Pro-choice or pro-life? Make up your mind

Tantri Yuliandini, The Jakarta Post, Jakarta

"When will this country cease its ambivalent attitude towards abortion, while at the same time, deaths of women go on unnecessarily?"

This rhetorical question was posed by Mely from Jakarta on an Indonesian Internet website www.aborsi.net recently. The question was one among dozens of others that cursed and condemned women who had abortions.

Some even quoted lines from the Holy Koran and the Bible, and most denounced women who had or supported abortions to eternal damnation and hell fire. Not surprisingly, those who have this outlook on abortion are mostly -- but not exclusively -- male.

The abortion issue has always been a controversy, not only here in Indonesia but also in countries like the United States where the heated debate between "pro-life" and "pro-choice" goes on unabated despite the fact that abortion was legalized in 1973.

Pro-lifers argue that all human beings, including those yet unborn, are created equal and endowed with certain inalienable rights, the first of which is the right to life.

Pro-choice activists allege a woman should have complete control over her body, therefore should be allowed the choice of whether or not to go on with her pregnancy.

In clear-cut cases like rape -- where going through with the pregnancy could cause long-term distress to the mother and potential abandonment to the child -- abortion is sometimes understood by some of the pro-lifers.

But pro-lifers say the legalization has also created a culture of "abortion on demand", or used as another method of birth control.

In Indonesia, too, this view is shared. Many believe legalizing abortion only harbors "sinful" conduct such as pre- marital sex and provides an easy way out for "sinners".

"If you don't want to run the risk of getting pregnant, then don't do illicit sex, if you do then you have to take responsibility in the face of God. Abortion is an act cursed by God and devil," Andrea from Surabaya, East Java, wrote, after going into great detail about the terrible things the aborted baby would do to the soul of a woman in the afterlife.

The country's law shows no mercy on people who have abortions, with the 1992 Law on Health stipulating that "certain medical actions" such as abortion could only be conducted in an emergency situation where the life of a mother and her baby is at stake, based on medical indications.

Otherwise, abortion is considered a criminal act, and punished under the Criminal Code article 346 against the woman, article 347 and 348 against the person or people conducting the abortion without and with the woman's consent respectively, and article 349 against a trained professional conducting the abortion.

Punishment ranges from four years to 15 years in prison, and could be increased if a professional conducts the abortion.

"The problem with our law is that it doesn't define health beyond the medical terms, meaning that a woman has to be bleeding to death for a doctor to be able to legally conduct an abortion," Zumrotin K.S., a member of the Women's Health Foundation (YKP) advisory board, said on the sidelines of a dialog on abortion here last Friday.

Contrary to popular belief that abortions are usually done by unmarried teenagers, data indicates that many more were sought by happily married couples, she said.

"In Medan for instance some 90 percent of those seeking abortions are married women, about 75 percent in other areas," Zumrotin said, adding that many quoted economic reasons.

"Only a small percentage of those seeking abortions are teenagers," Christoffel, a doctor with the Indonesian Society of Obstetrics and Gynecology (POGI), added without stating any numbers.

The rigid law apparently does not stop people from having abortions.

A study by POGI, the World Health Organization (WHO) and the Ministry of Health in 2000 showed that an average of 2.3 million abortions are performed in the country each year.

Some 600,000 abortions were done for reasons of contraceptive failure, 700,000 abortions due to poor economic conditions, and another million due to medical problems with the mother.

Of the various reasons given for abortions, 47.1 percent of the 579 respondents surveyed said they have had "enough" children, and at a distant 17.2 percent was the desire to continue school.

Other reasons given include for medical reasons (15.7 percent), work (6.8 percent), being on medication prior to the pregnancy (2.9 percent), and others (10 percent).

Given that abortion is largely illegal, many women wanting to have an abortion end up at illegal clinics, often with unconventional methods that pose a risk to their own lives.

Zumrotin said laws criminalizing abortion make abortions unsafe but do not eliminate them.

WHO estimates that 11 percent to 17 percent of maternal deaths are caused by unsafe abortion. In a country ranked high on maternal mortality, this is cause for concern.

Indonesia's maternal mortality rate ranked one of the highest in the Southeast Asian region at 390 maternal deaths per 100,000 live births, compared to 208 in the Philippines, 44 in Thailand, 39 in Malaysia, and 9 in Singapore.

"This situation is really embarrassing to our nation ... legislators are increasingly aware something should be done about this," Ermalena, a legislator of the House of Representative's Commission VII for social welfare, said in the dialog.

At present, she said, intense dialog goes on both within the House and various community and religious groups about an amendment to the 1992 Law on Health to give more access to safe abortions for women.

"We try to explain to various groups on the issue, explain in terms they can relate to, and the political importance (of bringing maternal mortality rates down)," Ermalena said, explaining that as long as it can be shown statistically that there is a problem then people will understand.

Organizations such as YKP are also on the forefront of the campaign to provide safe abortions to women, Zumrotin said, explaining it aims to make their views heard and heeded when the amendment on the Health Law takes place.

The decision to terminate a pregnancy is perhaps the most important and traumatic decision that a woman has to face in her lifetime.

"I am still haunted by guilt that is very painful to me. Abortion is painful and leaves an extremely deep scar," wrote Nita from Yogyakarta about her decision to undergo abortion.

It is therefore very important for women to receive counseling about her choices, Zumrotin said. A survey conducted by YKP in 2000 showed that some 85 percent of 600 people surveyed agreed that the decision to terminate a pregnancy had to be made with adequate counseling.

"When the concept of counseling was first introduced, many were suspicious it would encourage women to have abortions. But what we're doing is providing comprehensive information to the woman about her choices, so she can decide what's best for her," Zumrotin said, stressing that it was important for the woman -- not a third person or even the State -- to make that choice.

Considering that most women who have abortions just made the most difficult decision of their life -- that no one tries to get pregnant just so they can terminate it, they certainly do not need others telling them it is a murder.

In a sea of condemnation, Nale from Jakarta says wisely: "I'm not someone who agrees with abortion, but that doesn't mean I have to force others to think like me. I know that when a woman decides on abortion, it is a very difficult decision. No one chooses abortion if possible. Must we close our eyes then, without doing something, while thousands of women die every year from unsafe abortions?"