Today under the Lebanese law, that was drafted in 1943 based on the French penal code at the time (Hessini, 2007) articles 539-546 state that abortion is illegal under all circumstances. It wasn’t until October 1969, that the Presidential Decree No.13187 allowed abortion only to preserve the woman’s life, if in danger (United Nations, 2001).
The law that is governed by eight articles prohibits the dissemination of information on abortion or methods used to facilitate it, the selling or accusation of objects that are designed to perform it, in addition to punishing any woman who induces abortion and any other person who aids her to do so (United Nations, 2001). Abortion is permitted if it is only the means of saving the life of the pregnant woman with the consent of two physicians other than the attending one (Kaddour et al. 2002). Even with the woman’s consent, under the law, the person who performs an abortion is subjected to one to three years of imprisonment and the woman herself is subjected to six months to three years imprisonment. These acts reveal that any woman aborting and any person aborting her, except in specified situations, would be both committing an punishable illegal act. Induced abortion, according to reproductive health experts, is practiced in Lebanon (Kaddour et al. 2002).
Population Reference Bureau (2011) documented that the latest data (prior to 2006) in Lebanon showed that 58% of married women between the ages of 15-49 use some kind of contraceptive method, with 34% of them using modern methods. This leaves the remaining 40% of those women with an unmet need for family planning resources, not mentioning those engaging in pre-marital sexual activities.
The lack of comprehensive access to proper contraceptive methods and lack of nation-wide sexual and reproductive education in school demonstrates the absence of preventive measures and strategies provided by the state to lower unwanted pregnancies. While oral contraceptives and emergency contraception could be purchased over the counter without a prescription, the social stigma of pre-marital sex makes seeking healthcare providers’ advice, or buying contraception difficult for young unmarried women.
An interview held with a representative of the Lebanese Family Planning Association in 2001, (Kaddour et al. 2002) revealed that although aware of the ramifications of the abortion law, officials from the Ministry of Social Affairs and the Ministry of Public Health still refusedplacing the matter of abortion on their agenda. This signifies that both ministries overlook violations of the law; yet are not willing to modify it in order to strike a balancein the complex political and religious structure of the Lebanese society.
There are no official statistics that accurately estimate the prevalence of abortion in the Lebanon; yet, the procedure is sought in the “black market” where it is performed in private clinics or at homes in unsafe environments mostly with no support or post abortion care (Human Rights Council, 2010). According to statistics by World Health Organization (WHO), the estimated number of unsafe abortions (performed in unsanitary setting, by unskilled providers or both) in the Eastern Mediterranean Region (EMR)* in 2003 was around 2,800,000 abortions, accounting for 12% of all maternal deaths in the region (World Health Organization, 2007).
There are several surgical and non-surgical (medication) methods to terminate a pregnancy in the MENA region (Dabash & amp; Roudi-Fahimi, 2008). Surgical methods require anesthesia and sterilized equipment, include dilation and curettage (D&C) and manual vacuum aspiration (MVA); where MVA is considered to be safer and rather easier to perform by a wider range of trained medical providers. Non-surgical methods usually use one or several types of drugs/medication to induce the termination of early pregnancy; these medications include Methotrexate, Mifepristone, and Misoprostol (Dabash & Roudi-Fahimi, 2008). Mefepristone is banned in Lebanon, but both Methotrexate and Misoprostol exist, but available without a prescription. For a higher price,some pharmacists agree to sell Misoprostol without a prescription.
When it comes to surgical methods, due to the high risk on the Lebanese specialists performing these procedures under the law, physicians usually end up charging clients for their work and for the risk of legal prosecution, which can go up to very high unaffordable prices. With no regulation on the prices of abortion, the client is usually charged between $300 – $1200 depending on the geographical location and the space in which the procedure performed: home, clinic or hospital (Kaddour et al., 2002).
Even though some physicians claim that the price of an abortion can be negotiable based on the woman’s economic situation; however, visible inequality in access to care is evident. Married women have better access to abortion than the unmarried. Young unmarried women have to protect themselves from social occlusion, where even if they had wanted to remain pregnant, it’s socially very difficult to do so out of wedlock. Even more, the Lebanese law still does not recognize women’s rights to pass their nationality to their children if married to a foreigner; however illegitimate children would be registered as Lebanese. Other inequalities are also evident among women who are older and more financially secured since they are at an advantage of accessing safer abortions with better quality of care through their networks much easier than
* EMR include : Afghanistan, Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, South Sudan, Sudan, Syrian Arab Republic, Tunisia, United Arab Emirates & Yemen.