Institute for War and Peace Reporting | Giving Voice, Driving Change

Women Run Huge Risks Seeking Abortions

Ending a pregnancy is strictly illegal, but the shame of bearing a child out of wedlock drives many to take the risk.
By Suhaila Muhsini

Firuza, 17, stared at the ground, crying quietly. She wore black clothes under her burqa, and sat close to her mother, who was also in tears. Firuza (not her real name) had come to a private Kabul clinic for an illegal abortion, and her shame was obvious.

“I really did wrong, but I was deceived and he promised to marry me," she said.

The pregnancy was the result of a sexual liaison with a neighbour, a young man of about 25. When the man's family asked for her older sister's hand in marriage, Firuza confessed to her mother.

The abortion would cost 4,000 afghanis – a little less than 100 US dollars - and, according to the girl's mother, was far more than a face-saving measure.

"If her father learns about [the pregnancy], he will kill her," said Firuza's mother. "We are grateful to the doctor who helped us."

Firuza is not an isolated case. Every year many women are forced to seek abortions, defying the law and public opinion, and often putting themselves in physical jeopardy. Since the procedure is illegal, no statistics are available, but health care professionals say that incidences are increasing.

Pashtana, another pseudonym, 30, from Ghazni, was also at the clinic. Fighting back tears, she said she became pregnant three months ago, after her father-in-law raped her.

Her husband went to work in Iran six years ago, said Pashtana, leaving her in his father's house with two young daughters. Like Firuza, she was afraid of retribution.

"If my husband finds out about it, he will kill me," she said. "But God will punish my father-in-law. I was innocent."

The doctor who performed the abortions declined to give her name. "Although performing abortions is against the law, these patients, whose lives and reputations are at risk, should be helped," she said.

The doctor said she believed the number of out-of-wedlock pregnancies and illegal abortions had increased since the Taleban were overthrown in 2001. She attributed the increase to the easing of social restrictions.

Khuja Ahmad Sediqi, a lawyer in the Supreme Court, said that abortion is illegal according to the country's constitution, as well as Shariat law. It is also a very great sin, he added.

Sediqi said that according to Article 402 of the Criminal Code, the punishment for intentionally killing a foetus is seven years in jail. If someone accidentally gives a woman medicine that causes miscarriage, he or she can be jailed for 1-6 months.

In cases of rape, a woman is deemed innocent, and the man can be jailed for 15 years.

During the Taleban women could be killed for illegitimate pregnancy or abortion. But according to Sediqi ''the mullahs who stoned people at Kabul football stadium during the Taleban era were wrong."

Huma Kabiri, a specialist in surgery and ultra-sound at Malalai Women's Hospital, agreed that there has been a sharp increase in the number of illegitimate pregnancies and abortions.

Women in rural areas, where doctors are rare, face greater health risks when they seek an abortion.

Nadia Akramkhil, a doctor of obstetrics at the National Security Hospital, said the procedure there is often performed by old women who induce an abortion by inserting a small piece of an herb called “chub-e-panerak” into the neck of womb. Doctors say that this can cause severe bleeding and jeopardise the life of the mother.

Maryam, 50, who lives in Kabul, said she had seen village abortionists place heavy stones on a pregnant woman’s abdomen and grind it around until the foetus is dead.

Dr Akramkhil said abortions deemed necessary to save the life of the mother are legal in Afghanistan and can be performed after approval of the ministry of health.

But even women who attempt to obtain legal abortions face medical risks.

Farida, 32, came to Malalai Hospital carrying a four-month-old foetus that had died in the womb. She said that she had come the previous year with the same problem, and had endured severe pain and copious bleeding during the operation.

"When I asked for reasons, the doctors said that they did not have good equipment," she said. "God knows that whether I'll be alive after this operation."

Hospital officials admit the lack the proper equipment to perform such procedures.

"Because of three decades of war and the weak economy, hospitals can't afford modern medical instruments. said Dr Kabiri of the Malalai Hospital. “This is one of the factors that plays a key role in mortality rate among women." Afghanistan has one of the highest maternal mortality rates in the world, according to a survey conducted by UNICEF and released in 2002.

Dr Akramkhil denied that hospital perform illegal abortions and said she had no sympathy for those who performed them.

"The more that doctors help these patients, the more illegitimate pregnancies there will be," she said.

Various reasons are offered for the apparent increase in illegitimate pregnancies and illegal abortions.

Abdul Jamil, head of the criminal investigation department at Kabul police headquarters, blamed high wedding costs for preventing young couples from getting married legally.

He added that, as far as he knew, no one had been prosecuted for performing or receiving an abortion.

Dr Kabiri, of Malalai Women's Hospital, blamed the increase on films which she said can lead young people astray.

She suggested that the government control what is broadcast and educate young people about the proper relationship between men and women.

Suhaila Muhsini is a freelance writer in Kabul.