NOW & Zahra Hankir

Denial runs through Lebanon

26-year-old Nisrine* (not her real name) panicked when she found out that she was eight weeks pregnant. Aside from the fact that she was not ready to have a baby, she was unwed. Fearing the consequences she would face if her family learned of her pregnancy, she hurried to see a general practitioner, who referred her to a physician willing to administer an abortion.

Days later, Nisrine showed up at a private clinic, where the abortion was quietly and swiftly performed by a female gynecologist. Before the procedure, the doctor tried to convince Nisrine to marry her boyfriend and keep the baby. Distraught and in pain, both during and after the procedure, Nisrine was made to feel like a criminal. With no support groups to turn to, she began to see a therapist shortly thereafter.

Nisrine’s story is far from unique. She is just one of many women in Lebanon, from all socio-economic and religious backgrounds, who have had abortions. Because there are no official statistics, it is difficult to accurately estimate the prevalence of abortions in Lebanon. Anecdotal evidence and testimony from doctors, however, suggest that the practice is relatively widespread.

Legal status

The Lebanese Penal Code of 1943 defined abortion as illegal under all circumstances. However, a presidential decree passed in 1969 permits curative abortion in cases where it is the only way to save a pregnant woman’s life, in which case the procedure can be performed even over the objections of the woman’s husband or relatives (the woman, however, must give consent, unless she is unconscious). Still, by international standards, the grounds for permitting abortion under Lebanese law are very strict.

For example, Lebanon does not permit abortions even in the case of rape. According to a 2007 United Nations report on world abortion policies, this is in contrast to 84% of developed countries and 37% of developing countries, all of which have laws permitting abortion when pregnancy is caused by rape or incest.

By law, any person who performs an abortion is subject to one to three years imprisonment. Women who induce their own abortions or who allow for an abortion to be performed on them are considered to have committed a crime and can be sentenced to six months to three years imprisonment. If a gynecologist administers the abortion without consent, he or she faces at least five years of forced labor. (Interestingly, penalties are reduced for all parties when an abortion is performed as an act of honor.)

According to human rights activist Lina Osseiran Beydoun, the state of abortion laws in Lebanon is indicative of the broader fact that Lebanese law, in general, is not progressing. In particular, she said that this is true with respect to humanitarian law.

Doctors’ dilemma

Dr. Haddad*, a Beirut-based gynecologist who agreed to speak with NOW Lebanon on the condition of strict anonymity, said that unreported abortions, performed in secret, are not uncommon in Lebanon. Haddad said that he performs the procedure and also advocates the practice to those who are qualified, noting that his patients range from “young ladies” to “women who are married but do not want children.” In the latter case, he said, many women ask for abortions and do not inform their husbands. According to Haddad, “more gynecologists – rather than some – perform abortions or refer patients to those who do.”

Haddad described his own reasons for choosing to perform abortions as a modest attempt to prevent unqualified or untrained doctors and midwifes from taking advantage of, or “butchering,” women seeking to terminate a pregnancy.

Abortion, given its illegal status, is unmonitored by the state. And with no regulation, doctors are free to charge whatever they want for the procedure, often extorting their vulnerable patients.

Another significant problem stemming from abortion’s illegality, Haddad said, is that women have almost no protection against malpractice. With no professional oversight or safety regulations, many patients receive substandard care, raising the risk of maternal mortality. Most doctors do not keep any records of abortion procedures for fear that documentation could be used against them, making it nearly impossible to hold them accountable. Moreover, many women are reluctant to come forward with complaints because they fear that they will face criminal charges themselves. Haddad revealed that some doctors also “pay their patients off” to keep them quiet when complications occur during or after the operation.

Of course, many doctors do refuse to perform abortions, on legal and moral grounds. Another gynecologist who is based in the South, Dr. Youssef, said that while it is not uncommon for women to show up at his clinic asking for abortions, he refuses to administer the procedure. Like many others, Dr. Youssef’s choice is rooted in his religious convictions. “This is not to mention that it is strictly against the law. Abortion is a dangerous issue,” he said. “Anyone who dares approach it is playing with fire.”  

Promoting contraception use

As Dr. Haddad observed, the abortion issue is linked to broader questions about contraceptive use and general sexual education in Lebanon.“There is no answer to the question of whether or not actually conducting abortions is right, in the first place,” Haddad stated. “The only solution is to promote the use of contraception and to raise awareness.”

Unlike abortion, contraceptive use is not prohibited under Lebanese law. A wide range of contraceptive options is readily available to consumers. Moreover, awareness and use of contraceptives have increased significantly over the past few decades. But despite a measure of success, there is an urgent need to tackle the taboos still overshadowing contraception.

Though legal, Dr. Haddad said that the use of contraceptives is still “prohibited in the heads of the people. People like to assume that unwed women do not have sex and that married women always want to have children.” Though these social expectations may be increasingly unrealistic, Haddad said that they are a major factor in why “religious and political figures would never allow for the anti-abortion law to be repealed.” 

The importance of raising awareness about contraceptives was also stressed by Layal Assad, a social worker at the Lebanon Family Planning Association, a Beirut-based NGO. Tellingly, the organization does not directly address the issue of abortion in its programs, despite being the country’s leader in non-governmental family planning services.

“The society we live in does not accept it,” said Assad. Although she recognizes the importance of the issue of abortion, Assad nevertheless explained that, “as an organization, we can’t at all get into it.”

Out of the shadows

It is not unusual in Lebanon for civil society to fill a void left by the state. But in the case of abortion, it is not only the state that is absent. The legal status of abortion and the social taboos surrounding it have frightened off civil society actors as well. As a result, the difficult questions raised by the issue remain unresolved, and countless women seeking abortions, left with little support or protection and no regulation, continue to suffer from extortion and malpractice.

But it is not only the state and civil society that need to face facts. The conspicuous absence of any debate on abortion is evidence that the Lebanese population, too, is shutting its collective eyes. The abortion issue urgently needs to be brought out into the open, so a solution can be found that best balances the need to protect women with respect for the country’s traditions.

Unwanted pregnancies occur in Lebanon. That is simply reality. If the state and society want to keep abortion illegal without jeopardizing the well-being of Lebanese women, they need to give them other options. This means, for a start, abolishing all legal protections for the perpetrators of so-called “honor crimes,” developing a stronger support system and shelter network for unwed mothers, and promoting adoption as an alternative to abortion.

As Haddad and Assad stressed, the best solution is reducing the number of unwanted pregnancies in the first place. To this end, Lebanese society must work to break down lingering taboos around contraceptive use and sex education. But for this strategy to succeed, women and men – and particularly young people – will have to be provided with far greater access to family planning and sexual health services.

Living in denial will not make the problem of abortion go away; on the contrary, it will only exacerbate it. As much as it is the duty of the state to ensure that Lebanese women are protected, rather than victimized, by the law, it is also our own responsibility to bring the debate on this highly sensitive subject out of the shadows.

  • sam

    It is not a woman's body being aborted, it is her child's. Therefore the line "Its her body, therefore it's her choice" is INVALID! There is a reason people worry about the possible fatalities during abortion, because Everyone HAS A RIGHT TO LIFE! It is not only religious people who are against abortion. Look at the countries which support abortion. Infanticide becomes the next looked at thing. Why not just get a gun and shoot any child. Hopefully, most people wouldn't dream of this (religious or not). It is the same thing; killing an innocent human being.

    July 15, 2012

  • Moe

    "denial runs through lebanon" no it doesn't !!! just kidding :p abortion isn't a 1+1=2 kind of thing. you see, religion and morals are involved. it's bad enough having just one involved but when you have two it's a complete nightmare. to some people, abortion is solely the woman's choice (along with her beloved husba...lol i can't do this with a straight face, it's strictly a woman's choice, men are useless in life!...back to our topic) but to others(religious people) it's god's job to give a life or take it away (life). you can't possibly solve such a conundrum easily. on one side you have people that are with it because they don't believe in religion or believe that it's not only god's job. or even not believing that they are intervening with god's job(i didn't even try to rhyme that, i'm a natural). while the religious believe that they clearly are. so if you legalize abortion, rest assured you're walking on thin ice!

    January 27, 2008

  • Ex Aounsit

    These women educate your children during childhood as well.Things like that will show the world that the Islamic Arab world is serious about equality and tolerance and not after World domination. The Arab world needs to change it ways, ideology and principles or it is going to die from within!

    January 26, 2008

  • Ex Aounsit

    The Arabs world needs to promote some type democracy and implement some democratic means at some level. The Arab world needs to not base aspects of citizens life on one group's religious beliefs.I would like to see churches allowed in Saudi Arabia just like mosques are allowed in the Rome. Treat women as equal to men. Forget the dress code. How do you expect to advance if you restrict your wives, mothers, daughters and sisters from advancing equally? Females make up about 50% of the population if not more in the Arab world; so how can a nation advance when half of it is left behind?

    January 26, 2008

  • Ex Aounsit

    The whole Sunni Arab culture needs to be turned over on its head All of the Arab government should change the curriculum in the schools which praises and encourages Jihad to one which teaches tolerance and the acceptance and respect of other religions instead of teaching that Islam is the only faith accepted by God and that non followers of Islam are sinners and that it is the duty of Muslims to spread Islam. Promoting such supremest mentality is undermining any type of stability or forward progress in the Middle-East and must be abandoned if the Middle-East is to join the civilized world.

    January 26, 2008

  • sikg

    Awareness is the key. When it comes to preventing unwanted pregnancy, young men and women in Lebanon should be fully aware of the importance of contraceptive methods. Contraception doesn't need to be chemical, as physically blocking contraceptives (when used properly) can do the job just as well. Also, emergency contraception (i.e. "morning-after" pill) is widely available in pharmacies and does not require any prescription. The pill is particularly useful in the case of "accidents" and of rape since it decreases the chances of pregnancy by 95% when administered within 12-hours after the incident. Young women should be made aware of the early signs of pregnancy, since chemical abortion can be performed at the early stages (< 1 month) with less complications for the patient and doctor alike.

    January 24, 2008

  • Doctor's primary duty is toward the patient and not toward the church or a mythical figure that varies between different religions that some like to call God. IMPOSING POLICIES and threatening physicians by antiabortion activists claiming to answer to "higher divine laws" is not any different from what Shari'a, Alkaaidah or Hizbullah; all in the name of the loving God. Neither you (mthocott), nor the church or any other gang can impose false policies on people. A woman's body is her own body; you said it. Contraception and abortion are her basic right.

    January 23, 2008

  • MTHocott

    The solution is to teach teenage girls the Natural Family Planning method while they are still in high school. This teaches them to keep track of their fertility cycle long before it will become necessary to use it for (or against) conceiving. When a woman knows the signs of fertility and how her own body works, she will feel empowered, and will less likely accept to be a slave to chemical contraceptives that alter her hormones and bodily functions (and have many detrimental side effects). Look at the West and learn. Abortion scars a woman for life, not to mention, jeopardizes her soul. The doctors that think they are helping, are abusing their role as doctor and healer. They have crossed the line into playing God. If you care for her, offer her a loving choice or help her by teaching her and respecting her body.

    January 22, 2008

  • "Denial" is a good word to describe the entire Arab / Islamic culture, and the problem is not limited to abortion and women rights. The Arab world is in denial for rape, child abuse, prostitution, crime, sex education, and an entire host of moral / debatable issues. What is worst is that people believe that the above mentioned problems are rare or even do not exist in the Islamic / Arab world. If you think of it, one can not blame them since even the basic civil rights do not exist in most Arab / Islamic countries. The courts are also under supervision of a tyrant (Syria) or Shari'a (Saudi Arabia, Sudan, etc...).

    January 21, 2008