Abortion in Indonesia: between moral pressure and women's well-being

Every year, there are no less than 56 million cases of abortion worldwide. In Indonesia alone, based on data from the Indonesian Demographic and Health Survey (IDHS), the abortion rate has reached 228 per 100 thousand live births.

An abortion may be the last bitter choice for some, but many women out there see it as the only way out of an unplanned pregnancy. Whatever the reason, the decision to have an abortion is never as easy as turning your palm. But unfortunately, until now access to good abortion services has been difficult to obtain.

In fact, denying access to abortion for women in need not only increases their risk of having an illegal, life-threatening abortion, but also increases their risk of experiencing depression or anxiety disorders in the long term.

What is the law of abortion in Indonesia?

Abortion law in Indonesia is regulated in Law Number 36 of 2009 concerning Health and Government Regulation Number 61 of 2014 concerning Reproductive Health. Abortion in Indonesia is not permitted, except for medical emergencies that threaten the life of the mother and / or fetus, as well as for victims of rape.

An abortion for medical safety reasons can only be done after obtaining the consent of a pregnant woman and her partner (except for rape victims) and a certified health care provider, as well as through pre-action counseling and / or consultation conducted by a competent and authorized counselor.

Thus, all types of abortion practices that are not included in the provisions of the law above are illegal abortion. Criminal sanctions for illegal abortion are regulated in Article 194 of the Health Law, which stipulates a maximum imprisonment of 10 years and a maximum fine of Rp1 billion. This article can ensnare doctors and / or health workers deliberately carrying out illegal abortions, as well as women as clients.

Abortion is often considered taboo by society because it is closely related to adultery, which is equally prohibited. In fact, the reason women want an abortion is not only a matter of aborting a pregnancy outside of marriage.

Why do women choose to abort the womb

Pregnancies that occur at inappropriate times and conditions can have a long-term impact on a woman's quality of life going forward. Many women become pregnant women at a very young age, generally before turning 18 or graduating from high school. Students who are pregnant and giving birth are also much less likely to complete their education than their peers.

The lack of education has been linked to limited employment opportunities, and this could hamper women's ability to support families with stable incomes. And this is not just limited to pregnancies outside of wedlock.

In addition, single women who work and become pregnant may face disruption in the stability of their jobs and careers. This has a direct impact on their productivity, and perhaps some of them are unable to raise children alone For women who already have other children at home or are caring for elderly relatives, the extra expenses for pregnancy / childbirth can drag their family down below the level. poverty thus requiring them to seek state assistance.

Whether she is a high school or college student, or a single woman whose income is only enough to live independently, many women lack the financial resources to cover the high costs associated with pregnancy, childbirth, and raising children, especially if they do not have health insurance.

Saving for a baby is one thing, but an unplanned pregnancy places a huge financial burden on women who can't afford to care for the baby. What's more, paying for all kinds of doctor visits to ensure healthy fetal development. Lack of adequate medical care during pregnancy puts the baby at higher risk for complications during birth and in the early developmental period of the baby.

In addition, the majority of women with unplanned pregnancies are not living with their partners or in committed relationships. These women realized that they would likely be raising their child as a single parent. Many are unwilling to take this big step for reasons described above: educational or career disruption, inadequate finances, or an inability to care for a baby because of the care needs of children or other family members.

Limited access to abortion affects women's mental health

According to a 2016 study published by JAMA Psychiatry, women who have legal abortions can move on with their lives without the risk of developing depression, anxiety, or low self-esteem related to this. However, those who were denied the right to undergo the procedure (plus being overshadowed by criminal penalties for doing so illegally) experienced increased anxiety and feelings of inferiority immediately after being denied a case.

The research team from the University of California, San Francisco, has investigated nearly 1,000 women seeking abortions in 21 different countries over the past five years. These women were then divided into two subgroups: those who received abortions, and those who were rejected because they were outside the country's legal gestational limits (24-26 weeks). The women who were rejected were then subdivided into groups of women who ended up having a miscarriage or accessing an abortion through other means, and women who kept their pregnancy until the birth of the baby. Every six months, researchers looked at each of these women to assess their mental health.

"Nothing can prove that abortion causes depression," M. Antonia Biggs, a social psychologist at UCSF and lead author of a new report published in JAMA Psychiatry, told The Daily Beast. "What exists is that denying women the right to have an abortion can have a negative impact on their mental health and well-being."

The group of women who were denied an abortion application and ended up not giving birth reported the highest levels of anxiety, and the lowest sense of self-esteem and life satisfaction within one week of being rejected. In their findings, the researchers suggest that initial stress may be the result of outright refusal but still haunted by reasons to seek an abortion - financial problems, relationship problems, children, among others.

In addition, women who are denied abortion applications are faced with additional challenges. Although very few abortions are performed after 16 weeks of pregnancy, some women have to postpone abortions because they have problems with payment methods, find an abortion specialist, which may have to be achieved by traveling long distances due to different provinces or neighboring regions, and collect extra money to make the trip. . Over time, this stress can have an impact on her mental health if the pregnancy continues.

Depression due to refusal to abortion can have fatal consequences for the safety of both the mother and the fetus

Untreated depression during pregnancy poses potentially dangerous risks for both mother and baby. Untreated depression can lead to malnutrition, drinking, smoking and suicidal tendencies, which in turn can lead to preterm birth, low birth weight and developmental problems. Depressed women often also lack the strength or desire to care for themselves or the unborn baby

Babies born to depressed mothers may grow less active, less attentive or focused, and more restless than babies born to physically and mentally healthy mothers. This is why getting the right help is so important, for both mother and baby.