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Abortion in Togo

In Togo, abortion is only legal in the cases of pregnancy from rape or incest, risk to the mother's health or life, or risk of birth defects. The law requires abortion to be performed by a doctor.

In 1920, Togo banned abortion. Reproductive rights organizations have worked to raise awareness of abortion. In December 2006, it became one of the first African countries to reform its abortion law.

Access to abortion is low due to stigma, lack of knowledge, and lack of doctors. Abortion has increased in frequency in Lomé, and is more common among younger women. Illegal vendors provide abortion drugs. Post-abortion care has been available in hospitals since the 2000s.

Legislation

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In 2006, Togo passed a law that 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] Abortions without medical prescriptions are punishable up to ten years in prison or fines between 500,000 and 3 million CFA francs.[2]

Legislative history

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When Togo gained independence, it inherited the French Penal Code of 1810, which banned abortion.[3] A law from 31 July 1920 banned abortion unless it threatened the life of the mother and banned birth control propaganda.[4] When Togo re-enacted its criminal code in 1981, it intentionally omitted mentions of abortion.[5] By 1990, the lift of abortion restrictions had not increased the availability of services.[6] On 16 May 1984, a law banned providing an abortion to a girl enrolled in school.[3]

In October 2005, Togo ratified the Maputo Protocol, which provides for a right to abortion under certain grounds.[3] On 22 December 2006, the National Assembly accepted the law legalizing abortion.[7] The law had 46 articles, including legalization of medical assistance in contraception.[4] Togo was one of the first countries in Africa to legalize abortion in the case of rape[1] and the first Sub-Saharan Francophone to reform its abortion law.[2] Women's rights organizations influenced the law reform.[4]

The Episcopal Conference of Togo opposed the law, saying "It punishes the innocent: the unborn child."[8] The head of prenatal care at the Tokoin Teaching Hospital in Lomé, Boukari Amina, said the law "will fix a lot of things."[4]

Prevalence

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In 2015–2019, Togo had 60,300 abortions per year. Between 1990–1994 and 2015–2019, Togo's rate of unintended pregnancy decreased 26%, while the abortion rate remained level.[9]

Legal issues and social taboos lead to low access to abortion.[3] Abortions must legally be prescribed by a doctor, which is a limitation as the country has few doctors. Knowledge of the abortion law is low.[10] Sex workers in Lomé are more likely to experience stigma if they have had abortions.[11]

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 among Kabye people and Catholics.[3] Abortion is a factor in reduction of birth rates in the city. From 1988 to 1998, abortion rates rose from about 12.2 to 62.2 per 1,000 women. Younger women are more likely to have abortions.[12]

Medical abortion is commonly available from unsafe providers, who sell on the street. Drugs such as paracetamol, acetylsalicylic acid, quinine, chloroquine, and indomethacin are used. Usage is high among women who are young or unmarried.[13]

Activism

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The non-governmental organization L'Association Togolaise pour le Bien-être Familial (ATBFE, transl. Togolese Association for Family Well-Being) has worked in sexual and reproductive health since 1975. It has worked with journalists to raise awareness of abortion.[14]

In countries including Togo, U.S.���linked anti-abortion groups have set up centers disseminating misinformation related to abortion.[15]

Post-abortion care

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The cost of post-abortion care (PAC) is between US$18 and $20, as of 2016. Though manual 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.[16] Most patients opt for oral contraceptive pills. Some facilities face shortages of supplies.[17]

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.[16]

In 2004, ATBFE began an experiment providing free post-abortion care kits to poor women in two hospitals.[4] Decentralized PAC services were introduced in 2006.[17] USAID's Virtual Fostering Change Program began in 2008 to assess and improve PAC services in Togo, Burkina Faso, Guinea, and Senegal. In 2014, the USAID-funded Evidence to Action project began working with the Division of Family Health to increase access to post-abortion family planning. After the program trained health providers, facility managers delivered services more efficiently, clinics offered more contraceptives, and MVA became more common than manual removal.[18] PAC access for young people improved. In 2017, Togo updated its national family planning policies based on the recommendations.[16]

See also

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References

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  1. ^ a b "Togo legalises abortion in rape cases". Reuters. 9 August 2007. Retrieved 29 July 2024.
  2. ^ a b "Lomé et l'avortement" [Lomé and abortion]. Jeune Afrique (in French). 8 January 2007. Archived from the original on 19 August 2024. Retrieved 30 July 2024.
  3. ^ a b c d e N'Bouke, Afiwa; Calvès, Anne-Emmanuèle; Lardoux, Solène (3 July 2017). "Facteurs associés au recours à l'avortement à Lomé (Togo) : analyse d'une séquence d'étapes menant à l'avortement" [Factors associated with induced abortion in Lomé (Togo): Analysis of sequential steps leading to abortion]. Cahiers québécois de démographie (in French). 45 (2): 217–246. doi:10.7202/1040396ar. Archived from the original on 19 August 2024. Retrieved 2 August 2024 – via Érudit.
  4. ^ a b c d e Gbadamassi, Falila (29 December 2006). "Le Togo légalise l'avortement… sous certaines conditions" [Togo legalizes abortion... under certain conditions]. Afrik.com (in French). Archived from the original on 7 December 2023. Retrieved 30 July 2024.
  5. ^ Cook, Rebecca J.; Dickens, Bernard M. (October 1988). "International Developments in Abortion Laws: 1977-88". American Journal of Public Health. 78 (10): 1305–1311. doi:10.2105/ajph.78.10.1305. PMC 1349427. PMID 3048126.
  6. ^ Henshaw, Stanley K. (March–April 1990). "Induced Abortion: A World Review, 1990". Family Planning Perspectives. 22 (2): 78. doi:10.2307/2135512. JSTOR 2135512. PMID 2347411.
  7. ^ "IVG autorisée en cas de viol" [Voluntary termination of pregnancy authorized in the case of rape]. République Togolaise (in French). 9 January 2007. Archived from the original on 30 July 2024. Retrieved 30 July 2024.
  8. ^ "Les évêques disent non à l'avortement" [Bishops say no to abortion]. République Togolaise (in French). 9 May 2007. Retrieved 30 July 2024.
  9. ^ "Togo country profile". Guttmacher Institute. 2022. Archived from the original on 29 May 2023. Retrieved 29 July 2024.
  10. ^ "Avortement clandestin : un poison lent pour l'Afrique" [Clandestine abortion: a slow poison for Africa]. Le Nouveau Reporter (in French). 3 October 2021. Archived from the original on 30 July 2024. Retrieved 30 July 2024.
  11. ^ Lasater, Molly E.; Grosso, Ashley; Ketende, Sosthenes; Lyons, Carrie; Pitche, Vincent Palokinam; Tchalla, Jules; Anato, Simplice; Sodji, Dométo; Nadedjo, Felicity; Baral, Stefan (5 May 2019). "Characterizing the relationship between migration and stigma affecting healthcare engagement among female sex workers in Lomé, Togo". Global Public Health. 14 (10): 1428–1441. doi:10.1080/17441692.2019.1611896. PMC 6702054. PMID 31057037.
  12. ^ N'Bouke, Afiwa; Calvès, Anne-Emmanuèle; Lardoux, Solène (April 2012). "Induced Abortion in Lomé, Togo". Population. 67 (2). Translated by Lynda Springer: 309–336. doi:10.3917/pope.1202.0309. Archived from the original on 2 August 2024. Retrieved 2 August 2024.
  13. ^ Badjabaissi, E.; Diallo, A.; Yerima, M.; Assih, M.; Tchagbele, O. B.; Gbeassor-Komlanvi, F. A.; Douti Yendine, Y.; Eklu-Gadegkeku, K. (2021). "Usage des Medicaments a des Fins Abortives chez les Adolescentes Coiffeuses et Couturieres dans une Banlieue de Lome" [Drug use for abortifacient purposes among teenage hairdressers and seamstresses in one suburb of Lome]. Mali Medical (in French). 36 (1): 44–48. PMID 37973571.
  14. ^ Sat, Moulika (26 February 2024). "Au Togo, l'ATBEF implique des journalistes à la prévention de l'avortement clandestin" [In Togo, ATBEF involves journalists in unsafe abortion prevention]. 24heureinfo (in French). Archived from the original on 19 August 2024. Retrieved 30 July 2024.
  15. ^ Onékékou, Emma; Crowe, Portia (24 February 2022). "US-linked anti-abortion centre targeting women with misinformation in Côte d'Ivoire". openDemocracy. Retrieved 29 July 2024.
  16. ^ a b c Mugore, Stembile (22 August 2019). "Exploring Barriers: How to Overcome Roadblocks Impeding the Provision of Postabortion Care to Young People in Togo". Global Health: Science and Practice. 7 (Supplement 2): S342–S349. doi:10.9745/GHSP-D-18-00437. PMC 6711621. PMID 31455629.
  17. ^ a b RamaRao, Saumya; Townsend, John W.; Diop, Nafissatou; Raifman, Sarah (29 March 2011). "Postabortion Care: Going to Scale". International Perspectives on Sexual and Reproductive Health. 37 (1): 40–44. doi:10.1363/3704011. PMID 21478087. Archived from the original on 2 August 2024. Retrieved 2 August 2024.
  18. ^ Mugore, Stembile; Kassouta, Ntapi Tchiguiri K.; Sebikali, Boniface; Lundstrom, Laurel; Saad, Abdulmumin (September 2016). "Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception". Global Health: Science and Practice. 4 (3): 495–505. doi:10.9745/GHSP-D-16-00212. PMC 5042703. PMID 27688719.
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