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Abortion in Guinea

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In Guinea, abortion is illegal unless the pregnancy poses a threat to the life or health of the pregnant woman or fetus, if it resulted from rape, or if the pregnant woman is a minor. Illegal abortions are punishable by fines and prison. Legal abortions require approval from doctors in the case of therapeutic abortion or ethics committees in the case of abortion from rape. The conditions for legal abortion are debated. Women's rights activists and journalists have advocated for reform.

The use of contraceptives is low, which leads to unwanted pregnancies and abortions, especially among adolescents. Rape is a frequent cause of abortion. Post-abortion care has been available in Guinea since the 1990s and is available at public facilities across the country. Nearly all of these facilities use manual vacuum aspiration, and most offer post-abortion family planning.

Legislation

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Articles 262 and 263 of the penal code of Guinea prohibit abortion without a legal defense. The sentence for an illegal abortion is one to two years of prison and a fine of 500,000 to 5 million Guinean francs for first-time offenders. Repeat offenders may face 2 to 5 years in prison or a fine of 10 million francs.[1] The abortion ban is defined in a reproductive health law passed on 10 July 2000.[2] The country previously had a total abortion ban based on the Napoleonic Code.[3]

Legal therapeutic abortions require a diagnosis from a group of doctors that the woman cannot carry the pregnancy or the fetus would have defects. In the case of pregnancy from rape, an ethics committee may approve that the abortion is acceptable.[1] Minors can legally have abortions.[4]

Some lawyers say a woman can be imprisoned for receiving a non-therapeutic abortion even in the case of rape. Others believe that the ethical risks of pregnancy from rape are a ground for abortion under the penal code.[1] One legal interpretation says that the law does not penalize a woman who receives an abortion, but only the provider.[5]

Advocacy

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Today's Women International Network, a women's rights group founded in Guinea, advocates for sexual and reproductive healthcare, including family planning and post-abortion care.[6] On 18–19 March, 2020, twenty journalists met in Conakry for a discussion on sexual and reproductive rights and abortion. They recommended that the government revise the 2000 law and introduce sexual education programs.[2] On 25 March 2021, le Réseau des Médias Africains pour la Promotion de la Santé et l’Environnement (transl. African Media Network for the Promotion of Health and Environment) held a forum to inform journalists about illegal abortions. Its coordinator urged the government to bring its abortion law in line with the Maputo Protocol.[7]

Prevalence

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In 2015–2019, the annual number of pregnancies was 631,000, of which 204,000 were unwanted and 77,000 resulted in abortion. Between 1990–1994 and 2015–2019, the abortion rate increased 48% while the unintended pregnancy rate remained steady.[8] Guinea has a strong stigma about abortion.[9]

Guinea's rates of unsafe abortion and maternal mortality are among the highest in the world.[10] Safe abortion is only available in cases of fetal deformity or life-threatening pregnancy. The maternal mortality rate is 550 per 100,000 births.[11]

The low rate of contraceptive use contributes to unwanted pregnancies and unsafe abortions.[6] As of 1995, most girls aged 15-24 do not use birth control, and 25% have been pregnant, of which 22% resulted in abortion.[12] As of 2018, in Matoto sub-prefecture, 32.1% of sexually active secondary school girls have been pregnant, of which 30.8% had abortions.[13] Frequent rapes in the country lead to unwanted pregnancies and abortions.[1] Victims of sexual violence often face difficulty accessing emergency contraception, which may lead to unsafe abortions.[14]

Post-abortion care

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As of 2014, 38 of the 456 public facilities in Guinea provide post-abortion care (PAC). National policy requires 122 of them to provide PAC. PAC is available at all but one national hospital, all regional hospitals, three-quarters of prefectural and municipal hospitals, and 3.8% of urban health centers.[15] The price of PAC is legally fixed.[11] As of 2015, 34.5% of PAC patients have severe complications.[10]

As of 2014, 31 of the 38 prefectures of Guinea have PAC facilities. There are 416 trained PAC providers, of which the most are in Conakry and Boké Prefecture and the fewest are in Labé Prefecture and Faranah Prefecture. Only 16% of providers are in rural areas, where 62% of Guineans live.[15] As of 2015, all regions have comprehensive PAC, with the highest coverage in Nzérékoré Region and the best performance in Boké Region.[10]

As of 2014, 94.7% of PAC facilities offer 24/7 care. Manual vacuum aspiration (MVA) is used at 99% of providers and long-acting reversible contraceptives (LARC) are available at 95%. As of 2013, 95.2% of patients receive post-abortion counseling and 73.0% get post-abortion family planning, of which 29.6% were LARC. The use of modern contraception is significantly higher among PAC patients than the national average of 7.0%.[15] In two hospitals in Conakry from April to August 2014, there were 426 PAC patients, all of which were treated with MVA. Of these patients, 92.5% were satisfied with their care. They reported low waiting times, satisfactory pain management, confidentiality, and access to their desired birth control.[11]

History

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The 1994 International Conference on Population and Development led the government of Guinea to improve PAC services.[15] PAC was introduced to Guinea in 1998, following successful initiatives in Senegal and in Burkina Faso. The program debuted at Donka Hospital and Ignace Deen Hospital. The program was later introduced in 38 other public hospitals.[11]

The Ministry of Health's 2008–2012 Family Planning Repositioning Strategic Plan aimed to strengthen contraceptive use and PAC. In 2013, post-abortion contraceptive use was the highest in West Africa.[15] The frequency of PAC procedures went down during the COVID-19 pandemic.[16]

See also

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References

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  1. ^ a b c d Zézé Guilavogui, Elisabeth (3 April 2022). "Avortement en cas de viol ou d'inceste : ce que dit la loi guinéenne…" [Abortion in the case of rape or incest: here's what the Guinean law says]. Le Djely (in French). Retrieved 14 August 2024.
  2. ^ a b Bah, Alhassane (21 March 2020). "Conakry : Des journalistes formés sur la santé sexuelle de reproduction". Guinéenews. Retrieved 14 August 2024.
  3. ^ Brookman-Amissah, Eunice; Moyo, Josephine Banda (November 2004). "Abortion Law Reform in Sub-Saharan Africa: No Turning Back". Reproductive Health Matters. 12 (24): 227–234. doi:10.1016/s0968-8080(04)24026-5. PMID 15938178.
  4. ^ Bankole, Akinrinola; Remez, Lisa; Owolabi, Onikepe; Philbin, Jesse; Williams, Patrice (December 2020). "From Unsafe to Safe Abortion in Sub-Saharan Africa: Slow but Steady Progress". Guttmacher Institute. doi:10.1363/2020.32446.
  5. ^ Ibrahima, Olladi (9 March 2024). "«La loi guinéenne ne condamne pas une femme qui se fait avorter», Kalil Camara" ["The Guinean law does not condemn a woman who has an abortion", Kalil Camara]. Kale News (in French). Retrieved 14 August 2024.
  6. ^ a b "Today's Women International Network (TWIN) s'implique pour l'accès à la santé sexuelle et reproductive en Guinée" [Today’s Women International Network (TWIN) gets involved in access to sexual and reproductive health in Guinea]. Population Reference Bureau (in French). 7 September 2021. Retrieved 14 August 2024.
  7. ^ Keita, Youssouf (26 March 2021). "Guinée : des acteurs de la société civile et médias imprégnés en DSSR" [Guinea: Civil society and media personnel imbued with SRH]. Mediaguinee (in French). Retrieved 14 August 2024.
  8. ^ "Guinea country profile". Guttmacher Institute. 2022. Retrieved 14 August 2024.
  9. ^ Assignon, Carole (7 April 2022). "L'avortement, un sujet délicat aussi en Afrique". Deutsche Welle (in French). Retrieved 14 August 2024.
  10. ^ a b c Compaore, Rachidatou; Ouedraogo, Adja Mariam; Baguiya, Adama; Kpebo, Denise Olga; Sidibe, Sidikiba; Kouanda, Seni (19 April 2022). "Availability and Utilization of Postabortion Care Services in Burkina Faso, Côte d'Ivoire, and Guinea: A Secondary Analysis of Emergency Obstetric and Neonatal Care Needs Assessments (EmONC)". Health Services Insights. 15. doi:10.1177/11786329221092625. PMC 9021517. PMID 35464819.
  11. ^ a b c d Millimouno, Tamba M.; Leno, Jean P.; Sidibé, Sidikiba; Bah, Oumou H.; Delamou, Alexandre; Hyjazi, Yolande (June 2020). "Assessment of Post-abortion Care Services in Two Health Facilities in Conakry, Guinea". African Journal of Reproductive Health. 24 (2): 96–105. doi:10.29063/ajrh2020/v24i2.9 (inactive 1 November 2024). PMID 34077095.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  12. ^ Görgen, Regina; Yansané, Mohamed L.; Marx, Michael; Millimounou, Dominique (June 1998). "Sexual Behavior and Attitudes Among Unmarried Urban Youths in Guinea". International Family Planning Perspectives. 24 (2): 69. doi:10.2307/2991927. JSTOR 2991927.
  13. ^ Diallo, Abdourahamane; Diallo, Yaya; Magassouba, Aboubacar Sidiki; Bah, Ibrahima Koussy; Sy, Telly (13 April 2020). "Rapports sexuels chez les élèves de la commune de Matoto à Conakry en Guinée" [Sexual intercourse among students in Matoto, Conakry, Guinea]. Pan-African Medical Journal. 35 (113): 113. doi:10.11604/pamj.2020.35.113.20733. PMC 7320788. PMID 32637011.
  14. ^ Kane, Coumba (29 September 2022). "Impunity for sex crimes is commonplace in Guinea". Le Monde. Retrieved 14 August 2024.
  15. ^ a b c d e Pfitzer, Anne; Hyjazi, Yolande; Arnold, Bethany; Aribot, Jacqueline; Hobson, Reeti D.; Pleah, Tsigue G.; Turke, Shani; O'Colmain, Benita; Arscott-Mills, Sharon (22 August 2019). "Findings and Lessons Learned From Strengthening the Provision of Voluntary Long-Acting Reversible Contraceptives With Postabortion Care in Guinea". Global Health: Science and Practice. 7 (Supplement 2): S278–S284. doi:10.9745/GHSP-D-18-00344. PMC 6711623. PMID 31455624.
  16. ^ Millimouno, Tamba Mina; Dioubaté, Nafissatou; Nianou, Harissatou; Cellou Diallo, Mamadou; Maomou, Cécé; Sy, Telly; Diallo, Ibrahima Sory; Semaan, Aline; Delveaux, Thérèse; Beňová, Lenka; Delamou, Alexandre (25 March 2023). "Effect of the COVID-19 pandemic on maternal and neonatal health services in three referral hospitals in Guinea: an interrupted time-series analysis". Reproductive Health. 20 (1): 50. doi:10.1186/s12978-023-01599-8. PMC 10039677. PMID 36966343.
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