Abortion in Ethiopia

Abortion is legal in Ethiopia in cases of rape, incest, or maternal problems relating to foetal impairment. In 2005, the Ethiopian Parliament constitutionally approved the legality of abortion in the given criteria. Currently abortions services in Ethiopian facilities includes medical abortion using misoprostol and Mifepristone, surgical abortion, manual vacuum aspiration and dilation and curettage.

In 2008, estimated 382,500 induced abortions were performed in Ethiopia, for annual rate of 23 abortions per 1,000 women aged 15–44. This has been doubled the proportion in 2014, with rate of 53% (some 326,000) in all health facilities. Most abortions occur in non-governmental organization and private hospitals aboard Ethiopia.

Legality

In 2005, Ethiopia legalized abortion in cases of rape, incest, or foetal impairment.[1][2][3][4] Woman can legally terminate her child life if the pregnancy or childbirth endanger her life. Although abortion is prohibited by Criminal Code, the Ethiopian Parliament approved it in the following circumstances:[5][6]

  • When the pregnancy results from rape or incest
  • When continuance of the pregnancy endangers the health or life of the woman or the fetes
  • In cases of fetal abnormalities
  • For women with physical or mental disabilities
  • For minors who are physically or psychologically unprepared to raise a child
  • In the case of grave and imminent danger that can be averted only through immediate pregnancy termination

A woman can terminate the child upon a difficulty of giving birth owing to minor or physical disability.[7] However, the law engendered almost six in ten unsafe abortions in Ethiopia. In 2006, the government started national standard for safe abortion guideline that utilizes medications such as misoprostol with or without mifepristone) to terminate pregnancies, in accordance with World Health Organization (WHO) clinical recommendations on safe abortion.[8] Available abortion services are:[9]

Incidents

In 2008, an estimated 382,500 induced abortions were performed in Ethiopia, for annual rate of 23 abortions per 1,000 women aged 15–44.[10][11] The abortion rate in Ethiopia was lower than to African and Eastern African countries which has 29% and 39% respectively according to WHO estimates.[12] In urban areas, abortions rates is higher than in national average, such as Addis Ababa, Dire Dawa and Harar. Factors for these conditions include greater social and healthcare provision attracting women in these areas.[7]

Some of 35% women tend to undergo induced abortion whereas 27% of those obtaining post-abortion care report having had a previous abortion.[13] In 2014, about 620,300 abortions were performed in Ethiopia, corresponding to annual rate of 28 abortions per 1,000 women aged 15–49, an increase from 22 per 1,000 in 2008.[14][15]

Provision of abortion and post-abortion care

In 2008, about 27% women induced abortions were safe performed by health facilities.[16] However, 15% (58,000 abortions) reported safe despite lack of clear survey from private and public hospitals. Some of these practices were legal and mostly performed by private and small facilities; about half of all health facilities provided induced abortions in Ethiopia. The proportion is higher than for public hospitals (76%) and private or non-governmental facilities (63%) than for public health centers (41%).[7]

This proportion is likely fluctuating, as there are abortion services in public facilities. Currently, private and NGO facilities mostly provide induced abortion aboard. Access to second trimester abortions is severely limited, in which 9–10% of all facilities only provide these services.[7]

In 2014, legally performed induced abortions were reached 53% (some 326,200) in all health facilities, nearly double the proportion in 2008 (27%). Between 2008 and 2014, shared abortion rate increased from zero to more than one-third.[8]

Unintended pregnancy and contraception

Modern contraceptive absorption is much higher than in Addis Ababa (57% among women aged 15–44) than in Ethiopia as whole (14%), while in rural areas is below national average (3–16%). One of root causes of abortion is the low level of contraceptive methods, which leads to unintended pregnancy.[7] 13% of unintended pregnancy ended in 2014, up slightly from 10% in 2008.[8]

References
  1. Singh, Susheela; Fetters, Tamara; Gebreselassie, Hailemichael; Abdella, Ahmed; Gebrehiwot, Yirgu; Kumbi, Solomon; Audam, Suzette (2010). "The Estimated Incidence of Induced Abortion In Ethiopia, 2008". International Perspectives on Sexual and Reproductive Health. 36 (1): 16–25. doi:10.1363/3601610. ISSN 1944-0391. JSTOR 20696526. PMID 20403802.
  2. "Playing it Safe: Legal and Clandestine Abortions". 10 September 2022.
  3. O’Connell, Kathryn A.; Kebede, Addisalem T.; Menna, Bereket M.; Woldetensay, Mengistu T.; Fischer, Sara E.; Samandari, Ghazaleh; Kassaw, Jemal K. (2022-06-13). "Signs of a turning tide in social norms and attitudes toward abortion in Ethiopia: Findings from a qualitative study in four regions". Reproductive Health. 19 (1): 198. doi:10.1186/s12978-021-01240-6. ISSN 1742-4755. PMC 9195190. PMID 35698231.
  4. Alemu, Kidist; Birhanu, Solomon; Fekadu, Leta; Endale, Fitsum; Tamene, Aiggan; Habte, Aklilu (2022-08-18). "Safe abortion service utilization and associated factors among insecurely housed women who experienced abortion in southwest Ethiopia, 2021: A community-based cross-sectional study". PLOS ONE. 17 (8): e0272939. doi:10.1371/journal.pone.0272939. ISSN 1932-6203. PMC 9387822. PMID 35980966.
  5. Blystad, Astrid; Haukanes, Haldis; Tadele, Getnet; Haaland, Marte E. S.; Sambaiga, Richard; Zulu, Joseph Mumba; Moland, Karen Marie (2019-09-27). "The access paradox: abortion law, policy and practice in Ethiopia, Tanzania and Zambia". International Journal for Equity in Health. 18 (1): 126. doi:10.1186/s12939-019-1024-0. ISSN 1475-9276. PMC 6764131. PMID 31558147.
  6. "Abortion law in Ethiopia: A comparative perspective" (PDF). 10 September 2022.
  7. "Facts on Unintended Pregnancy and Abortion in Ethiopia" (PDF). 9 September 2022.
  8. "Induced Abortion and Postabortion Care in Ethiopia". Guttmacher Institute. 2017-01-04. Retrieved 2022-09-09.
  9. "It is abortion legal in ethiopia? | HowToUseAbortionPill". www.howtouseabortionpill.org. Retrieved 2022-09-10.
  10. Singh, Susheela; Fetters, Tamara; Gebreselassie, Hailemichael; Abdella, Ahmed; Gebrehiwot, Yirgu; Kumbi, Solomon; Audam, Suzette (March 2010). "The estimated incidence of induced abortion in Ethiopia, 2008". International Perspectives on Sexual and Reproductive Health. 36 (1): 16–25. doi:10.1363/ipsrh.36.016.10. ISSN 1944-0391. PMID 20403802.
  11. Senbeto, Elias; Alene, Getu Degu; Abesno, Nuru; Yeneneh, Hailu (2005-06-24). "Prevalence and associated risk factoprs of Induced Abortion in Northwet Ethiopia". Ethiopian Journal of Health Development. 19 (1): 37–44. doi:10.4314/ejhd.v19i1.9969. ISSN 1021-6790.
  12. Megersa, Bikila Soboka; Ojengbede, Oladosu Akanbi; Deckert, Andreas; Fawole, Olufunmilayo Ibitola (2020-09-03). "Factors associated with induced abortion among women of reproductive age attending selected health facilities in Addis Ababa, Ethiopia: a case control study". BMC Women's Health. 20 (1): 188. doi:10.1186/s12905-020-01023-4. ISSN 1472-6874. PMC 7469090. PMID 32883263.
  13. "Safe and unsafe induced abortion" (PDF). 10 September 2022.
  14. Moore, A. M.; Gebrehiwot, Y.; Fetters, T.; Wado, Y. D.; Bankole, A.; Singh, S.; Gebreselassie, H.; Getachew, Y. (10 September 2022). "The Estimated Incidence of Induced Abortion in Ethiopia, 2014". International Perspectives on Sexual and Reproductive Health. 42 (3): 111–120. doi:10.1363/42e1816. PMC 5568682. PMID 28825902.
  15. Moore, Ann M.; Gebrehiwot, Yirgu; Fetters, Tamara; Wado, Yohannes Dibaba; Bankole, Akinrinola; Singh, Susheela; Gebreselassie, Hailemichael; Getachew, Yonas (2016). "The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008". International Perspectives on Sexual and Reproductive Health. 42 (3): 111–120. doi:10.1363/42e1816. ISSN 1944-0391. JSTOR 10.1363/42e1816. PMC 5568682. PMID 28825902.
  16. Dibaba, Yohannes; Dijkerman, Sally; Fetters, Tamara; Moore, Ann; Gebreselassie, Hailemichael; Gebrehiwot, Yirgu; Benson, Janie (2017-03-04). "A decade of progress providing safe abortion services in Ethiopia: results of national assessments in 2008 and 2014". BMC Pregnancy and Childbirth. 17 (1): 76. doi:10.1186/s12884-017-1266-z. ISSN 1471-2393. PMC 5336611. PMID 28257646.
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