Especially for the many women who have unsupportable pregnancies, abortion is a vital yet normal medical procedure during their reproductive lives. When performed properly, abortion procedures are safe and can saves women's lives. However, unlike other reproductive health services, abortion is enveloped by stigma and silence, which leads to many women in Africa and globally lacking access to this crucial health service.
It is indeed a dichotomy that abortion remains such a highly stigmatised issue in countries that have the most progressive abortion laws around the world. Our much-celebrated choice on termination of pregnancy regulations in many African countries promote the reproductive rights and freedom of choice of women by allowing them to have a safe and legal abortion. Such regulations have saved the lives of many women.
This laxness stems from and feeds on the silence and stigma associated with abortion in African countries. This stigma due to religious, cultural or moral beliefs that abortion is wrong is one of the biggest barriers in the complete implementation of the African laws. It subjects women to judgmental attitudes, curtails their right to access safe services and drives them to illegal and unsafe abortion providers.
We already know that many healthcare providers - due to their own moral or religious beliefs - are reluctant to conduct abortions and provide pre- and post-abortion emergency care to women. The stigma related to abortion is so strong that some providers who may want to receive training on abortion or provide these services hesitate to do so as they fear being ostracised by their community. This has led to a shortage of health facilities offering safe abortion services in Africa, and the impact of this on women's health and well-being cannot be overstated.
Stigma, in turn, perpetuates silence. Fear of harsh judgment and ostracism by the community can prevent women from sharing their abortion experiences with their friends and families. Oftentimes, women use silence as a coping mechanism as they believe that if no one knows about their experience, they cannot be stigmatised. Due to this severe stigma and silence, even today many women are unaware of their legally recognised rights and lack information about where, how and when to access safe and legal abortion services. In fact, many of them believe that informal/illegal and possibly unsafe abortion service providers are their only option in the event of an unwanted and/or an unsupportable pregnancy.
Unsafe abortion procedures can lead to serious health complications for women and, all too frequently, death and disability. Therefore, addressing this stigma around abortion is the need of the hour if we are serious about reducing maternal mortality in Africa.
Towards this end, we need to empower women with easily accessible and accurate information to enable informed decision-making about their body, health and well-being.