Back to Square One: Attempted Legal Amendments and Abortion Practices in Sri Lanka
Indralal W. De Silva
University of Colombo, Sri Lanka.
M. Suchira S. Suranga *
The Family Planning Association of Sri Lanka, Sri Lanka.
Malith Kumarasinghe
Post Graduate Institute of Medicine, University of Colombo, Sri Lanka.
*Author to whom correspondence should be addressed.
Abstract
The Sri Lankan law only permits induced or iatrogenic abortion to save the life of the mother. Despite the restricted law, law enforcement mechanisms, and reported high national contraceptive prevalence rate, a significant proportion of pregnant women terminate their pregnancy outside the law. Despite the existence of restrictions and inertia, numerous stakeholders concerned about women’s health have made several attempts to liberalize the abortion law in Sri Lanka. Although several amendments were proposed to rationalize the abortion law in Sri Lanka, nothing has been successful – we are back to square one.
Expansion of legal exceptions for induced abortions and improved safe abortion with the revolutionized medical abortion (MA) were observed in numerous countries globally during the past decade. On the other hand, some countries with broadly liberal laws, including the United States, have added restrictions. How these global changes have affected countries like Sri Lanka is worth studying. This article assesses the response of the Sri Lankan government and the society towards those global changes in terms of the policies and practices on induced abortion. Authors argue that the paradigm shift in abortion practices in Sri Lanka, driven by the emerging occurrence of medical abortion, has highlighted the disparity between the existing legal status and the aspirations of most Sri Lankans. Given the widespread support for legalizing abortion in cases of rape, incest, and fetal abnormalities, it is imperative the government seriously consider legal amendments.
Keywords: Unsafe abortion, restrictive abortion law, sexual and reproductive health, Sri Lanka, medical abortion
How to Cite
Downloads
References
Kottke JM, Zieman M. Management of abortion. In: Operative Gynecology Lippincott Williams & Wilkins; 2008.
The American Heritage Medical Dictionary. The American Heritage Stedman's Medical Dictionary; 2002. [Online]
Available:http://dictionary.reference.com/browse/inducedabortion
Access on 28 January 2017
Mosby's Medical Dictionary. Mosby's Medical Dictionary. 8th ed. s.l.: St. Louis, Mosby Elsevier; 2009.
WHO. Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2003, Geneva: World Health Organization; 2007.
WHO. Reproductive Health Strategy, Geneva, Switzerland: World Health Organization; 2008.
WHO. Abortion Policy Landscape; Sri Lanka, Bangkok, Thailand: World Health Organization Regional Office for South East Asia; 2020.
Penal Code. Penal Code, Decratic Socialist Republic of Sri Lanka. Colombo, Sri Lanka: Parliment of Sri Lanka; 1883.
DCS. Demographic and Health Survey - 2016, Colombo, Sri Lanka: Deparment of Census and Statistics; 2017.
Senanayake L, Willatgamuwa S, Jayasinghe K. Reducing the burden of unsafe abortion in Sri Lanka, Colombo: Family Planning Association of Sri Lanka; 2008.
WHO. Policies, programme and services for comprehensive abortion care in South-East Asia Region, New Delhi: World Health Organization: Regional Office for South-East Asia; World Health Organization; 2020.
Made for minds. Afghan women use abortion as a way out; 2020. [Online] Available:https://www.dw.com/en/afghan-women-use-abortion-as-a-way-out/a-17612865
Access on 24 June 2022
Kumar R. Abortion in Sri Lanka: The Double Standard. American Journal of Public Health. 2013;103(3):400-404.
Senanayake L, Willatgamuwa S, Moonesinghe L, Tissera S. Unintended / unplanned pregnancies and their aftermath, Colombo; Sri Lanka: Family Planning Association of Sri Lanka in collaboration with the College of General Practitioners Sri Lanka; 2012.
SLCOG & FHB. National Guidelines on Post Abortion Care, Colombo, Sri Lanka: Ministry of Health, Nutrition and Indigenous Medicine; 2015.
Rajapakshe LC, De Silva WI. Profile of women seeking abortion, Colombo, Sri Lanka: University of Colombo; 2000.
Suranga MS, Silva KT, Senanayake L. Perception on the abortion laws in Sri Lanka: A community based study in the city of Colombo. Ceylon Medical Journal. 2016;61(4):171-175.
Abeyesekera S. Abortion in Sri Lanka in the context of women's human rights. Reproductive Health Matters.1997;5(9):87-93.
The Sunday Morning. Giving life to abortion law reform, Colombo, Sri Lanka: The Sunday Mornning; 2022.
Kumar R. Misoprostol and the politics of abortion in Sri Lanka. Reproductive Health Matters. 2012;20(40):166-174.
Law Commission of Sri Lanka. Medical Termination of Pregnancy; Proporsal of the law commission of Sri Lanka, Colombo, Sri Lanka: Law Commission of Sri Lanka; 2013.
Suranga MS, Dewasurendra JW, Rajakaruna DK. Knowledge, attitudes and practices on unintended pregnancy and unsafe abortion among female factory workers in a selected Export Processing Zone of Sri Lanka; A community based cross sectional study, Colombo, Sri Lanka: The Family Planning Association of Sri Lanka; 2022.
Suranga MS, Silva KT, Senanayake L. Design and validation of a scale to measure attitudes towards abortion legislation; Application of explanatory and confirmatory factor analysis. Asian Journal of Education and Social Studies. 2022;32(2):9-20.
Suranga MS, Silva KT, Senanayake L. Factors associated with altitudes on induced abortion: A community based study in the Colombo city of Seri Lanka. Sri Lanka Journal of Advanced Social Studies. 2015;5(1):41-55.
Suranga MS, Silva KT, Senanayake L. Gender differences in knowledge and attitudes concerning induced abortion in Sri Lanka: A community based study in the Colombo city. Sri Lanka Journal of Social Sciences. 2017;40(2):93-102.
Suranga MS, Silva KT, Senanayake L. Access to information and attitudes towards induced abortion: A community-based study among adults in the city of Colombo, Sri Lanka. Journal of the College of Community Physicians of Sri Lanka. 2017;23(1):28-38.
Wickramasinghe HK, Wickramasinghe IS, Atukorala RK, Weerasurendera B. Attitudes on abortion among a group of Sri Lankan medical students, Colombo: Faculty of Medicine, University of Colombo; 2009.
Simpson B, Dissanayake MVH, Wickramasinghe D, Jayasekara WR. Prenatal testing and pregnancy termination in Sri Lanka; Views of medical students and doctors. Ceylon Medical Journal. 2003:129-132.
De Silva WI. The practice of induced abortion in Sri Lanka. Colombo, Sri Lanka, Boston: Harvard School of Public Health; 1997.
Abeykoon AT. Estimates of Abortion Rate in Sri Lanka using Bongaarts Model of Proximate Determinants of Fertility. Colombo, Sri Lanka: The United Nations Population Fund; 2012.
SLCOG. Guideline for use of Misoprostol in Obstetric and Gynaecology, COlombo, Sri Lanka: Sri Lanka College of Obstetricians and Gynaecologists; 2020.
De Silva WI. Shifting of abortion practice in Sri Lanka. In: Sexual and Reproductive Health Research in Sri Lanka; Current Status, Challenges and Directions. Colombo, Sri Lanka: The Family Planning Association of Sri Lanka. 2019:3-8.
Suranga MS, De Silva WI. Induced abortion. In: De Silva WI, ed. Sri Lankan Youth: Sexual and Reproductive Health; Profile, Knowledge, Attitude, Behaviour & Vulnerability. Colombo, Sri Lanka: Child Fund Sri Lanka. 2020:176-188.
Kaluarachchi A, et al. Service provider perceptions of the trend in severity of symptoms and complications in women admitted following an incomplete abortion. Journal of Family Medicine and Primary Care, 2018;7(6):2-7.
American Hospital Bangalore. Abortion in Sri Lanka; What are your options; 2020. [Online] Available:https://americanhospitalbangalore.com/abortion-in-sri-lanka/
Access on 28 June 2022
WoW. Abortion with Pills in Women on Web; 2020. [Online] Available:https://www.womenonweb.org/en/abortion-pill
Access on 28 June 2022
Jayasinghe S, Matthias AT. Worsening economic crisis in Sri Lanka: Impacts on health. The Lancet Global Health. 2022;10(7).
Central Bank of Sri Lanka. Consumer Price Inflation; 2022. [Online] Available:https://www.cbsl.gov.lk/en/measures-of-consumer-price-inflation
Access on 28 June 2022
Suranga MS, De Silva IW, Kumarasinghe M. Journal of the College of Community Physicians of Sri Lanka. Impact of the Family Planning Association of Sri Lanka's contraceptive social marketing on the National Family Planning Programme (2001-2020): Is there an effect ofCOVID-19? 2021;27(4):483-494.
Gerstein J, Ward A. Supreme court has voted to overturn abortion rights, draft opinion shows. Politico; 2022. [Online] Available:https://www.politico.com/news/2022/05/02/supreme-court-abortion-draft-opinion-00029473
Access on 15 July 2022
Perera J, De Silva T, Gange H. Knowledge, behaviour and attitudes on induced abortion and family planning among Sri Lankan women seeking termination of pregnancy. Ceylon Medical Journal. 2004;49(1):14-17.
FHB. Family Health Bureau Annual Report 2019, Colombo, Sri Lanka: Family Health Bureau, Ministry of Health, Sri Lanka; 2022.