Friday, 6 May 2016

Maltiti's Story - unsafe abortions in Ghana

Maltiti's Story - unsafe abortions in Ghana

“15 year old Maltiti is fighting for her life in a hospital bed in Tamale, Northern Ghana. Her parents brought her here after finding her unconscious and heavily bleeding from her vagina. A ‘quack’ doctor had performed an abortion on Maltiti, at the same time removing her ovaries and fallopian tubes without her consent. She had been hiding her pregnancy from her parents, since she’s unmarried and it would have brought shame to her family, as well as fearing being beaten and ostracised by her community.”

Unfortunately this tragic story recounted by one of our in-country volunteers is not uncommon. Lack of access to affordable medical care and contraception has seen the number of unsafe abortions amount to 21.6 million/year worldwide, with 86% of these occurring in developing countries. Each year around 47,000 women die following unsafe abortions and a further 8 million are hospitalised for the treatment of serious complications such as bleeding and infection.

The World Health Organisation (WHO) defines unsafe abortion as a procedure terminating an unintended pregnancy performed by persons lacking the necessary skills, in an environment that does not conform to minimal medical standards, or both.

As ICS volunteers working with WOSAG we are educating women and girls in rural areas about the use of contraception with the aim of helping others like Maltiti avoid unwanted pregnancies. While we do not directly address the issue of un/safe abortion at WOSAG, we felt it was important to understand the implications and consequences of our work, considering the main cause of unintended pregnancy is lack of access to and knowledge of contraception. While abortion should not be considered a form of family planning, it is damaging to ignore the facts and it is important to understand that this is an issue of health and rights.

Shaban Practicing a demonstration on the use of contraceptives

Research conducted by the previous cohort of ICS volunteers at WOSAG discovered that 100% of women questioned in one of the communities WOSAG works in do not know how to prevent an unwanted pregnancy. In addition, in answer to the question “do you know how to put on a condom?” 100% of girls asked in the school replied, “no”. This indicates a clear need for education regarding correct use of contraceptives.

After a discussion among our team, we realised that we were not at all clear on the law regarding abortion. The law in Ghana states that abortion is legal in the instances of rape, incest, if the life or health of the woman is in danger, or if there is a risk of fetal abnormality.  In these cases the abortion must be performed by a qualified physician and in a registered medical facility. Shockingly, only 3% of pregnant women were aware of the legal status of abortion (based on 2007 statistics).

We have discovered that women seek unsafe abortions for a variety of reasons, but mainly due to ignorance of the law and the fact that abortion is heavily stigmatised in Ghana. Social  
perception and religious teachings, along with inaccessibility to safe services, have created a situation where quacks and charlatan doctors carry out the majority of abortions. As the abortion rate is similar in countries with legal abortion and in those with highly restrictive abortion laws, it is clear that women choose to have abortions, regardless of the legal implications. The law regarding abortions does impact on how women seeking abortions are treated, however. Failure to provide affordable access to safe abortions jeopardises women’s health and lives.

A 2010 DFID position paper on the subject of safe abortion notes: "Our position is that safe abortion reduces recourse to unsafe abortion and thus saves lives, and that women and adolescent girls must have the right to make their own decisions about their sexual and reproductive health and wellbeing.”

Due to the small size of WOSAG, network-building is crucial to filling in any gaps within our work. For example, while we offer education about sexual reproductive health rights, we recommend that women requiring further services surrounding pregnancy seek advice from Marie Stopes, an international organisation providing reproductive healthcare. One of their visions is a world in which every birth is wanted.

Our work is essential in achieving Sustainable Development Goal 5, Gender Equality, which calls for universal access to sexual and reproductive health and reproductive rights. As HiIlary Clinton said at the Fourth World Conference on Women in 1995, “Women’s rights are human rights”. The best way to avoid unsafe abortion is to avoid unwanted pregnancy. In line with the UN goals we seek to provide access to accurate information and contraception of choice with the hope that all women in the communities can have safe pregnancies and delivery when they choose to have children.

If Maltiti had had access to a girls’ support group like one of the ones set up by WOSAG, we hope that she would have been empowered to protect herself from such a tragedy.

Writers: Emma Irven & Abdul-Karim Mufty

Editor: Verity Quaite

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