Commentary: Do Liberian women and girls have heartbeats?

Liberia stands at a historic juncture to address and improve healthcare access for Liberian women and girls. In a few days, the revised public healthcare law will be able to support the improvement in lives of every Liberian, protection of rights to choose and make informed decisions on their healthcare and access to quality and gender response delivery. There are many benefits of the revised Public Health Law, including progress on protection for the people of Liberia. The revised law will guide service providers in service deliveries and against discrimination; it will prohibit street selling of drugs including fake, expired, and unsafe medications; it will protect mentally ill people, regulate the sale and marketing of tobacco and breastmilk substitute products. The revised law will also provide guidelines for the control and prevention of epidemics and diseases, improve access to safe abortion and post-abortion care, regulate traditional medicines, and provide coordinating mechanisms between the communities and the health authorities in all counties.

Liberia currently has the 7th highest rate of maternal mortality in the world and the 3rd in Africa with many women and girls dying from giving birth and related health complications. Liberia also has one of the highest rates of teenage pregnancy with 30% of girls and young Liberian women, aged 15 -19, are already mothers and or pregnant with their first child. This means of every 3 girls, 2 become mothers by age 19^th! Liberia has also a high rate of sexual and gender-based violence. In 2019, two out of every three rape cases are minors. In addition, limited access to comprehensive sexual health education and sexual health and reproductive services and commodities, including lack of access to safe abortion and post-abortion care, have resulted in women and girls dying. Between 2017 and 2018, statistics show that over 8,700 abortion cases were reported at health facilities in Liberia, and in 2021 over 2,600. These abortion cases were carried out in the least- safe and most dangerous conditions with 10% ending in deaths of young women and girls. Daily, hundreds of women, desperately take matters into their own hands, seeking services from backstreet abortion service providers; some use self-induced procedures to terminate their own pregnancies, and this includes women and girls of all ages, professions, and socio-economic status.

Abortion access is currently restricted in Liberia to when a woman’s life is at risk and or in cases of rape and or incest. However, even with this, access continues to be limited due to the bureaucratic hurdles that impede safe and medically supervised care, and as such we’ve seen thousands of children, living with lifelong healthcare complications and barely of age to care for themselves become mothers too soon. Worse is in cases of self-induced abortion where access to post-abortion care is again restricted either from deliberate lack of attention and care by health care facilities including those often misguided by assumption of what the law covers and or willful neglect due to religious and cultural biases. This also includes cases where women have miscarried and assumptions regarding attempted and or incomplete abortion led to neglect, further complicating their health care needs and, in some cases, resulting in preventable deaths. As such, we ask…DO women and girls not have heartbeats?

The Hippocratic Oath references “how one must tread with care in matters of life and death”, so we ask again, is the death of a woman not a matter of life and death when almost every death due to unsafe abortion can be prevented through sexuality education, effective contraception, safe, legal abortion, and timely care for complications. It is a known fact that abortion when conducted by a skilled health provider and in line with clinical guidance from WHO, can be one of the safest medical practices.

Restricting abortion restricts women and girls from receiving proper and timely information on their health, services available, and choices.

Restricting abortion leads to unsafe practices, in backdoor alleyways, in homes with self-induced and dangerous procedures, and death of women and girls.

Restricting abortion only leads to more women and girls already traumatized by sexual and gender-based violence to carry on with unwanted and or unviable pregnancies.

Restricting abortions means many babies becoming mothers too early as 10 years old and have limited access to education and a future of their choice.

Restricting abortion only leads to more women, married and unmarried, living with health complications and carrying unviable pregnancies to term.

Restricting abortion also mean women and girls are left to die in the very medical facilities tasked with giving care because medical professions are unable to provide needed and critical attention.

Abortion is health care. It enables Liberian women and girls …with heartbeats, to have a choice, in an informed, sanitized, medically supervised healthcare facility with appropriate and responsive care.

Liberian women and girls have heartbeats. Let’s safeguard their rights, their choices, and their lives with the passage of the Revised Public Healthcare Law. Abortion saves the Lives of Women and Girls with heartbeats.