Inside proposed Termination of Pregnancy Bill
By Chisale Mhango:
Much has been said that if the law on termination of pregnancies is liberalised there will be a free for all termination of pregnancies. The proposed law has taken care of that in section 4(1). The proposed law indicates that only approved health facilities shall be allowed to carry out termination of pregnancies.
The Minister has been given power to approve health facilities that carry out termination services. In which case, there will be no back street terminations or terminations at places or facilities that do not have the requisite facilities.
Though the proposed law has not indicated what criteria the Minister shall use to determine approval, it is clear that any approved facility will have the required and necessary equipment. In fact an approved health facility includes a hospital and it is common knowledge that a hospital is fully equipped and a safe environment.
In section 5 the proposed law provides for who can perform terminations. Terminations shall only be done by certified health service providers. These are clinical officers, registered nurses, nurse midwifery technicians, medical assistants and doctors.
The proposed law has also categorised which stages of the pregnancy can be terminated by which health service provider. Again, this acts as a safety net to the health of the pregnant woman. Further, this provision takes out the quacks, herbalists and any other unqualified person in the equation. The proposed law must have critically considered that termination of pregnancy is a health issue that has to be carried out with a lot of skill and professionalism.
Section 6 of the proposed law aims at tackling the fear that terminations will be open and performed willy-nilly. The section provides that before a decision to terminate the pregnancy has been given a go ahead there shall be counselling provided to the pregnant woman. This is mandatory. There will therefore be a thorough consideration done. The pregnant woman will have made an informed decision before the termination is done. The health service provider will provide counselling on options on termination or on continuation of pregnancy.
There will also be counselling on the methods that will be used and the short term and long term effects of the termination. The health service provider, in allowing the pregnant woman to make an informed choice will also provide counselling on the emotional and psychological responses to the termination. It is clear that this provision was considered in the light that opinions have been widespread that it was only a minor section of people who were and have been championing the enactment of the law on termination of pregnancy.
Clearly, the elaborate requirements of counselling indicate that it will not be as easy as people envisage that a pregnancy will be terminated just by walking into a health facility. These are deliberate safeguards put in place so that only those who have really made up their minds should freely exercise their choice to terminate the pregnancy. Further, counselling does not end at the termination stage. There is also post termination counselling.
The proposed law recognises that there may be some pregnant women who would want to continuously do terminations. The proposed law therefore provides that the certified health service provider shall provide counselling and information on family planning. This was put in to avoid recurrent terminations. Once one is on family planning methods, she will be in a position to avoid any unwanted pregnancies.
The proposed law has also addressed the issue of unwillingness by any health service provider to terminate a pregnancy on the grounds that his conscience does not allow him/her to do so. It is expected that some health service provides would not want to provide termination of pregnancy services due to their beliefs and may be religious affiliations. The law calls these people conscientious objectors.
The proposed has provided in section 7 will have to refer the case to another health service provider. However, the proposed law demands that despite that the conscientious objector will not perform the termination, he or she is under an obligation to offer pre-termination counselling and give information to the pregnant woman on termination of pregnancy services and other related issues.
In addition, the proposed law states that no conscientious objection will be exercised if the life of the pregnant woman is in jeopardy. Conscientious objection will only be exercised by a person (health service provider) who is directly involved in the termination. If the law in this section is not followed and the person is found guilty, he/she shall be fined MK 5,000,000.00 upon conviction.
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