Access to abortion in Africa and Latin America : a question of

W
Sheet n°298 - May 2008
Access to abortion in Africa and Latin America :
a question of public health and social inequality
countries of the South
and it reveals many
social injustices. The
World Health Organization (WHO) estimates that in Latin America 3.7 million women
resort to unsafe abortions each year. In
Africa, an estimated
4.2 million women put
their lives at risk to
terminate a pregnancy. Aiming to gain a
better understanding
of the situation of
abortion in countries
where this act is often
still illegal or where
access is highly restrictive, a research
team jointly involving
IRD and “El Colegio
de Mexico” reviewed
the scientific literature published from the
early 1990s up to the
present. Women’s access to safe abortions
and the abortion-related legislation in fact
hardly improved over
the past 15 years in
Africa and Latin America. The analysis moreover brought to light
problems of injustice
and inequality of access to this intervention, in that women
from the deprived social classes have to
resort to unsafe illegal
abortions, contrary to
those from better-off
sections of society.
© Foro Red de Salud y Derechos Sexuales y Reproductivos
bortion is a seA
rious public health
problem in many
A group of feminists campaigning for the decriminalization of abortion in the town of Los Lagos (Chile).
The World Health Organization (WHO)
estimates that 3.7 million unsafe
abortions are conducted every year in
Latin America and the Caribbean,
which comes down to nearly one abortion for every three live births. In Africa,
where 99% of these interventions are
done illegally, the number of unsafe
abortions is estimated at 4.2 million, representing one abortion for seven live
births. In order better to understand
the changes and developments of the
situation on these two continents, a research team jointly involving the IRD and
“El Colegio de Mexico” examined the
results of a range of studies conducted
since the early 1990s, approaching this
question from a social sciences angle
(profile of women concerned by abortion, consequences for their health and
life in society, the role of men and so
on). They also looked at the legislation
on abortion rights, changes in it over
the past 15 years and the debates that
run concerning these questions. The
legislative framework for abortion in
Latin America and the Caribbean remains restrictive, but it is even more so in
the African countries where it is founded
on laws dating from the colonial period.
Data in the area of abortion is still highly
fragmented, difficult to obtain owing to the
heavy legal and social penalties women
risk if they decide to have an abortion in
countries where this act is of limited access, even if not completely prohibited.
For Latin America, apart from a study
run in urban areas of Colombia, wideranging surveys based on representative
samples of the population are lacking. In
Africa, there is still no public debate on
the question of abortion, and the few studies conducted, most often among women who were victims of medical complications, showed a particularly marked
rise of such interventions in urban areas.
At present, although none of the 53
countries on the African continent totally
forbid abortion, only Cap Verde, Tunisia and South Africa permit abortion on
the woman’s demand. Since the Cairo
Conference of 1994, during which the
African countries made a commitment
to respect women’s reproductive rights,
20 of them have made small improvements to the legal framework for abortion. However, in reality, the progress
made is quite limited, pregnancy termi-
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CONTACT :
AGNÈS GUILLAUME
CEPED Unité mixte de
recherche Paris
Descartes-INED-IRD
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75020 Paris
Tel : (0)1 78 94 98 73
[email protected]
REFERENCES :
AGNÈS GUILLAUME,
SUSANA LERNER,
L’avortement en
Amérique latine et
dans la Caraïbe, une
revue de la littérature
des années 1990 à
2005 (CD rom), Ceped,
décembre 2007
http://www.ceped.
org/cdrom/avortement_
ameriquelatine_2007
AGNÈS GUILLAUME,
Bibliographie sur
l’avortement en Afrique,
Ceped, 2006
http://www.ceped.
org/article.php3?id_article=28
nation most often being allowed strictly
for medical reasons. The legal conditions for access to abortion have indeed
worsened since the mid 1990s, becoming more restrictive in four countries
of Africa. Congo, Malawi and Swaziland
now allow it only as a means of saving
the mother’s life. Algeria only accepts it
for such a circumstance and to preserve
the woman’s physical or mental health,
like 17 countries of 41 in Latin America
and the Caribbean. In 2006, six other
countries (Chile, El Salvador, Honduras,
the Dominican Republic, the Dutch part
of Saint Martin, Nicaragua) it was still
prohibited. Feminist groups and a civil
organization of Catholic women in these
countries (“Catholics for the right to decide”), are campaigning for decriminalization of abortion. But these movements
are confronted with the conservative
positions of the institutions, associations
and even health care professionals who
sometimes oppose pro-abortion legislation for ethical or religious reasons.
The researchers also sought to define
better the profile of women who resort
to abortion. In principle, the practice
concerns all women of child-bearing age.
However, in reality teenage girls are the
most concerned by unsafe practices. The
absence of recognition of their sexuality,
or even pure and simple prohibition, makes access to contraception complicated
for them, making abortion quite frequent
among young women. Yet scientific data
on this question for Africa, Latin America
and the Caribbean are still extremely
patchy. Better knowledge of the situation
is essential for defining suitable health
policies, making changes to abortion
legislation possible and increasing
awareness among the different social
actors about the health and social
repercussions that can be engendered by a legal framework that penalizes abortion. From the public health
point of view, unsafe abortion practices
significantly accentuate maternal mortality, but limited access to abortion and
non respect of reproductive rights also
make it a question of social injustice.
Grégory Fléchet - DIC
Translation - Nicholas Flay
AGNÈS GUILLAUME avec la
collaboration de WILLIAM
MOLMY, L’avortement
en Afrique, une revue
de la littérature des
années 1990 à nos
jours, Ceped, 2004
KEY WORDS :
Abortion, Africa,
Latin America
PRESS OFFICE :
GAËLLE COURCOUX
+33 (0)1 48 03 75 19
[email protected]
© Católicas por el derecho a decidir
Sheet n°298 - May 2008
For further information
INDIGO,
IRD PHOTO LIBRARY :
DAINA RECHNER
+33 (0)1 48 03 78 99
[email protected]
www.ird.fr/indigo
Demonstration for the right to abortion on the central square of Mexico City.
Grégory Fléchet, coordinator
Délégation à l’information et à la communication
Tél. : +33(0)1 48 03 76 07 - fax : +33(0)1 40 36 24 55 - [email protected]