Abortion in Indonesia

In Brief 2008 Series, No. 2 Abortion in Indonesia Each year in Indonesia, millions of women become pregnant about 29 abortions occur for every 1,000 women of reproductive age. 4 unintentionally, and many choose to end their pregnancies, despite the fact that abortion is generally illegal. Like their While the level of induced abortion is somewhat uncertain, there is clear counterparts in many developing countries where abortion evidence that of the 4.5 million births is stigmatized and highly restricted, Indonesian women that took place in Indonesia each year around the time of that study, 760,000 often seek clandestine procedures performed by untrained (17%) were unwanted or mistimed. 5,6 providers, and resort to methods that include ingesting Abortion clients are often unsafe substances and undergoing harmful abortive massage. married adults with unmet need for contraception. Although women of all walks of life likely Though reliable evidence does not exist, women’s experiences with abortion. Some utilize abortion services in Indonesia, researchers estimate that about two studies included women in rural areas information on the characteristics of million induced abortions occur each and those who sought abortions outside women who obtain abortions generally year in the country 1 and that deaths of clinics, but none were nationally comes from clinic- and hospital-based from unsafe abortion represent 14 –16% representative. Although these studies do studies. Thus, women who seek abortions of all maternal deaths in Southeast Asia. 2 not give a full picture of who is obtain - outside of facilities, including those who Preventing unsafe abortion is imperative ing abortions in Indonesia or what their induce abortions themselves, are not if Indonesia is to achieve the fifth experiences are, the evidence suggests represented by these studies. Millennium Development Goal of improv - that abortion is a common occurrence in ing maternal health and reducing the country and that the conditions The studies concur that the majority of maternal mortality. under which abortion takes place are women who obtain an abortion or often unsafe. menstrual regulation at a clinic or Current Indonesian abortion law is based hospital fit a certain profile: They tend on a national health bill passed in 1,7,8 Abortion is common in Indonesia. to be married and educated. For 1992. 3 Though the language on abortion It is estimated that about two million example, a study conducted in 2000 was vague, it is generally accepted that abortions occurred in Indonesia in 2000. 1 found that two-thirds of abortion clients the law allows abortion only if the were married, and nearly two-thirds had This number is derived from a study of a woman provides confirmation from a attained at least some secondary school sample of health care facilities in six doctor that her pregnancy is life- education (Figure 1, page 2). 1 In regions, and it includes an unknown, threatening, a letter of consent from her contrast, only 38% of ever-married though probably small, number of husband or a family member, a positive Indonesian women have received any spontaneous abortions (miscarriages). pregnancy test result and a statement secondary schooling. 6 In a more recent However, this is the most comprehensive guaranteeing that she will practice study, 54% of abortion clients were high estimate currently available for the contraception afterwards. school graduates, and 21% were academy country. The estimate translates to an or university graduates; 87% of urban This report presents what is currently annual rate of 37 abortions for every clients were married. 7 Moreover, nearly known about abortion in Indonesia. The 1,000 women of reproductive age (15–49 every abortion client was older than 20 findings are derived primarily from small- years). This rate is high compared with (58% were older than 30), and almost scale, urban, clinic-based studies of that of Asia as a whole: Regionally, half had at least two children. Figure 1 Who Gets Abortions? birth attendants, traditional In a study of women who had Most abortion clients are married and educated, but few were using healers or masseurs to termi - obtained an abortion at a contraceptives. nate their pregnancy. (Women clinic, only 38% reported that their procedure had involved 100 who induce their own abor - 0 0 75 8 0 vacuum aspiration, a safe and 2 22 tions are not included in these , s t established method of early n estimates.) i 80 o p 50 14 abortion, or dilation and y 46 r e 66 v curettage, an effective but i While the number of successful l 60 e d self-induced abortions is somewhat less safe method e c i 1 v 43 (Figure 2). Another 25% had r 40 unknown, one study suggests e s 33 received oral medication and t that most women who seek an a 37 s abortive massage; 13% had n abortion from a provider first o 20 i t 33 r received an injectable abortifa - o attempt to induce the abortion b 21 18 a 10 cient; 13% had had a foreign g themselves. In a study of n 0 i k Age Marital status Education Contraceptive use object or preparation inserted e clients seeking menstrual e s ≤19 Married Primary Never used into their vagina or uterus; n regulation (locally known as e m 20–29 Never married Junior Former user and 4% had been treated with o induksi haid ) at an urban clinic, w 30–39 Divorced Senior Current user f acupuncture. o women’s first step often was to ≥40 Academy/ % University use over-the-counter medicines Unsafe abortion leads to or herbal remedies ( jamu ) to Note: Percentages may not total 100 because of rounding. Source: Reference 1. an unknown number of induce menstruation. 11 Many complications and deaths. then took a pregnancy test. Evidence indicates that some Recent estimates of abortion- sought to terminate a preg - Once pregnancy had been women who have abortions had nancy in order to preserve associated mortality in confirmed, the most common been actively seeking to their physical health. 7 Indonesia are unavailable. The means women employed in prevent pregnancy when they World Health Organization their first abortion attempts conceived. In one study, about Many abortions in estimates that unsafe abortion was ingesting more herbal 19% of urban and 7% of rural Indonesia are unsafe. is responsible for 14% of products or receiving abortive abortion clients reported that Unlike safe abortions, unsafe maternal deaths in Southeast they had been using contracep - procedures are a threat to massage from a traditional Asia, and 16% of maternal tives when they became women’s health and survival, healer. If the abortion was deaths in regions of Southeast pregnant. 1 In another study, a and the relative safety of the unsuccessful, the women then Asia that have highly restric - much higher proportion—about procedure can depend on the terminated their pregnancy in tive abortion laws (including one-third of clients—reported provider and the method a clinic. Indonesia). 2 having experienced contracep - used. 9,10 A woman’s choice of Figure 2 tive failure. 7 Most abortion abortion provider varies clients, however, had an unmet according to her location. Methods of Abortion need for contraception, as they Researchers estimate that Vacuum aspiration is used in less than half of abortions in Indonesia. did not want a child soon or at hospital and family planning 8% all and were not using any clinic staff, obstetricians and 4% Vacuum aspiration or D&C contraceptive method. midwives perform close to 85% 5% of abortions obtained at Oral medication and massage One of the most frequent 8% service delivery points in urban Injected abortifacient reasons women give for seeking settings, and traditional birth 38% Foreign obj ect inserted into an abortion is that they have attendants perform 15%. 1 In vagina/uterus achieved their desired family rural areas, on the other hand, 13% Herbal/other p reparation inserted into vagin a/ut er us size. 1 In addition, many traditional birth attendants are Acupuncture unmarried women undergo the estimated to perform more 25% procedure because they wish to than four-fifths of abortions. Magic continue their education before Altogether, nearly half of all Abortions performed at service delivery points, 2000 getting married. In one study, women seeking abortion in only 4% of abortion clients Indonesia turn to traditional Notes: D&C=dilation and curettage. Percentages do not total 100 because of rounding. Source: Reference 1. Abortion in Indonesia 2 Guttmacher Institute The rate of complications from procedure itself; the broader Many Indonesians are who have an unmet need for unsafe abortion is likely far costs, including loss of income in need of effective contraception are relatively higher than that of deaths. and the price of postabortion contraception. unlikely to oppose contracep - Again, the rate for Indonesia is care; the physical and mental While contraceptive use has tion or to face opposition from unknown, but in Southeast trauma to the woman; the been on the rise in Indonesia their husbands about contra - Asia, it is estimated that three social costs, including stigma for most of the past two ceptive use, but they are more out of every 1,000 women aged and isolation; and the decades, there has been likely to cite concerns about 15–44 are hospitalized each expenses to the health care relatively little change since health risks or side effects year for abortion-related system and society. Most of the mid-1990s (Figure 3). 6,13 associated with contracep- complications. 12 This translates these costs are difficult to Many married women (61%) tives. 15 Given the prevalence of to about 130 hospitalizations measure; the available data use contraceptives and 57% these concerns, many women for every 1,000 women who primarily address the monetary use a modern method (not would likely benefit from obtain an unsafe abortion.

Load more