The definition of abortion is quite broad. According to article 3 of article 58 of Law 29 of the Penal Code of 1960: “Abortion or miscarriage means the premature expulsion or removal of the conception of the uterus or uterus before the end of the gestation period.” [1] Thus, the two words, abortion and miscarriage, can be used interchangeably to refer to the same phenomenon. The law appears to cover induced abortions, where the pregnant woman intentionally ejects a viable fetus, as well as spontaneous abortions or miscarriages, which can be encouraged by the pregnant woman in a variety of ways. On the medical front, there have been attempts to clearly distinguish between the two,[2] but Ghana`s laws on the matter do not make this distinction. She asked women to seek comprehensive abortion care (CAC) services, such as using contraceptives to prevent unwanted pregnancies, providing information on abortion treatment, abortion management and follow-up. In Ghana, abortion was restricted at common law and criminalized in the penal code, inherited from the British colonial government. However, during the years of military dictatorship in the 1980s, when the influence of institutionalized religion may have diminished, this law was amended and liberalized. The Government of Ghana`s PNDC 102 Act 1985 permits abortion in cases of rape, incest, foetal abnormalities or if the pregnancy poses a risk to the physical or mental health of the woman, although these exceptions remain in the Penal Code. Since then, Ghana has ratified most international treaties and made modest efforts to reduce maternal mortality by addressing the problem of unsafe abortion. Post-abortion care is an integral part of the Safe Maternity initiative, which was implemented in 1990, although guidelines for operational services were not finalized until 2006. The reality of providing safe and accessible abortion services was quite different.
Historically, safe abortion services were widely available in private clinics, so they were not financially accessible to all women. Some abortions were performed secretly in public hospitals and were difficult to access. However, over the past decade, there have been changes in individual providers in accordance with the law, and safe abortion services are more often provided in public health centers and hospitals by obstetricians and midwives trained and willing to provide services, although coverage remains uneven [14]. It is important to understand whether globalization has played a role in this transition to practice to institutionalize the transition in Ghana and draw lessons for other countries wishing to implement policies, but there is a lack of analysis of the elements of globalization in this regard. The purpose of this article is to draw on key informant interviews and document analysis to describe the development of laws and de jure guidelines for comprehensive abortion care in Ghana, the interpretation and de facto implementation of these policies, and to assess the role that globalization has played in the transition to abortion care in Ghana. Santa-Olaya EBB, Bissel S, Cortes A. Impact of globalization on efforts to decriminalize abortion in Mexico. Development. 1999;42(4):130–3.
Again, the law does not specify when pregnancy can be characterized as harmful to a woman`s physical and mental health, nor does it explain what she means by physical and mental health, and therefore different interpretations could be given. A threat to mental health could mean psychological distress caused by a factor that complicates pregnancy. Some of the most common factors in Ghana are unstable relationships with the male partner, professional development, poverty, lack of social support, need to care for other young children in the family, health problems, diagnosis of fetal abnormalities, fear of parents, and pregnancy as a result of rape or incest.15 18 Given that the level of risk or threat to a woman`s physical and mental health is not The law appears to allow abortion for much broader reasons than most practitioners realize, and also appears to leave room for intelligent but untrained staff to perform unsafe abortion procedures. It is therefore commendable that protocols and service standards are being developed by the Ministry of Health to standardize abortion in the country. However, it is necessary to clarify the scope of physical and mental health covered by the Act in order to allow for easy implementation. The courts could probably help in this regard; Recognizing that the interpretation of laws also depends on constitutional provisions. She told me how my novel, The Teller of Secrets, had awakened memories that she had tried to suppress. This was not the only shameful confession triggered by the book. An award-winning Ghanaian filmmaker wrote to me to share harrowing accounts of abortions by a Muslim woman that she could not make public. Literary friends of mine have confided in me a similar pain.
Almost every African woman I know, aged 30 and over, has had one or two or more abortions. Nationally, 70.8% of all abortions were illegal, representing 141,316 (95% CI 107,719 to 174,913) illegal abortions, estimated at 60.1% in the coastal zone, 72.2% in the northern zone and 78.3% in the middle zone. We estimated that 25.5% (results not shown) of women who had an illegal induced abortion in Ghana in 2017 were treated for complications in a healthcare facility. While others considered the inclusion of the abortion law in the penal code restrictive and could not be provided: Overall, we estimated that 5.7 out of every 1000 Ghanaian women aged 15 to 49 were treated in a facility for complications resulting from illegal or legal abortion (estimates reflect the likelihood of complications as well as access to residential care). The overall rate of complications treated ranged from 2.9 in the northern zone to 7.7 in the middle zone. This variation is mainly due to the variation in treatment complication rates by zone for illegal abortions (2.5 to 7.1), while therapeutic complication rates for legal abortions were similar in the zones (0.4-0.6). Despite Ghana`s relatively liberal abortion law and efforts to expand access to safe abortion services, illegal induced abortion appears to be widespread.