Law related to Abortion :
Brief history of the law:
After 8 years effort to put safe abortion as a part of Health law, finally the new Health law was launched on 15 September 2009. one chapter of the new health law, consist 7 articles of reproductive health issues ( articles: 71 – 77), which is article 75 consist of abortion regulation.
Abortion still illegal/abortion is prohibited except for:
- medical emergency, which is known from the early pregnancy;
- If the pregnancy will threat mother or fetus lives;
- If fetus has a dangerous genetic sickness;
- Pregnancy because of rape
Abortion only can be done after the woman have counseling process.
Abortion can be done :
- before 6 weeks of pregnancy
- implemented by medical doctor/worker, with certificate given by ministry of health
- The pregnant woman agree to do abortion
- With the agreement of the husband
- Provider fulfill the ministry of health criteria.
Short summary of conditions within the law: Abortion only can be done: to save the live of the woman; to preserve physical health; foetal impairment; and the woman pregnant because of rape.
Analysis of it being restrictive if at all : Because of Indonesian’s Penal Code and religion believes.
About 60% of 220 million people live in Java island. Big cities in Java (like Jakarta, Bandung, Semarang, Yogyakarta, and Surabaya) have Government hospitals which provide abortion facilities. The problem is they won’t give abortion services because it illegal. They only help married woman with emergency cases. But now with the health law, hopefully they will provide abortion services even though with many ministry of health criteria
There is no government policy (legal policy) pro with abortion/ allow abortion in Indonesia, even though many “illegal” abortion occurred. There is no accurate data for abortion because of abortion is illegal by law. In general estimated data is more than 20 abortion occur for every 1000 women of reproductive age.
The new law is the only policy which is allow abortion with many criteria (as mention above).
Providers should be trained and willing to do abortion
Reproductive Health Perspective :
Signatory to ICPD, CEDAW: Yes / No, any conditions
Yes, Indonesia have already signed the ICPD and CEDAW
Abortion Statistics :
There is no accurate national data for abortion. From several survey done by NGOs, abortion done by married and unmarried women. Data showed that more married women asking for abortion than unmarried women, because abortion is illegal, many unsafe abortion happened. This unsafe abortion contributed to MMR in Indonesia (which is very high: MMR à gov. data: 226/100,000).
Public sector :
No national data : From several survey showed: abortion done in 1 st and 2 nd trimester.
Cost: range of Rs 3,00,000 – Rs 2,000,000 ( US $ 30 – 200)
Private sector :
Abortion services available
1 st Trimester, 2 nd Trimester
Cost: US $ 100 – $ 1000
Methods used :
D&C, EVA, MVA, MMA with Mife Miso, MMA with Miso alone, MMA with Methotrexate Miso
2 nd Trimester with Ethacridine lactate , Misoprostol, D&E, Hyterotomy
Provider level allowed for surgical and medical abortion :
Ob Gyn, Medical doctor, Traditional Midwifes or “shaman”
Abortion related morbidity mortality statistics :
About 11% – 30 % contributed to MMR
Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment) :
Manufacture/ import of Mifepristone, Misoprostol :
Facility and provider certification norms in brief :
Some facilities provides by Education Hospital . In the new law certification provide by the ministry of health.
Information available in national service delivery standards :
There is no national service delivery standards yet. The law is still very new, national service delivery standards should be in the process now. There are several regulation should be done by the government to support the abortion regulation.
Informal / illegal providers – if present who are they :
Traditional midwife and shaman
Population urban/ rural – Demography of the country, with an analysis of availability of abortion services ratio to population :
60 % of Indonesia population lives in Java island, another 40 % lives in Sumatera, Kalimantan, Sulawesi , Papua and other small islands. Almost all big cities (provinces capital city) provides abortion services even though it is illegal. Women Health Foundation (YKP) survey on 2003 showed that government hospital and private clinics in 9 big cities (Medan, Batam, Jakarta, Bandung, Yogyakarta, Surabaya, Bali, Mataram, Menado) provides save-abortion.
Role of government :
Supportive, enabling, creating barriers, provides adequate funding to run training and service delivery programmes
Before the new law, government creating barriers to abortion. Hopefully after the new law abortion will be provide by the government with easy access for women.
Role of religion/ religious leaders :
Enabling,supportive, neutral, restrictive
There are several Islam religious leaders support implementation of safe abortion, if it is needed by woman because of unwanted pregnancy.
- abortion was permitted according to part of Hanafi, Maliqi and Hambali scholars.
- Abortion was permitted if there is medical reasons according to a part of Syafei scholars.
- According to Indonesian Scholar council, abortion is permitted as long as before 40 days of gestation.
Local Ob Gyn societies :
Supportive, conscientious objectors
Some of local Ob Gyn societies, support abortion but some not. Some of them still confused
Current status and potential of research :
Current Status is, after launching of the new law, there is potential research could be done, to see the implementation of the new law. It is important to see the readiness of the government hospital to provides facilities and trained medical doctor and trained counselor to help women who need the abortion.
Awareness amongst community
It is still need information and education for community members to know about abortion and SRHR issues. There is no information and education regarding safe abvortion for the community.
Role of member organization/ individual :
There are several organization like for example, YKP, YPKP, PKBI have conducted education on SRHR for the community. But still need more effort to inform the people especially women about SRHR issues.