Cameroon: The bad, good and ugly of abortion

Promise Mboh

Sep 12

By Mboh Promise

This article x-rays the practice of abortion in Cameroon as per the penal code and ethics of the profession.

According to the World Health Organisation, WHO, abortion is the termination of a pregnancy before the age of ability, which in the developed world, is from 22-24 weeks or a foetus that is less than 500g. Meanwhile, in the developing countries like Cameroon, it is a pregnancy less than 28 weeks with a foetus of birth weight less than 1,000g.

In an interview with Dr Dobgima W. Pisoh, Gynaecologist/Obstetrician, who works at the Bamenda Regional Hospital, with over eight years of experience, he revealed that there are two types of abortions which are common; spontaneous and therapeutic abortions.

Spontaneous abortion, he said, is the situation where a pregnancy stops progressing or is terminated on its own. Here, it is not done willfully with the help of a medical practitioner or with the knowledge of the woman.

Induced abortion, he disclosed, is when an individual or health professional uses techniques to stop the pregnancy from progressing. Here, it can be done due to medical reasons, which is called therapeutic abortion, where it's done to treat a condition.

When a woman decides to terminate a pregnancy without any medical reasons, it's known as criminal or clandestine abortion as per the penal code.

According to a publication on abortion guidelines by WHO in 2021, each year, almost half of all pregnancies – 121 million are unintended; six out of 10 unintended pregnancies and three out of 10 of all pregnancies end in induced abortion.

Abortion is safe when carried out using a method recommended by hospitals, appropriate to the pregnancy duration and by someone with the necessary skills. However, when women with unwanted pregnancies face barriers to obtaining quality abortion, they often resort to unsafe abortion.

The bad side of abortion as per Cameroon's penal code

Magistrate Shimenyi A. Ngeghe, Magistrate of the legal department of Cameroon, who also works at the United Nations office of legal affairs in New York, and Dr Dobgima W. Pisoh expatiates on the legal and ethical aspects and punishments and fines.

"Thank you for giving me the opportunity to talk on the issue of abortion in Cameroon. I will like to call the attention of the population on the penal code of Cameroon that abortion is punishable and on the other hand, it is not punishable," Magistrate Shimenyi said.

"Under section 337 of the penal code, any woman procuring to her own abortion shall be punished with an imprisonment from 15 days to one year or with a fine of 5,000 FCFA to 200,000 FCFA or with both imprisonment and fine," he added.

He discloses that "if the abortion was done without the consent of the woman, the actor shall be punished with imprisonment from one to 5 years and with fine from 100,000 FCFA to 2,000,000 FCFA".

The legal practitioner also revealed that the fine and penalty shall be doubled if the offender is found guilty of committing the act on usual basis. He added that the court may also order the closure of the premises and ban the practitioner, if he/she is a medical personnel.

According to Dr Dobgima W. Pisoh, unsafe or illegal abortion carries a big consequence in respect to the health of the woman, with short and long-term effects.

He says the Bamenda Regional Hospital has been strictly following the ethics and penal code, by only handling cases of spontaneous and therapeutic abortions and not illegal abortion.

"We only manage those who have spontaneous and therapeutic abortions and not illegal or voluntary abortion. We don't accept those ones which are against the law," says Doctor Dobgima.

According to a WHO publication of abortion guideline in 2021, each year, 4.7–13.2% of maternal deaths can be attributed to unsafe abortion. In developed regions, it is estimated that 30 women die every 100, 000 due to unsafe abortions. In developing regions, the number rises to 220 deaths per 100,000 unsafe abortions. Estimates from 2012 indicate that in developing countries alone, 7 million women per year were treated in hospital facilities for complications of unsafe abortion.

The good side of abortion as per the penal code

According to section 339 of the penal code of Cameroon, abortion can be done only in case of a pregnancy through rape or to save the life of the mother, if the pregnancy endangers the woman's health.

"The act shall be performed by a qualified medical practitioner, and prove necessary for the saving of the mother from grave danger. In case of pregnancy from rape, abortion can be done by the medical practitioner," Magistrate Shimenyi explains.

The Magistrate further explains that for abortion to be legal "the Doctor shall obtain the opinion of two experts, choosing from the members of the National Council of Medical Practitioners and the doctor shall testify in writing that the life of the mother can only be safeguarded by means of intervention. One copy of the document shall be handed to the patient, another to the physician and the decision shall be sent to the chairperson of the National Council of Medical Practitioners".

According to Dr Dobgima, who has a track record as an obstetrician, many Cameroonians still believe that abortion is used only for criminal termination of a pregnancy, whereas it's not the case.

"About one-thrid of pregnancies eventually end up in abortions spontaneously. One-tenth cases received in the labour room at the level of the Bamenda Regional Hospital have been abortion-related cases, which we have to manage. About 10% to 15% of pregnancies have the tendency of stopping spontaneously, so we are able to manage these termination of pregnancies without causing any complications. It is part and parcel of an obstetrician's job to manage these cases," says Dr Pisoh.

The ugly side of abortion

Though abortion seems to be legal in Cameroon, the law at times comes in to complicate the situation and makes it more difficult to obtain legal documents for abortion. This is especially in the rural areas, where people have to travel long distances, coupled with bad roads to obtain such documents.

"The law makes it difficult to obtain a legal abortion even when it's necessary. For instance, a woman who has been raped in a rural area might not even have access to two doctors from the National Council. This further makes it complicated. But in urban areas where they're doctors, at times the process becomes very lengthy and the final decision is always complicated," says Magistrate Shimenyi.

The use of family planning, practice of safe and protected sex, knowing your circle are key measures prescribed by medics to prevent pregnancies-which usually cause people to have no other option than to go for abortion at the end.