Sunday Times 2
Mortality and morbidity from unsafe abortions in Sri Lanka
Births, abortions and deaths have been part and parcel of what is happening in the human race since its beginning. Deaths we can’t prevent. During the last century with the advancement of medical knowledge, deaths from childbirth have been brought down to one-digit figures per 100,000 births, in the developed world. Sri Lanka is still lagging behind, with 32 deaths per 100,000 births in 2015 and we are unable to bring down the rate to that of countries such as in Singapore due to unsafe illegal abortions. Abortions take third place in the list of maternal mortality in the country. Why is this so??
Keep abortion legal: A global campaign by women health activists
In Sri Lanka, abortions have been criminalised by the British in 1883 by an archaic and antiquated Ceylon Penal Code which is still effective. Whereas, all developed countries have legalised abortions and made them safe for over 50 years, and thus brought down the deaths to almost zero. This, I consider, is a great achievement in view of the reproductive health and welfare of women. No country will be able to make births 100 percent safe. There will always be maternal deaths. It is unfortunate that Sri Lanka’s opinion leaders have not yet realised what obstetricians in other countries have achieved.
We have around 320 members in our specialty in this country. From a medical point of view, we, the obstetricians and gynaecologists, are the sole custodians of the reproductive health and welfare of women and we are duty bound to look after them, with tender loving care. We agree that abortion is evil, but millions of people are killed in this world for which there is no solution. I would like to ask a question. Which is more evil, and a bigger tragedy — the death of a 30-year-old young healthy mother with two or three children dying after complications of an unsafe abortion or the termination of an unwanted pregnancy, illegally and unsafely? It is obvious to anybody that the first is a much greater tragedy and evil than the second. Therefore, the developed countries have discarded anti-abortion laws and legalised abortion by choosing the lesser of the two evils.
What will you do if your only unmarried 16-year-old daughter becomes pregnant? I have had in my private practice many parents coming to me with this problem. Am I to ask them to send the child to an institution where unwed mothers are looked after for nine months and the child is given up for adoption after delivery and the mother returns home — or will I tell them to opt for a safe abortion in a country like Singapore where abortion is legal, thereby, safeguarding the parents and the child, who can get back to school within one week as if nothing has happened.
What do you think will be the future of the child who went to an institution for nine months and then returns to the school after that? It is obvious that the child will be ridiculed by classmates and teachers and she will commit suicide due to severe mental upset and depression and the parents will lose their only daughter.
I am the oldest living obstetrician in the country and have seen a large number of women dying in our wards from severe bleeding and infection following unsafe illegal abortions, performed by quacks, fleecing our women, when these can be performed legally and safely at state hospitals. We have over a thousand births a day and probably an equal number of unsafe abortions, based on various surveys carried out in the country. Around 10 percent of these are unmarried young women.
All these years no one made a hue and cry about these unsafe abortions, till the issue of legalising abortions came up recently. Obviously, the religious authorities never thought anything wrong with the killings of the foetuses and the deaths of mothers following abortions. Why is it that there is such a hue and cry when the Government wants to bring legislation to legalise abortions and make it safe in our country and bring down the deaths due to abortion to zero like in Britain?
If we don’t legalise abortions, it would be the illegal abortionist who would be most happy to carry out his trade without any hindrance from the religious authorities or the State, because the religious leaders in this country are unknowingly supporting the abortionist to carry out their trade and fleece the poor women of their hard earned money and killing some of these women and causing permanent disability to their future reproductive health, for which we as gynecologists are very much responsible in this country.
I would like to end this article with two quotes –“No law that has ever been passed and no law that ever will ever be passed can prevent a determined woman from trying to end an unwanted pregnancy. Society and hospitals must accept their role in keeping women safe in that process.” – John J Sciarra, Emeritus Professor of Obstetrics and Gynaecology, past president of FIGO (2013).
“If one does not support legal abortion, indirectly one supports illegal abortion to thrive.” S. Arulkumaran (2017), Emeritus Professor of Obstetrics and Gynaecology and Past President of the RCOG, BMA and FIGO.
I hope I have convinced the readers enough as to “why abortions should be legalised”.