Prevention is key in reducing abortions

By Mely G. Tan

JAKARTA (JP): "Every child is a wanted child". This is the ideal. This is the norm. This is how it should be. This is also in line with the Convention of the Rights of the Child, proclaimed by the United Nations and signed and ratified by practically all the member countries of this world organization, including Indonesia, only a few years ago.

However, what is the reality? From its inception, when a sperm from a man and an ovum from a woman, meet, come to fruition and start the conception process, the product of this meeting is at high risk to be destroyed. Natural processes, for example, can interfere with the nesting of the egg -- that is, the attachment to the wall of the womb. There are other causes for "misconception", but suffice it to note that not all meetings of an ovum and a sperm result in conception.

There are other ways to achieve "misconception", and this is by using contraception methods. This is the essence of family planning (to "plan" your family by planning the number of children you will have). Contraception aims to prevent the meeting of a sperm and an ovum. In other words, if you practice family planning, and if there is a pregnancy, it has been planned and is not the result of an "accident".

Due to strong and consistent efforts of family planning programs in Indonesia, the many contraceptive methods available are sufficiently known.

Nonetheless, the reality is that despite the knowledge disseminated, and the services available, there is still a high number of pregnancies that are "unwanted", resulting in the horrifying findings of aborted fetuses recently reported in the media.

What has happened? Undoubtedly, these "unwanted" pregnancies, are the result of "accidents" from sexual behavior based on a range from ignorance to irresponsibility to criminal actions.

Why ignorance? Ignorance is a factor when a pregnancy occurs among teenagers and other young adults who are ignorant about the reproductive organs in their body combined with not being prepared to handle the freedom in their relations with the opposite sex.

This has been shown in a study done by a psychologist, in two clinics in Jakarta (since discontinued) and in Bali in 1987 involving 405 cases of unmarried young women during a one-year period.

In most cases they had missed their menstruation for at the most two months. They were then treated with menstrual regulation or MR (basically a simple suction method), after consultation with the psychologist.

About half of these cases were girls between 15 to 20 years old. Almost half of them were still in school or had finished high school. One-third were active university students, while 12 percent finished primary school and 15 of the girls had a B.A. degree.

Clearly these were not uneducated girls. Yet they were appallingly ignorant about sexuality and the possible results of sexual behavior. When it turned out that they were pregnant, they became panicked. They were definitely not prepared for pregnancy and for taking care of a child.

What about the result of irresponsible sexual behavior? This is the type of behavior where both the man and the woman are knowledgeable about the consequences of sexual activity -- they know how to take precautions, but simply do not care, or just take their chances.

Then there are those who have become the victim of irresponsible behavior. Men take advantage of the ignorance and naivety of young, innocent girls. When the girl gets pregnant the man is nowhere to be found, or, if found will not feel responsible.

In the category of irresponsible behavior, but on the part of the men as well as the women, is pregnancy due to prostitution. The women know they can become pregnant, but do not take precautions. They may ask the men to use a condom, but some refuse.

Finally, there are those who become the victim of criminal behavior: of rape. Today there is a growing recognition of rape in marital situations. Incest has also become a problem.

Perhaps in a separate category, there is the pregnancy due to contraceptive failures. It is a well-known fact that most contraceptive methods still have the possibility of failure, resulting in a pregnancy. In this case, a woman can take the necessary precaution, yet she can still become pregnant. What should she do?

It is rather facile and callous, especially for men, to declare that abortions should never be carried out. First, they themselves would never get into a situation of becoming pregnant. Second, women who are found to have terminated their pregnancy, are accused of committing a despicable act, indicating that the blame is for the woman only. The involvement of the man is completely forgotten, and he is free to continue impregnating other women.

This double standard in judging behavior of men and women, especially where morals are concerned, is as old as the history of humankind. We can react by considering this a fact of life, that cannot be changed. Or, we can insist that human beings, unlike other creatures on this earth, possess the God-given power of reason, an analytical mind and the power to defer present pleasure for future gain.

In other words, human beings possess the power to regulate and restrain their instincts and their physical drives -- including the sex drive. Unfortunately, these powers are not always developed, or with young people, maybe not yet fully perceived.

Therefore, logically, what needs to be done is to develop these powers. Girls and young women should understand that they can say "no". A greater sense of responsibility among all men must also be developed.

These seem to be farfetched ideas. But actually there are not many other alternatives to avoid unwanted pregnancies and the horrible consequences that may result. Of course, one can say that abortion should not occur under any circumstances and the pregnancy should always come to term. But the realty is that this is not always the correct solution, for the woman, as well as for the "unwanted" child.

We have to look for ways to avoid unwanted pregnancies to occur. First, we must do away with ignorance. Young people, both girls and boys, as early as they can understand and absorb it, should learn about their bodies, including its reproductive functions.

They should have an understanding of sexuality and the consequences of sexual behavior. In this day and age, when people of the opposite sex can interact easily, without anyone else present, this knowledge is imperative.

Where should they get this knowledge? Ideally of course, at home from their parents or other significant adults. There are cynics who say they are getting this knowledge already from the street, from their peers and from films. If they are already so knowledgeable, why then do "accidents" still occur? Obviously, what they need is knowledge that empowers them. Girls and young women should realize that they can say "no", and make boys feel responsible for the girls they go out with.

In other cases, again more information should be given to women and men about preventative measures. In the case of rape and incest, the perpetrators should be given a punishment commensurate with the crime committed. This has yet to be the case in Indonesia's legal system. Victims should also be given more understanding and services to overcome their experience.

Finally, what about when an "accident" still occurs? The fact that abortions occur, despite strong condemnations by religious authorities and the society at large, indicates that this is a very complicated problem.

Closing the known clinics is no guarantee that abortions will stop. In fact, what we can be sure of is that they will go completely "underground", increasing the probability of cases of botched abortions -- thereby contributing to the continuing appallingly high maternal mortality rate in Indonesia.

Ways should be found to provide services that are medically safe, within the legal limits and tolerance limits of religious authorities, while taking into consideration the overall condition of the woman involved. This is not easy, but the options are limited.

Undoubtedly, the key is prevention, thereby ensuring that "every child is a wanted child".

Mely G. Tan, Ph.D. is the chairperson of the Research Institute, Atma Jaya Catholic University.