MEKELLE UNIVERSITY

SCHOOL OF LAW

ABORTION RIGHT IN ETHIOPIA

A Thesis submitted to school of law in partial fulfillment of the

requirement for Bachlor Degree of law (LLB)

BY: Yeheyis Alemu

ID: CLG/UR076/05

January, 2017

Mekelle, Tigray.
MEKELLE UNIVERSITY

SCHOOL OF LAW

ABORTION RIGHT IN ETHIOPIA

A Thesis summited by: Yeheyis Alemu to the school of Law, January, 2017, in partial
fulfillment of the requirements for the (Bachelor Degree of law (LLB)) has been approved
by the thesis supervisor Amanueal Assefa (LLB, LLM,)

Thesis Supervisor Amanueal Assefa (LLB, LLM,)

Mekelle University

Date January 2,2017.

 Acknowledgement

I am thankful to my adviser mr. Amanueal Assefa for his invaluable advice and for
his brotherly encouragement to do my research properly. I would also like to
extend my sincere thanks to my brother Mulugeta Girma for his generous
assistance in providing material support.
Abstract

Back ground: unsafe abortion is a significant cause of maternal mortality and morbidity
globally. In 2005, the Ethiopian penal code was amended to permit abortion under specific
circumstances to minimize the problem. However its practice is hampered by different reasons
such as stigma, professional unwillingness of health care providers to provide safe abortion,
lack of awareness on the abortion law, cost/misperception of cost, lack of adequately equipped
facilities. Method: since my research is doctrinal research the source which I used is secondary
sources hence I try to work my research depending on Journal and articles, researches, laws and
etc. objective: The main objective of the study is to assess the new revised abortion law and to
discuss the problem in accessing the abortion right of woman.
 ACRONYMS

AGA- Alan Guttmacher Institute

ANC- African National Congress

CEDAW- convection on the elimination of all forms of discrimination against women

CORHA- Consortium of Reproductive Health Associations

FDRE-Federal democratic republic of Ethiopia FDRE

FGAE- Family Guidance Association of Ethiopia

GMPs- general medical practitioners

HSDP- Health sector development plan

ICPD-international conference of population and development

LNMP- last normal menstrual period

MDGs- millennium development goals

MoH-ministry of health

MMR- The maternal mortality ratio

MSIE - Marie Stops International Ethiopia

NEWA- Network of Ethiopian Women’s Association

NGO-nongovernmental organization

OB -obstetrician-gynecologists

UN- United nation

WHO- world health organization

 CHAPTER ONE

INTRODUCTION

1.1 Back ground of the study

Abortion is the termination of pregnancy by the expulsion of a fetus or embryo from the
uterus. An abortion can occur spontaneously due to complications during pregnancy or can be
induced. In the context of human pregnancies, an abortion induced to preserve the health of the
pregnant female is termed as therapeutic abortion, while an abortion induced for any other reason
is termed as elective abortion. By convention, induced abortion is usually defined as pregnancy
termination prior to 20 weeks (for developing countries) gestation or less than 500 gm birth
weight; it can be safe or unsafe abortion. The term abortion must commonly refer to the induced
abortion of a human pregnancy, while spontaneous abortions are usually termed as miscarriages.1

Long ago abortion was with high incidence; approximately 26 million legal and 20 million
illegal abortion were performed in 1995.Approximetly 44% of abortions worldwide were
performed illegally (of which money, though not all, are unsafe).The proportion of abortion that
are illegal ranges, from almost non in eastern Asia, western Europe and northern America to all
most all in Africa, central America and south America among women aged 15-44.2

Unsafe abortion accounted for 14% of all maternal deaths in sub- Saharan Africa, where half of
the world maternal death occurred. Money women with unintended pregnancies resort to
clandestine abortions that are not safe.3

According to the health organization, around 1.5 million abortions in Middle East and North
Africa in 2003 were performed in unsafely settings, by unskilled providers, or both
complications from those abortions accounted for 11% maternal deaths in the region.4
1
Kenneth J. Steven L.John C.etal,mc Graw –hill companies medical publishing division, William obstetrics, twenty
second edition section 3 Ante partum, chapter 9. Abortion,2007,p232-251.
2
Stanly K.haw H. sing S and HasT. The incidence of abortion supplement, international family planning
perspectives 1999, p30-38
3
Rash dabash and farzanen Roudi-fanimi,abortion in the middle east and north Africa 2009 p35-36

4
Ibid
According to the world health organization, Ethiopia has the fifth largest number of maternal
deaths. The maternal mortality ratio (MMR) in Ethiopia was estimated at 673 deaths per 100,000
live births in a year 2005, and unsafe abortion was estimated to account for 32%of all maternal
death in Ethiopia. The restrictive laws on abortion before may 2005, in Ethiopia have been
revised to in clued four legal grounds in which abortion can be made available,(rape and incest)
lethal congenital malformation,(physical and mental health). Which contributes to an increase
induced abortion. 5

In reference to abortion, the international community has pledged commitment to reducing the
need for abortion through expanding and improving family planning service and where the law
of the land allows, providing women with high quality abortion care. Furthermore, at the five
year review of the ICPD there were calls for the governments to conceder reviewing laws that
contain punitive measures against women who undergo illegal abortions. Governments also have
agreed that, in circumstances where abortion is not against the law, health system should train
and equip providers and take measures to ensure that abortion services are safe and accessible.
Additional measures to safeguard women’s health are also required.6

At the UN summit in 2000 governments of the world ratified the millennium development goals
(MDGs) as international tool for reducing poverty and improving the standard of living in the
developing world. One of the eight MDGs is to reduce the maternal mortality rate by 75& by the
year 2015. Preventing unsafe abortion is one of the five strategies for reducing maternal
mortality that was endorsed by the world health organization (WHO) in 2004.7

5
Yirgu Geberhiwot, and Tippawan labsuetrakul, trends of abortion complications in transition of abortion law
revision in Ethiopia, on line august 14. 2008.
6
Federal democratic republic of Ethiopia ministry of health, Technical and procedural Guidelines for safe abortion
services in Ethiopia. June 2006
7
Ibid
Ethiopia has ratified international human right conventions and treatise that are legally binding
and that form international law. The convection on the elimination of all forms of discrimination
o f right women (CEDAW); provide s the foundation for reproduction right, the international
conference of population and development (ICPD), the fourth world conference women and the
united nation (UN) summits are the forums at which national governments hence express their
commitment to improve the states of women in the society. These and other international
institution have yield wider recognition of individual right to lead of one’s responsibility
reproductive lives hence underscore the responsibility of government not only respect this right
but also to creates legal police and environments for their recognitions.8

In response to these developments at the global level and changes in social and gender relations
with in the country, the government of federal democratic republic of Ethiopia (FDRE) has
reviewed its law and polices within the last decades.9

1.2 Statement of the problem

Until 2005 the Ethiopian penal code permitted abortion only to save the pregnant women’s life,
but in 2005 the penal code was amended to permit abortion under a much broader sets of
circumstances; in the case of rape, incest or fetal impairment; if pregnancy continuation dangers
her or the fetus; if the women has physical or mental unprepared for child birth. In most case,
women’s statement is sufficient to establish the legal indication for, and allow her to obtained,
abortion but many Ethiopian remain confused or unsure of their rights and do not know how to
prevent unplanned pregnancies.10

The Ethiopian government has accomplished a great deal since adopting the revised penal code.
However, despite the progress, Ethiopian women continue to be confronted by obstacles to
seeking abortion care. In 2005, Ethiopians maternal mortality ratio was 720 deaths per 100,000
live births; however, maternal mortality in the country is still 676 per 100,000 live births
notwithstanding the law.11

8
Ibid
9
Ibid
10
Singh,S,T,Geberesselessie H,Abdella A,Geberehiwot Y,Kumbi,Sand Adams, the estimated incidence of induced
abortion in Ethiopia, international perspectives on sexual and reproductive health, 2010,36(1):16-25.
11
Ibid
Even with changes to the penal code, many women remain unaware of their rights or weather
their unintended pregnancy would meet the legal criteria for safe abortion. Rural and poor
women’s, in particular, face great difficulty accessing safe, legal elective-abortion care.12

The history of policy and action in Ethiopia emphasizes restriction of lake of awareness and
access which contributes to the high rate of unsafe abortion and those high rates of maternal
mortality and morbidity. Although the revised penal code is a tremendous reform, there are
significant gaps in its implementation. In particular, dissemination of information about the new
abortion law has been weak and many within the health care system as well as the general
population have limited knowledge about the issue 13

In Ethiopia, as in most developing countries, access to safe abortion continues depend on

women’s awareness of the law, despite the relatively liberal nature of the law, knowledge of
legal right remain extremely low amongst women. Due to the major misconception about the
law, women often resort to utilizing unsafe services 14

The general population are often un aware that health care provider are obligated by law to refer
women to an appropriate health facility or to provide who will perform obligation’s the
result ,most women do not see safe abortion service although the move their right to do so under
the revised panel code.15

Form the above paragraph it can be generalized that legalization of abortion law under some
circumstances cannot reduces abortion, maternal mortality rate as need as possible; rather flow of
abortion and related deaths are common.

1.3 Significant of the study

The ministry of health guide line for the implementation of abortion law says the mere statement
by the women is adequate to prove that her pregnancy is the result of rape or incest. Because of
this stipulation some women’s who know this, they report that their pregnancy is the resulted by
12
Shimelash bitew et.dl,volume 2issue 2 journal of scientific and innovation research march –April 20013
13
Federal democratic of Ethiopia ministry of health “Technical and procedural guideline for safe abortion services
in Ethiopia” June,2006
14
Ibid
15
Ibid
rape or incest, even if it is not by rape or incest. Then they get legal and safe abortion service but
those who did not know especially rural woman (the large woman population) about the
exceptional circumstance under which legal abortion is available and the trick about the” mere
statement of the women is enough to get safe abortion” are forced to get illegal and unsafe
abortion therefore, this study can be used as an input to influence the national policy makers,
program formulators to liberalized the law on abortion under on all circumstance.

1.4 Objective of the study

The main objective of the study is to assess the new revised abortion law and to discuss the
problem in accessing the abortion right of woman.

1.5 Research Question

1. Why women’s are forced to get unsafe abortion through illegal methods?
2. Do most women know about the right on abortion?
3. What is the advantage of legalization of abortion law?
4. What are the main factors that hamper woman’s from setting legal and safe abortion
service?
5. What are the possible solutions to create awareness on women’s about their right on
abortion?

1.6 Scope of the study

The scope of this study is on Ethiopian abortion law which is on the new revised abortion law
of Ethiopia. It also tries to assess the other countries experience on abortion law.

1.7 Organization of the study

This study is divided into four chapters: chapter one is about background of the study, the
statement of the problem, significance of the study, objective of the study, research questions and
scope of the study and chapter two is concerned with literature review. Chapter three deals with
arguments on abortion which is pro choice and pro life and chapter four will contain conclusion
and recommendation.
1.8 Methodology:
Since my research is doctrinal research the source which I used is secondary sources hence I try
to work my research depending on Journal and articles, researches, laws and etc
 CHAPTER TWO

2.1 The History of Abortion

The control of fertility is a practice addressed by humans since ancient times. There are records
related to preconception and post conception practices throughout ancient, medieval, and
present times (McFarlane & Meier, 2001). In Egypt, archeologists found papyrus leaves
with recipes instructing women to use certain herbs and natural substances to prevent
contraception; even removal of the ovaries was already practiced by ancient Egyptians;
however, this practice was restricted to rich and powerful men. Ancient Hebrews practiced the
oldest known method of contraception defined as coitus interrupts. Around 500 A. D. ancient
Jewish scholars were among the first group to question if the fetus was considered as having the
same rights as a person. In this instance, it was decided that while the fetus was inside a woman,
it was part of the woman, and as soon as the child was born, it had the same rights as any person
(McFarlane & Meier, 2001).16

The Greeks learned with the Egyptians how to manipulate plants that were used as
contraceptive or abortifacients. Although the Greeks became famous for their
pharmaceutical and contraceptive practices, scholars such as Aristotle and Plato debated
the lack of participation of the state in limiting women to a certain number of children, and if
they passed such a number, then an abortion should be performed as soon as possible
(McFarlane & Meier, 2001). The use of herbs and plants as contraceptives was passed from the
Greeks to the Romans. The Romans had the same beliefs as the ancient Jews; therefore, the
child had all of a person’s rights after birth, and no rights while inside the mother.
Notwithstanding, Jews and Romans had dichotomous views towards abortion and infanticide.
Ancient Jews rarely used abortion or infanticide; whereas Romans practiced both, but more so
infanticide. 17

Socrates, Plato and Aristotle were known to have been supporters of abortion. Aristotle wrote
that “when couples have children in excess, let abortion be procured before sense and life have
begun; what may or may not be lawfully done in these cases depends on the question of life and
sensation.”
16
Reques Lopez, perspectives on abortion European journal of social science,vol,27no.2(2012) p.515-517
17
Id
Even Hippocrates, who was against abortion because he feared injury to the woman,
recommended it under certain circumstances by prescribing violent exercise. Greek and Roman
civilizations considered abortion an integral part of maintaining a stable population. According
to Soranus, abortion was practiced to conceal the consequences of adultery, to maintain feminine
beauty and to avoid danger to the mother when her uterus is too small to accommodate the
embryo. In primitive tribal societies, abortion was induced by using poisonous herbs, disrupting
the fetus or by sheer pressure on the abdomen until vaginal bleeding occurred. It should,
however, be noted that all scholars are not in agreement with the assertion that abortion was
practiced with impunity by all ancient societies. Some have maintained that “the ancient Persians
and Assyrians punished abortion …and the Code of Hammurabi (c. 1728 B.C.E.) and the
Septuagint version of the Book of Exodus. Both texts, however, addressed only the unintentional
causing of an abortion by a third party.”18

In America, specifically, the ethical perspectives on abortion became highly publicized after the
1973 case of Roe v. Wade, where Jane Roe affirmed to have been raped by a gang and
became pregnant. The state of Texas only accepted abortions to be performed if the woman’s life
is threatened by the pregnancy (Beckwith, 2007). According to Beckwith (2007), not only did
Roe win her lawsuit against the state of Texas, but she also changed the current law of the United
States; where only a few states obstruct a woman from obtaining an abortion whenever she feels
necessary. About 20 states in the United States have rigorous homicide laws in regards to the
fetuses as victims at any prenatal stage; whereas, the other states either allow abortion up to a
certain prenatal stage, or do not recognize fetuses as victims. 19

2.2 Unsafe abortion in Ethiopia

Unsafe abortion is a procedure for terminating a pregnancy by individuals lacking the
necessary skills or in an environment failing to meet minimal medical standards, or both.
According to the World Health Organization (WHO), Ethiopia has the fifth largest number of
maternal deaths in the world. One out of every seven Ethiopian women dies from pregnancy-
related issues, and unsafe abortion accounts for over 50% of the 20,000 maternal deaths
occurring each year. Approximately half of the 500,000 abortion procedures performed in
Ethiopia each year are unsafe, and between 7,000 and 10,000 Ethiopian women die annually as a
18
Tsehai Wade, abortion law in Ethiopia a comparative perspective, vol.2no,1. Jan 2008 p.3-4
19
Requel lopez Supra not 16 pp515-517
result. Despite the fact that Ethiopia has one of Africa’s most liberalized abortion laws, unsafe
abortion continues to be a leading cause of death among Ethiopian women of reproductive age,
second only to HIV/AIDS.20

As many as 67,000 women in the world die annually as a result of unsafe abortion, and 48% of
all abortions worldwide are deemed unsafe. WHO and the Alan Guttmacher Institute
(“AGI”), a non-profit organization that works to advance reproductive health, have found
that unsafe abortion is disproportionately concentrated in the Global South, with more than
97% of all unsafe abortions occurring in those countries where abortion is legally restricted.8It
is for this reason that unsafe abortion is recognized as an important public health problem.
Over 4.2 million African women undergo unsafe abortion procedures every year, with
approximately 30 unsafe abortions occurring for every 1,000 women of reproductive age (15-
44 years).10 These figures translate into unsafe abortion accounting for roughly 14% of all
maternal deaths in Africa.21

The reasons for these alarming figures vary. In countries where abortion is limited, there are non-
medical barriers that cause delays in obtaining an abortion, which increase the chance of abortion
complications. These barriers may include: the need for permission from a husband or parent;
counseling requirements; mandatory waiting periods; approval procedures and the need to locate
and travel to an authorized provider, including traveling to countries where abortion is legal.
Such barriers can be found in laws, regulations or simply practiced by medical providers. In
desperation, many women put their lives in danger by procuring or inducing unsafe, “backyard
abortions.”22

Unsafe abortion methods outside of medical facilities range from traditional remedies,
such as toxic Alligator chili peppers, to physical force, such as repeated blows to the
stomach and insertion of rubber catheters into the terus. Many of the Ethiopian clients
interviewed for this report at the Marie Stops International Ethiopia (MSIE) Clinic in Asella, a
rural town 100km outside of Addis Ababa, stated that they were aware of women who self
induced abortions by swallowing pills from traditional healers. The use of contaminated,

20
Leitner center for international law and justice report ,US foreign policy as an obstacle to the implementation of
Ethiopia’s liberalized abortion law may 2010 p.6-8
21
Id
22
Id
unclean and unsterilized instruments during unsafe abortions are a common source of infection
and often lead to post-abortion complications such as hemorrhage and sepsis, and in many cases,
death.23

Many women resort to these methods because abortion is highly restricted, contributing to high
abortion-related mortality rates. Countries with strict abortion laws suffer from higher abortion
rates than those countries with liberalized laws.4 There has been much documentation
showing a decrease in abortion-related mortality and morbidity with the liberalization of
abortion laws. In South Africa and Romania, the legalization of abortion resulted in a
substantial reduction of abortion-related maternal deaths. The rate of deaths caused by abortion
complications decreased by a remarkable 91% in South Africa from 1994 – 2001, and in
Romania, maternal mortality fell by 73% between 1990 and 2002.The cases of South Africa and
Romania demonstrate that enacting liberalized abortion laws is an effective way of reducing
unsafe abortion rates.24

2.3 Overview of Abortion Laws and Practices

The 2008 annual report of the Centre for Reproductive Rights indicated that at least 26% of
world citizens live in countries where abortion is prohibited (Centre for Reproductive Rights
2008). Currently, most countries, even those with relatively liberal laws on abortion, still have
penal code provisions that indicate the situations in which abortion is a crime (Goodman
et al. 2008). Laws, policies, economic status, and social norms strongly influence women’s
choices when undertaking abortion, and especially unsafe abortion (Centre for
Reproductive Rights 2008).Berer on review of national laws and the influence on unsafe
abortion Reported that in many countries mortality and morbidity that resulted from abortion
are declining due to the legalization of abortion and provision of accessible and affordable safe
services (Berer,2004). Similarly Gebrehiwot and Liabsuetrakul also reviewed studies in
South Africa and Guyana, which shows legalization of abortion has an effect on reducing
maternal mortality although factors influencing on maternal mortality vary between
countries (Gebrehiwot & Liabsuetrakul, 2008).25

23
Id
24
Id
25
Fasika Ferede Alemu,thesis on Minors Awarness about the new abortion law and access to safe abortion service
pp23
Historically, the Ethiopian government and public service organizations have provided limited
access to reproductive health services. Safe abortion services were largely unavailable to women
for most of Ethiopia’s modern history. The restrictive penal code of 1957, coupled with narrow
access to family planning services, limited women’s options, thereby forcing them to seek unsafe
abortions. The impact of restrictive laws and lack of services was far-reaching. According to
CEDAW, access to services during pregnancy as well as access to safe abortion services is a
critical area in need of government intervention. WHO guidelines identify essential components
for the transition from unsafe to safe abortion services as: changing national policies, training
providers on abortion procedures, ensuring provision of services at accessible delivery points and
guaranteeing that women are accessing these services. The revised penal code significantly
liberalized abortion law and the Technical and Procedural Guidelines for Safe Abortion Services
in Ethiopia, which followed in 2006, demonstrated a sign of significant reform in addressing
women’s reproductive health needs. Although the aforementioned policies, strategies and
programs demonstrate significant efforts to address the population’s dire and complicated
reproductive health needs, the implementation of laws and policies remains limited and
inefficient. Lack of enforcement mechanisms and delays in updating and disseminating pertinent
regulations constrain the public’s access to the much needed services.26

2.4 Comparative study of the legal regime in some countries

2.4.1 South Africa

It is helpful to study the liberalization of South Africa’s abortion law because South Africa’s
history of restrictive laws on reproductive health under apartheid negatively affected women’s
rights similarly to Ethiopia’s history of restrictive laws. Women’s low social status in Ethiopia
and South Africa has contributed to limited access to safe abortion services, which has been and
continues to be a major contributing factor to high rates of mortality and morbidity in both
countries. Even though Ethiopia is at a different stage of economic and social development than
South Africa, important comparisons may still be drawn.27

Historically, South Africa’s high number of unsafe abortions stemmed from discrimination of
women’s reproductive right under apartheid. Further, a lack of health care facilities and
26
Neesha Good Man, Anna Sacket, Rachel Vasilver, Bridging the gaps; implementation of comprehensive Abortion
care in Ethiopia. December 15,2008 p.16
27
id
sresources hindered the ability of women to have a safe abortion. In 1975, the South African
government passed the Abortion and Sterilization Act, which provided that abortions could be
carried out under certain circumstances. These include “…when a pregnancy could seriously
threaten a woman’s life or her physical or mental health; could cause severe handicap to the
child; or was the result of rape (which had to be proved), incest or other unlawful intercourse,
such as with a woman with a permanent mental handicap.”28

However, the Abortion and Sterilization Act required two doctors’ permission for the abortion to
occur. Due to stigma, this was almost impossible. Thus, the act ultimately had little effect on
reducing unsafe abortions. The number of women who visited hospitals due to incomplete
abortions continued to grow and strain the health care system. The South African government
recognized further reform of the 1975 act was needed. African National Congress (ANC) leaders
proposed improvement of reproductive health policies, calling for expanded access to abortion
and for legalized abortion. The proposed reform passed—a monumental step towards protecting
women’s reproductive rights. In 1997, South Africa became the first country in the world to
legislate access to abortion services. After years of debate; the government of South Africa
passed the Choice on Termination of Pregnancy Act which grants a woman the legal right to
terminate a pregnancy. A woman need not consult with anyone, even her husband. Further, the
act “encouraged the development and integration of abortion as part of reproductive health
services at the primary health care level.”29

According to the new law, abortion is permitted if a woman is less than 12 weeks pregnant.
Women who are between 13 and 20 weeks of gestation can seek abortion services if a health care
provider believes that the pregnancy may threaten the mental or physical health of the woman or
fetus, if the pregnancy resulted from rape or incest, or if it negatively affects the woman’s
socioeconomic situation. A woman may terminate a pregnancy after the 20 week, only if a
doctor or trained midwife finds that continuing the pregnancy would threaten the woman’s health
or result in severe handicap to the fetus.30

In South Africa it is most often only medical doctors who may perform abortions, though it is
permissible for properly-trained nurses to do so, but only up to the 12 th week of pregnancy.
28
Id
29
Id
30
Id
Health care providers are given the option, if specially trained, to perform an abortion. The
government has ruled, however, that trained health care providers are obligated to perform an
abortion if the woman’s life is in danger. The government also ruled that tides the duty of all
doctors, nurses and health care providers to inform the woman that she has the right to abort the
fetus. In South Africa, abortion is free at almost all government run health facilities. By law, all
health care facilities must provide abortion and reproductive health counseling. Unfortunately,
studies show that some health care providers do not counsel the woman if she does not request it.
Medical abortion is the most common method used in South Africa.38 A medical abortion refers
to “pregnancy termination with abortion-inducing medications in lieu of surgical intervention.
The most common regimen includes two medications: mifepristone, followed by 1-2 days by
misoprostol.”31

As per the Technical and Procedural Guidelines for Safe Abortion Services in Ethiopia, skilled
health care providers at all health facilities equipped with the appropriate supplies and equipment
can perform an abortion if the gestation period is less than 12 weeks. Between 13 and 28 weeks,
abortions must be performed at secondary or tertiary level health facilities by general medical
practitioners (GMPs) or obstetrician-gynecologists (OB/GYNs). Legal abortions in Ethiopia are
not free. Medical abortions are administered up to nine completed weeks since the last normal
menstrual period (LNMP) and for pregnancies within 12 weeks of gestation from the first day of
the LNMP. The preferred method of termination is manual or electric vacuum aspiration.
According to the guidelines, dilation and sharp metallic curettage should be used only when
medical methods are not available.32

Ethiopia’s 1957 penal code resembled South Africa’s 1975 Abortion and Sterilization Act in
that both restricted women’s right to legal abortion, resulting in an increased number of women
seeking unsafe abortions. The South African government recognized the 1975act’s detrimental
effects and passed the Choice on Termination of Pregnancy Act in 1996.41The ANC procured
passage of the abortion legislation and began to implement the law on all levels including
primary care. South Africa’s new law provides for increased access to abortion services and
resources as well as expanded educational initiatives. The purpose of these initiatives is to
inform women of their reproductive rights and providers of their responsibility to counsel
31
Id
32
Id
women and perform abortion services. Ethiopia took similar steps by passing the revised penal
code in 2005.In 2006, the Technical and Procedural Guidelines for Safe Abortion Services in
Ethiopia provided an official interpretation of the law. Although Ethiopia has made strides,
further action is necessary to bridge the gap between policy and action. Ethiopia can draw from
the actions of South Africa to institute methods of expanding and enhancing safe abortion care.
In order to do this, it is imperative that governmental, nongovernmental organizations and
community leaders take collective action towards raising awareness and increasing access to safe
abortion services.33

2.4.2 USA, Canada and England

Although restrictive abortion laws endured for a long time, many social and technological factors
forced them to give way to more liberal laws. The advance in medical technology, women’s
enhanced awareness about their rights, and concerns about population militated against
maintaining restrictive laws. It was under such a setting that American physicians opted for the
relaxation of restrictive abortion laws, and movements towards asserting a Oman’s right to full
control of her body enhanced the momentum. As a result, state laws allowed abortions for a
variety of reasons, such as: best interest of the patient, sound clinical judgment, informed patient
consent, avoiding harm to the woman’s physical or mental health, avoiding birth of a fetus which
will be born with serious mental or physical handicap, pregnancy resulting from rape, incest, and
illicit intercourse with a minor girl.34

Moreover, a case decided by the Supreme Court of the United States in 1973brought about a
radical change in the abortion laws of the country. Roe v Wade is an important case because it
established a federal constitutional right to abortion. In Roe v Wade (1973)”42 the ruling of the
US Supreme Court included the following:

During the first trimester of pregnancy, the state cannot bar any woman from
obtaining an abortion from a licensed physician. During the second trimester, the
state can regulate the abortion procedure only to protect the woman’s health. In
the third trimester, the state may regulate to protect fetal life, but not at the
expense of the woman’s life or health. “

33
Id
34
Tsehai Wade abortion law in Ethiopia comaparative perspective vol,2 No 1Jan 2008 p.9
The decision has endured a quarter century and remains essentially intact, despite many
subsequent decisions.”43Roe’s holding have dealt with issues such as interest of the state,
husbands, parents, and others.44It should, however, be noted that the decision on Roe v. Wade
has not brought about a consensus between the pro-life and pro-choice lobbyists. Thus, the issue
of abortion s stills a legally controversial issue in the United States. Different cases have been
brought to the Supreme Court since 1973, among which Webster v Reproductive Health Services
(1989) and Planned Parenthood of Southern Pennsylvania v Casey (1992), can be cited as
examples.35

Canadian abortion laws have also passed through many changes through time. The 1869 law of
Canada prohibited abortion and punished it with life imprisonment. In 1969, the criminal law
was amended to legalize abortion when pregnancy poses a threat to the life or health of a woman.
In 1988, in a case that involved a well known abortionist by the name of Dr. Henry Morgantaler,
the Supreme Court struck down the abortion law as contrary to section 7 of the Charter of Rights
and Freedoms (guaranteeing “life, liberty and security” of the person) and the court reasoned out
that, Section 251 [that part of the criminal law that allowed abortion for therapeutic reasons]
clearly interferes with a woman’s physical and bodily integrity. Forcing a woman, by threat of
criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own
priorities and aspirations, is a profound interference with a woman’s body and thus an
infringement of security of the person 36

England substantially liberalized its abortion laws in 1967 by allowing the range of justifications
for therapeutic abortion to include almost any aspect of the pregnant woman’s circumstances,
including the impact on existing children.47 It is also believed that the reduced influence of
religions at this time enhanced a secular and pragmatic mindset regarding the issue of abortion. 37

2.5 The impact of restrictive abortion laws on maternal and infant mortality
Poverty, extreme youth, unpreparedness for motherhood, abuse, abandonment by a partner are
some of the factors the lead to abortion due to unwanted pregnancy. Current social realities
clearly show that there are numerous reasons which create the will and determination in many
women to terminate pregnancy. World Health Organization’s (WHO) database and periodical
35
Id
36
Id
37
Id
studies show that abortion is widely practiced throughout the world – legally as well as illegally.
According to reports, nearly 20 million unsafe abortions took place in 2003, 98% of them in
developing countries with restrictive abortion laws. In another study conducted in 1991, an
estimated 26 to 31 million legal abortions and 10 to 22 million clandestine abortions were
performed worldwide in 1987. Legal abortion rates ranged from a high of at least 112 abortions
per 1,000 women of reproductive age in the Soviet Union to a low of 5 per 1,000 in the
Netherlands. Other statistics indicate that China performed 10,394,500 abortions in 1987 alone.
[In the same year], 6,818,000 abortions were performed in the Soviet Union. …In 1975,
2,250,000 abortions were performed in Japan and in 1982, 11million abortions were performed
in the Soviet Union.38

Illegal abortion is shown to be the major cause of maternal mortality in many countries and a
cause for infanticide, abandonment of newborns, selling of unwanted children and placement of
so many children in orphanages. The data also reveal that Latin America and Africa are the worst
affected regions in this regard. Latin America and the Caribbean had the highest incidence of
induced abortion in the developing world, with between 2.7 and 7.4 million performed each year.
Moreover, complications arising from these procedures are the principal causes of death among
women of reproductive age. Approximately 800,000 Latin American women are admitted to
hospitals every year for post-abortion complications.39

Abortion is a major public health problem for most of Africa, where most of the abortions
carried out are illegal and hence unsafe. For example, “the restrictive statutory formula has
driven many pregnant women and girls to non physician providers in a bid to avoid reluctant
parenthood by accessing secretly illegal and septic abortions” which are unhygienic and unsafe.40

Almost 5 million unsafe abortions are performed each year, approximately 30 unsafe abortions
per 1,000 women of reproductive age. Of these 5 million abortions, a disproportionately high
number of the world total result in death: 34.000 a year, 40% of the world total, at a rate of 100
per 1,000 live births.41

38
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39
Id
40
Id
41
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Maternal mortality rates are 880 deaths per 100,000 live births, and 12-13% of all maternal
deaths are the result of unsafe abortions. The risk of death from unsafe abortions is one in 150
procedures, and this is by far the highest in the world.42

Despite legal reforms and improved access to health services in many countries, latest figures
show that the situation is not encouraging. The incidence of unsafe abortion is still very high in
Africa and South America, compared to other regions. The estimates for the year 2003 show that
only about 40% of women of reproductive age live in countries where abortion is available on
request and there is no evidence of unsafe abortion. On the other hand, unsafe abortion rates are
close to 30 per 1000 women of reproductive age in both Africa and Latin America.82Thus, in
these regions, unsafe abortion is still a major cause of maternal mortality and responsible for,
inter alia, the consumption of a significant share of resources, including hospital beds, blood
supply, medication, and often operating theatres, anesthesia and medical specialists.43

Based on analysis of data gathered on the correlation between restrictive abortion laws and
maternal and infant mortality rates, Chad M. Gerson noted that lesser access to abortion is
correlated with higher rate of maternal and infant mortality:

“Access to abortion in inversely correlated with both maternal and infant mortality.
These correlations are suggestive of a palpable cause and effect relationship between
access to abortion and maternal and infant mortalities.”

Recent figures show that Burundi, Chad, Ethiopia, Guinea, Mozambique, Rwanda, Sierra Leone
and Somalia have the highest mother mortality rates of 1,300 or above per one hundred thousand
live births.84 It is to be noted that three countries with restrictive abortion policies (Egypt,
Libya and Mauritius)85have managed to have very low maternal mortality rates owing to
another significant variable, i.e. very high per capita income compared to most countries in
Africa.

With regard to infant mortality, Angola, Guinea-Bissau, Liberia, Niger, Sierra Leone and
Somalia have the highest rates which range from 130 to 165 per one thousand

42
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43
Id
deliveries.86Ethiopia’s infant mortality rate, i.e. 114 per one thousand deliveries is also
considerably high.44

2.6 The Revised Criminal Code of 2004

The Revised Criminal Code has maintained most of the provisions of the former Ethiopian Penal
Code, including the order of articles. This law has, however, introduced the following major
changes:

a) The former law exempts those who committed abortion negligently under Art.528(1),
Paragraph 3. This defense has been omitted from the new law and the probable reason is that
under (Article 59/2) of both Codes, negligent acts are made punishable only when the law
expressly so provides and it will be redundant to show the same in the Special Part.

b) The 2004 Criminal has repealed Articles 802 and 528/2 of the 1957 Penal Code. Under the
1957 Penal Code advertising for abortive means was punishable.

c) The punishments provided under Art. 529 of the former law for a woman who procures her
own abortion and against those who procured for her the means of or aid her in the act are
reduced from 3 months up to five years simple imprisonment and 1 to 5 years simple
imprisonment respectively, to simple imprisonment, Art. 546(1) & (2).

d) The punishment provided for those who perform abortions or assist in the act contrary to the
law under Art.530 of the former law is reduced from rigorous imprisonment not exceeding five
years to simple imprisonment, under Art. 547(1).

e) Consenting to abortion contrary to the law was not an illegal Art. 547(3).

f) The former law did not provide for a special punishment for those persons who perform
abortions without having proper medical profession.

The Revised law has, however, made this act punishable by simple imprisonment for not less
than one year, and fine, Art. 548(1) (b).

g) The major departure from the former law is reflected under Art. 551 of the Revised law
which deals with “Cases where terminating pregnancy is not punishable”. According to this
44
id
provision, termination of pregnancy resulting from rape or incest, which was a ground of
mitigation under the former law (if it entails exceptionally grave state of physical or mental
distress), are no more punishable (Art. 551/1/a), and mere statement of the woman is adequate to
prove that the pregnancy resulted from these causes (Art. 552/1). Termination of pregnancy
where the child has an incurable or serious deformity or where the pregnant woman, owing to a
physical or mental deficiency, suffers from or her minority, is physically as well as mentally
unfit to bring up the child are new defenses introduced by the 2004 Criminal Code, Art. 551(1)
(c &d). Moreover Article 550 allows mitigation of punishment for abortion done “on account of
extreme poverty.”

h) The Revised law has also done away with the formalities required for abortions performed for
medical reasons and provides that the Ministry of health shall issue directives under which
pregnancy may be terminated (Art. 552/1). Violation of such directives is made punishable by
fine not exceeding one thousand Birr, or simple imprisonment not exceeding three months (Art.
552/2). The new law has broadened the grounds of legal abortion and this is definitely a step
forward. Articles 551 and 550 of the 2004 Criminal Code have thus elevated Ethiopia’s position
in the spectrum of Levels of Freedom of Abortion: 45

- Grounds on which abortion is permitted under the 2004 Criminal Code

•To save the life of the woman…………………. Yes (Art. 551/1/b)

•To preserve physical health…………………… Yes (Art. 551/1/b)

•To preserve mental health……………………... Yes (Art. 551/1/d)

•Rape or incest…….…………………………… Yes (Art. 551/1/a)

•Foetal impairment……………………………... Yes (551/1 /c /b)

•Economic or social reasons…………………… No*

•Available on request.………………………….. No *

45
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 To sum up, it can be said that Ethiopian abortion law started its voyage from rigid restrictions to
some reform in 1957, and it has indeed broadened the scope of permissible abortion under the
2004 Criminal Code although it has yet to elevate itself towards the level it deserves. Until the
pro-choice stance of our laws become commensurate with our needs and the objective reality, the
abortion is bound to continue underground thereby rendering the lives of pregnant women and
girls susceptible to the dangers of unsafe abortion.46

2.7 Perspectives on Abortion

2.7.1 Pro-Life Perspectives

There are two main approaches to pro-life: one of moral perspectives and the second of
religious perspectives; and although they sometimes intertwine, for this discussion, both views
will be treated separately. The religious perspective has very little to be debated considering it
embraces the belief in a super natural almighty entity; and there is, in fact, very little literature
discussing the logics of religion. 47

Nonetheless, there is abundant literature covering the moral and ethical rhetoric related to
abortion.Pro-life authors often compare the views of its opposition as very individualistic
and centered on personal preferences; comparing the choice of choosing vanilla ice cream or
chocolate ice cream with having or not having an abortion (Beckwith, 2007). 48

Critics of abortion attack the fact that despite cultural background, abortion is
wrong just as killing is wrong and stealing is wrong in any society, regardless of cultural values.

2.7.1.1 Moral Relativism

Some scholars defend relativism, stating that the lack of moral norms is based on
the fact that individuals have dichotomous perspectives of values. However, pro-life advocates
reply by stating that, first, because people disagree on a matter, that does not mean a lack of truth
to the matter; second, if the relativist agrees that there is no truth, than it invalidates itself
(because there is no truth, than relativism cannot be correct; or valid); and finally, the

46
Id
47
European Journal of social science,vo,l 27 No. 4 2012 p3-4.
48
Id
overrating of disagreement, considering most people in the world have a common
understanding of what appears agreeable or disagreeable (Beckwith, 2007). 49

2.7.1.2 The Unborn as Moral Subject

There are heated debates among scholars whether the unborn entity should be given full
rights and moral status; although both, pro-life and pro-choice agree that a fetus is a human
being belonging to Homo Sapiens species, pro-choice supporters argue that the unborn is
not intrinsically valuable because of a lack of ability to reason and self-awareness (Beckwith,
2007). It appears as a reasonable comparison that there are many cases of retardation in adults
where a lack of self awareness or ability to reason is present as well; however, there is no such
law favoring the termination of the mentally handicapped.50

2.7.1.3 Philosophical Considerations

The realm of the debate on abortion appears to be deeply rooted in a philosophical
puzzle, and the puzzle consists of three basic sets of questions (Tooley, Wolf-Devine, Devine,
& Jaggar, 2009):

1. Do embryos have a moral value? If they do, what is it? Are they entitled to human
rights?

2. What makes abortion ethically permissible?

3. How should a society organize itself towards limiting, facilitating, or banning

abortion? It is reasonable to agree that if an unborn is a human, the unborn is entitled to rights;
and if a human is entitled to rights, it must have moral values. This statement appears to make
abortion unethical from the standpoint that the unborn entity is being deprived from the right of
choosing to live, considering someone else is making that choice; and, therefore, society should
ban the practice of abortion (Boonin, 2003). 51

2.7.2 Pro-Choice Perspectives

To be an advocate of pro-choice initiatives raises serious ethical, moral, and philosophical
questions. Since the beginning of time, women were given the title of caregivers and nurturers;

49
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50
Id
51
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entrusted with the welfare of the offspring and organization of the home. Nowadays, a trend
has developed in Westernized countries especially; where women decide to do whatever
they feel like instead of following the old housewife stereotype. Such sudden change in
human behavior must have its consequences, considering the role animals have been playing
since the first animals arrived. One of the most visible consequences of the impact of a new trend
for women’s behavior relates to the lack of attention to the children because their mothers are at
work. In many occasions, the lack of attachment leads children to lack of self-esteem, lack
of self-confidence, anger problems, and other attention deficit behavioral issues. Aside from
mentally related issues, there are physical issues that could occur for the lack of maternal
vigilance; such as child battery, child sexual molestation, verbal abuse, lack of awareness of
dangerous situations and so forth. Notwithstanding, there are greater chances that children might
not foresee a promising future because of a lack of parental interest or because of a lack of
parental time with the child; or both. Pro-choice advocates tend to focus greater attention on
parents who do not want to have a child considering the future implications of having an
unwanted child.52

2.7.2.1 Philosophical Considerations

The same questions utilized to debate pro-life’s philosophical considerations will be utilized to
debate pro-choice’s philosophical considerations; seeing that ethical behavior is of the essence
(Tooley, olfDevine, Devine, & Jaggar, 2009):

1. Do embryos have a moral value? If they do, what is it? Are they entitled to human
rights?

2. What makes abortion ethically permissible?

3. How should a society organize itself towards limiting, facilitating, or banning

abortion?

To answer the first question in a pro-choice perspective is to say, without entering deep
philosophical considerations proposed by Boonin (2003), that the fetus is not yet a person and

52
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does not have a moral value yet. Boonin proposed that if a fetus is considered a person,
then a zygote or a woman’s egg is a person as well; and therefore are entitled to human rights.
According to the ideology of pro-choice followers, what makes abortion ethically permissible is
the fact that

(a) The mother does not want the child;

(b) The father does not want the child;

(c) The mother will possibly die from giving birth;

(d) The pregnancy is the result of rape. The fact that the mother does not want the child could
embrace several reasons: (a) the mother knows the child will be born with physical or
mental abnormalities; (b) the mother is a drug or alcohol abuser; (c) the mother knows she is not
financially fit to take care of the child; (d) the mother knows her relationship with the father of
the child will not last, and she feels insecure; or (e) for no specific reason, she does not want the
child. As far as facilitating, limiting, or regulating abortion, it does not appear that pro-choice
followers defend an irresponsible and indiscriminate use of abortifacients; but rather, a more
efficient use of reasoning by men and women generally speaking.53

53
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 CHAPTER THREE

ABORTION RIGHT IN ETHIOPIA

3.1 Awareness on new abortion law of Ethiopia

Ethiopian Federal Ministry of Health in its Health sector development plan (HSDP) had planned
to reduce unsafe abortion from 50% in 2005 to 10% in 2010, however unsafe abortion is still
above 50%. A 2010 research and fieldwork in Ethiopia found that unsafe abortion causes more
than half of the 20,000 maternal deaths that occur annually. The reasons suggested are women
and health care providers are not aware about the revised 2005 Criminal Code of the
Federal Democratic Republic of Ethiopia. 54

In Ethiopia, as in most developing countries, access to safe abortion continues to depend on

women’s awareness of the law. Despite the relatively liberal nature of the law, knowledge of
legal rights remains extremely low amongst most women. Due to major misconceptions about
details of the law, women often resort to utilizing unsafe services. Women, health care providers
and the general population are often unaware that health care providers are obligated by law to
refer women to an appropriate health facility or to a provider who will perform the abortion. As a
result, most women do not seek safe abortion services although they have the right to do so under
the revised penal code.

54
Worku Animaw ,Binyam Bogale Awareness and attitude to liberalized safe abortion services among female
students in university and college of arba minch town, Ethiopia science Journal of public health. September 10,2014
p2
Study conducted in arbamench university shows us this reality, Study participants were asked
questions asking their knowledge about criteria set by the law which liberalized safe
abortion service. Only sixteen students among 813 participants (1.9%) knew all the
criteria asked about abortion law which liberalized safe abortion service. Majority of the
students knew only one criterion (173(21.28%). Ninety four students (11.5%) were totally
unaware of the criteria set by law. 552(67.9%) of the total 813 study participants were found to
be not knowledgeable about the law that liberalized induce abortion.55

Other study which is conducted in yergacheffe town on knowledge and attitude of women of
child bearing age towards abortion and it’s legalization tells us Knowledge about the
legalization of abortion accounting for 48.21% and more than half of the respondents has no
knowledge about the legalization of abortion which accounts for 51.79%.Of those respondents
who have knowledge about the legalization of abortion in our country 86.17% know that it is
legalized considering rape, the rest 64.36% in cases of incest, 60.11% in cases of maternal
health problem, 50% considering congenital malformation of the baby which is
incompatible with life and the remaining 5.85% do not know on what scenarios abortion is
legalized. Of all the respondents who have knowledge about abortion legalization in our
country, more than half agree with its legalization which accounts for 115 (61.17%) and
those who do not agree with the legalization accounts for 63 of the (33.51%) & the rest 10
(4.79%) are neutral. Of those respondents who do not agree with the legalization of
abortion, 56 (88.89%) disagree considering religion as a reason, 28 (44.44%) regarding
social cultural norms and the rest 19 (30.16%) considering as a result of maternal health
problem. Of those respondents who do not have knowledge about the legalization of abortion
in Ethiopia 71 (35.15%) agree if abortion is legalized but 127 (62.87%) disagree and the
rest 4 (1.98%) are neutral about it. Of those respondents who haven’t knowledge about the
legalization of abortion, but they agree on rape 66 (92.5%), incest 55 (77.5%), congenital
malformation 45 (63.3%) and maternal health problem 61 (85.9%) scenarios to be
legalized. Of those respondents who haven’t knowledge but they also disagree by
considering religion 97 (96.4%), 60 (47.24%) considering socio cultural reason and 74
(58.27%) considering maternal health.56
55
Id
56
Shemelash Bitew, Samerawit Ketema, Minyahelal Worku,Mustefa Hamu, Eskender loha :Knowledge and attitude
of women of Child bearing age towards the legalization of abortion, Journal of scientific and innovation research
From afro mentioned and other researches which are conducted in university and in some cities
of Ethiopia we can infer that as there is poor knowledge regarding abortion law of Ethiopia.

3.2 Why women’s are forced to get unsafe abortion?

Many women resort to these methods because abortion is highly restricted, contributing to high
abortion-related cases Countries with strict abortion laws suffers from higher abortion rates than
those countries with liberalized laws. There has been much documentation showing a
decrease in abortion-related mortality and morbidity with the liberalization of abortion
laws. In South Africa and Romania, the legalization of abortion resulted in a substantial
reduction of abortion-related maternal deaths. The rate of deaths caused by abortion
complications decreased by a remarkable 91% in South Africa from 1994 – 2001, and in
Romania, maternal mortality fell by 73% between 1990 and 2002.8 The cases of South Africa
and Romania demonstrate that enacting liberalized abortion laws is an effective way of reducing
unsafe abortion rates.57

As i try to discus in literature review the history of abortion in South Africa is the same with
Ethiopia, before she liberalized its law on abortion. But after liberalized abortion complications
were decreased by 91% starting from 1990-2001. From this we can infer that it is good to
Ethiopia to take the experience of South Africa, and liberalized its abortion law under all
circumstances and try to decrease abortion related deaths.

As many as 67,000 women in the world die annually as a result of unsafe abortion, and 48% of
all abortions worldwide are deemed unsafe. WHO and the Alan Guttmacher Institute
(“AGI”), a non-profit organization that works to advance reproductive health, have found
that unsafe abortion is disproportionately concentrated in the Global South, with more than
97% of all unsafe abortions occurring in those countries where abortion is legally restricted 58.
It is for this reason that unsafe abortion is recognized as an important public health problem in
the world and specifically in our country.

vol 2 issue 2.aprial 2013. Pp20-22

57
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58
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3.3 What are the advantages of legalization of abortion?
. It reduced the probability of women to seek for traditional abortion practices which are
performed by untrained professionals in a place that does not meet the minimal medical
standards or both and also decrease the chance of gaining access to post abortion care, so that
there will not be a high incidence of complications.

Each year greater than 42 million pregnancies are terminated due to various reasons. Of
this million occur in countries where abortion is legalized and in safe ways. The rest 20
million occur mostly in the developing countries where abortion is not legalized and in
unsafe ways. Ethiopia is the 5th in maternal mortality according to the WHO 2005 report and
unsafe abortion accounts for 32 % of the causes of maternal death. It is also one of the top 10
reasons for mothers to seek hospital admission in Ethiopia.59

Legalization of abortion is based on the right to life, the right of women, the right of liberty and
the right of reproductive health. In our country before, May 2005 there was a strict rule against
abortion which only considers maternal conditions to perform an abortion. After May 2005 there
is a new provision of law regarding abortion which is stated in the criminal code of
Ethiopia article 551/2005. This article allows abortion in certain cases such as pregnancy
from rape, incest, congenital anomalies of the fetus which is incompatible with life and
maternal physical and mental health. So as to decrease the maternal mortality from unsafe
abortion and the immediate and late complications of abortion, our country put legislations
on the abortion practices. 60

The Ethiopian government has accomplished a great deal since adopting the revised penal code.
However, despite the progress, Ethiopian women continue to be confronted by obstacles to
seeking abortion care. In 2005, Ethiopia’s maternal mortality ratio was 720 deaths per
100,000 live births; however, maternal mortality in the country is still 676 per 100,000 live
births notwithstanding the law.

59
Shemelesh bitew Supra not 56 pp 20 -22
60
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3.4 What are the main factors that hamper women’s from accessing safe
abortion services?
There are some factors that hamper women’s from accessing safe abortion services from these:

3.4.1. Stigma
The controversial nature of abortion and the negative stigma associated with it has
created difficulties for the implementation of Ethiopia’s abortion law. Deeply rooted social
norms and religious values influence an Ethiopian woman’s regarding the termination of an
unwanted pregnancy. Geta Alem Kassa and Dagmawi Selamssa of HIWOT-Ethiopia explain
that the degree to which stigma permeates the society can be observed at the government
level, as parliamentarians are unwilling to further discuss the abortion issue because of
“religious influence.” Powerful Christian and Muslim religious groups have voiced opposition to
the liberalization of the law. These groups have developed a strong anti-choice movement
supported by exported United States policies, such as the Helms Amendment and the
recently-rescinded Global Gag Rule. However, resistance to the Ethiopian abortion law does
not lie solely at the institutional level; it also exists at the community level, where some women
are unwilling to discuss abortion issues because of the associated stigma. Local NGOs have
recognized the need to address this issue with a three-pronged approach. Abebe Kebede, from
MSIE, stated that lawmakers and NGOs alike should “promote conversation at the community
level, by engaging local leaders, and at the grassroots level.” It is true that Ethiopian
61

parliamentarians are not interested freely to discuses abortion issues because of religious
influence, so they them self’s are one obstacles to women in Ethiopia not to enjoy their rights.

3.4.2. Professional Unwillingness of Health Care Providers

Despite their professional code of conduct and training, health care providers may carry
religious, cultural and societal biases that prohibit them from providing services when abortion
is legally permissible. Individuals who refuse to perform certain medical services because of
religious or moral beliefs are commonly known as “conscientious objectors.”Some conscientious
objectors display their intolerance for the abortion law by refusing to complete routine training
for abortion-related equipment. This is problematic because some equipment is not only used to
induce abortions but also necessary to correct post-abortion complications. 62
61
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62
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Additionally, there have been accounts of health care professionals at government clinics
working in brokerage capacities. Gynecologists with private clinics, midwives, and/or other
hospital personnel at public clinics with financial ties to a private clinic have diverted
women seeking abortions or post abortion care at public clinics to their associated private clinics.
Those private clinics are often more expensive, costing more than 300 Birr, and may be
kilometers away from the location of the public clinic or from the woman’s home. In this case,
properly trained doctors who are capable of administering safe abortions in public clinics are
refusing to do so on monetary grounds.63

3.4.3. Lack of Awareness

There is a pervasive lack of awareness of the abortion law in Ethiopia because Ethiopian women
are unaware of the specific provisions of the law and, in turn, are unaware of their rights. This
lack of awareness is further compounded by service providers’ erroneous interpretation of the
law, which limits the actual services women are able to obtain. Even with the issuance of the
Technical and Procedural Guidelines for Safe Abortion Services in Ethiopia, there still remains a
lack of awareness. Many clients interviewed at the MSIE Clinic stated that they were unaware
that public clinics provide abortion services, and those who initially went to the public clinics
had been nonetheless referred to MSIE.64 It is surprising that health care providers (workers) are
not aware of the enumerated exceptions in the abortion law. They should have to know what the
law says trough different means for example by giving training, because this is the matter of their
daily work, If not they misinterpret the law, and they finally prohibit women from accessing
abortion service.

Health care workers often misinterpret the enumerated exceptions in the abortion law. Many
healthcare workers, such as midwives, may not understand a woman’s rights under the reformed
law and may therefore impede the quality and quantity of services delivered. For example, Saba
Geberemedhin of the Network of Ethiopian Women’s Association (NEWA) stated that health
care providers such as midwives need training to better understand the scope of the legal
provisions under the MoH Guidelines. In some cases, midwives may create requirements
that are barriers to safe abortion care and may not understand that proof of a woman’s age or
an investigation into a woman’s alleged rape or incest would violate the legal provisions
63
Id
64
Id
in place to ensure women’s access to safe abortion services. This evidences a continuous
need to provide training that will inform providers on the content and intent of the law.65

3.4.4. Cost/Misperception of Cost

Many Ethiopian women believe that abortion procedures are expensive, but these services are
supposed to be free at public clinics. However, when government clinics do not provide these
services because of the aforementioned reasons, women are forced to go to private clinics, which
are in fact costly. Although MSIE is able to provide essential abortion services, their clinics
charge a fee that totals anywhere between 125 and 175 Birr. Even this small fee can easily be a
week’s worth of sustenance for the average rural Ethiopian woman. MSIE offers services free of
charge if the woman cannot afford the fee; however, this information is not widely known. Thus,
low-income, rural women, who comprise the majority of the Ethiopian female population, are
often barred from accessing services and from exercising their legal right to abortion because
they lack the necessary economic means to procure health services. 66

3.4.5. Lack of Adequately Equipped Facilities

Part of the reason why Ethiopian women are unable to obtain safe abortions at public clinics is
because those clinics are unequipped to provide such services. As the Executive Director of
Consortium of Reproductive Health Associations (CORHA), a local Ethiopian NGO aimed at
improving access to health care, Holie Folie is in a unique position to comment on the
widespread lack of equipped facilities.Folie believes this is a resource and capacity issue to
which the government must pay serious attention. Some health care professionals themselves
believe they are improperly trained to provide safe abortion care. They often instead refer clients
to clinics run by Marie Stopes International Ethiopia and Family Guidance Association of
Ethiopia (FGAE). Shegu Kumsa, the director of the MSIE Clinic in Asella, recalled needing to
retrain a midwife who was initially trained at a government clinic because the midwife lacked
experience and did not demonstrate proper skills. Although the Ethiopian government
should be applauded for establishing training programs at public clinics, they should
continue to allocate resources to ensure the clinics are providing adequate care.67

65
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66
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67
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3.5 Pro-life and pro-choice debate in Ethiopia
The two prominent positions towards abortion which is pro-choice and pro-life is in debate in the
eve of adoption of the new Ethiopian abortion law .both groups had campaigned to promote their
respective positions by organizing workshops, street demonstrations, publication and other
means.68

3.5.1 Pro-life groups

According to those groups abortion is strictly forbidden in bible they also alleged that to allow to
women to abort is damaging for herself because women who abort suffer from different types of
physical as well as psychological disease, including cancer and are vulnerable to suicide
Supporters of this group recommend that individual should abstain from sexual inter course,
before marriage and extra marital sexual inter course, after marriage, Women should be
supported and encouraged to use different types of contraceptive methods. If conception ones
happen it is important to persuaded to accept this situation and also to try to help them by
material and financial support.

Those groups insist that abortion should not be allowed in all circumstance even in cases of
pregnancies resulting from rape or incest

3.5.2 Pro-choice groups

There are so many peoples and groups who support legalization of abortion in Ethiopia. From
these groups one typical example is ESOG (Ethiopian society of obstetricians and
Gynecologists) stands first among all others.

According to these group since all data collected in the country indicate that abortion is the major
cause of maternal mortality, that’s way women’s right to abort should not be deprived. This is
because reproductive health rights are indivisible women’s right.

They also insist that abortion should be allowed when it is proved that the pregnancy jeopardizes
the health and socio life of the women and the fetus, when pregnancy results from rape, or due to
contraception failure.

68
Tsehai Wade abortion law in Ethiopia a comparative perspective vol 2 no 1 jan 2008 p,3-4.
3.6 Public opinion during the Legislature’s workshops and public meetings
and constitutional issues
The Women’s Affairs Committee and the Legal and Administration Affairs Standing Committee
of the Legislature, had organized two workshops in November 1999 and March 2003,
respectively, to discuss the draft criminal law. Abortion was one of the major issues that were
deliberated in these workshops. Although no votes were taken during these deliberations, it was
apparent that the general view leaned towards liberalization of the existing law. Almost all
resource persons were pro-choice (or close to this view), though there were some participants
who voiced anti-abortion views based on religious grounds. Resource persons were drawn
mainly from two professions, namely law and medicine. The presentations and the discussions
addressed the magnitude of the problem of abortion in Ethiopia and the legal issue of abortion in
light of the Constitution and laws of other countries. 69

The following provisions of the Constitution of the Federal Democratic Republic of Ethiopia
(Proclamation No.1/1995) were invoked during the workshops:

Art.35. Rights of Women

(4) The State shall enforce the right of women to eliminate the influences of
harmful customs. Laws, customs, and practices that oppress or cause bodily or
mental harm to women are prohibited. …

(9) To prevent harm arising from pregnancy and childbirth and in order to
safeguard their health, women have the right of access to family planning
education, information, and capacity.

It was also argued that the constitutional right to privacy, which is enshrined under Article 26 of
the Constitution, should be interpreted in line with the decision in the case of Roe v Wade. The
conclusion was, therefore, that the Ethiopian law of abortion (under the 1957 Penal Code) is
unconstitutional. 70

69
Id
70
Id
3.7 Ministry of health guidelines on the new abortion law of Ethiopia
To promote clarification, and pursuant to article 552 of the 2005 abortion law, the Ethiopian
Ministry of Health issued the Technical and Procedural Guidelines for Safe Services in Ethiopia
in 2006. The Ministry of Health (MoH) Guidelines were the Ethiopian government’s
attempt to move towards a functional implementation of the revised abortion law, focusing on
two types of care: woman-centered abortion care and post-abortion care They serve as the
official interpretation of the abortion law, mandating that: abortion should be performed within
three days of a request; a woman seeking an abortion on the grounds of rape or incest does
not need to provide proof or identity of the offender; a woman seeking an abortion on the
grounds that she is a minor does not need to provide proof of age and; midwives and midlevel
providers are permitted to perform abortions. The fact that a woman does not need to prove
rape, incest or her age provides a woman with “greater power over her reproductive health. 71
but
the problem is as we try to see in some researches’ which are conducted on women’s awareness
on abortion law shows us the majority of the women population have not knowledge on the
details of the law . especially rural woman (the large woman population) they are not aware
about the exceptional circumstance under which legal abortion is available and the trick about
the” mere statement of the women is enough to get safe abortion” that’s way they are forced to
get illegal and unsafe abortion.

3.8 National and International Law and Policy

Over the past two decades, the international community has increasingly recognized the need to
improve maternal health and protect reproductive rights. However, the Ethiopian government has
historically played a limited role in providing adequate reproductive health services, educational
initiatives and access to resources for its population. The Penal Code of Ethiopia 1957 permitted
abortion only to save the life or health of a woman. In order for a woman to have an abortion,
visible signs of suffering were required. In addition, termination of pregnancy had to be
diagnosed and certified in writing by a health care provider and two doctors had to authorize the
procedure. Health care providers were subject to prosecution if they terminated a pregnancy
based on false information provided by a woman. The restrictive penal code, coupled with lack

71
Id
of access to reproductive health services, contributed to a higher use of unsafe abortion
services.72

Ethiopia has ratified international human rights conventions and treaties that are legally binding
and that form international law. The Convention on the Elimination of All Forms of
Discrimination against Women (CEDAW), which provides the foundation for reproductive
rights, is one such notable convention. The Tehran Proclamation, the International Conference
on Population and Development (ICPD), the Fourth World Congress on Women, and the 2000
United Nations (UN) Summit are some of the major forums at which national governments have
expressed their commitment to improve the status of women in the society. These and other
international initiatives have yielded wider recognition of individuals’ rights to lead safe and
responsible reproductive lives and have underscored the responsibility of governments to not
only respect those rights but also to create the legal and policy environment for their realization.
73
In reference to abortion, the international community has pledged commitment to reducing the
need for abortion through expanding and improving family planning (FP) services and, where the
laws of the land allow, providing women with high quality abortion care. Furthermore, at the
five-year review of the ICPD, there were calls for governments to consider reviewing laws that
contain punitive measures against women who undergo illegal abortions. Governments have also
agreed that, in circumstances where abortion is not against the law, health systems should train
and equip providers and take measures to ensure that abortion services are safe and accessible.
Additional measures to safeguard women’s health are also required.74

In 1993, the National Policy on Ethiopian Women addressed the affairs of women, in particular,
disparities relating to health, harmful customs and practices and education. Despite Ethiopia’s
official acknowledgement of its responsibility to uphold the rights of women, women still
continue to be denied basic human right.

At the UN summit in 2000, governments of the world ratified the Millennium Development
goals (MDGs) as an international tool for reducing poverty and improving the standard of living
in the developing world. One of the eight MDGs is to reduce the maternal mortality rate by 75%
72
Neesha Goodman, Anna sackett,Reachal Vasilver Bringing the gaps Implementation of comprehensive abortion
care in Ethiopia December 15,2008 p 4.
73
Federal, democratic republic of Ethiopia ministry of health, technical and procedural guidelines for safe abortion
service in Ethiopia june 2006
74
Id
(from 1990 levels) by the year 2015. Preventing unsafe abortion is one of the five strategies for
reducing maternal mortality that was endorsed by the World Health Organization (WHO) in
2004. In response to these developments at the global level and changes in social and gender
relations within the country, the government of the Federal Democratic Republic of Ethiopia
(FDRE) has reviewed its laws and policies within the last decade. Articles 14, 15, and 16 under
Section I (Human Rights) of the Constitution refer to the rights to life, liberty, and security of the
person. Article 35 refers to women’s equality with men and their rights to information and the
capacity to be protected from the dangers of pregnancy and child birth. 75But Ethiopian women
carry a disproportionately high morbidity and mortality as compared to their counterparts in
other parts of the world. This is happen because Ethiopian government fails to implement the
conventions ratified which it granted women’s right to decide on their reproductive right.

CHAPTER FOUR

Conclusion and Recommendation

4.1Conclusion

Each year great than 42 million pregnancies are terminated due to various reason. 22 of this
million occur in countries where abortion is legalized and in safe ways. The rest 20 million occur
mostly in the developing countries where abortion is not legalized and in unsafe ways. This
reality is expressed specifically in Ethiopia because she is the 5th in maternal mortality according
to the WHO 2005 report.

Many women resort to unsafe abortion methods because abortion is highly restricted,
contributing to high abortion-related cases Countries with strict abortion laws suffers from higher
abortion rates than those countries with liberalized laws. There has been much documentation
showing a decrease in abortion-related mortality and morbidity with the liberalization of
abortion laws.

75
Id
The Ethiopian government has accomplished a great deal since adopting the revised penal code
however even with changes to the penal code different researches unveiled us many women
remain un aware of their right or weather their unintended pregnancy would meet the legal
criteria for safe abortion rural and poor women’s in particular face great difficulty in accessing
safe, legal elective abortion care.

far as awareness of the law is concerned Ethiopia is not exception as in most developing
countries, access to safe abortion continues depend on women’s awareness of the law,
knowledge of legal right remain extremely low among women.

Even if the Ethiopian government has ratified international human right conventions and treaties
that are legally binding and that form international law. such as CEDAW, ICPD, the fourth world
conference women and unified nation (UN) summit, however Ethiopian women carry
disproportionally high morbidity and mortality as compared to their counterparts in the other
prates of the world this is happen because Ethiopian government fails to implement the
conventions ratified which it granted women’s right to decide on their reproductive right.

Generally, there are some factors which hamper women from accessing safe and legal abortion
services in Ethiopian from these: stigma, professional un willingness of health care providers,
lack of awareness, misperception of cost, lack of adequately equipped facilities are some of
them.

4.2 Recommendation
 Abortion should be legalized in Ethiopia because Ethiopian government has express its
commitment to improve the states of women in society .for this reason the Ethiopian
government has ratified international human right conventions and treaties that are
legally binding and that from international law, such as CEDAW,ICPD,2000 UN submit
MDG.
 Abortion should be legalized in Ethiopia because it is women constitutional right to have
liberty on their body.
 Since Ethiopian abortion law practically legalized abortion by creating gap; the solution
for this is legalization of abortion for all without discrimination for those who are aware
of the gap and for those who are not aware of the gap.
  The easy way to create awareness on the right of abortion is legalizing abortion on
demand.
 Finally, because of aforementioned problems the researcher recommends for concerned
body to amend Ethiopia’s abortion law again so that abortion related death in Ethiopia
may decrease.

BIBLIOGRAPHY

LAWS
Local laws
 FDRE constitution of 1999
 Revised criminal law of Ethiopia 2005
Foreign and international laws and documents
 Convection on the elimination of all forms of discrimination against women
 International conference on population and development
BOOKS

 Kenneth J. Steven L.John C.etal,mc Graw –hill companies medical publishing division,
William obstetrics, twenty second edition section 3 september,2007.
 Stanly K.haw H. sing S and HasT. The incidence of abortion supplement, international
family planning perspectives march 1999.
 Rash dabash and farzanen Roudi-fanimi,abortion in the middle east and north Africa
2009.
  Singh,S,T,Geberesselessie H,Abdella A,Geberehiwot Y,Kumbi,Sand Adams, the
estimated incidence of induced abortion in Ethiopia, international perspectives on sexual
and reproductive health, 2010.
 Federal democratic republic of Ethiopia ministry of health, Technical and procedural
Guidelines for safe abortion services in Ethiopia. June 2006

JOURNAL AND ARTICLES

 Federal democratic of Ethiopia ministry of health “Technical and procedural guideline

for safe abortion services in Ethiopia” June,2006
 Reques Lopez, perspectives on abortion European journal of social
science,vol,27no.2(2012)
 Tsehai Wade, abortion law in Ethiopia a comparative perspective, vol.2no,1. Jan 2008
 Leitner center for international law and justice report ,US foreign policy as an obstacle to
the implementation of Ethiopia’s liberalized abortion law may 2010
 European Journal of social science,vo,l 27 No. 4 2012
 Worku Animaw ,Binyam Bogale Awareness and attitude to liberalized safe abortion
services among female students in university and college of arba minch town, Ethiopia
science Journal of public health. September 10,2014
 Shemelash Bitew, Samerawit Ketema, Minyahelal Worku,Mustefa Hamu, Eskender
loha :Knowledge and attitude of women of Child bearing age towards the legalization of
abortion, Journal of scientific and innovation research vol 2 issue 2.aprial 2013
RESEARCHES
 Fasika Ferede Alemu,thesis on Minors Awarness about the new abortion law and access
to safe abortion service August 2010.
 Neesha Good Man, Anna Sacket, Rachel Vasilver, Bridging the gaps; implementation of
comprehensive Abortion care in Ethiopia. December 15,2008
 Yirgu Geberhiwot, and Tippawan labsuetrakul, trends of abortion complications in
transition of abortion law revision in Ethiopia, august 14. 2008.