Indonesia
ABORTION POLICY
Grounds on which abortion is permitted: To save the life of the woman To preserve physical health To preserve mental health Rape or incest Foetal impairment Economic or social reasons Available on request Additional requirements: The medical procedure must be performed by a health worker possessing the necessary skills and authority, under the guidance of an expert team. Consent of the pregnant woman, her husband or her family for the procedure is necessary and it must be performed in an approved health-care facility. Yes No No No No No No
REPRODUCTIVE HEALTH CONTEXT
Government view on fertility level: Government intervention concerning fertility level: Government policy on contraceptive use: Percentage of currently married women using modern contraception (aged 15-49, 1997): Total fertility rate (1995-2000): Age-specific fertility rate (per 1,000 women aged 15-19, 1995-2000): Government has expressed particular concern about: Morbidity and mortality resulting from induced abortion Complications of childbearing and childbirth Maternal mortality ratio (per 100,000 live births, 1990): National South-eastern Asia Female life expectancy at birth (1995-2000): Too high To lower Direct support provided
55 2.6 58
No Yes
650 440 67.0
Source: The Population Policy Data Bank maintained by the Population Division of the Department for Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references.
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Indonesia
BACKGROUND
Modelled on the turn-of-the-century Dutch Criminal Code, the Indonesian Criminal Code, enacted in 1918 by the Dutch colonial Government, adopts a restrictive view of abortion. Under section 348 of the Code, any person performing an abortion is subject to imprisonment for five and one-half years. Under section 346 of the Code, a woman wilfully inducing her own miscarriage is subject to imprisonment for up to four years. In addition, physicians, midwives, and pharmacists are subject to harsher penalties, including the revocation of their licence to practise their profession. Although the Code contains no exceptions to its general prohibition on the performance of abortions, in the 1970’s an “understanding” was reached by medical professionals, on the advice of the Chief Justice of the High Court, that abortions could be performed to preserve a woman’s life or health. However, actual reform of the abortion law did not take place until 1992 when the Government enacted Health Law 23/1992 containing abortion provisions. Since the early 1970s, there had been continuous attempts in Indonesia to reform the abortion law. These efforts were spearheaded by members of the legal and medical professions, as well as by women’s organizations that sought to reduce morbidity and mortality associated with clandestine abortions. As a result of these efforts, in 1977 the Government established an interdepartmental committee with members drawn from the Departments of Health, Religion and Justice, the Police Service, the Attorney General’s Office, academic institutions and related associations of health professionals, with the mandate of drafting a bill of law concerning abortion. The committee’s draft bill of 1989 on Pregnancy Termination for Health Considerations was passed into law in September 1992 by a narrow margin. The new Health Law specifies that “in the case of emergency and with the purpose of saving the life of a pregnant woman or her foetus, it is permissible to carry out certain medical procedures”. The abortion must be based on the guidance of a team of experts, must have the consent of the pregnant woman or of her husband or family, and must be performed by health workers with the expertise in a “certain structure.” An explanatory note to the Law specifies that the health worker must be an obstetrician/gynaecologist, that the expert team is to be multidisciplinary, and that the husband or family is to give consent only when the woman is unconscious or otherwise unable to give consent. What impact the new law will have is not clear, given the informal understanding reached by medical professionals in the 1970s as to the permissibility of abortions performed to preserve the life or health of a woman. Although it has been reported that the intent of the new law was to codify that understanding, the performance of abortions on health grounds may be inhibited, because abortions are permitted under the law only if the woman’s life is threatened. Although the laws in Indonesia with regard to induced abortion are relatively restrictive, they are not strictly enforced. A considerable number of Indonesian women are believed to seek termination of unwanted pregnancies. Owing to the restrictive nature of the laws on induced abortion, most women wanting to terminate a pregnancy usually go to a traditional practitioner (dukun), despite the associated risk of infection arising from unsanitary conditions and practices and the possibility of serious complications arising from an incomplete abortion. Because it is a criminal offence to perform an induced abortion and because officially acknowledged cases of abortion are usually classified as spontaneous abortions, it is difficult to determine accurately the incidence of abortion in Indonesia. It has been estimated that as many as one in every five pregnancies may end in abortion. From hospital and clinic records, it is apparent that the incidence of abortion has not
Source: The Population Policy Data Bank maintained by the Population Division of the Department for Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references.
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Indonesia
decreased despite the country’s laws. Most abortions are performed during the first 12 weeks of pregnancy. Complications from induced abortion continue to be a major cause of death among women of reproductive age and contribute to the high maternal mortality in Indonesia. The family planning movement was begun by the Indonesia Planned Parenthood Association, which was established in 1957. In 1967, the Government became a signatory to the Declaration on Population, a high-level statement endorsed by a number of heads of state in Asia, which states that family planning is a basic human right. Since 1969, family planning has been a national programme that has been included as part of the Government’s five-year national development plans (REPELITA). A contraceptive prevalence survey conducted in 1997 found that 55 per cent of currently married women in Indonesia were using contraceptives. The current (1995-2000) total fertility rate is estimated at 2.6 children per woman. The Government seeks to reach replacement level fertility by 2005-2010. It noted that this would involve reaching 70 per cent of eligible couples by 2005. Increasingly, women in Indonesia with more than three children have been opting for long-term contraceptives, such as the intrauterine device (IUD), Norplant® or sterilization. However, voluntary sterilization is not encouraged. Although induced abortion is not permitted, except to save the life of the woman, menstrual regulation, which was begun at the Teaching Hospital of the University of Indonesia in 1973, is available. Qualified physicians are permitted to offer menstrual regulation services.
Source: The Population Policy Data Bank maintained by the Population Division of the Department for Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references.
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