Reforming abortion law in Sri Lanka

Protesters supporting reproductive rights demonstrate outside the U.S. Supreme Court in Washington

• Even though abortion is illegal in Sri Lanka, in 2015, the Sri Lankan Ministry of Health issued the National Guidelines on post-abortion care
• Guidelines stipulate that any woman who undergoes an illegal abortion can seek medical care for complications, if needed, at any government facility without fearing prosecution
• The guidelines recognize the need to have emergency post-abortion care services even at the most basic rural health posts
• According to United Nations Population Fund (UNFPA), unsafe abortions hospitalize about seven million women a year globally and cause 5 to 13 percent of all maternal deaths
•  When it comes to the developed world, the United States of America is a country where abortion has had a significant impact even on elections
•  Section 303 of the Sri Lankan Penal Code provides that ‘causing a miscarriage’ is a punishable criminal offence, punishable with imprisonment ranging from three to ten years, with or without fine

Abortion is illegal in Sri Lanka unless the life of the mother is at risk. Regardless of the law, Sri Lankan women still have access to illegal abortion services. Rights groups have been demanding authorities to decriminalize abortion in order to make the provision of abortion services safer, less expensive and more equitable.   Around 45% of all abortions are unsafe and unsafe abortions are still a leading – but preventable – cause of maternal deaths globally, according to the World Health Organization (WHO). According to United Nations Population Fund (UNFPA), unsafe abortions hospitalize about seven million women a year globally and cause 5 to 13 percent of all maternal deaths.   

In developing countries, unsafe abortions cost an estimated $553 million per year in treatment costs alone.   
When it comes to the developed world, the United States of America is a country where abortion has had a significant impact even on elections. What legal reforms were enacted in the United States to decriminalize abortion? How do American citizens perceive female reproductive rights? What can we, as Sri Lankans, learn from what is going on in the United States?   

The politics of abortion in the US

Abortion is a powerful political issue in the U.S. It has been a crucial factor motivating democratic voters since the U.S. Supreme Court ruling last June that overturned a 1973 court ruling (Roe vs. Wade) that protected a woman’s right to choose to have an abortion.   

The Supreme Court on April 21 blocked restrictions set by lower courts on a widely used abortion pill while litigation continues in lower courts in a challenge by abortion opponents to the drug’s federal regulatory approval.
In the United States, Federal Law trumps State Law. When the court overturned the Roe vs. Wade decision, a woman’s right to choose became a state-by-state matter, and many states severely restricted or banned abortion rights.   

In response to the recent court decision, in January, Minnesota became the first state in the U.S. to pass legislation that recognizes abortion as a fundamental human right in the Minnesota Constitution.   

According to the existing regulations, abortion is legal in Minnesota until “viability,” which is the stage of pregnancy when a fetus has developed far enough that it can survive outside the uterus with medical help.   

Although Minnesota has recognized abortion as a fundamental human right, there are currently moves that seek to change the access that is available in Minnesota. Abortion rights opponents continue to protest and propose measures to curtail access.   

Abortion debate in the eyes of an abortion clinic escort

Following is the much controversial debate from the experience of a local Minnesotan woman who has lived during and after the landmark Roe vs. Wade decision by the U.S. Supreme Court.   

In 1969, when Jane* was in college, her roommate Camila* became pregnant. Camila’s boyfriend, also a university student, made the decision for her that she should terminate the pregnancy.   

“He found someone in a back alley in Minneapolis, Minnesota, a person known to perform illegal abortions,” said 71-year-old Jane, who is currently volunteering as a security escort at a health clinic in St. Paul, Minnesota – the first state in the country which passed legislation that recognizes abortion as a fundamental human right.   
Soon after the surgery, Camila started haemorrhaging. She recovered, but, never returned to college. What her roommate went through at the age of 18, left an impact on Jane.   

“Her education was interrupted, but her boyfriend, who made the decision on her behalf, finished higher education and graduated with flying colours,” Jane said.   

“Nothing affected his education.”   

Jane has been volunteering for 15 years at the St. Paul location of a nonprofit organization that provides reproductive and sexual healthcare – Planned Parenthood, which operates 28 health centres across five states (Iowa, Minnesota, Nebraska, North Dakota and South Dakota). In addition to abortion care, Planned Parenthood also provides breast/chest examinations, HIV-related tests, fertility awareness education, LGBTQ+ care and treatment for anxiety/depression.   

However, anti-abortion demonstrations continue to take place, and protesters hold anti-abortion placards with messages like, “Don’t murder your baby” and “Abortion tortures and kills,” outside clinics. 

In their brightly coloured signature pink vests, being yelled at is a part of the daily life of a security escort. Clinic escorts like Jane serve as compassionate lines of site and guides to help patients navigate through the protesters and find the entrance to check in for their healthcare appointments.   

“When I volunteer at Planned Parenthood, I feel that what I do truly matters and has an impact on the community,” Jane said. “That is why I do what I do.”   

Escorts are advised to follow strict policies of non-engagement. They provide patients with comfort and help them navigate the chaotic environment that exists outside many clinics.   

“I don’t engage with the people who are against abortion,” Jane said. 

“My task is only to make sure men and women who come to the clinic feel safe.”   
Many people come to volunteer, thinking they can do this. But it takes a lot of patience to control emotions, stay calm, and continue this volunteer work.”   

She described that just like her being the security escort for 15 years, the protesters who come near the clinics also have shifts and schedules. Jane said she hears anti-choice proponents calling out to passersby during her escort shifts, and the people who protest make the assumption that everyone who comes into the clinic wants an abortion.   

For example, Jane recalled one woman who was driving into the clinic and was stopped by an anti-abortion protester. The woman said, “I have cancer and came here to get my tests done.” In return, the protester, who was also a woman, said, “I don’t care. Don’t murder your baby.”   

When people thank Jane for being there and helping them feel safe, she responds:   
“I am glad to help you, but I am sad that I have to.” 

Jane*, Camila* – Names have been changed to protect privacy and safety   

Failed attempts to legalize abortion in Sri Lanka

Section 303 of the Sri Lankan Penal Code provides that ‘causing a miscarriage’ is a punishable criminal offence, punishable with imprisonment ranging from three to ten years, with or without fine. According to Human Rights Watch (HRW), Afghanistan is the only other country in South Asia whose abortion laws are as punitive as Sri Lanka.   

Even though the topic of reforming laws applicable to abortions has been raised in Parliament on several occasions in the past, and even proposals made by the Law Commission of Sri Lanka in 2013 to legalize abortion in cases of rape, those attempts have not been successful to bring new legislation so far.   
The latest attempt was made in March 2022, by Minister of Justice Ali Sabry who said it is essential to hold a national-level discussion on allowing abortion in certain circumstances.   

“We suggest that the Women MPs Caucus in Parliament should initiate a discussion on it and come up with some suggestions. Abortion must be allowed if it becomes essential to save a woman’s life and when a woman becomes pregnant as a result of rape,” the Minister said.   

He made this statement in response to a question posed by MP Shantha Bandara, who expressed concerns about women dying by suicide due to unwanted pregnancies. Ali Sabry told Parliament that he believed that reforms should be made concerning the laws on abortion in Sri Lanka, and pointed out the practical issues faced by women who give birth to children as a result of abuse.   

Past attempts at reform unsuccessful due to opposition mainly by religious groups: Ambika Satkunanathan

Speaking to the Daily Mirror, Former Human Rights Commissioner Ambika Satkunanathan said that it is unsurprising in a deeply patriarchal nature of society that women still do not have the choice to make decisions about their own bodies - i.e. bodily autonomy is denied to them. 

She opined that in Sri Lanka, ridiculous and counterfactual arguments, such as that women will use abortion as a form of contraception, are made against decriminalizing abortion.   

“There have been many unsuccessful attempts in the past to decriminalize abortion, at least in cases of rape, due to opposition mainly by religious groups,” Satkunanathan said.   

The former Human Rights Commissioner also pointed out that criminalizing abortion has not prevented people from having abortions- it has only driven it underground, thereby resulting in women choosing unsafe means that lead to harmful health impacts or even the death of the woman. 

Statistics

• Every year, almost half of all pregnancies are unintended.   
• Over 60 percent of unintended pregnancies, and almost 30 percent of all pregnancies, end in abortion.   
• 45 percent of all abortions performed globally are unsafe.   
• Unsafe abortions hospitalize about 7 million women a year globally and cause 5 to 13 percent of all maternal deaths, one of the leading causes of maternal death.   
• In developing countries, unsafe abortions cost an estimated $553 million per year in treatment costs alone.   
• According to research done by American think tank Pew Research Center in 2022, about six in 10 Americans think abortion should be legal in all or most cases.   

Post-abortion care provided by the government 

Even though abortion is illegal in Sri Lanka, in 2015, the Sri Lankan Ministry of Health issued the National Guidelines on post-abortion care. The guidelines stipulate that any woman who undergoes an illegal abortion can seek medical care for complications, if needed, at any government facility without fearing prosecution.+
The providers at the health facilities are not permitted to withhold post-abortion care services citing personal, moral and/or religious beliefs, as noted in the guidelines.   

Post-abortion care is provided primarily in specialist gynaecology units. The guidelines, however, recognize the need to have emergency post-abortion care services even at the most basic rural health posts. The medical officers at primary care health facilities are expected to be able to diagnose the complication following an abortion and initiate treatment before referring to a higher facility.

Illegal abortion is a problem that has been ignored for too long in Sri Lanka. According to unofficial, non-government data, the number of illegal abortions and deaths have increased in the country. Future discussions about abortion law reforms in Sri Lanka could learn from what is happening in developed nations like the U.S. The social, cultural, and religious background of the country should be carefully analyzed with suitable approaches as those elements may stand in the way of liberalizing the grounds on which abortion can be legalized.     

The writer is currently in the U.S. following World Press Institute’s journalism 
fellowship programme