Ipas > Moving forward: Ethiopia develops new safe abortion guidelines

Moving forward: Ethiopia develops new safe abortion guidelines

August 1, 2006

Under Ethiopia’s recently released abortion care guidelines, women who seek abortions or care after an unsafe abortion must receive counseling to help them understand the health-care procedures they’ll undergo and options for preventing future unintended pregnancies. Photo courtesy of Clive Shirley, Panos Pictures.

The Ethiopian Ministry of Health has released guidelines for safe abortion services, making major progress toward implementing 2005 revisions of the country’s abortion law.

Ethiopian President Girma Wolde-Giorgis opened the Addis Ababa symposium where the guidelines were released on July 10 to commemorate World Population Day. The event was organized by the Ministry of Health, the Ministry of Finance and Economic Development, the United Nations Population Fund and nongovernmental organizations.

A working group developed the technical and procedural guidelines after the Ethiopian Parliament revised its criminal code in May 2005. The group included representatives from Ipas, the Ethiopian Society of Obstetricians & Gynecologists (ESOG), the Ethiopian Nurse Midwives Association, the Family Guidance Association of Ethiopia, the Ethiopian Public Health Association and representatives from the Ministry of Health’s Family Health Department.

Under the updated code, abortion is permitted under a wider array of circumstances than before, when abortion was only allowed to save the woman’s life or health. Today, abortions can be performed when the pregnancy is a result of rape or incest; when the woman’s or fetus’ lives are in jeopardy; when the fetus has severe abnormalities; when the woman has physical or mental disabilities; and when a minor is physically or psychologically unprepared to raise a child.

These guidelines will ensure that more women and girls can access safe abortion care rather than the life-threatening back-alley procedures that maim and kill thousands of Ethiopian women and girls annually.

According to the guidelines’ introduction, statistics from hospitals and health facilities “show that unsafe abortion is one of the top 10 causes of hospital admissions among women” and may account for as much as 60 percent of all gynecologic admissions.

The guidelines use as their foundation two approaches supported by the World Health Organization and Ipas: woman-centered abortion care and postabortion care. Each approach includes nonjudgmental counseling about the health-care procedures the women undergo as well as information about available contraceptive methods to prevent future unintended pregnancies.

The guidelines mandate that:

any woman eligible for abortion should obtain the service within three working days. Such a clause is important because in some countries such as South Africa and the United States, health-care providers have used delaying tactics in order to block women’s access to abortion services.
medication abortion — specifically, the use of the drugs mifepristone and misoprostol — is an acceptable method of ending a pregnancy. This regimen is appropriate for the low-technology settings that predominate throughout the mostly rural nation.
midwives and other midlevel providers can perform abortions. This is key to making services available throughout the country because the number of obstetrician-gynecologists (the physician most likely to have training in abortion provision) is far less than that of nurse midwives. Ministry of Health data from 2005 reported 163 employed ob-gyns but 1,509 nurse midwives. Trained midwives can provide abortions where and when ob-gyns or other physicians aren’t available.

Ipas Ethiopia director Saba Kidanemariam was a member of the working group and applauded the resulting guidelines.

“The liberalization of the criminal code was a highly positive development, and the guidelines represent a crucial step for the realization of the law. In order to save women’s lives, the law must be translated into real health-care and real change in the hospitals, health centers and even in the knowledge of medical workers and the public itself.

“The guidelines must be disseminated throughout Ethiopia; health-care providers must learn of their responsibilities and, in some cases, undergo training; and Ethiopia’s citizens must learn their rights under the law and what constitutes quality services.”

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258