-Liberians disquieted by the amended abortion law, as Senate contemplates on 18 weeks gestation, but experts recommend the first trimester of pregnancy, as the cut off point for elective abortions.
By: Jerromie S. Walters
The 54th National Legislature of the Republic of Liberia Tuesday, August 22, 2023, kick-started a special Session, and from the end of the Liberian Senate, President Pro-Tempore, Albert T. Chie, named several items that will be considered, including the continuation of the debate on the amended Public Health Law, which includes the amended abortion law, for concurrence.
Liberia’s amended Public Health Law (Title 33 of the Liberian Code of Law Revised) which includes a provision on abortion currently being considered by the Liberian Senate for passage into law, would ban abortions after 18 weeks of gestation.
However, since the abortion news surfaced the public space, there have been mixed reactions, as health experts have suggested that it be minimized to 12 weeks, while scores of women have defaulted completely with justifiable abortion, as they believe it is ungodly, unsafe and shouldn’t be tolerated in an African society like ours.
This, we established following interviews we conducted with individuals from different backgrounds, who vehemently condemned the legislation, and called on the legislature divert from the discussion of amendment of the law, to a total ban, which they said could be followed by an awareness on the need for contraceptive.
What more did they say?
Patricia Wollor is a resident of central Monrovia, she frowns at the amended law that’s before the senate, and like several other Liberians, she holds a strong belief that abortion should never be tolerated in Liberia.
This position of hers, was justified by her experience of howscores of young women have met their early demise, as a result of abortion.
If the Senate concurs with the House of Representative on the amendment of the abortion law, Patricia Wollor is optimistic that it will expose more young to the act.
This, she doesn’t see right, as she’s experienced to the fact that abortion itself has multiplicity of complications on women, even if it doesn’t end their life.
“Sometimes if you go to abort a certain pregnancy, you might not be able to get another child. In cases of women being raped, she still doesn’t see it as a justifiable reason to do abortion. If a lady is rated, and it results to pregnancy, for me I won’t keep it, because you can’t determine the risk ahead,”
She continued, “whether rape or father disowning child, let them forget about abortion,” she admonished the Liberian Senate.
Ms. Patricia Wollor further warning young females against the abortion and recommended the need for contraceptives. “As for me when I’m into sex, I prevent pregnancy,” she said.
Tarnue Kollie D. Seaboe, a resident of Carey Street, “When I heard that it was going to be debated in the legislature, I was one of those that got irritated, because as a Christian, it is against my religion, no Christian or believer will really support such, whether amendment or not, I’m against it in totality.”
In his view, “It should be thrown in the dustbin, we will not support that kind of thing, if those guys make any attempt to pass it into law, we will be heading for destruction because it will affect us.”
“I don’t even want to hear about amendment, the idea, it must not even be passed into law.” For him, he can only embrace the idea of abortion being prohibited in Liberia, despite a given circumstances.
“Since it happened and you didn’t die in the process, let the baby survive, you don’t know what that child will be tomorrow, whether one week old, two weeks old, I don’t even want to hear about abortion,” he said.
Mary Weah, an experienced Liberian midwife flagged the consequences of abortion, and joined the millions of other Liberians who see nothing good about abortion.
“When pregnancy remove by itself through sickness, it’s okay, but for the women herself to remove it, I don’t think it’s okay, it’s not fine.”
She sees abortion as an act of murder, as such, she recommends to the legislature. “If they want to make law, they should stop abortion.”
Two global public health experts, Dr. Tolbert G. Nyenswahand Dr. Mardia Stone, weigh-in on Liberia’s Amended Public Health Law.
The health experts believe any abortion laws in Liberia should consider 12 weeks gestation, the first trimester of pregnancy, as the cut off point for elective abortions.
According to them, it gives a woman sufficient time to confirm that she is indeed pregnant and address all issues relating to her pregnancy… whether impregnated through incest, rape, or other criminal acts …that would legally support her desire to safely obtain an abortion.
“The health risk of an abortion is directly related to how, when, where and by whom the procedure is performed. Therefore, health authorities should setup safe abortion clinics with trained providers, equipment, logistics and supplies.”
They have said because of intrusive legal restrictions and stigma, many young teenage girls and women seeking abortions in Liberia, often resort to clandestine procedures, where safety cannot be assured. “Even in the case of a justified abortion, providers should be reminded that continuing an unwanted pregnancy could induce considerable mental anguish for the mother, if the pregnancy resulted from rape, incest, or other felonious intercourse, or the fetus was found to have a genetic defect that could result in a child, born with grave physical or mental defects.”
“When a woman is not pregnant, it’s improbable that she will die from pregnancy related causes, thus prevention of unwanted pregnancies is essential. When considering abortion, whether justified or unjustified, the Government of Liberia should guarantee women’s reproductive rights by ensuring that reproductive health and family planning services are readily available and accessible for women of child-bearing age.”
According to them, Liberian women need to be better able to avoid unintended pregnancies, the root cause of most abortions. They believe making a wider range of modern contraceptive methods available, strengthening access to emergency contraception, and improving family planning services, would potentially lower the rate of unintended pregnancies, and alleviate unsafe abortions, thereby significantly reducing maternal mortality.
“The general population should be informed and educated on the amended abortion law. This extends to medical professionals, the religious community, the judiciary, and law enforcement officials, who need to know and understand fully the legal criteria for the provision of abortion services. The law should allow abortions up to 12 weeks of pregnancy.” In their opinion, any abortion beyond that period, would be a criminal offence.
Tolbert Nyenswah, LLB, MPH, DrPH is an international recognized legal scholar and global public health expert, a faculty member in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Prior to joining the Bloomberg School, he was Deputy Minister, Assistant Minister, Ministry of Health of Liberia, and Director General of the National Public Health Institute of Liberia. He’s credited and decorated as Ebola hero/czar for leading Liberia’s successful and unprecedented Ebola response as Incident Manager.
Mardia Stone, MD, MPH is a senior consultant and advisor in the Division of Global Psychiatry at the Boston University School of Medicine/Boston Medical Center. A global public health expert, she is formerly a WHO consultant in emergency preparedness and response, an Ebola Response Team Coordinator, senior and technical advisor to the Incident Manager of Liberia’s Ebola response and the National Public Health Institute of Liberia. Dr. Stone is also a retired obstetrician/gynecologist.
Liberia current abortion law/status
The current penal law (Title 26 – Liberian Code of Laws Revised, chapter 16), however, allows abortions up to 24 weeks gestation (about 6 months of pregnancy).
The old Title 33 has been in effect since 1976, over four decades, without any revision, rendering it obsolete. Abortion is illegal in Liberia as per the current law, if it is done after 23 weeks.
Like the women whose views were gagged, abortion is considered a sin by the majority of Liberians who identify as Christians and Muslims. Just like the timing, it is considered with a few exceptional cases such as when the life or health of the mother is at risk.
Abortion in the international world
Only seven nations including the U.S. permit nontherapeutic or elective abortion-on-demand after the twentieth week of gestation. According to the March 19, 2018, Mississippi, United States, Gestational Age Act, Bill 1510, seventy-five percent (75%) of all nations do not permit abortion after twelve (12) weeks gestation, except (in most instances) to save the life and to preserve the physical health of the mother.
Trend analyses conducted by a team of researchers at the National Public Health Institute of Liberia, on maternal and other major causes of death in Liberia, between 2018 to 2022, indicated that, the leading causes of maternal mortality in the country are, post-partum hemorrhage (PPH) at 38% of all maternal deaths; eclampsia/pre-eclampsia at 14%; followed by sepsis; obstructed labor; and, abortion, the fifth most common cause of maternal death.
Globally, unsafe abortions cause 8–11% of maternal deaths, predominantly in low and middle-income countries, where the most restrictive access policies are concentrated, and socioeconomic factors further affect access to care (Lancet Global Health, 2018).
Consequently, experts believe abortion is a subject that attracts substantial attention and is widely deliberated around the world (Liberia included) in all spectrums: public health, medical, political, social, religious, and legal.
Liberian health experts proposal to restrict abortions to 12 weeks of pregnancy in Liberia is based on statistical data in the Liberia Demographic and Health Survey of 2019/2020 (DHS 2019/20) which indicates that Liberia is among countries with the highest maternal and newborn mortality rates (MNMR) in Sub-Saharan Africa.
The DHS also indicates a decline of maternal mortality rates (MMR) in 2013, from 1072 maternal deaths per 100,000 live births to 742 maternal deaths per 100,000 live births. That is, for every 1,000 births in Liberia, about seven women die during pregnancy, during childbirth, or within 42 days postpartum, from causes other than accidents or violence. With such a disproportionally high MNMR, they say affecting primarily women in households with substantial socioeconomic inequalities, catastrophic health expenditures remain pervasive.
Therefore, it is believed that if access to abortion education and nontherapeutic abortion or, abortion-on demand is readily available and affordable, we believe that more women would choose abortion in the first trimester (12 weeks) when it is safer, as opposed to later in the second trimester (13-16, or 16- 24 weeks), when the risks of complications or even death, is much greater.
Similarly, international law has always viewed abortion rights within a medico-legal paradigm, the notion that legal and medical control would guarantee safe abortions.
Meanwhile, on June 24, 2022, the world witnessed the reversal of Roe vs. Wade, a landmark decision of the U.S. Supreme Court, of 1973, which ruled that the Constitution of the United States generally protected a woman’s right to choose to have an abortion.
Legal perspective
Public health practitioners believe this is an effort to make the law fully compatible with contemporary public health issues and norms. The old Title 33 has been in effect since 1976, over four decades, without any revision, rendering it obsolete.
The current penal code of Liberia, Title 26 – Liberian Code of Laws Revised chapter 16 – legalizes abortion up to 24 weeks gestation. However, the proposed revised public health law would only allow legal abortions up to 18 weeks gestation, thereby reducing the period a woman can choose to legally have an abortion from 24 to 18 weeks. The revised Title 33 has been passed in the House of Representatives.
In the Liberian situation, the Supreme Court did not rule on the Abortion Law. The legislators, the elected representatives of the people, decided to amend the law based on the recommendations or influence of local public health officials.
The Public Health Case for abortion rights
Experts say there is a strong correlation between low education among young women, poverty, unintended pregnancies, unsafe abortion, and maternal deaths. In Liberia, forty-seven percent of young women with no education have begun childbearing, as compared with twenty percent of those with a senior high school education. Similarly, forty-two percent of young women are among the poorest people in the country who have begun childbearing, compared with ten percent of those among the wealthiest, according to DHS 2019/20.
The DHS 2019/2020 report indicates further that, sixty percent of pregnancies resulting in live births in a span of 5 years were wanted at the time of conception; thirty-three percent were mistimed, meaning that, women wanted to have children later, and eight percent were not wanted at all. When you combine women who want to get pregnant later, and women who do not want to get pregnant at all, it constitutes a gigantic forty percent. Hence, ensuring general education for all women, providing reproductive health and family planning services, would avert unintended pregnancies and mitigate unsafe abortions.
Health gurus have recommended that the Government of Liberia and health authorities need to bolster the activities of the Planned Parenthood Association of Liberia, an organization responsible for providing quality sexual and reproductive health services, including family planning services, across the country.
“Family planning is hailed as one of the greatest public health achievements of the last century (Amy Tsui et. al, 2010). It lowers the number of unplanned pregnancies and abortions and saves lives.”
It is establish that the current contraceptive use in Liberia is twenty-four percent of married women and forty-five percent of sexually active unmarried women, who currently use a modern method of contraception, according to the DHS 2019/20.”
Sweden’ heightens efforts for abortion legalization in Liberia
It can be referenced, the regular session of the 54th Legislature adjourned on Friday, the 21st day of July, 2023 and, during that same week, the Government of Sweden disclosed that it remains steadfast in supporting pro-choice activists and funding campaigns that advocate for the legalization of abortion in Liberia even though it “respects the views of religious leaders” who oppose abortion.
The Swedish position, which was made known by Ambassador Urban Sjöström, comes a few days after members of Liberia’s Religious Council strongly criticized the Swedish Embassy in Liberia for funding campaigns that push for the legalization of abortion in Liberia.
“Yes, Sweden supports decriminalization of abortion, as recommended in WHO’s 2022 Abortion Care Guideline, which recommends the full decriminalization of abortion,” Sjöströmsaid in response to an email from a local daily, seeking comments. “Sweden recognizes that this is a complex issue in Liberia and in many countries and respects the views of the leaders of faith based organizations in Liberia.” Abortion is illegal in Liberia as per the current law, if it is done after 23 weeks.
Like the women whose views were gagged, abortion is considered a sin by the majority of Liberians who identify as Christians and Muslims. Just like the timing, it is considered with a few exceptional cases such as when the life or health of the mother is at risk.
The Swedish Embassy, and with several international organizations, have been actively promoting the legalization of abortion by supporting local pro-choice activists and funding campaigns that aim to change the existing laws on abortion in Liberia.
Controversies
Like several other reactions, some group have said, “Pressure mounting against extreme abortion bill that will end an estimated 40,000 lives each year in Liberia.Members of the public throughout Liberia are being encouraged to visit www.StopLiberiaAbortionBill.com to ask their senators to vote against the Bill.”
“Under Liberia’s current law, abortion is allowed in exceptional circumstances – where the mother’s life is at risk, rape/incest/felonious intercourse, and disability of the fetus. These are rare situations.”
Many believe that the Public Health Bill “would scrap Liberia’s current abortion law and replace it with an extreme law that allows abortion, for any reason, on demand, up to when the baby in the womb is at 14 weeks gestation.”
They have reported that, “It has been estimated that this change from allowing abortion in exceptional circumstances to allowing abortion on demand would lead to the lives of 40,000 babies being lost to abortion in Liberia every single year. This is a conservative estimate, the actual number could be much higher.”
Liberians believe this data demonstrates that this bill would introduce a very big change to our legislation here in Liberia and would directly lead to the death of thousands of innocent babies through abortion in Liberia.
“Most African countries prohibit abortion except in extreme circumstances, such as the life of the mother, rape/incest, and fetal disability. Most countries in the world likewise prohibit abortion except in extreme circumstances. Only a minority of countries allow abortion on demand.”
Former President of the Liberia Council of Churches Bishop Kortu K. Brown
“We are calling on all Liberian citizens to visit StopLiberiaAbortionBill.com to ask their senators to vote against this horrific Bill.
“A change from allowing abortion in exceptional circumstances to allowing abortion on demand would lead to the lives of thousands of innocent babies being lost to abortion in Liberia every single year. This is a low estimate, the actual number could be much higher.”
“This bill would introduce a very big change to our legislation here in Liberia and would directly lead to the death of thousands of innocent babies through abortion in Liberia.”
The special session of the legislature
The special Session is in fulfilment of Article 32(b) of the 1986 Constitution of the Republic of Liberia, which says: The President shall, on his own initiative or upon receipt of a certificate signed by at least one-fourth of the total membership of each House and by proclamation, extend a regular session of the Legislature beyond the date for adjournment or call a special or extraordinary session of that body to discuss or act upon matters of national emergency and concern.
Setting the agenda for the Special session Tuesday, President Pro-Tempore, Albert T. Chie, named several items that will be considered during the Special Sitting.
Pro-tempore Chie named the Continuation of the debate on the amended Public Health Law, the issues of elections, the attraction of Public Sector investment, continuation of the confirmation process for nominated Commissioners of the of the Liberia Anti- Corruption Commissioners amongst other.
According to the Senate Press Release, the Senate Pro-tempore disclosed that the Plenary will consider within the two weeks the continuation of the debate on the amended public Health Law.
According to him, the law contains many contemporary issues important to health care delivery in the Liberian society other than the issue of abortion contained in the bill, adding “Most especially challenges experience and knowledge gained from the EBOLA outbreak and the COVID 19 pandemic”.
Furthermore, Pro-Temp Chie added that the bill contains issues on bio-security and bio-safety, improvement on occupational health, provision on foods and other products for infants and young children, new chapter on traditional alternative medicines, new provision for emergency treatment and many others.
He also stated that the bill came to the Senate from the House of Representatives for concurrence, wherein the Senate committee on Health has had several consultations and public hearings but have not arrived at a final version for the final approval of the Senate Plenary.
“Fellow citizens, we are appalled by the interference in our Legislative process and condemn the lies which are being propagated by people who have little or no understanding of the various issues contained in the proposed new Public Health Law and the transparent manner in which the debate has been proceeding at the Liberian Senate” Pro-Temp Chie stressed.
