Abortion: A legal issue we cannot ignore

Abortion: A legal issue we cannot ignore

By Rebeka Harsono

YOGYAKARTA (JP): The report that two private clinics in
Jakarta have carried out more than 100 abortions has created a
public outcry.

Police are collecting more information from employees of the
clinics which carried out the abortions and are looking for the
women who received the procedure.

Abortions can be classified as having a medical or nonmedical
motive. An abortion on medical grounds would probably not incur
punishment because it is legal according to the 1992 Health Law
No. 23.

However, if an abortion is carried out for nonmedical reasons,
the procedure is illegal and considered amoral. In many of these
instances, women who have become pregnant out of wedlock seek
abortions to avoid social stigmatization. In other cases, married
women terminate their pregnancy if the child is simply unwanted.

Abortions sought for both medical and nonmedical reasons have
often ended in death for the mother. LIPI reported in 1994 that
during the period from 1980 to 1988, abortions contributed to the
high mortality rate of mothers. Out of every 100,000 pregnancies,
450 women died from childbearing or abortion procedures.

This is cause for great concern because the number is close to
half of the deaths among mothers nationwide.

The recent controversial abortion cases may create the
momentum needed to legalize abortions for nonmedical reasons.

The motives behind abortions cannot always be considered
amoral. But whether for amoral reasons or not, abortions take
place illegally in Indonesia and the health risks for the women
are high.

Research by Made Heny Urmila Dewi on 75 health officers in
Bali revealed that 78 percent of the respondents recommended the
legalization of abortion in certain cases to ensure the
availability of safe medical services and to provide legal
protection to medical officers.

These medical officers' opinions should be seriously
considered because they believed that abortion was wrong but have
reconsidered its legality. They found it alarming that many
women, faced with the fact that professional medical clinics
could not legally perform the procedure, took the risk of having
an unprofessional practitioner carry out their abortion.

With a majority being Hindu, 59 percent of the respondents
claimed they believed abortion for nonmedical reasons was a sin.
The remaining 41 percent thought abortion was justified in
special socio-economic circumstances such as in cases of poor
married couples with too many children, unfaithfulness and family
planning.

But, of the 44 persons who disagreed to such abortions, 72
percent did not think they would refuse to recommend an abortion
and only 28 percent would advise to maintain the pregnancy.

The group's doctors had an even more flexible attitude: 58
percent said they would be willing to carry out an abortion for
nonmedical reasons. Of the paramedics and midwives, only 29
percent said they would perform abortions. But they said
abortions should be carried out only if the pregnancy was not
more than four weeks old and they could perform a menstrual
regulation, an abortion using a sucking method. If the pregnancy
was more than four weeks old, they would refer the patient to a
more sophisticated hospital in the Balinese capital of Denpasar.

Other medical officials tended to assume an ambiguous
attitude. They would advise a pregnant woman give birth to the
baby and get married if the pregnancy occurred outside of
wedlock. But in cases where the woman demanded an abortion, the
medical officers indicated they would perform the abortion or
provide a referral.

Paramedics and midwives emphasized that abortions should be
viewed in a case by case basis. Economic reasons due to a
family's financial income or cases in which the man did not wish
to take responsibility for the child were seen as difficult
circumstances for a pregnant woman to face.

Many doctors admitted that they disagreed in principle to
abortions but their opinions changed after many women
experiencing crises came to them to ask for help. For example,
one doctor could not turn away a woman who had tried to abort her
pregnancy by using a cassava stalk resulting in heavy bleeding
and a life-threatening situation.

F.A. Moeloek, a reputed gynecologist, said that the demand for
abortions for social, economic and psychological reasons was
increasing. This was due to better educational opportunities for
women -- bringing about changes in their roles in society -- and
the less restrictive socialization among young persons. These
have been factors influencing women to want less children.

Failures in birth control and rape cases are also instances in
which legal abortions can be carried out according to family
planning counselors. The national family planning coordinating
board (BKKBN) goes as far as paying for abortion costs for
families who fail in birth control.

Traditional midwives and family planning counselors think that
the fear of social humiliation and ostracism often pushes the
parents of a daughter who is pregnant out of wedlock to pay any
sum for an abortion.

Even families who strongly hold to religious values may resort
to abortion if faced with the disaster of a daughter's pregnancy
outside of wedlock.

It is clear that abortion is a reality in our society and it
cannot be denied that it takes place as a result of poverty,
disdain for women, saving a family's reputation and family
planning.

Therefore it would not be wise if we stuck inflexibly by moral
reasons to keep abortion illegal while many women in crisis
continue to die. Abortions are the cause for nearly half of
mothers' deaths nationwide. Death caused by unsafe medical
services need not happen if abortions for nonmedical reasons were
legalized.

The September 1992 health law is ambiguous concerning the
legality of abortions in certain cases. According to a report by
LIPI, the term "abortion" is never used in the law. It is instead
referred to as "a certain medical act". This shows how sensitive
the abortion issue is in discussions within the House of
Representatives.

Article 15 of Law No. 23/1992 stipulates that in an emergency,
a "certain medical act" could be performed during efforts to save
the life of a pregnant woman and/or her fetus. However, this
"medical act" must be justified medically by a team of health
experts, be performed by authorized professional personnel, and
have the mother's or family's approval.

The law does not explicitly mention abortion as a legal
method, so it does not differ much from the previous Law No.
9/1960.

The phrase "a certain medical act" indicates the possibility
of a method other than abortion. Although the health minister
refers to Law No. 23/1992 as the legal basis for medically needed
abortions, the medical community is worried over the law's
ambiguity.

Medical officers who have been performing the menstrual
regulation method since the 1980s for medically called-for
abortions are still demanding a unambiguous law that can protect
them.

This is urgent. Otherwise, there will be an increasing number
of clinics that take advantage of women facing crises by
demanding exorbitant fees.

It cannot be denied that such a law would become the last
stronghold to stem moral degradation -- hence the importance of
the law. Custom and social values need to be emphasized, but
people faced with desperate circumstances tend to commit the act
all the same.

The function of the law would not seek to control Indonesians'
sexual behavior. Legally married couples have the right to decide
on the number of their children. But when a man does not want to
take responsibility for his actions, a girl or a woman, whether
she likes it or not, often feels forced to seek an abortion.

Deviant behavior and immoral acts happen all the time, whether
there is an abortion law or not. Therefore, the legalization of
abortion is not the only factor that can increase the number of
abortions or inversely prevent them. The facts show the contrary.

The number of abortions are influenced by many factors. Are we
really doing all we can to prevent these causes? For example, is
our society seriously trying to curb the circulation of
pornographic films, and the showing of big screen and television
films which make irresponsible sex look socially acceptable?

Modern society has turned women into sex objects. We must
change how our society views sex through more responsible social
models and methods of sex education.

We need to hold a dialog on sexuality between men and women in
an effort to change the perception that women are subordinate.

An agreement to legalize abortion would not be simple. It is
not easy to come to a universal conclusion on the concept of a
baby's life -- especially on the priority for the safety of the
mother or the child, or even the acceptable methods to be used.

However, the essence and the objective of such a law are the
same -- it would be a reply to the community's problems. The law
should not make normative stipulations only. The morality of the
law would reside in the extent to which it is in accordance with
the realities of the community's problems.

A problem needs to be prevented but a problem also needs to be
settled. That would be the function of the law.

The writer is a graduate of Gadjah Mada University's School of
Political Science, Yogyakarta. She is an observer of women's
issues.