When she got pregnant at 16, Fatou Esther Jusu was terrified that it would derail her future.
Abortion is illegal in Sierra Leone. Fearing judgment from her family, she took friends’ advice and bought misoprostol, a drug whose uses include abortion, from a local pharmacy. It didn’t work. Desperate, she tried again and miscarried. “I went to the toilet… and the baby came out,” she said. She fainted and was taken to a hospital, where she pleaded with doctors not to tell her parents.
Fatou Esther Jusu
Now 21, Jusu considers herself lucky. One friend died after taking an expired version of the medication. With those experiences in mind, the nursing student is mobilizing others in support of a bill that would decriminalize abortion in the West African country. “Even though I made a mistake, this mistake is saving other people,” Jusu said.
In Sierra Leone, abortion is illegal in all circumstances, and unsafe abortions account for at least 10% of maternal deaths. Health workers say the numbers are much higher. Decriminalising abortion would significantly improve the safety of pregnant women, decrease the number of preventable deaths and bring an end to the current colonial-era law.
Over 20% of girls aged between 15 and 19 in Sierra Leone get pregnant, according to the U.N. Population Fund, one of the highest teenage pregnancy rates in the world. Tens of thousands of women and girls (attempt to) self-terminate their pregnancies every year. Supporters of the bill say unsafe abortions account for around 10% of maternal deaths. Healthcare workers are known to perform terminating procedures when the situation is “incompatible with life” of the woman, usually in the case of “incomplete” abortions. Because abortion is illegal, they cite other reasons for the termination.
Meanwhile, MSI Reproductive Choices offers post-abortion care, including terminations in cases of incomplete miscarriage, often when people have tried and failed abortions themselves. They are the largest individual service provider of family planning services in the country.
Sierra Leone’s President Julius Maada Bio introduced the Safe Motherhood Bill in 2022 in response to the US overturning Roe v. Wade. “At a time when sexual and reproductive health rights for women are either being overturned or threatened, we are proud that Sierra Leone can once again lead with progressive reforms,” he said.
If approved, the bill would have been West Africa’s most progressive legislation on abortion, allowing abortion up to 14 weeks. But Sierra Leone since then has been torn apart by debate. Following opposition from religious leaders, the bill has been amended and now limits abortion to cases of life-threatening risk, fatal fetal abnormalities, rape or incest.
The government says it expects a vote in parliament in the coming weeks. It is not clear whether even that will be approved. Officials also say the bill is needed to strengthen gender reforms in Sierra Leone, which include last year’s ban on child marriage. The bill also would allow wider access to family planning and reproductive health services. Activists fear those will all be lost if the bill fails.
SOURCE: AP News, by Caitlin Kelly, 25 March 2025. PHOTO: Caitlin Kelly, AP Photo, 3 March 2025.