Access to Safe Abortion in post 2015; What Needs To Change For Women And Girls.

September 28 is the Global Day of Action for Access to Safe and Legal Abortion. The day has its origin in Latin America and the Caribbean where women’s groups have been mobilising around September 28 over the last two decades to demand their government to decriminalise abortion, to provide safe and affordable abortion services and to end stigma and discrimination towards women who have abortion.

Over the years, the discussion on access to safe and affordable abortion services have advanced in global advocacy spaces for the health, rights and well being of girls and women. But what does this mean to young girls in Ghana?

I recently lead a group discussion among young people between the ages 10-24 in the Teshie and Nungua communities in the Greater Accra region of Ghana to gather statistics and other evidence on the Sexual and Reproductive Health and Rights (SRHR) and Maternal Health challenges among young people on the CSE4All project with support from Women Deliver and the findings are revealing.

Nationally, among adolescent young girls in Ghana, 3 out of 5 pregnancies are unplanned, and 16 percent of all abortions occur among girls between the ages 15-19 as described by the Demographic Health Survey 2014.. The situation may vary from community to community but it is more disturbing for young people in these communities.

It is quite disturbing that despite the successes in ensuring the health, rights and wellbeing of women, girls and all as supported by the International Human Right declarations and the global development agenda, many girls and women continue to be shamed for accessing safe abortion services. 

Two years after she had an abortion, the 19 year old cannot publicly participate in discussions on SRHR or maternal health. For her, the stakes are high for yet another ridicule or shame. She still goes through stigma among her female counterparts and boys/men alike. “Until now, I never thought I could share my experience but I am doing this for other young girls reading to learn from me. I am sharing my story because, it will save lives.” She says.

For Teki, a 20 year old mother of a 5 year old son, it is easier for girls in her age group to receive post-abortion care at the health centres than comprehensive abortion care services. 

For many young girls like her, the fear of counselling and the experience with some health workers who may stand in their way to safe services due to lack of training, poor attitudes of health workers towards them, affiliations with faith and their rights to privacy and confidentiality against the community who already ridicules them for being pregnant at a young age.

A quick way out in such dilemma is to mix herbs, broken bottles and other known harmful ways of abortion out of desperation and they mostly end up in the health centres when complications get critical.

This is where health workers work round the clock to save the situation without any of the earlier challenges/fears expressed by Teki.

With coverage from the national health insurance, professionalism of health workers to save the situation in a supportive environment by all, “young girls will always prefer to visit the health centre with complications if things do not change”. She added.

The question however remains, who changes what?

The law on abortion in Ghana clearly states the legal indications under which abortion is permitted as stated in the criminal offences Act 1960 (ACT29) section 58 to section 59 as;

(i) When the pregnancy stands as a risk to the life or injury to the physical or mental health of the woman.

(ii) When conception was a result of rape, incest, defilement of Mentally Challenged woman.

(iii) When there is a substantial risk that foetus has or will have serious abnormality or disease

Legally, girls and young women have the rights to access safe abortion services, health workers are protected legally as well as by standards and protocols in the health system however attitudes, beliefs and society’s outlook on abortion continue to change gradually.

Perhaps if we critically examine the issue with a public health lens, preventing the severe complications and injury that many young girls go through today and be less judgmental, provide more education on their SRHR. The global discourse on safe abortion services will impact and save more lives

“Some girls deliver like I did, but others have abortions using all sorts of herbs. They don’t have a choice because their partners (the men/boys) and the community pressure them to do it.”-Teki

 And perhaps, the situation shared by Teki , will improve.