Dear fellow Ghanaians,
As a general practitioner who has been practising in Ghana for a few years, I feel compelled to write to you about the scope of abortion in our country. Abortion is a contentious issue in many countries, including Ghana. It is a sensitive issue that often sparks heated debate and controversy, but it is also a critical health issue that affects the lives of many women in our country. I have seen firsthand the devastating consequences of unsafe abortions, and it is heartbreaking to see women suffer needlessly because they do not have access to safe and legal abortion services. I have also seen the importance of access to safe and legal abortion services for women in our country.
Firstly, it is important to note that abortion is legal in Ghana in certain circumstances. These include when the pregnancy poses a risk to the physical or mental health of the woman, when there is fetal anomaly, in cases of rape or incest, or when the pregnancy has terminated on its own but has not completely been expelled from the womb. Despite the legality of abortion in these circumstances, access to safe and legal abortion services remains limited, particularly in rural areas where there is a shortage of healthcare providers and facilities. This has often led to many women resorting to unsafe procedures, putting their lives and health at risk.

One of the main reasons for limited access to safe abortion services in Ghana is the stigma and discrimination associated with it. Many women are afraid of being ostracised or judged by their family or society. This often results in them seeking abortion secretly. They end up taking advice from unqualified individuals, taking matters into their own hands and drinking all sorts of concoctions, or even buying untrustworthy medications. Some also fall in the hands of quack healthcare providers, who perform these procedures in unsafe ways in unsafe environments. Another issue is the limited access to information. This makes it difficult for women to make informed decisions about their reproductive health and in seeking safe abortion. The cost involved in obtaining safe abortion services is sometimes too high and makes it inaccessible to low-income women and this pushes them to try more unorthodox and cheaper methods. The patriarchy seen in Ghanaian Societies, where the man often holds decision-making power over women’s bodies, can limit women’s ability to access safe abortion services. Lastly, the majority of Ghanaians are Christians or Muslims and their religious beliefs and teachings, which sometimes oppose abortion, make it difficult for women belonging to these religions to seek and access safe and legal abortion services.

The harms and complications associated with unsafe abortions far outweigh the stigma and the so-called negative connotation in public. According to the World Health Organization, an estimated 7 million unsafe abortions occur worldwide each year. Ghana is not immune to this problem and according to the Ghana Health Service, unsafe abortions account for about 11% of maternal deaths. Poorly performed abortions can lead to infections, excessive bleeding, possible loss of womb and even death. Just a few weeks back, I saw a case of an unsafe abortion where the womb and intestines of the woman had been punctured. She came in a very bad state and we would have lost her if not for timely intervention. I remember during the height of COVID-19, I experienced another case where an unsafe abortion led to a lady’s kidneys shut down resulting in inability to produce urine. She had to be admitted in the Intensive Care Unit and undergo dialysis before she made a full recovery.

The Ghana Health Service provides guidelines and protocols for safe abortion. This includes counselling before the procedure, the procedure itself which could be medical or surgical, and post-abortion care. This is available to every woman in Ghana in almost every registered health facility. If the health facility closest to you does not offer the service, they can easily direct you to the nearest health centre that offers this service. HowToUseAbortionPill also provides accurate and reliable information on how to safely terminate a pregnancy using the abortion pills. They also have a country profile on Ghana which provides information on abortion care, names and pictures of the pills as well as centres you can contact for further support.

Even with all the effort in recent years, the problem of unsafe abortion still exists. There is an extent to which the Ghana Health Service can go to curb this, but a lot of responsibility lies at our doorstep. As a nation, religious institutions, families, healthcare providers, healthcare seekers, we all have a part to play. We need to change our attitude towards abortion. The stigmatisation, finger pointing and accusations have to stop. Healthcare providers have even changed the terminology in some cases from abortion to miscarriage to help deal with the stigma. The government and Ghana Health Service has a role to play by increasing access to safe and legal abortion services especially in rural and underprivileged areas. Access to accurate information and counselling options is also needed, provided by platforms like How To Use Abortion Pill and safe2choose, as we hear so many people come in after unsafe abortions with stories of having received one bad advice after the other from friends, family and unidentified health workers. Regular training workshops for health workers are needed, so that they are able to offer safe abortion care right from counselling through the procedure to the post abortion care. HowToUse has a comprehensive course on medical abortion for health providers that I highly recommend. As a community, our attitude towards people who have had abortions need to change.
In conclusion, unsafe abortions are a significant public health issue in Ghana and I urge all Ghanaians to recognize the importance of safe and legal abortion services as part of comprehensive reproductive health care. We must all work together to ensure that women in Ghana have access to the care they need to be able to make informed decisions about their reproductive health.

A Concerned Medical Officer.