Issues of pregnancy remain contentious in EAC reproductive health bill. Science could help strike a compromise
Monday, July 25, 2022

It is probably not surprising that the East African Community Sexual and Reproductive Health Rights Bill 2021 is still stymied by opposition since the process to enact it began in 2017.

One of the perpetually sticking issues at the recent public hearing in Juba, South Sudan, was when or whether to end a pregnancy. 

This is perplexing. Studies show that continued opposition to granting women the right to decide whether to carry a pregnancy inevitably leads to many of them to terminate it under unhealthy conditions, often with deadly consequences.

Unsafe abortions are among the leading cause of maternal deaths, accounting for about 10 per cent of maternal mortality.

Among other reproductive health issues, the bill seeks to address the problem. 

While it ideally should grant the woman the right to decide, it instead provides for limited access to abortion. And this upon the advice of a doctor, should a pregnancy endanger the life or mental or physical health of the woman.

It also seeks to allow terminating a pregnancy in case of sexual assault, rape, and incest.

The bill further looks to protect the right of women and girls to post-abortion care, whether the abortion was acquired legally or not. It protects health care providers from prosecution for providing post-abortion care.

These provisions are in accordance with the Maputo protocol which affirms women’s rights in Africa, and which EAC partner states have ratified.

Opponents of the bill, particularly religious and conservative groups, are against it employing a familiar trope: They claim that some provisions of the bill are pushing the Western agenda.

They are dissatisfied with the definition of abortion in the bill, arguing that it does not reflect African values. 

Advocates for the bill are equally vehement, insisting that expanding access will help reduce the deaths and prevent recourse to unsafe abortions.

They point to the health risks and show how forcing women and girls to have an unwanted child often has dire social and economic consequences on their lives.

That abortion should provoke so much passion for or against it shows why it remains a difficult issue morally, emotionally and legally the world over, not just in the region.

Yet to suggest that it has anything to do with African values – whatever those are – is also highly contentious and deserves closer examination.

Let us first consider the fact that the majority of Africans are either Christian of Muslim, which informs many of their moral concerns. The same majority agreement may not be said of the supposed "African values”.

With over 2000 ethnic groups in Africa, anthropologists are quick to point out how each culture is different from the other in its beliefs and customs. This is to say that while there may be a similarity in their values, many of them differ nonetheless.

I was reading an insightful analysis showing how each culture, for example, has its idea about who – or what – constitutes a person, which really is at the core of the abortion debate – whether the fetus is a person to deserve living.

If the fetus is a person, for instance, at what point does it become so? Is it at the moment of conception as some believe, or at the moment the child is born? Or is it a certain point between these two stages it becomes a person?

In many traditional African cultures, this is not the question. Rather, personhood in the cultures is a process that does not distinguish life among the living or life among the dead.

I learnt that in some societies – for example Tallensi of northern Ghana – if an individual ever achieves full personhood, it is only after death, when they become an ancestor, fully involved in the lives of their descendants.

In other cultures, "persons” are not even necessarily human. Among Mande cultures in West Africa, the Dyula communities, for example, every clan is associated with a "ntana,” a large and dangerous wild animal species, whether lions, leopards, elephants, crocodiles or pythons, for example. Members of the species are considered persons, but only for individuals in the associated clan.

Between these two examples are countless variations, including in East Africa and elsewhere in the continent. 

Space does not allow me to delve more into this. But the point to make is that it is not that the traditional beliefs are right or wrong any more than one can fault the deeply felt concerns of the opponents of the EAC bill.

It is that values evolve in keeping with the times, especially today as may be guided by science.

Scientific evidence shows that the viability of a fetus, the point during gestation a baby can survive outside of the womb is around 23 to 24 weeks.

However, how to apply this is about compromises. Even in some the most liberal countries in Europe the standard practice for legal abortion is at least during the first trimester of pregnancy, or 12 weeks.

That the EAC bill proposes limited abortion services already suggests a workable compromise.