Leila Hessini Director, Community Engagement and Mobilization Ipas December 14, 2010

1. Leila Hessini Director, Community Engagement and Mobilization Ipas December 14, 2010 Unwanted pregnancies and unsafe abortions in Africa : strategies for change from within Muslim contexts

2. Unsafe abortion 21 2 million unsafe ach year – affecting >100 million women during their reproductive lifetimes 47000 deaths per year, 93% in Africa and South-central Asia Over half of deaths are young women <24 Source: WHO, 2008

3. Latin America and Caribbean 4.2 million Africa 6.1 million Europe 0.3 million Asia 10.8 million Estimated annual numbers of unsafe abortions (2008 Total = 21.2 million (Source: WHO, 2008

4. Unintended pregnancies • Close to 40% of pregnancies are unplanned • 80 million unintended pregnancies each year (27 million as a result of method failure or ineffective use) • Preventing unintended is critical to reducing unsafe abortions

5. Unintended pregnancies in Africa • 14 million unintended in Africa • Various factors: sexual violence, pregnancy outside of marriage, lack of knowledge, access to or use of contraception • 1/3rd of all unintended end of aborted • Age pattern of unintended pregnancies is changing – many more young women

6. Consequences of Unsafe Abortion In addition to death, unsafe abortion can lead to: • 1.7 million hospitalized annually • Significant short- and long-term illness and injury to women • Infertility • Negative impacts on women, families, children, and communities • Increased likelihood of death among children whose mother has died

7. Abortion Laws of Africa Without Restriction as to Reason Socioeconomic Grounds To Preserve Mental Health To Preserve Physical Health Legally Permitted to Save a Woman's Life

8. Health Sector Impact • Treatment for unsafe abortion costs health systems up to $1 billion per year • OB/GYN hospital capacity often overwhelmed by post-abortion patients • Post-abortion care significantly more expensive than safe abortion (or contraception) • Unsafe abortion can also reflect the overall quality of health systems. WHO; Guttmacher

9. Global conference on Gender Equality in Islam

10. Regional roundtable on Abortion and Islam

11. What can be done: Strategies from within Muslim contexts • Analysis of medieval Arabic texts • Compiling supportive fatwas • Supporting women religious leaders • Legal and policy reform • Health system change • Networking across regions

12. Analysis of medieval Arabic texts • Coitus interruptus encouraged others as long as there was mutual consent. • Abortion: debates regarding pregnant women’s circumstances; fetal age and analysis of if more harm would be caused by continuing or by ending the pregnancy. • Maternal life carried precedence over that of the foetus at least until “ensoulment” defined as occurring anywhere between 40, 90 or 120 days.

13. Analysis of medieval Arabic texts • Abortions after ensoulment were prohibited unless there was “just cause” – usually defined as saving a women’s life or their health • The lives of existing children were also considered more important than that of the fetus; breast-feeding women or mothers who could not afford another child were allowed to terminate a pregnancy.

14. Documenting fatwas on abortion • Algeria (1998) rape victims of Islamist violence • Egypt (1998) for unmarried women who had been raped • Saudi Arabia (1991) and Iran (2005) in cases of fetal abnormalities • Indonesia (2004) rape and incest

15. Supporting women religious leaders • Training women - mourshidat – Islamic scholars and spiritual guides • Working through the pesantren, - Muslim boarding schools – to incorporate information on SRHR into school curricula • Building global networks – musawah - gender equality in Islam

16. Documentation of women’s voices • Islam is a strong presence in women’s lives, but it does not necessarily govern women’s everyday reproductive and sexual choices • Women often rely on their belief in God’s compassion rather than on the opinions of religious authorities. • Women may simultaneously believe that abortion is “harem” but yet necessary and even justified • Young and unmarried women experience much more shame and stigma • Women’s social networks are an important source of information, transportation and resources for women seeking abortion care.

17. Changes in abortion laws of OIC • Tunisia: and Tunisia: 1973 and 1982 • Algeria (1985) and Benin (2003) • Burkina Faso (1996) and Chad (2002) • Djibouti (1995) and Guinea (2000) • Indonesia (1992) Iran (1991), Kuwait (1981), Mali (2002) Niger (2006), • Pakistan (1990), Saudi Arabia (1990) Sudan (1993) and Togo (2007).

18. Service delivery approaches • Menstrual regulation • Medical abortion • Training midlevel providers and midwives • Ensuring that women have knowledge, skills and ability to obtain safe abortion services • Ensuring that women have safe abortion information and care in their communities

19. Next steps • Compile existing resources into a database and toolkit • Develop training and capacity-building curricula for community education • Engender awareness and support from religious leaders and individuals at community level • Share experiences across countries (study tours)

20. Islam & RH Toolkit About Law and Policy Gender & Rights Country – Specific Related Sites Drop-Down Lists maybe Tabs SRH and Islam SEARCH Welcome! Intro Homepage We could use these side tabs to reorganize the resources in another conceptual manner, if need be, for example: Abortion, FP, Contraceptives, ETC. Standard contact links at the bottom