According to the International Women’s Health Coalition (IWHCO), globally, millions of pregnant women have safely ended their pregnancies using Misoprostol. This seems to be the clear case in Sri Lanka as many searches for misoprostol prices in Sri Lanka take place. The sad part of this is although available in numbers, Misoprostol is not legally available in Sri Lanka, as such there is no maximum retail price on this product.  Further, Misoprostol is not included in the Essential Medicine List of Sri Lanka.

Abortion is not legal in Sri Lanka

Often sold secretly in pharmacies in Sri Lanka, Misoprostol is inexpensive, easy to store and handle, and is a safe method for people seeking to end their pregnancy. It is best advised to take Misoprostol with the doctor’s advice. Misoprostol’s multidimensional use in medicine makes it more accessible when compared to other abortion pills. As mentioned on the IWHC website, Misoprostol is 85% successful in inducing abortion in the first trimester, when used as recommended.

Why use Misoprostol?

Misoprostol is essentially used for labour induction, management of miscarriage and post-partum haemorrhage. Also, it is used for induced abortion and the treatment of post-abortion complications. In common parlance, it is known as the abortion pill in Sri Lanka.

Abortion in the Sri Lankan context

Sri Lanka is mainly dominated by a Buddhist community and the religion has deep-rooted stems even in the functioning of civil society. Let’s face it, abortion is a taboo and complicated topic in Sri Lanka. Although abortions take place in Sri Lanka in great numbers, it is meant to be a social secret. So hush hush! Always under the carpet. In reality, abortions have been done in Sri Lanka for decades and nothing new. But giving it a form of legality has not taken place due to religious ramifications.

In 2017 public debate raged over proposals that were made to amend the law on abortion in Sri Lanka. The sensitivities of the Roman Catholic Church’s opposition to the reforms remain at the forefront. Even the Catholic Church of Sri Lanka is anti-abortion.  The Sri Lankan cardinal has urged Catholics to recognize that abortion is the ‘murder of the innocent’.

The Sri Lanka Journal of Medicine estimates that nearly 700 abortions take place in the country daily. While The Ministry of Health stated in 2016 that 658 abortions are performed in Sri Lanka daily. According to reports, abortion is the second or third cause of maternal mortality, with the majority being undertaken by married women”

Political backlash due to legalising abortion

For example, the cosmopolitan liberals would support the registration of Misoprostol, as an abortion drug while the opposition comes from various groups who see abortion as morally wrong. Disagreements exist, as many groups appear to be divided on the need for abortion law reform. From the side of governments, this is a touchy subject. Just imagine if the government makes it legal to conduct abortions in Sri Lanka. There will be a political backlash from religious groups. This could mean losing votes big time!

Views are polarized when it comes to abortion in Sri Lanka

Abortion and prostitution

Prostitution is said to be the world’s oldest profession. Of course, this is the same case in Sri Lanka. Likewise, giving it legal status would result in regulation of women who are involved in the profession. Similarly, this will involve training on better health and safety protocols and so on. Identically, legalising abortion in Sri Lanka is the same fate that befell legalising prostitution. As a matter of fact, we all know we are in a modern era, where informed choices could be made. Further, giving prostitution legal status would imply “just go and have sex as you like”. At least this is what religious leaders would think.

In reality, religious factions will never allow legalising prostitution in Sri Lanka. As you would have seen, religions, especially Buddhist and Catholic religious leaders play an important part in the politics of Sri Lanka. In reality, they have been in the past and will be in future.

Abortion laws in Sri Lanka are among the strictest in the world, only allowing termination of pregnancy in the circumstance that the mother’s life is in danger as per Section 303 of the Penal Code of 1883.

Legal implications of abortion in Sri Lanka

The Sri Lanka Journal of Medicine estimates that nearly 700 abortions take place in the country daily. Correspondingly, The Ministry of Health stated in 2016 that 658 abortions are performed in Sri Lanka daily. According to reports, abortion is the second or third cause of maternal mortality, with the majority being undertaken by married women.

Laws pertaining to abortion in Sri Lanka remain restrictive. Uniquely, abortion is illegal in Sri Lanka unless the life of the mother is at risk. Equally, causing an abortion is a criminal act under the Sri Lankan Penal Code. Additionally, it is punishable with imprisonment ranging from three to ten years, with or without a fine. Within the provision, the Penal Code contains no procedural requirements for the legal termination of pregnancy, except that the pregnant woman’s consent is necessary. There are no provisions specifying the qualifications of those authorized to perform abortions. Further, there are no provisions for the type of facilities in which the procedures are to be performed.

Unwanted pregnancies are on the rise in Sri Lanka

Abortion care in Sri Lanka

In 2015, the Sri Lankan Ministry of Health issued the National Guidelines on post-abortion care. What are these guidelines?

  • The guidelines stipulate that any woman who undergoes an illegal abortion can seek medical care for complications, if needed, at any government facility without fearing prosecution.
  • The providers at the health facilities are not permitted to withhold post-abortion care services citing personal, moral and/or religious beliefs.
  • Post-abortion care is provided primarily in specialist gynaecology units. The guidelines, however, recognize the need to have emergency post-abortion care services even at the most basic rural health posts.
  • The staff at primary care health facilities (viz. medical officers) are expected to be able to diagnose the complication following an abortion and initiate treatment before referring to a higher facility.
  • Further, the guidelines recognize various methods for management of incomplete abortions, including manual vacuum aspiration, dilatation and evacuation, or drugs such as misoprostol.
Thankfully, there is abortion care in Sri Lanka

Unknown to many, Misoprostol came in for registration in Sri Lanka in 2010, with the health authorities. Sadly the buck stopped there. However, since then, Misoprostol, a WHO essential medicine continues to be available through the back door.

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