberally. There, abortion rate is five out of 1,000 pregnancies.

Medical experts have given reasons ranging from economic to health and social considerations for the prevalence of abortion in the country, despite its illegality.

Oseyemwen, a doctor, believes that it is because abortion has not been legalised in Nigeria, that many people patronise quacks. “And that is why some people have been advocating that we officially make a law for it because it’s going to create room for specialists to handle the cases rather than quacks who do it behind their houses,” he said.

Uwaifo, a gynaecologist, said that in a developed country like the Netherlands, the abortion rate is lowest, yet abortion is legalised there. He said the reason for this is that because abortion is legal in that country, people go to specialists to procure it instead of quacks.

On the controversy over the legalisation of abortion in Nigeria, Uwaifo believes there are so many factors responsible for this. They are the moral point of view, the religious point of view and the social point of view.

“Christianity does not permit it and even the Islamic religion does not also support it. So, you have a lot of problems making it very difficult for us to revisit that abortion law.

But it should be revisited so that the law can be reviewed in a way that it will favour Nigerians and reduce the rate of unsafe abortion and all the deaths resulting from abortion,” he said.

Matthew Oriakhi, senior consultant obstetrics and gynecology, Central Hospital, Benin City, believes that since the rate of abortion in Nigeria is high despite the fact that it is considered a criminal offence, the best thing is for government to legalise it.

“The only thing I think the Nigerian government can do is to legalise it like South Africa and some states in North America have done so that the people can easily walk to specialists rather than quacks,” he told Newswatch.