Life as we know it, is the most sacred trust God has bestowed to humanity. And the disrespect of life is a most heinous crime. However, there are many dilemmas one faces in terms of social dictums, and abortion is an important one. Terminating a life within a woman’s body seems a gory predicament, and it has turned into one of the biggest morality debates the world has seen. The moral judgment has made its way into state legislatures and the practice has been banned in many parts of the world.
We must understand what abortion is and why women go for it in Pakistan despite knowing 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 is done in non-clinical facilitations by untrained midwives, back alley doctors and quacks—putting the health of women in danger and leading to horrific deaths. A nationwide survey conducted by the Population Council in 2002 estimated that at least one pregnancy in five is terminated. Maternal deaths stand at 20.3% of women belonging to reproductive age, and deaths due to unsafe abortions stand at 5.6% approximately. These are huge numbers.
Abortion however, is not to be defined as the use of contraceptives, which is how most clergy interpret it in their preachings, thereby discouraging couples from using it. The trend has caused serious repercussions on family planning and population control initiatives, but there are very nominal efforts undertaken by the government to confront clerical teachings. Furthermore, since devolution, there are no concrete steps taken at the provincial level for birth control initiatives.
In Pakistan, since 1997, abortion has been allowed in the first 120 days since conception in cases of rape, physical disability or threat to a woman’s life, but this law is widely unknown to most practitioners which leaves women in peril when seeking abortions. In 1997, the Commission of Enquiry for Women presented three recommendations. These were: 1) Allocations to health and population sectors be increased by 6% of GDP; 2) Regulations be amended to ensure women’s right to tubal ligation without husband’s permission; and 3) Women’s right to obtain an abortion by her own choice within 120 days of pregnancy be unambiguously declared her absolute right. These recommendations presented by Justice Nasir Aslam Zahid were never legislated for clarity in the law.
Social factors play a pivotal role in cases of abortions. Sometimes, abortion is carried out without the will of women, forcing her to abort if the child she’s carrying is female. Sometimes, she is forced to keep the child against her will. Whether women should be in control of their bodies remains a heated debate, as religious injunctions are brought in to separate the dimension of control from women.
Most women seeking abortions belong to poorer social stratas. Because they lack the resources, they are not able to pay the private fees for safe abortions. The services they seek through traditional Dayas is risky business, but women are helpless in seeking safer options.
The inaccessibility of health services and the refusal to provide them to women remains the biggest challenge in maternal health service. Most of the cases that reach the hospital are usually complicated due to incomplete abortions that were undertaken by midwives and back-alley doctors. Most of the cases undertaken are by the private sector health care providers that reach out to approximately 70% of the population that the public service sector cannot reach out to. However, in the private sector, the income matrix of women seeking help is detrimental in acquiring the quality of care.
There are a number of reasons why women seek abortions; most commonly, due to rape. Another reason is the low income of the household, and the inability of women to provide for their unborn children. In fact, most women seeking abortion live below the poverty line. The circumstances under which abortion is sought should not be ignored and facilities should be tailor-made to be more synchronised with the local needs of women seeking to undergo the procedure.
The government should take into consideration the various recommendations presented to it on the matter. The fact that the female morbidity rate is on the rise, means that rapid steps must be taken to redress the grievances of women in peril. The situation must be objectively overseen, with the consideration that women will get an abortion whether or not there is a ban on it. The stigmatization of abortions should be removed first, before coming to terms with a woman seeking the termination of her pregnancy. Post abortion care should be more systemized and streamlined in order to provide easy, accessible and essential care to those seeking abortions. All this cannot be done until the consent and will of women is made the profound basis in the conduction of abortion, and nobody else’s.
The writer is a freelance columnist.
@zeebahashmi