Gaining Better Access to Abortion in Indonesia

At the same time that the United States is embroiled in a political battle about whether abortion would be covered by health insurance under the Stupak Amendment, a little-known victory on abortion rights has been under-way in Indonesia that has the potential to change the lives of millions of women and girls.

At IWHC, we were very lucky to have Professor Terry Hull visit us last Tuesday to discuss these exciting developments, and to contextualize the long-fought battle for women’s right to safe abortion in this region. Professor Hull teaches Demography at the Australian National University and is a long-time friend and ally of IWHC and our colleagues, YKP. He has been working as a key strategist in the efforts to promote reproductive health rights in Indonesia and according to insiders, is an honorary Indonesian (check out his recent book, People, Population and Policy in Indonesia).

As Professor Hull explained, abortion rights in Indonesia are difficult to access. Most of the estimated 1- 2 million abortions performed yearly in Indonesia are unsafe. Although statistics indicate a higher ratio of abortion to live births in Indonesia than what is reflected in much of the world, there are still too few institutions in place to ensure proper access to safe access. As a result, abortions are often performed by midwives under dangerous conditions.

One major cause for these unsafe conditions was the vague and confusing legal landscape regarding abortion that existed prior to this year. As summarized by Hull, “Legally, socially, morally, this was a mess.” According to the Criminal code, abortion was technically allowed, but only under certain restrictive circumstances. The word “abortion” was not used, but instead replaced by the highly ambiguous and problematic phrase “certain medical procedures needed to save the life of a mother or child”. The procedure was disproportionately mentioned in medical malpractice laws, acting as a deterrent to doctors from even attempting to carry out the procedure.

Apart from its ambiguous nature, the laws surrounding abortion in Indonesia have had other problems: they’ve not been implemented equally, according to Hull. Those with financial resources were often able to find high-quality abortion services within the private sector, while the poor were forced to resort to other methods, consuming weeds and chemicals. In some cases, women had been known to ingest substances with the goal of starting the onset of bleeding, while knowing that they will not be able to complete the abortion at home. They could then be admitted to a hospital and given abortion services, since their life was deemed to be in danger. Thus, in Indonesia, expanding legal access (as we see very much in the debate over Stupak in the United States) was fundamentally an issue of equality and social justice.

Hull went on to explain the activist efforts towards improving this reality for women. Since 2001, a small but determined group of non-governmental organizations, doctors, and government officials have fought to expand women’s rights to safe abortion in Indonesia. This group has been spear-headed by our dear colleagues, YKP, the Indonesian Women’s Health Foundation. YKP was formed after a well-respected and loved feminist doctor was arrested for performing abortions. This event galvanized a core group of activists to come together to lobby for a new Health Law to clarify existing legal confusions regarding abortion, which passed in September of this year.

The new law has not clarified all legal ambiguity as YKP was hoping, but it has expanded rights significantly. Although the new law has not yet been posted publically by the Ministry of Health, insiders believe its stipulations on abortion are that it is illegal except in three contexts:

      a. If a woman’s life “Nyawa” is threatened. Nyawa denotes life, but also spirit or soul, leaving it open for interpretation, which YKP believes could be advantageous in ensuring access to safe abortion


      b. In case of rape (not incest, which considered “ a family matter” and not a legal concern)


      c. Up to 6 weeks from start of last menstrual period


    The law also requires the male partner to be involved in the decision, as he has rights to the unborn child.

In a country that recently passed legislation on stoning women for adultery and where a woman can be imprisoned for up to 12 years for “suggestive behavior” under a tough 2008 anti-pornography law, this law is good news.

So, while this law is far from perfect, our fierce allies are cautiously optimistic. They are poised to use this law to expand women’s rights, namely in creating a national implementation plan, training medical providers and informing women and community groups about their rights. As the lives of women continue to be taken by unsafe abortions, YKP does not believe they have time to waste.

Hull stated, “We have all these things wrapped up in abortion, but at the end of the day there is no leadership in repro health, and there are no champions inside the governments. So essentially the only voice there is the one IWHC is supporting, the YKP. If it weren’t for them there would be nothing. They are the only ones out there trying to get this thing fixed.”

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