Unsafe abortions are one of the causes of female mortality and morbidity worldwide. According to the WHO, estimates of the number of abortions in Africa stand at 6 million. Of this figure, only 3% are done in medicalized and safe conditions for women. Among the victims who eventually succumb or suffer over time from serious infections, cancer of the cervix or sterility, there are a large number of adolescent girls and young women. To remedy this, a few rare African countries are taking the resolution to legalize voluntary termination of pregnancy (abortion). Among these, is now added Benin. Is the legalization of abortion the solution to reduce clandestine abortions and a step forward in access to sexual and reproductive health rights (SRHR) in Benin?
The WHO defines abortion as a simple health intervention that can be managed effectively by a wide range of health workers using drugs or by surgery. Abortion is a subject that we avoid talking about especially in the presence of adolescents and young people in Africa. This neglected point in the debates is an integral part of SRHR. Adolescents and young people do not have access to reliable information related to sexuality and reproduction as they should.
Too much demand, not enough supply
Moreover, the supply of family planning services does not match the demand. Priority is given to married couples. However, unmet needs for contraception are twice as high among sexually active adolescents as among married women: 12.8 million adolescent girls do not benefit from the family planning services they need (Fnuap report 2017).
In Benin, between 2016 and 2020, more than 9,000 cases of pregnancy were recorded in public and private schools by the Ministry of Secondary Education, Technical and Vocational Training. After having contracted an unwanted or early pregnancy, the first reflex of certain young women and adolescents not yet prepared for this stage of life is to resort to abortion, more precisely unsafe abortion. But the latter are still not aware that this can compromise their health and well-being. In Benin, maternal mortality is still a tragedy. Unsafe abortions contribute 20% according to government figures.
The grim picture of unsafe abortions
According to another study by the Guttmacher Institute dating from 2020, “during the period of 2015-2019, “8 million abortions were performed in sub-Saharan Africa, three quarters of which were unsafe and could lead to medical complications or even the death of the woman”. In Benin, maternal mortality is still a tragedy. Unsafe abortions contribute 20% according to government figures.
Ayouba Orou Gounou Guéné is a communicator in the sexual and reproductive health of adolescents and young people. For the activist, “the abortions that kill most often are abortions performed clandestinely outside health facilities, in hygienic conditions that do not guarantee any safety, endangering the lives of the victims”. This means that clandestine abortions are a reality in Benin, despite the adoption of thelaw 2003-04 of March 03, 2003 on sexual health and reproduction.
The Beninese context
In the context of Benin, cases of pregnancy for which women express a need for termination are not authorized by the law which regulates abortion. In the absence of such a service, clandestine abortion stands out as the last resort for these women who no longer know where to turn. And this with all the risks that this implies, including death when it is badly done. “Nearly 200 women die each year from abortion complications. These losses in human life often concern women who are still in the prime of life,” announces Minister of Health Benjamin Hounkpatin.
To remedy this deplorable situation, the government is quick to react. He presents this gloomy picture to the deputies so that they vote the law N ° 2021-12 modifying and supplementing the law 2003-04 of March 3, 2003 relating to sexual health and reproduction in Benin. Convinced, the deputies vote and adopt on Thursday, October 21, 2021 the legalization of abortion, previously prohibited except in exceptional circumstances. Now at the request of the pregnant woman, abortion “may be authorized” up to twelve weeks “when the pregnancy is likely to aggravate or cause a situation of material, educational, professional or moral distress”. Benin thus joins Tunisia, South Africa, Cape Verde and Mozambique, 4 other African countries which have legalized abortion.
Some injuries that the legalization of abortion will prevent
During the collection of information, while some people were hostile to discussing the issue of abortion, others agreed to answer questions and, moreover, testify.
It is with great pain that the father of the deceased recounts the early death of his adopted daughter. Brilliant and respectful with a strict and religious upbringing, she should be 17 in 2020 and make the final class this same year. ” She had become pregnant for about two months. According to her friend, she would have introduced capsules acquired in the street in her private part to voluntarily interrupt the pregnancy for almost 3 weeks. Unfortunately, she passes from life to death because the capsules, whose characteristics are unknown, cause a serious wound which causes enough damage to the level of the uterus, say the doctors hours before her death in the hospital. “. This is how several teenagers, young girls and women from Africa and Benin died as a result of clandestine abortions.
The woman with fistula
The second testimony is that of a widow named Valley. The forty-something confesses that at one point in her life, with her back to the wall, she opted for unsafe abortion, which left her with bitter wounds. Her husband, she and their 06-month-old baby lived in precariousness. A few weeks later, her husband died following an accident. Meanwhile, she says, I had no idea that I had become pregnant again “. Valley had no support from her family and that of her in-laws. 6 weeks later, she informs one of her friends hoping that she can help her find a solution.
« My friend recommends me to have a clandestine abortion. During the operation, the pain was unbearable. Quite sharp instruments similar to knitting needles are introduced into my vaginal part. The next day, a hemorrhage started. Driven to the hospital, I barely got out of it but with an obstetric fistula that I have been carrying around for almost 8 years ».
Access to abortion, a fundamental right
UN experts perceive the criminalization of abortion and the impossibility of adequate access to services for the termination of unwanted pregnancy as forms of discrimination based on sex. Restrictive legislation that denies access to safe abortion is a serious violation of women’s human rights. For what ? First, “because abortion is essential health care to which everyone is entitled. Then “because access to abortion and contraception is necessary to ensure reproductive justice for all. », certifies Partners for Reproductive Justice (Ipas).
Studies have shown that the countries with the lowest abortion rates are those where access to information is assured, modern methods of contraception available, accessible and abortion legalized. The example of South Africa is instructive. The Choice in Termination of Pregnancy Act 1996 came into force on 1is February 1997 in this country. Estimates show a reduction in women’s deaths from abortion-related complications by 90% over a 7-year period.
Safe abortion is therefore a right to which women must have access in the hospital without being stigmatised. Health Minister Benjamin Hounkpatin also announces that arrangements will be made for the vote on implementing decrees. But in the meantime, family planning services will work to ensure that young people and anyone in need of SRH services can have access to them. This by already limiting early and unwanted pregnancies through the use of condoms and contraceptive methods according to the choice of the woman.
Benin by adopting Law No. 2021-12 amending and supplementing Law 2003-04 of March 3, 2003 relating to sexual health and reproduction in the Republic of Benin ” contributes to the preservation of the health and life of our young girls, our sisters, our wives and our mothers” concludes the mminister of health.