Liberia: Liberia Records 38K Illegal Abortions

A record number of more than 38,000 illegal abortions has been recorded to have taken place in Liberia.  

The figure, which is for 2021, according to a report by Clinton Health Access Initiative and partner, shows an induced abortion rate of 30.7 per 1,000 women and a ratio of 229 abortions per 1,000 live births. 

The study — the first of its kind on abortion incidence in the country — comes as abortion remains illegal and punishable by a jail term of up to three years in prison as the country is deeply religious and vocal in its condemnation of abortion.

Existing law allows in Liberia abortion only in cases ofest, fetal abnormality, danger to the mother's life, or risk to her physical or mental health. Medical exemptions require written approval by at least two doctors. In cases of rape or incest, proof must be provided in court.

“About 38,779 induced abortions occurred in Liberia in 2021, resulting in an induced abortion rate of 30.7 per 1,000 women of reproductive age and an induced abortion ratio of 229 abortions per 1,000 live births,” the study, which was jointly conducted by the Clinton Health Access Initiative, the African Population and Health Research Center, and the  Guttmacher Institute, finds.

“To address abortion-related complications in the country, the study recommends advanced legal and policy reforms that address the causes of unsafe abortion and unwanted pregnancies,” the study, which aimed at estimating the incidence and severity of abortion-related complications, finds. 

It was conducted across all regions and counties in Liberia from September 2021 — March 2022 with the finding released a few days ago. 

According to the study,  the rate of abortion varies per region, with North-Central having the lowest abortion rate of 6 women per 1,000 and South-Central having the highest 49 women per 1,000.

It also notes that induced abortion is common in the country with most of the cases associated with unintended pregnancies and that 14,555 women received care for abortion-related complications that are life-threatening and can potentially result in death.

Abortion in Liberia, according to experts is primarily driven by unwanted pregnancies as a result of poverty and limited access to family planning.  But worrisomely, experts noted the high rate of unsafe abortions among the poor in the country indicates that there is a standard for the rich and another for the poor and uneducated when it comes to the implementation of the country's law even though it is hard enforceable. 

The penal code says women who abort illegally can be jailed for three years. But wealthier and more educated women take advantage of “medical guidelines,” which allow terminations in the interests of a woman’s physical or mental health but require the signatures of multiple doctors.

Meanwhile, the Chief Medical Officer of Liberia, Dr. Francis N. Kateh, has said that the country's first report on the incidence of abortion and its severity is needed for comprehensive data on abortion so as to help  in implementation of sexual and reproductive health interventions.

According to him, Liberia has been struggling with the lack of scientific abortion records because of its illegal status, something he says causes most abortions to be done at home. 

The study, which Kateh has hailed as a milestone, recommends to address the causes of unsafe abortion and unintended pregnancies, and provide an enabling environment for access to sexual and reproductive health services for all women and girls.

It proposes  an expanding access to quality post-abortion care, including post-abortion contraception counseling and method provision at all health system levels, strengthening the capacity of lower-level health facilities and mid-level providers to ensure quality care.

Unsafe abortion, according to Dr. Moses Massaquoi, the Country Director of Clinton Health Access Initiative country director (CHAI), is among the top causes of maternal mortalities and other illnesses, and the treatment of abortion complications drains significant health system resources — something that the government needs to address.  

He noted is the term used to describe a pregnancy termination performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical standards or both.The data for study by Clinton Health Access Initiative, the African Population and Health Research Center, and the  Guttmacher Institute  was collected using three surveys — the Health Facilities Survey (HFS), the Knowledgeable Informant Survey (KIS), and the Prospective Morbidity Survey (PMS).