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Illegal Abortions Trigger Debate of Law and Ethics

Posted by vmsalama on January 30, 2006

By Vivian Salama

Daily Star Staff

Click here for Daily Star Lebanon link

CAIRO:  “One of my female patients once told me, ‘I have infrequent sex, and I can never guess when – maybe every 40 or 50 days.  So, I just take the pill when I know I am about to have sex,’” recalls Ahmed Ragab, professor of reproductive health at Al-Azhar University. 

            “This is very wrong,” he insists.  “And of course, condoms are not an accepted contraceptive among most married couples, so as a result you find a high level of unwanted pregnancies.” 

            There are no statistics accurately indicating the frequency of abortion in Egypt or anywhere in the Middle East, as it is illegal throughout the region, though the level of tolerance varies both by the society and in the courts.  Doctors across the Middle East confirm, however, that abortion, albeit punishable by law, happens with great frequency, very often, via methods that put the pregnant mother’s health at risk. 

            Variance between the courts and religious community has created a lingering cloud of controversy.  Early last year, Egypt’s highest Islamic authority, Al-Azhar, issued a fatwa saying “it is impermissible for a mother to induce abortion even if is proven that the fetus is deformed or suffers from mental retardation… It is not justifiable.”

The only difference that erupted between scholars is whether the abortion was intentional, or the woman didn’t know she was pregnant and intentionally did something that would cause an abortion, or someone else harmed her in a way without knowing she is pregnant,” explains Sheikh Safwat Hegazy, Secretary General of Dar El Ansar for Islamic Affairs.  “Even if the pregnancy is a result of adultery, it is prohibited.”

            Religious authorities in Kuwait, on the other hand, ruled at Islamic conferences over the years that abortion under such circumstances is permissible.  However, even among moderates, there is debate.  The central issue among theologians is when a soul enters the embryo.  Whether it is after 120 days, or 80, or as some believe, after 40 days, those accepting abortion argue that it is merely a question of “when?”  

            In Christianity, the issue varies from one denomination to the next.  For Catholics, it is prohibited – the Vatican constantly issuing statements of condemnation against the practice.  Christian Orthodox faiths hold a more lenient view on the issue.  While the church preaches that abortion is against the will of God, it tends to handle matters on a case-by-case basis.

The courts have their own take.  Under legislation set by the Egyptian Court of Cassation, abortion is justified only if the pregnancy and/or delivery pose a high risk to the mother’s health.  If the baby risks serious deformity, the courts will also consider the matter.  The court does not show pity for women impregnated through rape.  Doctors who perform abortions outside these parameters risk up to 10 years imprisonment.  The laws are similar in Iran, Lebanon, Libya, Oman, Syria, United Arab Emirates and Yemen.

            “Basically, it’s a conflict of two human rights – the right for every female to control her private life, including the decision of not wanting the baby, and the right to life,” explains Mahmud Moustafa, a Cairo prosecutor.  “Here, we say it is life, so it is killing.  But it is not [murder].  The embryo is alive but not a living person.  It is a legal technicality.  It should be separate from the mother’s body for the baby to be alive.” 

            In the late 1980’s, Al-Ahzar’s Grand Imam at the time, Sheikh Gad El-Haq addressed the issue from two perspectives, the issue of genetic abnormality and rape.  “I asked him, ‘now that we can diagnose some of the genetic abnormalities with 100 percent accuracy, what should we do?’” recalls Ragab.  “He was against it, saying ‘science which today allows you to diagnose genetic abnormalities will allow you in the future to treat these abnormalities.’” 

            Similarly, on the issue of rape, Sheikh Gad advised that Islamic leaders take the children and provide them with proper foster homes and schools, where they are given the chance of a bright future.   

            Regardless of the moral and religious dilemmas, women are receiving abortions daily – and because it’s illegal, women in many cases are going to great lengths to rid their bodies of developing embryos.  Doctors describe a number of methods by which women have punctured their uteruses to induce abortion.  Ragab recalls incidents where hospitals found the stems of molikhaya plants and cotton trees shoved into the patient’s uterus – often the roots were doused in kerosene.   

“In hospitals, you hear of doctors removing matches from the uterus, knitting needles, once I learned a nurse pulled a catheter from the uterus,” Ragab explains.  “We have found as many as 10 tablets of aspirin – their impact on an empty stomach will definitely cause an ulcer.  Yes, these things can kill the embryo, but before killing the embryo, it will damage the health of the mother.” 

Another issue is that illegal abortions tend to be performed in secret.  Often times, the pregnant woman is unmarried, one of the greatest social taboos in Arab culture.  Such occurrences have led to hundreds of honor killings across the region.  Families – as a symbolic undertaking to preserve their honor – kill the unmarried pregnant woman, regardless of how she was impregnated to begin with.  Most modern, educated societies have abolished the practice of honor killing, though family honor is still very much at stake.    

            “Unmarried abortions have certainly increased but in our society, this is seen as unaccepted and extremely sensitive,” explains Tarek Tamara, doctor of gynecology and obstetrics in Cairo.  “A lot of people demanded that I do illegal abortions for them. Patients who come for an illegal abortion usually come in hiding.  Then, when I tell them I do not do it, they try to disappear quickly hoping I will not tell anyone about them.”

            “Except for certain health risks, it is completely illegal to perform abortions, and they teach them this in medical school.  It is a felony – the doctors are aware, hospital administrations are aware,” notes Moustafa.  “The bottom line is we press charges frequently, but not as often as the actual abortions happen.  For every 100 abortions, we might prosecute 20, maybe.” 

            There are other options, despite legal restrictions, such as the morning-after pill which is available over the counter at most regional pharmacies and pills which medically induce abortion, also available at pharmacies.  There are clinical procedures, such as uterus dilatation and curettage, and a suction devise which literally sucks the embryo right out.  These are all happening with great frequency, as the Arab culture has not openly embraced contraceptives such as condoms, and sterilization – vasectomies and hysterectomies – is prohibited by Islam. 

            Ragab describes extreme cases, such as a woman who was impregnated through premarital sex with her cousin and promised marriage only if she aborted the child.  In the fifth month, the woman finally succumbed to her cousin’s request, and had to remove the fetus via cesarean section.  In the end, her cousin abandoned her and married another.  She resorted to getting a hymenography – virginity reborn.    

            “I met in my life many women who justify abortion and see it as a way of life, and even see it as a contraceptive,” Ragab admits.  “Everybody hates abortion, even me.  I don’t call for abortion legalization, but we have to face reality.  Let’s see what the causes of unwanted pregnancy are, and deal with them first.”



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