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Legalizing abortion in Uganda? Sr. Dr. Duggan

Legalising abortion in Uganda?

Dr. Sr. Miriam Duggan FRCOG, Consultant Gynaecologist
Having worked in Uganda as an Obstetrician & Gynaecologist for 30 years I am surprised to learn of the recent efforts to further promote Legalisation of Abortion as a way of addressing “Unsafe Abortion”.
I have read with interest the briefing Paper entitled “A Technical Guide to Understanding the Legal and Policy framework on Termination of Pregnancy in Uganda”. I would like to take this opportunity to remark on some of the content.
The Briefing Paper states:
• Uganda has ratified international and regional treaties that affirm women’s Human rights.
• International and regional human rights standards have established that access to safe and legal abortion and post-abortion care is essential to protecting women’s most fundamental human rights.
• Although Uganda has made reservations to article 14(2)(c) of the Maputo Protocol, which concerns access to abortion, this has no effect on Uganda’s existing abortion law—nor does it prevent future changes to that law.

Yes Uganda has ratified international and regional treaties that affirm women’s human rights, but this right does not give the right to end life be it in the womb or outside the womb. Claiming that Human Right’s Treaties can be interpreted to allow the right to abortion is completely without foundation. The right to abortion is not supported by the 1948 Universal Declaration on Human Rights which recognises the right to life, liberty and security of the person.
Additionally the Convention on the right of a Child states in its preamble that the child needs special safe-guards and care, including appropriate legal protection before as well as after birth. The Human Rights Committee has a duty to protect life and not seek to pressure countries to remove Human Rights Protection from certain sections of society. The unborn child is a living human being entitled to all the same rights as other members of the Human family.
Sometimes it is argued that women should have equal rights to men, but one area in which a woman is superior to a man is that she can nurture life within her womb. That fundamental right of protection of the mother when pregnant and the child within her womb is all important. Women of Uganda uphold that right to protection of the life you are nurturing. The child that is being aborted may be female also with rights to life.
The paper argues that International and Regional human rights standards have established that access to safe and legal abortion and post abortion care is essential to protecting women’s most fundamental human rights. Interestingly there is no mention of God given Human Rights which over ride all international and regional rights.
Uganda made a reservation to article 14 (2)(c) of the Maputo Protocol which concerns area of abortion and Uganda Policy Makers should stand firm on its decision, and if it is necessary to change the law, to change it to protect the unborn child not to make it easier to kill the child within the womb who has Human Rights..
Interestingly the review paper states: “that failure to legislate for safe abortion is failure to safeguarding women’s right to life, health, liberty and security, freedom from torture and cruel treatment and degradation”. They fail to recognise that many women who undergo induced abortion, suffer from mental health later, that a woman is not liberated but often carries severe guilt. Should the child within the womb not also be safeguarded from torture and cruel treatment. Modern imaging of an abortion being induced shows the infant, or foetus riding with pain as the abortion is being performed.
There follows in the briefing paper a lot of confusion about the terminology of when a child is a child. Medically once conception takes place there is a new life with the potential to developing into a human being. This wonderful mystery takes place so rapidly that at 12 weeks all the organs in the new person have developed and from then on grow and mature. Interference at any stage of development is killing new life. Maybe in the light of new technology the law needs to update itself in the protection of life within the womb.
The briefing paper also states: “The constitution also provides that the State shall take all practical measures to ensure provision of basic medical services to the population. This makes clear that the Government has an obligation to train enough health workers and care providers and to provide the necessary equipment to offer abortion related services. Restrictive abortion laws and the failure to provide quality termination of pregnancy and post abortion care services violate the right to health”.
The right to the provision to health care is very different to the right to terminate life. It may be good to remind ourselves of the Hippocratic Oath that Medical people on graduating take. In the classical edition it states: “I will neither give a deadly drug to anyone who asked for it nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and art.”
It is interesting to read “restrictive abortion laws” so now it would seem that abortion is being pushed on rights to have an abortion by choice.
The Briefing paper also states: “ that Uganda shall be governed based on principles of National Interest and common good. Why then is this briefing paper coming from the Centre of Reproductive Rights based in New York where it has been printed and from the Centre of Reproductive Rights based in Nairobi, Kenya?
In my experience of working in Uganda most deaths due to abortion are in single women not from people who are married and in a stable relationship. The basic underlying problem is young women getting pregnant when they are not ready for marriage and family life. Making abortion safe and freely available is not answering the problem. Two wrongs never make a right. Whether the abortion is carried out in a clinic or in a back street does not change the act of killing life. Would it not be preferable to promote the value of abstinence before marriage which is deeply ingrained in Ugandan culture?
The briefing paper also quotes abortion in cases of cancer of the cervix. Studies done in Europe have demonstrated that treatment of Cancer of the cervix by radiation after 12 weeks of gestation does not harm the growth of the baby, the baby being shielded.
The paper also argues for abortion in cases of mental health. Mental health cases are more likely to occur after the termination of a pregnancy rather than in cases where the pregnant woman is given support during her pregnancy even if the circumstances are stressful. What women need is loving support and care from family and friends.
In modern day medicine almost all complications that occur in a pregnancy before viability can be treated successfully, and once the pregnancy has reached viability the baby can be delivered prematurely.
Having worked for thirty years as an Obstetrician in a busy maternity unit at Nsambya hospital I have never had to terminate a pregnancy to save the life of a mother, but it did call often for long hours of monitoring and treating a complicated case.
Many legal arguments can be proposed with the manipulation of words to justify legalizing abortion but the basic fact is that we are only custodians of life, especially the life of the most vulnerable. We have no right to destroy life.
There is a better way to reduce Maternal Mortality. 1. Through providing good maternity care in all areas of the country. 2. By continuing to receive and treat with good after care and compassion, cases where termination of pregnancy have been carried out and run into complications. 3. By reducing the need for abortion by upholding the values of abstinence among unmarried women and girls. 4. By having support facilities available for women who are faced with a crisis pregnancy.
My prayer is that Members of Parliament, Legislators, the Medical and Nursing Profession will have the courage to uphold the sanctity and dignity of the unborn child.