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Similarly, you have dominion over what is in the physical parameters of your body. This dominance is identified as your physical autonomy. In most cases, the right to physical autonomy is respected. Your right not to be physically assaulted is part of your right to physical autonomy. Actions that violate the right to govern your body are recognized in everyday life, especially when it comes to medical intervention. For example, the requirement of consent when taking medication or an invasive medical procedure is typical of the right to physical autonomy. Such an understanding of physical autonomy is exactly what determines a woman`s dominance over her body in the event of an abortion. Sri Lanka has been praised internationally for its achievements in maternal health.6 Maternal mortality has steadily declined since the 1950s, declining due to progressive social policies, including universal health coverage and education, and a well-developed health infrastructure.6 Between 2000 and 2010, the maternal mortality rate rose from 58 to 35 deaths per 100,000 live births.7 According to the latest The Demographic and Health Survey (2006-2007) included the war-torn Northern Province, about 98% of births were attended by skilled personnel and took place in hospitals this year.8 While these achievements are indeed commendable, in this context of a functioning and accessible health care system, the Ministry of Health is doing little to combat unsafe abortions. Although non-governmental organizations such as the Family Planning Association of Sri Lanka have supported legal reform33, there have been few public statements of support from civil society. With less than 10% of Sri Lanka`s population Catholic, the current reform campaign is facing enormous resistance from the Catholic Church.

The Catholic Bishops` Conference issued a statement earlier this year expressing its collective opposition to any kind of reform.34 The Archbishop of Colombo, Cardinal Malcolm Ranjith, even linked this decision to Western conspiracies.34 Groups of Catholic professionals, including doctors, have expressed anti-abortion sentiments in the media.35,36 More recently, declared the Catholic Episcopal Conference on March 11. November 2012, «The Sunday of the Unborn Child». 37 An official from the Ministry of Child Development and Women`s Affairs claimed that these attempts to obstruct legal reform had led to delays in the process.5 Although a number of Buddhist monks have expressed their individual views against the reform in media interviews,4,38 official statements opposing the change have not yet been made by other religious sources. Studies of women seeking abortions in Sri Lanka have consistently found that most women have had abortions, either because they have already completed their family or because they become pregnant too soon after the birth of their youngest child.13-16 One found that out of a sample of 356 women, a quarter had already had one or more abortions. and 10% had three or more.14 Taken together, these studies suggest that abortion is used as a method of family planning. It has also been recognized that abortion has contributed significantly to the decline in fertility in the country.13 There are no statistics at the national level on induced abortion.9 The only National Abortion Survey, a project sponsored by the United Nations Population Fund conducted in the late 1990s, revealed a high prevalence of induced abortions. On average, the abortion rate was 45 abortions per 1000 women of childbearing potential (95% confidence interval [CI] = 38, 52); Abortion rates were highest among married women in rural provinces. It is estimated that nearly 650 abortions took place daily this year.10 Nevertheless, India`s legal reform and India`s Supreme Court, unlike Sri Lanka, have recognized the state`s duty to guarantee reproductive rights. In the case of Suchita Shrivastava v.

Chandigarh, India`s Supreme Court issued a landmark ruling recognizing that «a woman`s right to make reproductive decisions» lies in her right to personal freedom. The court also noted that a «decisive consideration» should therefore be to respect «a woman`s right to privacy, dignity and physical integrity.» In March 2021, India amended the MTP Act of 1971 to expand access to safe and legal abortions. For example, section 3 of the MTP Act was amended to include the failure of contraceptives «used by a woman or her partner» as a ground for medical abortion within 20 weeks of pregnancy. In addition, the law extended the deadline to 24 weeks in some cases, such as rape, requiring two medical opinions. The high rate of unwanted pregnancies has been attributed to the paucity of contraceptive information provided by formal health education programs in schools and in the community.29 However, these analyses overlook the fact that contraceptives never eliminate the need for abortion services due to their relatively high failure rates with typical use, as well as the fact that they are unlikely to be used when sexual intercourse is applied. 32 Admittedly, these are legal frameworks which say nothing. on their implementation or effectiveness. For example, india and Nepal could be used as examples to oppose the reform, as abortion-related mortality in these contexts remains quite high despite legal reform. However, various factors, including the lack of resources to provide primary health care, have prevented the implementation of these laws in India.28 Similarly, the provision of accessible and affordable abortion services in remote areas of Nepal has remained a challenge due to a lack of health infrastructure and resources.41, 42 Given Sri Lanka`s success in providing them. Safe maternity services throughout the country It seems unwise to predict the effectiveness of reforms in Sri Lanka based on the experiences of India and Nepal. There is no government-approved legal or policy framework to provide abortion services to women under the law. In practice, the recommendation of two obstetricians and gynecologists is necessary for legal abortion to be performed in a public hospital.9 Abortion is a controversial issue at the local and international levels, with opposition from various groups and interest groups.

One could argue that legislative reform is not necessary because Sri Lanka has done well on maternal health with restrictive abortion laws in place. Or it could be argued that the provision of safe abortion services does not need to be prioritized at this time because abortion-related mortality is low. Others may fear that the expansion of abortion rights could lead to an increase in rates of «promiscuity» and indiscriminate use of abortion services. Perhaps for these reasons, Sri Lankan politicians and policymakers have been determined to limit pressure for reform to legalize abortion in circumstances where women are perceived as «beyond reproach.» While such an approach is more likely to find support, it does not recognize that most women resort to abortion for other reasons. In addition to recognizing that unsafe abortion is a problem, the Department of Health offers little substantial advice on how to combat unsafe abortions.