17th February 2002

The Sunday Times on the Web
















Matter of life and death

Doctors and human rights activists call for selective abortions in special cases. Kumudini Hettiarachchi reports
Proposals for selective abortions
For whom:
 Victims of incest, a majority of whom are children

 Victims of rape

 Specific women who find out through early procedures available in Sri Lanka that the foetus is severely malformed and may die soon after delivery. 

And how:
 Decided on a case-by-case basis by an eminent review board comprising medical and other experts. 

A 14-year-old child is in hospital. No, not stricken by a common childhood disease, but to have a baby. A child having a child. That alone is pathetic, made doubly worse by the fact that the child she is about to deliver is her own uncle's. 

What are this girl's options? None. Just another young life ruined. 

With many women toiling in the Middle East as housemaids, the spectre of incest has reared its ugly head in humble Sri Lankan homes. Young children are left in the care of the father, step-father, uncle or "trusted" adult and incest is on the increase. According to organizations in the know, 21 cases of incest were reported in 2001. But what of the many which go unreported?

Children such as the 14-year-old are the cases which need to be considered with compassion and sympathy. They, rape victims, both minors and women, are the "vulnerable groups" who have been left no choice by the archaic anti-abortion laws in the country. The victim faces victimization twice over, compelled to go through a pregnancy that is not of her making. She ends up sentenced to a life of misery, stigma and shame. 

None in this country, where the four major religions of the world are practised fervently, would push for blanket legal cover for abortions and canvass for abortions on demand. At present it is illegal. However, as experience has shown, every rule has an exception and the exceptions in this case are quite pathetic and need help. On the flip side is the shocking fact that though abortion is illegal, 750 illicit abortions are being carried out each day, maybe mostly by quacks.

Taking this horrific figure into account, the time seems right for Sri Lanka to look at reason, check out expert opinion and bring about a solution taking into consideration the real victims, who should be given this option, while cracking down on illegal abortions.

Some experts who have been active in the field of women's and children's rights stress there is an urgent need to look at abortion laws and provide a choice as well as relief to selected, specific categories only.

Well-known gynaecologist Dr. Lakshmen Senanayake puts his thoughts across clearly. Countries spanning the globe fall into three groups. The first group is where abortions are offered on demand. The second is where abortion is legal for selected reasons like rape, incest and severe fetal abnormalities not compatible with life. The third and most primitive legal stand is that it is available only to save the mother's life. Sri Lanka belongs to the third, and should change over to the second with strict monitoring and checks. 

"There should not be over-the-counter access to abortions. But there are certain unfortunate groups who should be considered sympathetically. Take the plight of a woman who has conceived after rape. After getting over a most demeaning and horrible experience, she has to face the risks of a pregnancy that she does not want and be burdened for life with an experience she would rather forget. 

"Next come victims of incest. There is also a very vulnerable group _ children under the care of others such as those in orphanages, institutions and even in some schools, where an adult can coerce a child into having sexual relations. The child does not have anyone to turn to. There's no legal way out, but to resort to illegal abortion. The other option is having the baby. She has to choose between the devil and the deep blue sea and it is not much of a choice," explains Dr. Senanayake who is attached to the Castle Street Hospital for Women. 

The law says no abortions. Such victims are ostracized and the perpetrator, in most instances, goes undetected. As the victims do not have recourse to legal redress, either they labour through the pregnancy or seek the help of quacks in hole-in-the-wall clinics. Medically unsupervised pregnancy terminations often result in the victim bleeding to death or having serious complications such as permanent damage to her internal organs and not being able to have children ever. The psychological trauma and the stigma too last a lifetime. Not only the victim, but also her whole family is finished.........ruined.

How can we talk of women's rights, or for that matter children's rights, if we do not deal with this issue of abortion? asks Dr. (Mrs.) Hiranthi Wijemanne of UNICEF. Dealing with it mainly from the point of view of women's rights, she too repeats the vulnerable categories. "Illegal abortions and also the dumping of babies in lavatory pits or dustbins happen and everyone knows that. The statistics reveal a lot." 

Yes, they do. Statistics released by the Registrar-General's Department to The Sunday Times indicate that in 1997, over 8,000 of 333,219 babies born that year were delivered by mothers who were under 18 years of age. And remember 18 is the legal age for marriage. Of them 7,833 were born to women who were married and 236 to those unmarried. Meanwhile, figures collected from women's NGOs reveal that for 2001, 562 rapes and 21 cases of incest were recorded.

As Dr. Wijemanne points out proposals to loosen the anti-abortion laws need to be tossed up and discussed. The humane angle has to be considered about children having to bear children and the fate of rape victims who conceive.

Meanwhile, another group that worries Dr. Senanayake are expectant mothers who, after normal procedures such as scanning find out that their children have a severe abnormality. "Should a woman who knows that her foetus is destined to be incompatible with life, go through the stresses and complications of pregnancy and risk of illness or even death? Isn't that a sad state of affairs? Once a doctor detects an abnormality, he is duty-bound to inform his patient. From that point onwards, under the present system there is nothing that can be done. Is the law just by the doctor and the woman?" 

"It's ridiculous to think that if abortion is de-criminalized, all the women will rush off and have abortions. It's like divorce laws. Just because we have them, do we all seek divorce?" asks Mrs. Manel Abeyesekere, Chairperson of the National Committee on Women. 

Urging more open discussions on the issue, she says that the public and relevant authorities should look at and discuss it seriously. Then they would be able to get rid of all the hang-ups they have. "Half the battle would be won."

The need is there and the authorities should work on it, but, cautions Dr. Senanayake, a mechanism should also be in place to prevent miscreants from misusing the law for their gain. "A review board comprising specialists from medical professional colleges and experts should take decisions on a strict case-by-case basis."

Abortion is a dirty word in Sri Lanka. It is a criminal offence, unless two specialists certify that the termination of a pregnancy is essential to save the life of the mother. But isn't it time to take a long hard look at reality and a law that is over 120 years old?

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