The issue of abortion is, perhaps, one of the most controversial topics on the agenda of the 21st century. Despite numerous debates and a consistent analysis of the issue, there has been no clear answer to whether it should be legalized or banned, and chances are that there never will be, due to the complicated ethical and religious dilemmas that need to be resolved to make a reasonable decision.
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As it has been stressed above, the phenomenon of abortion is viewed as unacceptable in many countries, mostly because of religious issues (Early 2002). Particularly, the Islamic religions view abortion as a deadly sin (Early 2002). As a result, abortions are prohibited in most regions of the Middle East, excluding Tunis and Turkey (Early 2002). Herein the key healthcare concern for the Middle East women lies. A recent study of the subject matter has shown that the rates of unsafe abortions in Middle east are getting increasingly high: as the official data states, out of 1,000 women ages 15–40, 11 will have to undergo an unsafe abortion in the course of a year (Unsafe abortion incidence and mortality 2008, p. 2). As a result, the death toll among Middle East women has been rising consistently in the area under analysis over the past few decades. According to the recent data on unsafe abortions in the Middle East region, around 830, 000 unsafe abortions are performed in the specified area on an annual basis, 17,000 women dying in the process annually (‘Unsafe abortion incidence and mortality’ 2008, p. 2).
It would be wrong to claim that every single state of the Middle East accepts the idea that abortions should be illegal. Quite on the contrary, several states have adopted a fairly liberal manner of looking at the issue in question. Particularly, the government of Tunis and Turkey adopted the law that claims abortions as legal. The effects of the specified practice are evident – the death toll among women is slightly lower in Tunis and Turkey than in other states of the Middle East. Unfortunately, the permission granted to the state clinics and healthcare services for providing abortion-related services to women is only one of the steps to be taken to reduce mortality rates among Middle East women, as the level of technological advances in the Middle East healthcare facilities providing abortion services leaves much to be desired. According to the recent data, not only are abortions performed with the help of outdated equipment but are also very expensive; as a result, most Turkish and Tunisian women prefer a cheaper option of an unsafe abortion, even though the outcomes thereof may turn out to be dire: “Most abortions take place in the private sector, where the services are more costly. Only about one in five abortions takes place in a public health clinic” (Dabash & Roudi-Fahimi 2008, p. 5).
As a result, the rates of death among women are becoming increasingly high in the Middle East despite the technological advances that modern medicine has to offer. The specified phenomenon can be attributed to several factors, the economic, the technological and the cultural one playing the greatest role in the specified area. Even though abortion as a concept contradicts the basic principles of most religious confessions, including Islam, which is the dominant religion in the Middle East, vaginal dilatation and curettage must be legalized in the specified geographic region, as most abortions made in the specified area can be defined as self-induced ones, with major traumatic consequences for women, which may result in death or a near-death experience.
Traditionally, abortion used to be defined as “an untimely delivery voluntarily procured with intent to destroy the fetus” (Potts, Diggory & Peel 1977, p. 21). It should be noted that, because of the aforementioned controversy of the subject matter, the definition for an abortion has not been located up until recently. Even nowadays, the identification of a proper definition of an abortion spark heated debates. As a rule, the term is loosely rendered as a “fetal death” (Potts, Diggory & Peel 1977, p. 20) by a range of scholars and nursing specialists; however, a range of researchers agree that the specified definition cannot be considered adequate, as it does not reflect the complex nature of the procedure (Potts, Diggory & Peel 1977). It is quite peculiar that the specified type of abortion is traditionally characterized as a fairly safe medical procedure (World Health Organisation 2012, p. 21), though the death toll among women undergoing an abortion in the Middle East shows that the surgery often poses a very tangible threat to the life of a patient.
Among the key types of abortion, legal and illegal ones are typically distinguished. The latter, in its turn, is defined by the WHO as the “procedure for terminating a pregnancy performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical standards, or both” (Ganatra et al. 2014, p. 155). Legal abortion, in its turn, is nowadays called as induced one and identified as a “medical termination of pregnancy” (Norman, Soon, Maughn & Dressler, 2014, p. 1).
Apart from the specified taxonomy, another classification of abortions is typically recognized as quite valid. To be more exact, abortions are often referred to as either ‘safe” or ”unsafe” (World Health Organisation 2012). Though the line between the specified means of distinguishing among types of abortions and the one provided above is rather thin, it can be assumed that the given classification views the procedure from the perspective of the patient’s physical safety, whereas the former identifies the procedure as valid or invalid from the perspective of the current law. In other words, all illegal abortions are traditionally referred to as unsafe due to poor medical conditions, in which they are performed; however, not all unsafe abortions are necessarily illegal, as even the ones warranted by the law may be carried out in unsafe conditions, as the case of certain Middle East states (e.g., Tunisia and Turkey) show.
It should be born in mind that, despite a common misconception about illegal abortions and unsafe ones being the same phenomenon, the two cannot be treated as interchangeable concepts based on the current definition of the phenomenon. According to the modern interpretation of an unsafe abortion, the latter is a “termination of an unintended pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both” (Warriner & Shah 2006, p. vii), according to the WHO definition. As the members of the organization confess, though rarely acknowledged in contemporary society, unsafe abortions remain one of the key driving factors behind deaths among women all over the world.
Apart from the taxonomy provided above, the one splitting abortions into spontaneous and induced ones deserves to be mentioned. According to the existing definition, a spontaneous abortion, also known as a miscarriage, occurs in women involuntarily and is typically caused by a range of factors such as virulent infections, as well as basically any maternal factors that cause a rapid increase in body temperature. Additionally, hormones may cause a miscarriage; to be more exact, the deficiency of certain hormones, including progesterone, may trigger a spontaneous abortion (Potts, Diggory & Peel 1977, p. 47). Moreover, recent studies of the factors that affect pregnant women negatively at various stages of the fetus development have shown that a miscarriage may be caused by the factors such as parental age in general and the maternal age in particular, lifestyle (e.g., smoking, drinking, consumption of chemicals, drugs, lifting heavyweight, etc. (Roberts, Avatos & Sinkfold 2012)), among others are the key threats to the safety of the fetus and the mother even at the late stages of the first trimester (Maconochie, Doyle, Prior & Simmons 2007). As far as induced abortions are concerned, the reasons behind the surgery traditionally include financial and economic issues within a family (e.g., the inability of parents to provide for the child to be born), the fact that the biological parents of the child are not ready for creating a family due to their age or personal beliefs, the childbirth posing threat to the health of the mother and the fact that the pregnancy is a result of a rape (Drezett et al. 2012).
The debates concerning the phenomenon of abortion, its definition, and legal status, etc., have been taking place since recently in the designated region (Roudi-Fahimi 2015). As it has been stressed above, at present, abortions are prohibited in the Middle East, with two key exceptions (Tunis and Turkey).
Causes of Abortion
As has been mentioned above, the causes of abortion are quite numerous, seeing that the pregnant woman may experience pressure from both external and internal factors. Also, when determining the causes of abortion, one must clarify the difference between a miscarriage and an induced abortion to identify not only biological but also cultural and societal factors that affect a pregnant woman’s choice. As far as a miscarriage is concerned, traditionally, the factors listed below are identified.
As has been stressed above, most pregnant women are extremely vulnerable to the effects of infectious diseases. The latter, in their turn, case temperature to rise in the woman’s body, therefore, leading to the creation of an unnatural environment for the fetus. As a result, a miscarriage may ensue (‘Common causes of miscarriage’ 2015).
As it has been stressed above, a pregnant woman must maintain her body temperature at an average rate of 95 degrees Fahrenheit. Thus, exposure to heat, including overheated buildings, heaters, etc., may trigger a miscarriage (‘Common causes of miscarriage’ 2015).
Needless to mention, the exposure to the toxic environment or the environment with high rates of radiation contamination may also cause a miscarriage or make a pregnant woman go into a preterm labor (‘Common causes of miscarriage’ 2015).
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A severe lack of the hormone progesterone is likely to cause major problems for a pregnant woman, leading to a preterm delivery or a miscarriage (‘Common causes of miscarriage’ 2015).
A heart or kidney failure affects the health status of a pregnant woman severely, often triggering preterm labor or a miscarriage (‘Common causes of miscarriage’ 2015).
Needless to say, the structural problems, including abnormalities in the structure and/or functioning of a uterus, are also the key factors contributing to a miscarriage (‘Common causes of miscarriage’ 2015).
As far as induced abortions are concerned, the key reasons are traditionally split into health-related, economic and social ones. While not all of them are considered valid for making abortions legal in most Middle East states, these factors need closer attention for the further analysis and re-evaluation of the attitudes towards abortion in the specified geographic region.
As a rule, abortions are carried out in case the life of the pregnant woman is threatened and the outcomes of the delivery may be dire (Glacier et al. 2004).
As it has been stressed above, not all families may allow having children due to financial issues and the inability to provide for all family members (Glacier et al. 2004). Thus, making an abortion is the only reasonable alternative to facing poverty and starving.
There is no secret that childbirth is traditionally viewed as a phenomenon that should occur in matrimony; otherwise, the mother of a child is likely to be socially ostracised. Therefore, with no prospects for creating a family, a pregnant woman with no fiancé and living in the area, where prejudices against single mothers are very strong, is most likely to resort to an abortion (Glacier et al. 2004).
Apart from the specified scenario, the instance of a pregnancy being induced by rape is, unfortunately, a possibility (Glacier et al. 2004). In the above-mentioned scenario, an abortion can be considered a viable solution, especially if the victim is underage.
Therefore, the factors that affect an increase in the number of abortions made on an annual basis are very numerous and cannot possibly be ignored. The problems described above show in a very obvious manner that, no matter what the law on abortions within a specific state says, the number of pregnancy terminations is not going to drop.
Abortion and Modernisation
Seeing that abortion rates are not going to decline in the observable future, there is a solid reason to consider the idea of making abortion legal in the Middle East, following the example of Turkey and Tunis. In other words, the basic principles, according to which pregnant women are treated in the Middle East, need to be reconsidered so that women could be granted a basic right to choose what is best for their health and further life.
It should be noted, though, that the process of providing Middle East women with their rights is going to be rather complicated, as it is likely to face a strong resistance from the citizens of the state, as well as the government thereof. Although the 20th and the 21st century can be viewed as the eras of breakthroughs as far as granting people with their irrefutable rights and freedoms are concerned, certain conservative viewpoints still hold the progress back, slackening its pace and setting the state back in its evolution. The above-mentioned problem is especially characteristic for the present-day feminist movements and the attempts at providing women with their rights and freedoms. The above-mentioned characteristic of the area stands in a sharp contrast to the overall progress that has been made worldwide. As Kelly and Breslin (2010) explain, “Women’s social and cultural rights have remained relatively unchanged in recent years, and what progress was made, such as improvements to the health sector, affected both sexes equally” (Kelly & Breslin 2010, p. 273).
The problem concerning granting women with their indefeasible rights for making either a pro-life choice or a choice related to making an abortion becomes all the more significant as the lack of equality in other states, including European and American ones are revealed. Kelly and Breslin (2010) explain that the problem of providing women and men with equal rights persists despite the attempts of the corresponding organizations to affect the current situation positively. According to the authors, not only political but also sociocultural factors are to blame for the current deplorable state of affairs; specifically, the deleterious effect of media deserves to be mentioned: “The media continue to stereotype women, focusing primarily on their reproductive role or physical appearance” (Kelly & Breslin 2010, p. 273).
One must admit, though, that the alternative solution, which the Western culture suggests, is far from being perfect. For instance, the very concepts of contraception and abortion have become so common among people that they have been devoid of their ethical significance (Glasier et al. 2004). The moral implications of an abortion seem to have been toned down to a considerable degree, therefore, leading to a misconception of their meaning. As Browning explains, consultations provided by reputable and proficient healthcare specialists may help address the specified issue: “The use of contraception and abortion as an expression of technological intervention needs containment and moral guidance as well, and the Consultation aspires to do this” (Browning 2003, p. 239). Indeed, while the fear of allowing abortions on a state-wide level and making them legally acceptable as a key factor contributing to the wring idea of family and social values is quite legitimate, there are ways of addressing the specified danger, the creation of consultations being the most adequate one.
In order to understand the implications and consequences of abortion, women need to realize the significance of maternity and parenthood. The modernization of the existing consultation services, which shed light on the specified issue, will trigger a better understanding of not only sexual relationships but also the childbirth, the creation of a family and the resources that one needs to accomplish both tasks, including both financial and spiritual ones. As long as women give a full account of the consequences of their actions, they will be capable of making a sound choice when it comes to determining whether an abortion is going to solve the problem. More importantly, the creation of the above-mentioned facilities will help prevent unwanted pregnancies and, therefore, reduce the number of induce abortions among Middle East women. Seeing that the process of modernization and abortion legalization is going to be very long and hard (Correa 1994), the specified measure is also likely to bring the rates of unsafe abortions down and, thus, reducing the death toll among the Middle East women.
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