The second reason relates to conservative attitudes among women’s rights activists and doctors. Sudan boycotted the Population Conference of 1994 for reasons linked to religion. Although these doctors personally believe that abortion is forbidden in Islam, they object to the Islamist state’s disproportionate and unfair punishment of predominantly young, unmarried, and socioeconomically vulnerable women. (interview, 2017). Whether a woman with an illegal pregnancy is reported to the police depends on the ideological view of the doctor. Like conscientious objection, civil disobedience is motivated by sincere views about what is morally right. Surprisingly, most of the women’s rights activists and obstetrician-gynecologists we interviewed did not know that abortion after rape is allowed within 90 days. That was because she will be punished enough by the psychological impact of her doings and the stigma of losing her virginity. 121–156. [19] Traditional methods for self-inducing abortion include drinking herbs, ingesting various drugs and poisons, and inserting objects into the uterus. Studies - Depression / Suicide / Mental Health Pro-Abortion Study: Purports ‘the Stigma Around Abortion is More Dangerous to a Woman’s Mental Health than Abortion Itself’ President Omar al-Bashir and his circle of supporters instigated a process of the comprehensive Islamization of Sudanese law. vs Republic of Korea It is interesting to note that conservative attitudes go across Islamic-secular divides. Get updates about the policies and topics that matter the most to you. “Why the bureaucratic hurdle? Given that doctors’ Hippocratic disobedience means that unsafe abortions are not officially registered, they remain hidden in official statistics. We conducted a qualitative interview-based study in Sudan’s capital. The women who seek emergency medical care because of complications after an illegal abortion are at the mercy of doctors in terms of whether they will be reported to the police. Maybe they are justified in their focus on abandoning FGM/C and child marriage, as these harmful practices are widespread in Sudan. Such sexual intercourse is criminalized in Sudan’s 1991 Criminal Code with 100 lashes for non-married offenders (fornication) and stoning to death for married offenders (adultery). But it was right after the election that we stopped and said, "How have we gotten to a place that the issue of abortion has become so politicized, that … 2011. All interviewees gave their oral consent to be interviewed. The patient who came to me to get misoprostol and she came later with incomplete abortion, my feeling at that time was that I was sorry for her and I never felt that she should be punished. Rising Up with Sonali is a radio and television show that brings progressive news coverage rooted in gender and racial justice to a wide audience. In Sudan, the introduction of hudud was embedded in a larger call for Islamization by the Islamists, who came to power through a military coup in 1989. But either way, the issue seems likely to become even more politicized and could become important in the 2020 presidential race. Women’s reproductive rights and policy in Sudan, There has been an intensified focus by Sudan’s Islamist government on reducing the country’s maternal mortality rate, which is currently estimated at 295 maternal deaths per 100,000 live births. [29].          K. Abuelgasim, “Who do I turn to? is one of the last standing national, independent news networks committed to advancing progressive social change. This article was funded by the Research Council of Norway (grant number 248159). The belief that illegal pregnancy is morally wrong and illegal abortion is against Islam was prominent among the doctors we interviewed. New Report Zeroes In On Fracking Pollution, How Donald Trump’s CPAC Speech Echoed His Jan 6th Incitement. is a radio and television show that brings. One of the crucial questions in determining whether a pregnancy is illegal is assessing whether the patient is married. Ilyse Hogue Michelsen Institute, Norway. [37].          J. Rawls, A theory of justice (Oxford: Oxford University Press, 1971), p. 365. The Lie That Binds: How Abortion Became Political Rising Up With Sonali takes a look at how the anti-abortion movement politicized an issue to maintain white patriarchy at the expense of women and people of color w/ its author Ilyse Hogue from NARAL. Any woman who comes to the hospital alone is suspected of an illegal pregnancy. Abortion Rights (interview, 2015). If you enter a maternity ward alone, you are a suspect” (interview, 2018). It is also considered unfair that the punishment applies only to women, not men. One activist summed it up thus: It is a very sensitive subject and linked to religion in a state like Sudan. Copyright © 2019 Tønnessen and al-Nagar. The first relates to the fear of double backlash, from both the authoritarian Islamic state and from the country’s conservative society. Misoprostol is available only in pharmacies in maternity hospitals and must be prescribed by a senior obstetrician-gynecologist with a signature and hospital stamp. However, there are multiple interpretations in Islamic jurisprudence as to under what circumstances women can induce abortion and as to when ensoulment occurs. [6].             L. Tønnessen and S. al-Nagar, Women and girls caught between rape and adultery in Sudan: Criminal law reform, 2005–2015 (Bergen: Chr. (see note 7). The 2010 Reproductive Health Policy addresses the prevention of abortion and unwanted pregnancies, as well as post-abortion care, for the first time. [15], According to one of the few studies conducted in Khartoum, the majority of the women seeking abortion services (96.7%) come for the treatment of post-abortion complications or after incomplete abortions. Sudan has not ratified any international or regional conventions protecting women’s human rights. In Sudan’s Islamist state, abortion is politicized through its association with illegal pregnancy. The Netflix documentary “Reversing Roe” was an eye opening look at how the abortion issue became politicized. Check out Rising Up on FSTV VOD anytime or visit the show page for the latest clips. If a woman is suspected of an illegal pregnancy, the police question her while at the hospital, sometimes even while she receives medical care: “One time during an emergency C-section, the police showed up in the operating hall, asking where her husband is, because they thought it was an illegal pregnancy” (interview with an obstetrician-gynecologist, 2018). According to this view, only unmarried women who get pregnant illegally would seek abortion in order to “hide” the evidence of fornication. This high prevalence is associated with many risk factors, including female genital mutilation/cutting (FGM/C), early childbearing, high fertility, and barriers to accessing maternal health services. How Has Biden Helped Separated Families Hurt By Trump? PERSPECTIVE Safe Abortion in Women’s Hands: Autonomy and a Human Rights Approach to COVID-19 and Beyond Article 135 of the 1991 Criminal Code restricts legal abortion to cases where it is needed to save the woman’s life, in cases where the fetus has died in the woman’s womb, and in cases of rape occurring fewer than 90 days before the pregnant woman obtains the abortion. [2].             L. Hessini, “Abortion and Islam: Policies and practice in the Middle East and North Africa,” Reproductive Health Matters 15/29 (2007), pp. The second stream of literature that influences our idea is that regarding civil disobedience, given that the acts described above go beyond “objection”: doctors refuse to follow policies and protocols to report women to the police, an act better described as disobedience. [20] Misoprostol has recently emerged as a safe alternative, but only in selected private hospitals and on the black market (of course at a much higher cost). Such sexual intercourse is criminalized in Sudan’s 1991 Criminal Code with 100 lashes for non-married offenders (fornication) and stoning to death for married offenders (adultery). The criminalization of abortion forms an important part of the Islamist government’s restrictive ideological stance on women’s sexual and reproductive rights generally. There has been no legal mobilization, whether by health workers or the women’s movement, to liberalize the right to abortion in Sudan. The Right to Non-discrimination of Persons with Disabilities in the Context of Coercive Interventions. [12] In particular, FGM/C (with a prevalence rate of 89%) and child marriage (with a prevalence rate of 34%) have been at the forefront of international aid efforts and the national government’s and civil society’s reproductive health and rights agendas. These barriers, which contravene women’s human rights to health, dignity, and security, are found primarily in public hospitals, where there is an increased police presence outside maternity and emergency wards. [4], In this article, we explore the political dynamics driving the criminalization of abortion in Sudan and its effects on women’s access to abortion-related care in Khartoum. Conservative attitudes are predominantly framed within religion and social values connected to the institution of marriage. A peaceful popular uprising, which started in December 2018 with doctors and other professionals going on strike, ousted Bashir, who had ruled Sudan since a military coup d’etat in 1989. All interviewees remain anonymous. In the words of one obstetrician-gynecologist, “Most doctors take a neutral position to whether the patient is married or not married. However, the acts of the doctors interviewed for this study do share some traits with conscientious objectors in that they do not necessarily try to publicize their actions or their reasons for breaking the law. [27] Sudanese medical schools offer little to no training on post-abortion care. Allowing for abortion means approving socially immoral and un-Islamic relations and this affects young women opportunities for marriage. Strict procedures are in place in order to prevent misuse. (interview, 2017). 17 Feb 2021, The Value of Human Rights for Vaccine Prioritization at the National Level It was a rousing success to the point that the GOP has permanently expanded their base to include that audience. [1].             S. M. Latt, A. Milner, and A. Kavanagh, “Abortion laws reform may reduce maternal mortality: An ecological study in 162 countries,” BMC Women’s Health 19/1 (2019). [10].          G. Hussein Ibrahim, “The role of the health system in women’s utilisation of maternal health services in Sudan” (PhD thesis, London City University , 2015), p. 36. [9].             World Health Organization, Trends in maternal mortality 2000–2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division (Geneva: World Health Organization, 2019). 1–15. They will do their duty and save her life regardless. This intrusive police presence at public hospitals can make it difficult for doctors to provide medical care with dignity and integrity to patients suffering complications after an illegal abortion. Sudan is unique in the MENA region, for pregnancy among unmarried women is considered sufficient evidence for the crime of zina as outlined in the 1991 Criminal Code. Over the 46 years since Roe was decided, the constituencies on both sides of this issue have changed radically, and the debate has become increasingly complex and increasingly politicized. Forty-five years ago today, on Jan. 22, 1973, the U.S. Supreme Court legalized abortion across America with its historic Roe v. Wade (and companion Doe v. Bolton) decisions. [3] In Sudan’s Islamist state, induced abortion is a crime except when performed to save the pregnant woman’s life, if the fetus has died in the woman’s womb, and in cases of rape. Tuberculosis Care in Mexico’s Chiapas Highlands Region: A Right to Health Analysis, Sleep Deprivation of Detained Children: Another Reason to End Child Detention, A Virtual Roundtable on COVID-19 and Human Rights with Human Rights Watch Researchers, Law, Human Rights, and Health Databases: A Roundtable Discussion, A Virtual Roundtable with Special Rapporteurs on the Right to Health, in Women’s Hands: Autonomy and a Human Rights Approach to COVID-19 and Beyond, A Time for Optimism? [26].          A. Abdel Halim, “Gendered justice: Women and the application of penal laws in the Sudan,” in L. Oette (ed), Criminal law reform and transitional justice: Human rights perspectives for Sudan (Farnham: Ashgate, 2011); S. A. Nageeb, New spaces and old frontiers: Women, social space, and Islamization in Sudan (Lanham, MD: Lexington Books, 2004). Liv Tønnessen is Research Director at the Chr. Protestant churches in the 20 th century became politicized and divided into liberal and conservative factions, in part over questions of contraception and abortion. Lepore, J. [36].          See, e.g., ibid. [38].          J. F. Childress, “Civil disobedience, conscientious objection, and evasive noncompliance: A framework for the analysis and assessment of illegal actions in health care,” Journal of Medicine and Philosophy 10 (1985), p. 67. Global Health in the Age of COVID-19: Responsive Health Systems Through a Right to Health Fund, Eric Friedman et al. In our interviews, they described how they subvert this police presence because they feel that reporting patients to authorities contradicts their Hippocratic oath. So the doctor said to the police that if she died then this is his responsibility because he delayed her treatment. In other words, the disobedience of the doctors we interviewed is hidden to the public. Most doctors do not report. Evangelical Protestants were not deeply troubled by the prospect of liberal abortion laws until they became politicized … Family planning and abortion is among these reasons. Abortion looks to play a significant role in the contentious vote that could decide whether Republicans or Democrats control the chamber. They do not take responsibility for their mistakes. There is fear that girls will have premarital sex and get pregnant every month. A religious scholar at Africa International University, who has been working as a religious and health advisor to the National Council for Child welfare, summarized it thus: Islam is clear on abortion, it is haram, but there is legal abortion in case three obstetricians and gynecologists confirmed harm to mother from presence of baby or if the baby is 100% deformed. Thus, unmarried women in search of lifesaving treatment find themselves under surveillance the minute they enter a hospital building unaccompanied by a male guardian. Although FGM/C was an equally taboo topic a decade ago, women’s rights activists interviewed claim that it is easier to put this violent and harmful act in which the girl child has no say on the agenda because “in FGM/C, the girls are victims” (interview, 2017). As stated previously, pregnancy outside marriage is evidence of the crime of fornication. Another obstetrician-gynecologist recalled a case where the police were so eager to arrest a woman for an illegal pregnancy that they handcuffed her during childbirth: Security staff and police treat women badly, as if they are the judges, even before presenting her case to the legal system. [19].          DKT International, “DKT Sudan: Ensuring the right for all to quality family planning options since 2005,” Sudan White Paper. [4].             “Sudan: The Criminal Act 1991,” Arab Law Quarterly 9/1 (1994), pp. According to conservative political and religious elites, if abortion becomes readily available, it would be an incentive for unmarried women to commit immoral crimes (“illegal pregnancies”), and Sudan would descend into moral chaos. In a country with a dearth of doctors—particularly in rural areas, where maternal mortality is the highest—this provision could make a huge difference in reducing the number of hemorrhage-related maternal deaths. Missed an episode? The Supreme Court in 1973, in the case of Roe v. Wade, declared most existing state abortion laws unconstitutional. We cannot solve a crime with a crime. The experiences of Sudanese women and Eritrean refugee women when trying to access healthcare services in Sudan after being subject to gender-based violence” (Master thesis, Uppsala University, 2018). Sudan’s legal restrictions on abortion stem from a set of laws codified by the Islamist regime that are discriminatory toward women. How Birth Control And Abortion Became Politicized . Nor has Sudan ratified the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa, which recommends the legalization of abortion. 38–45. Samia al-Nagar is an independent researcher based in Sudan. However, many doctors, honoring the Hippocratic oath, disobey state policy and refrain from reporting such crimes to the police to protect unmarried and vulnerable women from prosecution. In the words of a women’s rights activist, “The security may not allow NGOs to work on reproductive rights issues” (interview, 2019). Wade legalized abortion nationwide in 1973, became an organizing principle of the newly politicized evangelical right —these efforts have already made it … Abortion after Roe chronicles and analyzes what the new legal status and changing political environment have meant for abortion providers and their patients. For example, in Sudan, it is not possible to give birth in a public hospital without first providing a marriage certificate. Based on original data collected through fieldwork between 2011 and 2019, we have found that although abortion does not appear in the domestic political debate on women’s reproductive and maternal health and is not on the agenda of the Sudanese women’s movement, it is politicized in the implementation of the law. But abortion outside marriage is not allowed. Unsafe abortion is one of the leading causes of maternal mortality, and abortion-related maternal deaths are generally higher in countries that restrict women’s access to induced abortion. Reforms years ago weakened party bosses and gave primary election voters power to pick presidential candidates. In the words of one general physician, “It is illegal and it can end your career” (interview, 2018). [12].          Republic of Sudan Federal Ministry of Health, The National Strategy for Reproductive Health 2006–2010 (Khartoum: Federal Ministry of Health, 2006); Republic of Sudan Federal Ministry of Health, Road Map for Reducing Maternal and Newborn Mortality in Sudan (2010– 2015) (Khartoum: Federal Ministry of Health, 2009). (interview, 2019). Because of the sensitivity of the topic, we did not record the interviews, instead taking elaborate notes. Abortion (except to save the woman’s life) is widely recognized as going against Islamic doctrine. One obstetrician-gynecologist at a public hospital in Khartoum described it thus: “Are you married? A new non-profit that provides financial assistance to residents of New Hampshire seeking abortion services launches Monday. In the words of an activist: I know that abortion is made illegal by Islamic laws … Some progressive young activists are for sexual freedoms and rights, but as a Marxist I think that we must be careful so that freedoms may not lead to commoditization of our bodies, or to prostitution. The police came and said she was illegally pregnant. Can you chip in $5 today to help keep us on the air? The interviews varied from half an hour to one and a half hours. In other words, it is a matter of luck. Any opening to abortion means giving girls the opportunity to have sex as they want … We are a conservative society, and there should be discipline. Therefore, the punishment of 100 lashes for the crime of fornication is often viewed as disproportionate. As abortion became a political issue linked closely to the Republican party, Republican state governments tried to address Roe v. Wade. Internationally, the Islamist government has taken an actively restrictive stance on women’s right to abortion. “How birth control and abortion became politicized.” Fresh Air. [39] In this case, the disobedience is related to the state’s disproportionate and unfair punishment for women who are already in a vulnerable position. However, interviewees also expressed that this right is limited to emergency contraception in conflict zones. The military council and the coalition representing peaceful protesters have agreed on a new constitutional declaration that enables reform of Sudan’s gender discriminatory laws. I had a case, but I did not report it to the police” (interview, 2018). One obstetrician-gynecologist recalled a case: A young lady came in. However, the extent to which the topic is debated is in closed groups on social media, like Whatsapp. Available at. [10] Sudan experienced a significant reduction in its maternal mortality rate in 2011, when South Sudan separated from the north and became the country with the world’s highest maternal mortality rate. Illegal pregnancy is a sign of legal and social misconduct; therefore, it is unthinkable that a married woman would seek an abortion, as her main duty is a reproductive one. The question that came to my mind is why there are  … thousands of children with unknown fathers [as a result of rape]. [9] However, huge urban-rural disparities exist. In other words, they would disregard Form 8 and treat the case as a miscarriage, without disclosing that the woman is unmarried. (interview, 2018). [33].          Abuelgasim (see note 29). Abortion is a particularly sensitive area within maternal health and reproductive rights because it is mediated through the crime of zina (sexual intercourse before and outside of marriage). [33] When treating an unmarried woman suffering complications after an illegal abortion, doctors’ ethical commitment toward the patient trumps compliance with what is perceived as unjust and disproportionate punishment. The first of these is the literature on conscientious objection, which defines such objection as “the refusal to participate in an activity that an individual considers incompatible with his/her religious, moral, philosophical, or ethical beliefs.”[35] The literature focuses on whether conscientious objection hinders women’s rights and access to abortion in both liberal and restrictive legal contexts. A new report from NARAL Pro-Choice America and Global Strategy Group (GSG) found most abortion coverage in mainstream media to be “deeply, and problematically, politicized.” It is clear that in their aims to reduce maternal mortality and strengthen women’s reproductive rights, interest groups prefer not to address the issue of unsafe abortion. Therefore, illegal abortion—a means through which women who have committed the crime of zina can be discovered—is strictly policed. When treating unmarried women suffering complications after illegal and unsafe abortions, doctors are forced to maneuver between their commitment to medical ethics and their compliance with government laws and policies. [25] Sudan is thus one of the few Islamic countries (along with Iran, Saudi Arabia, Pakistan, and Afghanistan) to have criminalized zina and the only one to consider pregnancy as sufficient proof of the crime by unmarried women. Alabama’s new abortion law puts the issue of women’s rights in the spotlight for the upcoming 2020 elections. Fornication is a crime against God punishable with 100 lashes, and pregnancy outside a marriage contract constitutes sufficient evidence of a woman’s immorality. (interview, 2019). We personally conducted all interviews. Much has been made of the fact that Joe Biden is only the second Catholic to become the president of the United States, and the first since John F. Kennedy. [21], The available research suggests that only a small minority of women seek legal abortions, doing so primarily to save the pregnant woman’s life. While most of those interviewed oppose a complete decriminalization of abortion, they are open to expanding the circumstances under which abortion is permitted, such as in cases of fetal deformity. The court found him guilty of failing to report to authorities that he was treating unmarried pregnant women. [41].          L. Tønnessen, “Enemies of the state: Curbing women activists advocating rape reform in Sudan,” Journal of International Women’s Studies 18/2 (2017). We identified three ways that doctors disobeyed the Islamist government policy toward medical care of patients with illegal pregnancy/illegal abortion: not filling out Form 8, advising patients to lie or lying on their behalf, and distracting the police. Progressive news directly to your email. According to our interviewees, one of the strategies used by doctors to evade the attention of the police is to lie on the patient’s behalf or encourage her to lie when asked about her marital status, such as by saying that her husband is working abroad. Empowered by the 2006 Voluntary and Humanitarian Work Act, the government can (and does) impose severe restrictions on the work of national and international nongovernmental organizations.
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