InTogo,abortion isonly legal in cases ofpregnancy from rape or incest,risk to the mother's health or life, or risk ofbirth defects. The law requires abortion to be performed by a doctor.Unsafe abortion is a major cause ofmaternal mortality in the country.
Togo inheritedFrance's abortion law in 1920, banning abortion. The country's 1981 criminal code did not include the abortion ban, but access did not increase.Reproductive rights organizations have worked to raise awareness of abortion. After ratifying theMaputo Protocol in 2005, Togo passed a law legalizing abortion in December 2006. It was the first country inFrancophone Africa to do so.
Access to abortion is low due to stigma, lack of knowledge, and lack of doctors. Some women travel to receivelegal abortions in Benin. Abortion is particularly frequent inLomé, where it is more common among younger women, and it is also frequent amongsex workers. Illegal vendors provideabortion drugs.Post-abortion care has been available in hospitals since the 2000s, though barriers to access exist.
A 2006 reproductive health law says, "The voluntary interruption of pregnancy is only authorised when prescribed by a doctor and on request of the woman in cases where the pregnancy is the result of rape or of an incestuous relationship [or] if there is a strong risk that the unborn child will by affected by a particularly serious medical condition."[1] The reproductive health law requires that abortions be performed at approved facilities with the approval of three physicians. Thepenal code of Togo otherwise criminalizes abortion.[2] Abortions without medical prescriptions are punishable up to ten years in prison or fines between 500,000 and 3 millionCFA francs,[3] which apply to both the provider and the patient.[2]
When Togo gained independence, it inherited theFrench Penal Code of 1810, which banned abortion.[4] A French law from 31 July 1920 banned abortion unless it threatened the life of the mother and banned the promotion ofbirth control.[5] When Togo re-enacted its criminal code in 1981, it omitted mentions of abortion with the intent to remove the ban.[6] By 1990, lifting abortion restrictions had not increased the availability of services.[7] On 16 May 1984, a law banned providing an abortion to a girl enrolled in school.[4]
In October 2005, Togo ratified theMaputo Protocol, which provides for a right to abortion under certain grounds.[4] On 22 December 2006, theNational Assembly accepted the law legalizing abortion.[8] The law had 46 articles, including legalization of medical assistance in contraception.[5] Togo wasone of the first countries in Africa to legalize abortion in the case of rape[1] and the first Sub-SaharanFrancophone to reform its abortion law.[3] Women's rights organizations influenced the law reform.[5] TheEpiscopal Conference of Togo opposed the law, saying "It punishes the innocent: the unborn child."[9]
In countries including Togo, U.S.–linkedanti-abortion groups have set up centers disseminatingmisinformation related to abortion in the 2020s.[10] In 2024, thenon-governmental organizationL'Association Togolaise pour le Bien-être Familial (ATBFE,transl. Togolese Association for Family Well-Being), which has worked insexual and reproductive health since 1975, worked with journalists to raise awareness of abortion.[11]
In 2015–2019, Togo had 60,300 abortions per year. Between 1990–1994 and 2015–2019, Togo's rate ofunintended pregnancy decreased 26%, while the abortion rate remained level.[12] Legal issues and social taboos lead to low access to abortion.[13] Abortions must legally be prescribed by a doctor, which is a limitation as the country has few doctors.[14] Knowledge of the abortion law is low.[15][14] Women who cannot access abortion in Togo may travel to Benin,where it is legal.[15]
Medical abortion is commonly available from unsafe providers, who sell on the street. Drugs such asparacetamol,acetylsalicylic acid,quinine,chloroquine, andindomethacin are used. Usage is high among women who are young or unmarried.[16] Illegal abortions may also be performedsurgically in unsanitary conditions.Unsafe abortions are the largest cause of maternal mortality in the country.[15]
Lomé has undergone an increase in abortion, similar to other African cities. As of 2016, 32.4% of women in the city who have ever been pregnant reported having abortions, and 43.2% of people know someone who has had an abortion. Almost 40% of abortions are performed in hospitals, 14.9% are by doctors, 36% are performed at home, and 17.9% are induced with drugs. Abortion rates are highest amongKabye people and Catholics.[17] Abortion is a factor in the reduction of birth rates in the city. From 1988 to 1998, the city's abortion rates rose from about 12.2 to 62.2 per 1,000 women, with younger women being more likely to have abortions.[18] A 2024 study ofsex workers in Lomé andKara found that 40% had ever had abortions and that Lomé had a higher rate.[19] Sex workers in Lomé are more likely to experience stigma if they have had abortions.[20]
The cost ofpost-abortion care (PAC) is between US$18 and $20, as of 2016. Thoughmanual vacuum aspiration (MVA) is the recommended treatment method, many facilities lack equipment and training for it and instead use manual removal. Facilities offer post-abortion contraceptives for an additional fee.[21] Most patients opt fororal contraceptive pills. Some facilities face shortages of supplies.[22] Many PAC patients are young. Barriers to PAC for adolescents include lack of provisions for young patients, high cost, and poor organization leading to low privacy.[23]
In 2004, ATBFE began an experiment providing free post-abortion care kits to poor women in two hospitals.[5] Decentralized PAC services were introduced in 2006.[22] TheUnited States Agency for International Development (USAID) launched the Virtual Fostering Change Program in 2008 to assess and improve PAC services in Togo,Burkina Faso,Guinea, andSenegal. In 2014, the USAID-funded Evidence to Action project began working with theDivision of Family Health to increase access to post-abortion family planning. After the program trained health providers, clinics widely began distributing free contraceptives, and the country incorporated the program's recommendations into its PAC guidelines.[24] PAC providers involved in the program had higher knowledge and more positive attitudes about providing PAC for young people. In 2017, Togo updated its national family planning policies based on the recommendations.[25]
