Illustrative photo (Mikhail TereshchenkoTASS via Getty Images)

Framing the Abortion Picture in the Arab World

Turkey and Tunisia offer the least restrictive laws, and a growing number of women now rely on telemedicine for abortion pills

While the abortion rights debate continues to be hotly disputed in the United States, with opponents using the Bible as a base for their views, women in Arab countries also remain subject to widely varying abortion laws primarily based on a country’s interpretation of Islam.

In the semi-autonomous Kurdistan region of northern Iraq, women and girls who have become pregnant after being raped by ISIS members have access, albeit secretly, to safe abortions at a clinic set up by the locally based Nujeen For Family Democratizing Organization.

“Islam has some different ideas regarding abortion,” Zhiman Hussein, a project manager at Nujeen, told The Media Line. “[In Iraq], only unsafe abortions are available. There are no service providers for abortions except [for] those women and girls who were released from Islamic State’s rule.”

Hussein said her organization had opened the clinic so that women would have access to safe abortions.

“This process happened secretly because abortion is still illegal in Iraq,” she explained. “We’ve opened a clinic if [women and girls released from ISIS capitvity] want to visit.”

In Iraq, abortion is prohibited in almost all cases and is punished by imprisonment and fines, according to Nujeen.

A 2013 Pew Research poll revealed that a majority of Muslims (75 percent) interviewed in 24 countries believed that abortion was morally wrong. Still, some Arab women who are financially able seek out private doctors who are willing to conduct the procedure for high fees.

“Women with money are safe,” a lifelong abortion rights advocate from the US, who requested to remain anonymous, told The Media Line. “Misoprostol, one of the two kinds of medical abortion pill, is often available from pharmacies, from some doctors and on the black market in some countries.”

The activist, who has been living in Europe for the past four decades, emphasized, however, that there was a lack of data from the Arab world regarding exact figures on abortions performed for unwanted pregnancies.

“Invasion, war, civil war, dictatorship and occupation have probably been the most important reasons why taking up women’s issues, of which access to safe abortion is only one of many, has not progressed in the Middle East,” she said.

Hazal Atay, a comparative politics PhD candidate at the Paris Institute of Political Studies who has worked in the field of sexual and reproductive rights for several years, said that Tunisia and Turkey currently have the least restrictive abortion laws.

“In the Middle East, there are only two countries which allow on-demand abortions: Turkey and Tunisia,” Atay told The Media Line. “Turkey allows abortions until the 10th week of the pregnancy, but if the pregnancy occurred as a result of a criminal act [such as rape or sexual abuse], abortions can be performed until the 20th week of gestation upon the decision and approval of courts and doctors.”

Nevertheless, married women in Turkey must obtain the consent of their husbands before going through with the procedure, and many medical professionals do not offer abortion services at all. The practice has also become increasingly rare in the country under President Recep Tayyip Erdogan, who in 2012 referred to it as “murder,” she added.

“A nationwide study showed that only 8% of public hospitals in Turkey offer abortion as per the law,” Atay said. “Similar to Turkey, in Tunisia, access to abortion remains tenuous as women are denied [access] by medical staff and are still stigmatized by society for wanting to terminate their unwanted pregnancies.”

Arab countries typically fall within three categories when it comes to abortion: countries such as Iraq, as well as the Palestinian West Bank and Gaza Strip, prohibit the procedure altogether, while Bahrain, Iran, Lebanon, Oman, Syria, the United Arab Emirates and Yemen permit abortion only to save the life of the woman. In Jordan, Kuwait, Qatar and Saudi Arabia, abortions are permitted in cases of possible health complications, according to the New York-based Center for Reproductive Rights.

What Islam Says

According to Atay, Islamic religious law has conflicting views about abortion, and though it is largely forbidden, it is acceptable under specific circumstances.

“There are conflicting views,” she said. “We know that in the Ottoman Empire, the Hanafi school of Sunni Islam had a relatively tolerant approach to the issue until the 18th century. According to this school, abortion was not haram [forbidden], but makruh [frowned upon] until the 120th day of gestation.”

Several interpretations of Islamic religious texts in fact view the fetus as having a living soul after a four-month period. The moment at which a human being gains a soul is referred to in religious terminology as “ensoulment.”

“No Sunni school allows abortion after this time, as it is considered that the fetus is ensouled after 120 days of gestation,” Atay said. “The Maliki school of Sunni Islam, which is dominant in North Africa, is the most restrictive, and they do not permit abortion at any stage.”

Atay further noted that in Shia Islam, which is prevalent in Iran, Iraq and Bahrain, termination is traditionally forbidden after implantation, in which the embryo becomes firmly attached to the uterine wall, which occurs within days after fertilization.

However, Leila Hessini, vice president of programs at the US-based Global Fund for Women, believes that Islam is more lenient than Christianity with respect to abortion.

“Abortion laws in most majority Muslim countries are more progressive than the anti-women legislation that we are seeing in the US South,” Hessini told The Media Line via email. “For example, Tunisia, a majority Muslim country, reformed its abortion law in 1973. Its legislation is more progressive and abortion is more accessible than many states in the US.”

Hessini wrote in a paper published in the Reproductive Health Matters Journal that Islamic religious law was open to interpretation regarding abortion, but noted that official religious leaders and interpreters in the Middle East and North Africa region were all men.

In the paper, she said that abortion was more socially acceptable and accessible until the late 19th century in Egypt and Turkey, adding that according to some historians, women’s rights, including reproductive rights, diminished as European laws were incorporated into Middle Eastern legal systems.

“Today, positions on abortion continue to vary, though family planning is encouraged in practically all MENA [Middle East/North Africa] countries. Abortion is generally forbidden after the fetus achieves ensoulment except to save the woman’s life,” Hessini wrote.

What Happens When Abortions Are Outlawed

Despite the legal hurdles present in many countries, 25% of all pregnancies globally end in induced abortions. The World Health Organization (WHO) estimates that roughly 25 million unsafe abortions take place worldwide each year, with the majority occurring in developing countries. Unsafe practices result in the deaths of 47,000 women annually, in addition to five million suffering disabilities.

“Legal restrictions on abortion do not result in fewer abortions,” according to the New York-based Center for Reproductive Rights. In a statement to The Media Line, the center continued: “Instead, they compel women to risk their lives and health by seeking out unsafe abortion services. International human rights bodies have recognized, therefore, that safe and legal abortion services are essential for guaranteeing women a full range of human rights, including women’s rights to life, health, equality and non-discrimination, privacy and bodily autonomy.”

Many women, meanwhile, are increasingly relying on telemedicine, the remote delivery of healthcare services, to terminate unwanted pregnancies.

Mifepristone and misoprostol, both abortion-inducing pills, are abundantly available for purchase online. For instance, a US-based website calling itself Aid Access regularly ships abortion pills by mail to Americans despite having been threatened by the Food and Drug Administration to cease delivery. Similarly, Women on the Web is another global service shipping such pills directly to people around the world.

“The WHO affirms that a medical abortion until the 12th week of pregnancy does not need to take place in a clinic,” Atay said. “Women always find a way to obtain abortion. Restrictive laws just make it unsafe, clandestine, lonely and more traumatic for women. These reasons were exactly why such legislations were abandoned in the past, and we should not go back on these laws.”

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