KIGALI, Rwanda – Civil society groups, health experts and lawmakers in Rwanda are divided over a proposed change to the penal code that would make it easier for a woman to get an abortion. The draft amendment, which was passed by Parliament in December and now needs the approval of President Paul Kagame, would allow a woman and her doctor to decide among themselves whether or not to terminate a pregnancy. Currently the final decision lies with a third party: the courts.
In Rwanda, abortion is a criminal and punishable offense, except when it is the result of rape, incest or forced marriage, or when a pregnancy poses a danger to the life of the child or mother.
In those instances, if a woman and her doctor agree an abortion is necessary, the procedure cannot go ahead until an intermediate court has examined the case and decided it complies with the country’s strict laws. This process can take weeks or even months, with rulings sometimes coming too late for a woman to have the abortion.
The new amendment will mean the courts only become involved if the pregnancy is the result of a criminal act, or if the woman is accused of seeking an illegal abortion.
Some civil society organizations have welcomed the change, after years of campaigning to reduce the bureaucracy involved in procuring abortions.
“Our concern was mostly about the time it took before someone was allowed to conduct a safe abortion, because it required a court trial and ruling, which would sometimes last even more than nine months,” says Dr. Aflodis Kagaba, executive director of Health Development Initiative, an organization that has been calling for the removal of barriers to safe abortion.
“But now it will be a decision between the doctor or a qualified health provider and the person seeking the abortion.”
Rwanda’s current law, which was adopted in 2012, is among the strictest in the world. Despite that, around 22 percent of unintended pregnancies end in abortion. About half of those abortions are considered unsafe, having been carried out by someone with no medical training or by the woman herself. As a result, an estimated 40 percent of abortions in Rwanda lead to complications that require treatment.
By reducing the red tape around the process of getting an abortion, the new amendment should cut down the number of women who are injured or who die as the result of an unsafe abortion, some health experts say.
While they applaud the government’s move, campaigners say a lot still needs to be done in terms of children’s rights when it comes to abortion. The draft amendment adds a new requirement that girls who go to a doctor seeking abortion for a pregnancy that was the result of rape have to be accompanied by their parents, a detail that Kagaba says will limit access to abortion for women under 18.
“Very many children will be afraid to engage their parents on such matters, and [the process] becomes even longer if parents are involved,” Kagaba says. “So we have asked parliament to see whether they can allow children who are 16 and above to go [to the doctor] alone.”
But lawmakers argue that excluding parents from the decision of whether or not to grant an abortion would be a denial of the rights of parents to protect their children, and could lead to more young women seeking abortion as a form of birth control, even when the procedure isn’t medically necessary.
“Denial of parents’ accompaniment in the process of [granting] abortion will not only widen gaps for possible abuse of the law, but it wouldn’t make sense to parents who are committed to protecting their children,” said MP Euthalie Nyirabega at a committee session on the new amendments. “I am not convinced by the argument.”
Meanwhile, the sidelining of the courts in decisions around abortion has some health experts worried that cases of illegal abortions will slip through the system.
“Going forward, it will be hard to determine who should be criminally liable in the case of [illegal] abortion, but we hope the government will come up with directives that compel doctors to get more information on women seeking abortions,” says community health worker Albertine Kaliza.
Christopher Sengoga, a lawyer and consultant working with HDI, says he supports the new amendment, pointing to two cases the organization has come across that illustrate the need to speed up the process of procuring an abortion.
Recently in Kayonza district, a 14-year-old girl who was gang-raped on her way home from school became pregnant and sought a court order to terminate the pregnancy. But because she didn’t file her case with the court within the required time period – up to 15 days after the rape – the court denied her request. She had no choice but to deliver the baby.
In a similar case in the southern district of Muhanga, another teenage rape survivor was also denied an abortion because the court took too long to come to a decision.
“When she finally received the court order, it had already been eight months and the hospital could not take the risk of terminating the pregnancy,” Sengoga says. “She ended up delivering the child.”
Even if the proposed change is approved by the president, Rwanda’s abortion law will still severely restrict access to the procedure for thousands of women each year. Among Rwandan women, an estimated 47 percent of pregnancies are unintended, either because they came too soon or they were unwanted.
For any woman who decides to take the risk of having an illegal abortion, the amendment hands out a harsher punishment than before. Those charged with helping a woman commit an illegal abortion could face a jail term of more than six years – up from a current maximum of five years – and a fine of between 300,000 Rwandan francs ($350) and 500,000 Rwandan francs ($600).
If a woman decides her only option is to self-induce an abortion, the penalties remain as unforgiving as they are now: She could be forced to pay a fine of up to 200,000 Rwandan francs ($250) and end up in prison for one to three years.