InLiberia,abortion is onlylegal in cases ofrape,fetal impairment, or risk to the mother'sphysical or mental health orlife, up to the 24th week of pregnancy. About 32% of women have had abortions, which Liberians call "spoiling the belly".Unsafe abortions are common and account for 15% ofmaternal deaths in the country.Self-induced abortions are common.Medical abortion is legally restricted.Post-abortion care is available from public and private facilities.
Liberia's abortion law is from 1976. TheLegislature of Liberia introduced a bill to legalize abortion in 2020. The legislature began debating the revision in 2022 after it was introduced by SenatorAugustine Chea.Pro-abortion advocacy groups have said it will reduce the high rate of unsafe abortions. Religious leaders have opposed it, saying it violatesfetal rights. As of 2024, the bill is being debated.
Section 16.1 of thepenal code of Liberia criminalizes abortion without a legal defense, and Section 16.3 sets the gestational limit at 24 weeks of pregnancy.[1] A 1976 law permits abortion in the cases ofrape, incest, risk to the physical or mental health of the mother, or risk to the life ofthe mother orthe fetus.[2] Police and judiciary investigations are required in the case of rape or incest, and medical exemptions require written agreement from two physicians.[3] The law defines that pregnancy begins after completeimplantation and specifically does not apply to actions taken to prevent pregnancy.[4][5]
In July 1976, an amendment to the penal code received presidential approval, which included Section 16.3 on abortion.[6] Liberia legalized the abortion pillmifepristone before 1996.[7]
In February 2020, a revision to the Public Health Bill addressing abortion was introduced to theLegislature of Liberia.[8] The proposal would amend Section 16.3 to legalize abortion forsocioeconomic reasons.[3] It would lower the limit for legal abortions to the fourteenth week of pregnancy. Deputy Health MinisterVarfee Tulay said the limit would emphasize that the law intends to avoidmaternal deaths rather than promote widespread abortions.[9] If passed, the law will beone of the most liberal in Africa, where a vast majority of women live in places with restrictive laws.[10]
On 13 June 2022, ajoint committee began debating the bill.[11] The debate was introduced byAugustine Chea ofSinoe County, who was chair of the Senate Health Committee and a member of the Senate Judiciary Committee. Speaking to the Women's Legislative Caucus as a proxy for President Pro TemporeAlbert Tugbe Chie, Chea said his goal was to stop abortion being a criminal offense.[3] TheHouse of Representatives passed the law. The proposal addressedsex education andfamily planning, as well as other major health issues, despite a public perception that there was a standalone bill about abortion.[10][8] A special session convened on 22 August 2023 and adjourned on 5 September afteranti-abortion groups called for the legislature to reject the bill.[12] As of February 2024, the Senate is reviewing the law.[13] TheCoalition for Democratic Change opposes the proposal. The party's Secretary General,Jefferson Tamba Koijee, argued that the bill would threaten population growth.[14]
Advocates for legalizing abortion have cited high rates of illegal abortions in Liberia and the risk of complications. An anonymous group of senators told theLiberian Observer, "Don't you think it's finally time for a change? Yes. Having an illegal abortion may cause more deaths because it is done in backyard clinics and sometimes we throw our babies in dumpsites because most women can't even afford a daily meal or provide a good home for the children."[3] The Community Health Initiative, an advocacy group campaigning for the law, worked with the national government to form coalitions and led workshops with journalists to report on the topic.[13] The nationalnot-for-profit organization Sister AID Liberia held media dialogues to discuss prevention of unsafe abortions.[15] Vice PresidentJewel Howard Taylor voiced support for the law in an interview with state broadcasterELBC-FM.[10]
Many religious andtraditional leaders believe abortion is againstChristian teachings and local traditions.[13] Opponents have argued that prioritizing abortion rights ignored therights of the unborn child.[3] Bishop Kortu K. Brown, former president of theLiberian Council of Churches, has been a vocal protestor.[10] His organization, the Campaign to Stop Abortion in Liberia, urges citizens to write to their representatives opposing the bill.[9] Members of Liberia's Religious Council criticized theSwedish Embassy and other organizations that funded activism supporting legal abortion.[16] Swedish ambassador Urban Sjöström defended the country's support for legal abortion, and the embassy denied allegations of bribing lawmakers.[10][17][18] ARepublican member of theUnited States House of Representatives,Chris Smith, called for Liberian legislators to reject the bill and for the US Congress to investigate whetherJoe Biden's administration had illegally advocated for legal abortion in Liberia.[19]
According to a report by theMinistry of Health, 38,779 abortions occurred in Liberia in 2021, equalling 30.7 per 1,000 women (of reproductive age), or 229 per 1000 live births.[13] The country'sabortion rate increased from 28 per 1,000 women in 1990–1994 to 42 per 1,000 women in 2015–2019. In the latter period, 49% of pregnancies were unintended and 40% of unintended pregnancies resulted in abortion.[note 1][20] As of 2015, the only representative survey of abortion in Liberia is the 2007 Demographic and Health Survey, in which 6% of women, speaking face-to-face, reported having had abortions. Anecdotal evidence and statistical analysis indicate that 32% of women have had abortions as of 2013.[21]
In Liberia, abortion is referred to as "spoiling the belly" or "taking the belly".[22]Backstreet abortions are commonly available. Some providers are nurses who usespeculums and syringes, some use knives or sharp bones, and others use remedies such as herbs, ground avocado, or chalk. A 2013 study of sixcounties of Liberia found that over 10% of women had undergone unsafe abortions.[22] Many young women have performedself-induced abortions by vaginally inserting cassava, chalks, or an herb mixture known as "rocket-propelled grenade". This sometimes results in fatal sepsis.[23] Some have drunk water mixed with ground glass or an herb known as "Christmas leaf".[10] The most common demographics recorded to have unsafe abortions are young women, students, and people who have previously been pregnant. Risks includesepsis, which accounts for 15% of maternal deaths in Liberia, andhaemorrhage.[24]Septic abortions are a common cause oftetanus.[25]
Liberia has no government-supported training for abortion providers.Medical abortion is provided by private organizations that import registered abortion pills, but distribution is legally restricted.[26] Public and private facilities such asPlanned Parenthood offerpost-abortion care. Some unsafe abortions result in severe pain or the need toremove the uterus.[22] Liberia'sstandard treatment guidelines includemisoprostol for post-abortion care and haemorrhage treatment.[26] Most cases of unsafe abortion requiring surgery are referred to theJohn F. Kennedy Maternity Center inMonrovia, the onlytertiary medical facility in the country. The center'sexploratory laparotomy surgeries have a fatality rate of 22.4%, as of 2022. Delays in treatment contribute to the fatality rate, caused by cost of travel, fear of legal or social ramifications of abortion, or time taken by primary care.[27]
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