Grounds on Which Abortion Is Permitted s6

Rwanda

ABORTION POLICY

Grounds on which abortion is permitted:

To save the life of the woman Yes To preserve physical health Yes To preserve mental health Yes Rape or incest No Foetal impairment No Economic or social reasons No Available on request No

Additional requirements:

An abortion must be performed by a physician in a public hospital or other authorized health-care facility. Two physicians must confirm in writing that continuation of the pregnancy would seriously endanger the woman’s health.

REPRODUCTIVE HEALTH CONTEXT

Government view on fertility level: Too high

Government intervention concerning fertility level: To lower

Government policy on contraceptive use: Direct support provided

Percentage of currently married women using modern contraception (aged 15-49, 1992): 13

Total fertility rate (1995-2000): 6.2

Age-specific fertility rate (per 1,000 women aged 15-19, 1995-2000): 56

Government has expressed particular concern about: Morbidity and mortality resulting from induced abortion .. Complications of childbearing and childbirth ..

Maternal mortality ratio (per 100,000 live births, 1990): National 1 300 Eastern Africa 1 060

Female life expectancy at birth (1995-2000): 41.7

Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references.

59 Rwanda

BACKGROUND

Until 1977, abortion was generally illegal in Rwanda. The Criminal Code (Ordinance 43/Just. of 18 May 1970), which was based on the 1940 Penal Code of the Belgian Congo, contained no stated exceptions to the prohibition on the performance of abortions, and an abortion could be carried out only under general criminal law principles of necessity to save the life of the pregnant woman.

In 1977, Rwanda enacted a new Penal Code (Law 21-77 of 18 August 1977) that liberalized to some degree the performance of abortions. The law prohibits abortion except when the continuance of the pregnancy seriously endangers the health of the pregnant woman. In such cases, a second medical opinion is required, and the intervention must be performed by a State physician or physician approved by the State in a public hospital or a private hospital approved by the State.

Any person who induces an abortion is subject to 5-10 years’ imprisonment if the woman does not consent and to two to five years’ imprisonment if she consents. A person who is employed in a health profession and performs an abortion is subject to suspension from practicing his or her profession for one to five years or, in the case of repeat offenders, for life. A woman inducing her own abortion or consenting to an abortion is subject to two to five years’ imprisonment.

Illegal abortions are performed in Rwanda, usually by means of plant extracts or heavy massages. However, abortion is not reported to be widespread. When abortion does occur, it appears to be limited mainly to unmarried women. Rather than relying upon contraception or abortion, women in Rwanda space their births by means of such traditional practices as abstinence due to mourning rites or prolonged breastfeeding.

Family planning efforts in Rwanda date back 30 years. The first family planning programme offering modern contraception was established in 1962, but family planning goals were included for the first time in the Five-Year Plan for the period 1977-1981. In 1974, the Government of Rwanda established the Scientific Council for Socio-demographic Problems, which proposed the creation of an institution that would address population issues on a permanent basis. In 1981, the National Population Office (ONAPO) was established to implement population programmes and to begin a programme to integrate family planning services into all of the health-care facilities in Rwanda.

The Government of Rwanda has long been aware of the major threat that population growth poses for the development of the country. Nevertheless, Government actions were constrained by the strong pronatalist sentiments of the population and by the opposition of religious groups to family planning. However, the pressure of population on agricultural land gradually brought about a change in attitude, and family planning is now considered to be a key element in national development. Religious groups have also acknowledged demographic problems in Rwanda and have begun to soften their opposition. In 1990, the family planning programme was expanded and a national population policy and plan of action were adopted, with the goal of reducing the population growth rate from 3.7 to 2.0 per cent by the year 2000. Related goals were to increase the contraceptive prevalence rate from 2 to 48 per cent and to decrease the total fertility rate from 8.6 to 4.0 births per woman.

Currently, however, Rwanda is facing overwhelming consequences of its civil war, which led to the death of more than 500,000 people and a massive exodus from the country. The main challenge is to rebuild the health and family planning infrastructure so as to restore the accessibility of services. Victims of sexual abuse during the genocide suffer persistent health problems in the area of reproductive health including the spread of HIV/AIDS. The National Population Office has estimated the “pregnancies of war,” “enfants non-desirés” (unwanted children) or “enfants mauvais souvenir” (bad memories children) to be between 2,000 and 5,000. Rape-related pregnancies resulted in a substantial number of induced abortions after the war despite their illegality, and Rwandan doctors have treated women with serious complications resulting from self-induced or clandestine abortions. As a result, there is continuing political pressure to further liberalize abortion law despite a general pronatalist view arising from the genocide’s traumatic loss of life.

Rwanda’s maternal mortality ratio was estimated at 1,300 deaths per 100,000 live births in 1990. The country has a low level of modern contraceptive use (13 per cent in 1992) and a current total fertility rate of 6.2 children per woman (1995-2000 estimate).