Abortion Law and Policy News: Sénégal, Laos, Italy, India, Armenia

2 November 2016


Le Soleil
Viol, inceste et grossesses non désirées : Des associations de femmes plaident pour l’avortement médicalisé
(Unwanted pregnancy after rape and incest: women's associations plead for safe abortion)

Le Soleil, by E Kaly, 18 October 2016
L’autorisation de l’avortement médicalisé en cas de viol et d’inceste est toujours demandée par des organisations de la société civile sénégalaise. L’application de cette mesure permettra aux femmes violées de pouvoir se débarrasser de leur grossesse, sans courir certains risques.
(Legalisation of abortion in cases of rape and incest has long been called for by civil society organisations in Senegal because it would free women from a forced pregnancy without risk.)
L’Association des femmes médecins du Sénégal (Afems), le Réseau « Siggil jigeen » (Rsj), l’Association des juristes sénégalaises (Ajs) et Population Council reposent le débat sur l’accès à l’avortement médicalisé au Sénégal. Ces associations de la société civile, regroupées dans un comité de plaidoyer pour l’avortement sécurisé, ont partagé, samedi dernier, à Dakar, une étude portant sur « l’expérience des femmes victimes de grossesses non désirées à la suite d’un viol ou d’un inceste au Sénégal ».
(The Association of Women Doctors, the Network « Siggil jigeen », the Association of Senegalese Women Jurists and the Population Council have formed a coalition and reactivated this campaign to advocate for access to safe abortion in Senegal following rape and incest. On 15 October, in Dakar, they shared the findings of a 2015 study on this issue.)
En présentant les résultats de cette étude, Mme Nafissatou Diop de Population council a révélé qu’en 2010 environ 3,6 % des décès maternels étaient liés à un avortement clandestin ou à risque fait de manière traditionnelle ou par un prestataire non qualifié. Une autre étude réalisée à Dakar du 15 juin au 30 août 2015 a montré que 51.500 avortements provoqués ont été enregistrés. Suffisant pour que les associations en question demandent la légalisation de l’avortement médicalisé.
(In presenting this study, Mme Nafissatou Diop of the Population Council said that in 2010 about 3.6% of reported maternal deaths were due to unsafe and clandestine abortions. A more recent study in Dakar, however, from 15 June to 30 August 2015, had found that 51,500 induced abortions had been recorded.)...




Unsafe abortion: prevention and care, a practical guideline for health workers:
Presentation of the guideline, by Prof Dr Bounkong Sihavong, Minister of Health, Vientiane

The following statement was made by Prof Dr Bounkong Sihavong, the Minister of Health of Lao PDR, at a presentation of this guideline in Vientiane:

Maternal mortality in Laos is high in comparison with neighbouring countries in South East Asia such as Vietnam, Thailand and Cambodia. Deaths mostly occur in rural and remote areas where there is a lack of roads to allow good access to health care services. Based on maternal death reports from 17 provinces and Vientiane Capital, there were 130 cases of maternal death reported in 2013 and 126 in 2014. Some of these are caused by unsafe abortion.
Reports of previous studies from Mahosot Hospital, and from Louangprabang, Champasack and Savannakhet provinces in December 2004 revealed that 2,877 women received gynaecological treatment, of whom 42.6% (1,225 women) were due to unsafe abortion. In March 2015 a new assessment of abortion cases treated in hospitals was conducted in Laos. It found that unsafe abortion still prevails in the country and that 20-50% of those admitted to public hospitals were due to unsafe abortions.

As a result of these findings, in order to reduce maternal morbidity and mortality related to unsafe abortion in the country, the Ministry of Health's Maternal and Child Health Centre will give more attention to making abortions safe. "Unsafe abortion: prevention and care, a practical guideline for health workers" has been developed to serve as a reference. It contains recommendations and a tool for implementation, in order to be applicable within the real life situations in our country. The guideline will also contribute in assisting the Lao government to achieve its goals in the National Strategy and Action Plan for Integrated Services on Reproductive, Maternal, Newborn and Child Health 2016 -2025...




Hospital where Valentina died

Valentina, who had no choice but to die from a miscarriage

The story of the death of Valentina Milluzzo, a young woman from Catania, Sicily, in the 19th week of a pregnancy with twins

by Elisabetta Canitano, Gynaecologist and Chair of the Association "Vita di Donna" (Women's Lives) of Rome

 “The child’s heart is still beating.” Throughout Italy in religiously-affiliated maternity wards, and birth centres where religion is predominant, that phrase is used to put women at risk.

Still. “Still”, referring to a pregnancy that is fatally compromised but the fetal heart continues to beat. For women between the 16th and 22nd week of pregnancy, with fetuses that are incompatible with survival, this phrase carries the risk of a death sentence every day. Because women might not get an immediate abortion to save their lives, as recommended by international medical guidelines.

Most of these women at risk have a ruptured gestational sac. We don’t know for sure if that happened in Valentina’s case, but apparently her cervix had prematurely dilated, creating a threat of miscarriage, and it’s known that she had a high fever at least 12 hours before she delivered the first stillborn twin – already dead for some time. Bacteria must have found an open path into her uterus many hours before. When the uterine cavity is in direct contact with the outside environment, it creates the risk of a dangerous infection called septicaemia, nowadays called sepsis. And sepsis happens frequently if the pregnancy is not terminated without delay. In rare cases, the heartbeat stops or contractions begin unaided, and the woman's body is able to empty itself without further incident. But, for each hour the unviable fetus is left inside by those saying "we can’t intervene, there’s a heartbeat", the risk of fatal sepsis increases...




India's anti-sex determination law faces new challenges
by Dinesh C Sharma

The Lancet, October 2016, 388(10055):1971
India's 1994 law banning the use of ultrasound to establish fetal sex seems to be hampering the use of ultrasound for legitimate purposes while not necessarily improving the girls-to-boys sex ratio at birth.
Many medical professionals have been saying for some time that legal provisions are being misused to harass doctors, e.g. over details of record keeping and reporting of data, and that over-regulation is hampering use of ultrasound in general. “Radiologists are being harassed for minor clerical errors like not keeping a copy of the Act, not wearing an apron, or improper filling of forms. Such mistakes are being considered equal to sex determination and, in many cases, highly qualified doctors are being treated like culprits”, said Jignesh Thakker from the Indian Radiological and Imaging Association…
The article talks about whether the Act is even preventing sex selection through banning ultrasound for sex determination. Some data indicate it is not. Moreover, a link between fertility decline and sex ratio at birth has been identified, that is, the fewer children couples are having, the more they try to have a boy as at least one of them (or the only one). The problem exists more in urban areas than rural ones as well. While ratios are worse in some places, they have improved in states like Meghalaya, Goa, and Tripura, where a substantial proportion of women with two daughters reported not wanting any additional children...




Changes in the law on abortion: statement by the Women's Resource Center, Armenia

A number of changes were made in the Law (Article 10) covering abortion. The amended version of the law has been signed by the President and came into force from 6 August 2016. The objectives of the amendments were as follows:

– Sex-selective abortions are prohibited by law (such a provision was not included in earlier legislation).

– It is now an obligation to provide a mandatory three-day "period of reflection" before the final decision of a woman who has applied for an abortion.

– Commitment to set mandatory counselling before the abortion, in order to provide the woman with details of all the consequences and complications of pregnancy, as well as informing her and raising awareness of contraceptive methods after termination of pregnancy.

– The Minister of Health are assigned to medical, social abortion instructions, contraindications, powers invested to establish standard forms of documents necessary to establish lists of research, the process of abortion.

– It was also stipulated administrative responsibility for the doctor in case of failure to comply with a written notification and consent procedure.

For more information on the text, see:

The Women’s Resource Center, a women’s rights organization, has expressed its concerns about the above points...




"The world is facing a crisis in funding for international family planning programmes, which are essential to supporting the rights and health of women everywhere. UNFPA Supplies, the largest global programme for family planning and the world's largest provider of donated contraceptives, currently has a funding gap of about $850 million…" (UNFPA)
And we thought we had problems !!

Editor: Marge Berer

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