Abortion In Indonesia

According to the World Health Organization, unsafe abortion can be defined as a “procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both”.

Republic of Indonesia is a democratic country that often called as the country of thousands islands which in located in Southeast Asia, In Indonesia, there are five official religions recognized by the country, which are Islam, Protestantism, Catholic, Hinduism and Buddhism. However, Indonesia is the largest Muslim country in the world with approximately 204 millions people that avow to be Muslims, which account about 88.1% of the total population in 2010 . Although practice of Abortion is illegal in Indonesia, it has the highest rate of abortion in the Muslim world As quoted in Jakarta Post, “National Population and Family Planning Agency (BKKBN) data reveals that the number of abortions in the country has increased by 15 percent annually. The agency estimates there were 2.4 million abortions in Indonesia in 2012, about 800,000 of those women were teenagers.”

Picture Books Illustrations of Isabelle Arsenault

Women in Indonesia

Indonesia can be described as a male-dominated society, in which it places a man’s desire first and women’s secondary to men . In Indonesia, sexism is considered to be acceptable and normal; the term sexism can be defined as “any type of discrimination, prejudice or negative attitude based on a person’s sex or gender” . As mentioned by Hooks, sexism conditions us to accept discriminations, violence, objectifications, and inequality as inevitable, normal and even desirable. Although most women in most of Indonesia’s big cities have access to education and are able to hold a high positions in big corporations, they are still expected to be “less” then man, especially their spouse. Most of girls in Indonesia are being encouraged to have ambitions and goals, with one exceptions; they are expected to put marriage above all else; this means that women are expected to be thin, act, talk and dressed a certain way in order to attract men and they are expected to plan their career and education with putting marriage first. In Indonesia, both women and men are expected to be heterosexual; Indonesia does not acknowledge the existence of the LGBT community. In addition, sex education is still seen to be taboo to talk about in public that is eventually creates confusion and burning questions among teenagers. It is common to hear that women does not need to pursue their education as some of the society believes that smarter women will scare off men.

In her essay, Fyre describes oppression with the illustration of a bird in a cage; this illustration perfectly describes most women in Indonesia. Oppression can be defined as limiting individuals’ potential to be fully human . Fyre describes how, when individuals are being oppressed, they are like a bird with myopic vision in a cage – they are not aware that they are being oppressed until they came out of the cage. This illustration shows how most Indonesian women think that it is their destiny to be their husband’s servants.

From how women are expected to keep their virginity until marriage and how young women are not able to express their sexuality encourages teenagers to do sexual encounters secretly, which resulted in the high number of teen pregnancy, which eventually lead to unsafe abortion.

Indonesian Laws regarding to abortion

The Medical Ethics Code of Indonesia (KODEKI) and Indonesian Criminal Code (KUHP) prohibit an abortion

Law Number 39, year 2009 on Health:

Article 75

1. People are prohibited to carry out abortion.
2. Prohibition as intended in paragraph (1) may be exceptional based on:
   1. indication of medical emergency detected as of the early age of pregnancy, either those threatening the life of the mother and/or fetus, those suffering from serious genetical disease and/or inviable deformity, or those unfixable so that troubling the infant to live outside the womb; or
   2. pregnancy due to rape that may cause psychological trauma to the victim
3. Measures as intended in paragraph (2) may only be carried out following counseling prior to measures and ended with counseling post measures by competent and authorized counselor.
4. Further provision concerning indication of medical emergency and rape, as intended in paragraph (2) and paragraph (3) provided for in a Government Regulation.

Article 76

Abortion as intended in Article 75 may only be carried out:

• before the pregnancy reaches 6 (six) weeks from the first day of the last period, except in medical emergency situation;
• by health personnel who have expertise and authority and have certificate stipulated by the minister;
• with the consent of the pregnant mother concerned;
• with the consent of the husband, except rape victim; and
• in health service provider which satisfies the requirements stipulated by the Minister.

Article 77

The Government shall be obliged to protect and prevent woman from abortion practice as intended in Article 75 paragraph (2) and paragraph (3) which is of non quality, unsafe, and irresponsible and against religious norms and the provisions of statutory regulations.

According to the laws stated above, it can be seen that abortion is only allowed under the circumstances of serious illness or raped. These exceptions to do abortion then create a new dilemma; couples that get pregnant outside marriage may claim that the women got raped in order to do abortion. Sex education and abortion awareness is considerably poor in Indonesian schools as they some of the education system consider it as being taboo to talk about such issues.

Abortion from the perspectives of various religions

As mentioned above, Indonesia acknowledges five religions: Islam, Protestantism, Catholic, Hinduism and Buddhism. Religions have a significant influence in shaping public opinion towards the issue of abortion. As quoted in the Guttmacher Institute report, “the majority of religious leaders (82%) agreed that abortion is acceptable is a women’s life is in danger” . In Islam, abortion is only allowed if the pregnancy is threatening the mother's well-being and it can only be done before the embryo turns into a fetus. In Christianity, abortion of any kind is seen to be a sin as according to the Bible, the moment that the sperm fertilize the egg, life has begun, therefore abortion is considered as murder. Moreover, in Hinduism, abortion is not being recognized and it is strictly not allowed. Buddhism also prohibited abortion and it sees the practice of abortion as an act of murder.

Methods of Abortion in Indonesia

There are six major abortion methods that are commonly used in Indonesia which are:

Massage

Massage or pijat is the traditional method of abortion, which involves the “kneading” and “punching the woman’s abdomen . The Dukun Bayi, someone who assists women while giving birth using traditional procedures, will do the massage. Since these Dukun Bayi are not professionally trained, there are a high risk of uncontrollable bleeding during the process. Since the process of massage abortion can be done anywhere, it has become very easy for women use this method of abortion.

Jamu (Indonesian traditional herbal drink)

Jamu is a traditional Indonesian herbal drink that has numerous flavors for various usages. There are Jamu for stamina, for fat loss and to cure common cold to name a view. Jamu is originated from the island of Java, which explains why it is very famous and easy to find in Java. In terms abortion, Jamu telat bulan (also called Jamu Peluntur) is believed to be the most effective one; this herbal drinks are made from leaves and roots boiled in water. This traditional drink is meant to regulate menstruation, especially when they are late. This means anyone able drink Jamu even before they are pregnant to avoid pregnancy. Jamu are very accessible and relatively cheap for women to get; jamu are easily found in small shops on the street. “Another form of jamu are leaves, sticks, or other preparations that are interested into the vagina and cervix to induce contractions” .

Dilatation and curettage (D&C)

This method of abortion is the one being taught at the national medical school “as a means of treating incomplete abortions and has probably been used secretly for as long to induce abortion” . Most of Indonesian midwives learn about this method through being the assistant to the doctors and then practicing it illegally, which is very risky for the patients.

Menstrual regulations

Menstrual regulations or MR is “the most widely used medical method of pregnancy termination in Indonesia” . The technique of MR involves using a manual vacuum and only trained practitioner should perform the procedure. It is known as the “quick and easy” method of abortion.

Saline Injections

The method of saline injections when the pregnancy is into the second-trimester and this method have to be done several times. In most cases, saline injections alone is not sufficient to complete an abortion, therefore the method of dilatation and curettage (D&C); this combined procedures has the potential to cause uterine damage and perforation

Prostaglandins

Prostaglandin is a type of drugs that can be used for abortion, which is considered as an easy method for abortion in the second-trimester. However, “the Department of Health refused to approve the drugs for this purpose, for fear that suppositories would distributed and used without medical supervision”

Consequences of Induced Abortion

There are numerous consequences of induced abortion, which can be categorized into two main categories: Medical consequences and Psychological consequences

Medical Consequences

There are numerous health risks that can occur during and after the abortion procedure, which includes: sudden death due to excessive bleeding and/or anesthetic failure, cancer such as ovarian, breast, cervical cancer, pelvic inflammatory disease and many more .

Women who are doing the abortion procedure in illegal abortion clinic in Indonesia are in much higher risks of suffering those diseases because of the untrained doctors or medical assistants that helps them during the abortion process, the uncontrolled standard of hygiene and medical procedure, as well as the medication or tools that are used during the process. It is important to acknowledge that most of Indonesian Illegal abortion clinic are located in rural areas and most of them are located in back alley, in a regular houses . This also implies that those abortion clinics have very limited resources in case other medical procedures are required during an emergency situation.

Psychological consequences

As mentioned above, most society in Indonesia is still very conservative and the teachings of their religions are used to conduct their judgments. As a young woman who is unmarried, it is considered as a “sin” and unacceptable to be pregnant before marriage. These judgments from society are also one of the main reasons why young woman chooses to do abortion instead of keeping the baby.

The procedure of abortion can create trauma towards the woman for various reasons. Mother creates special bonds with the child inside them, however, abortion creates double pressure for the mother as they have to lost their baby by “killing” it themselves. The pain from the medical procedure can also create a trauma for the mother. In an interview of BBC, a 19-year old Indonesian girl who have gone through abortion mentioned that she was traumatized by the pain and the splattering blood that she witness during the process. She mentioned, “they inserted a tube inside me, it was painful, when they said I am ready, they pull the tube out so forcefully there were blood splattered everywhere” .

Summary

In a society where any sexual activities before marriage is considered as a sin, young women who got pregnant outside marriage does not really have a choice to keep their baby, especially if they are still in school. The movie Juno by directed by Jason Reitman and written by Diablo Cody shows how a pregnant young woman are able to choose between keeping the baby or not, and is still able to continue with her education although she is pregnant. In the movie, the parents also presented to be very supportive of her pregnancy and are there to assist her with her need. However, this is the complete opposite of how a pregnancy outside of a marriage will be handled. Although not all, but most Indonesian families will not support the idea of keeping the baby, especially considering what their friends and families will think of them. The whole idea of induced abortion is unfair for the women, especially with the consequences that come with illegal abortion. Although the law of Indonesia prohibits the practice of abortion due to sex outside of marriage, the government may think of chancing the rules in order to ensure the safety of the abortion procedure. Although the practice of abortion cannot be fully eliminated, if the law allows abortion for pregnancy outside marriage, this can ensure that the procedure is safe for the woman. It is also important to educate the society from a young age about sex education and the danger of abortion since it is still seen as a taboo topic.