Abortion; Which is less evil? The death of a mother or access to safe terminations
I am writing this article in view of the recent hue and cry by various Religious Organisations in the country, against legalising abortions in this country. I have read the Global literature on the subject and consulted some international authorities to gain more knowledge. I am distilling my thoughts for the information of the public in this country. Some of these International authorities have been working with the Irish Family Planning Association, and the Citizen’s Bureau on the issue of Liberalizing Abortion in Ireland. I have also drawn my findings from some of the presentations given to the Citizen’s Bureau and to the Parliamentarians requesting them to change the Irish law related to abortion. Results of the Citizen’s Assembly voted that abortion should be made lawful in Ireland by a vote of 65%. After a debate in the Irish Parliament, it has agreed to have a referendum in the country in early 2018 to repeal and redraft Act 8 which will allow abortions for certain conditions and up to certain gestation including social reasons. It is time for Sri Lanka to consider this question in order to abolish illegal abortion which is a major cause of maternal mortality and significant number of admissions to our gynecology wards with the attendant morbidity.
The above map of Europe indicates that except for Poland, abortion has been legally allowed elsewhere. Now Ireland is going to have a public referendum early this year to legally allow abortions up to certain gestation on request and different gestations based on the condition for which abortion is requested.
Abortion Laws can be brought in, in a controlled manner as was in the UK i.e. gestational limits, indications, who can do it, where should it be done, who should certify, collection and auditing of data etc.
Good reproductive health should be viewed as a public health concern which, apart from the provision of safe and high quality abortion care, must include having Sex and Relationships Education (SRE) in the national school curriculum and access to family planning and contraception services.
Let us join Europe and rest of the world to provide the sexual and reproductive health and rights for women, which they richly deserve. The green area shows where abortion laws are liberal. The orange depicts countries where the laws are being reviewed and red indicates countries with restrictive abortion laws.
How does the above well documented Authoritative article synthesized by me help this Country to solve our abortion issues?
Births, abortions & deaths have been part and parcel of what is happening in the human race since its existence. Deaths we can’t prevent. During the last century with the advancement of medical knowledge, deaths from child birth have been brought down to one digit figures per 100,000 births, in the developed countries in the world. Sri Lanka is still lagging behind with 32 per 100,000 births in 2015 and we are unable to come down to figures like Singapore due to unsafe illegal abortions, which have been taking place in the country from time immemorial. Abortions take third place in the list of maternal mortality in the Country. Why is this so??
In Sri Lanka abortions have been criminalized by the British in 1883 by an archaic and antiquated Ceylon Penal Code which is still existing. Whereas, all the developed countries in the world which one can observe as given in the Charts above, have all legalized abortions and made them safe for over 50 years, and thus brought down the deaths to almost zero in many of those countries, which I consider a very great achievement for the reproductive health and welfare of women throughout the world. No country in the world will ever be able to make births 100% safe. There will always be maternal deaths in the world. It is very unfortunate that opinion leaders in this country, still have not realized what other Obstetricians in the world have achieved.
We have around 320 Members in our specialty in this country. Throughout the world we obstetricians and gynaecologists are the sole custodians of the Reproductive Health & Welfare of women and we are duty bound to look after them, with tender loving care. We agree, that abortion is an evil, the taking away of a life, but millions of people are killed in this world for which there is no solution. I would like to ask all of you a question. Which is more evil, the death of a 30 year old young mother with two or three children dying after complications of an unsafe abortion or the termination of an unwanted pregnancy, illegally and unsafely? It is obvious to anybody that the first is a much greater tragedy and evil than the second. Therefore, the developed countries in the world have discarded Anti-Abortion Laws and legalized abortion by choosing the lesser of the two evils.
On the other hand I would like to pose another question to the readers. What will you do if your only unmarried 16 year old daughter becomes pregnant? I have had in my private practice many parents coming to me with this problem. Am I to ask them to send the child to an Institution where unwed Mothers are looked after for nine months and the child is given up for adoption after delivery and the mother returns home or will I tell them to opt for a safe abortion in a country like Singapore where abortion is legal, thereby, safeguarding the parents and the child, who can get back to school within one week as if nothing has happened.
What do you think will be the future of the child who went to an Institution for nine months and then returns to the school after that? It is obvious that the child will be ridiculed by the class mates and teachers and she will commit suicide due to severe mental upset and depression and the parents will lose their only daughter.
I am the oldest living obstetrician in the country and have seen a large number of women dying in our wards from severe bleeding and infection following unsafe illegal abortions, performed by quacks, with high charges, when these can be performed legally and safely at no cost in our hospitals. We have over a thousand births a day and probably an equal number of unsafe abortions, based on various surveys carried out in the country. Around 10% of these are unmarried young women.
All these years no one made a hue and cry about these unsafe abortions, till the issue of legalizing abortions came up recently. Obviously, the religious authorities never thought anything wrong with the killings of the foetuses and the deaths of mothers following abortions. Why is it that there is such a hue and cry when the government wants to bring legislation to legalize abortions and make it safe in our country and bring down the deaths due to abortion to zero like in the UK??
If we don’t legalise abortions, it would be the illegal abortionist who would be most happy to carry out their trade without any hindrance from the Religious Authorities or the State, because the religious leaders in this country are unknowingly supporting the abortionist to carry out their trade and fleece the poor women of their hard earned money and killing some of these women and causing permanent disability to their future reproductive health, for which we as gynecologists are very much responsible in this country.
I would like to end this article with two quotes –“No law that has ever been passed and no law that ever will ever be passed can prevent a determined woman from trying to end an unwanted pregnancy. Society and hospitals must accept their role in keeping women safe in that process.” John J Sciarra, Emeritus Professor of Obstetrics and Gynaecology, past president of FIGO (2013).
“If one does not support legal abortion, indirectly one supports illegal abortion to thrive.” S Arulkumaran (2017). Emeritus Professor of Obstetrics and Gynaecology and Past President of the RCOG, BMA and FIGO.
I hope I have convinced the readers enough “WHY ABORTIONS SHOULD BE LEGALISED”.