BEIRUT -- Unmarried and pregnant, Ranya gathered up her courage and confided to a friend that she was considering a drastic step: an illegal abortion.
She braced for criticism. But to her surprise, her friend disclosed that she had had one too.
Ranya asked another friend, who also said she'd had an abortion. And another gave her the phone number of a doctor in Beirut who would perform the procedure on the sly. The doctor used no anesthetic. The pain lingered for days, but the guilt engulfed her weeks later.
"It doesn't make me feel guilty because of Islam," said Ranya, 29, a short, brown-haired artist, struggling with her words. "It's a very complicated guilt to explain. I tend to philosophize things. I feel guilty in a weird way. It crosses my mind all the time."
Despite legal and religious restrictions against abortion in much of the Arab world, changing social values and economic realities as well as demographic shifts have contributed to an apparent increase in the number of the procedures in the Middle East.
"There's definitely an increase compared to 10 to 15 years ago," said Mohammed Graigaa, executive director of the Moroccan Assn. for Family Planning. "Abortion is much less of a taboo. It's much more visible. Doctors talk about it. Women talk about it. The moral values of people have changed."
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"I think abortions are going up for just for one reason: Sex is becoming more permissive," said Wissam Ghandour, a Lebanese obstetrician and scholar. "I assure you that the majority of girls getting married now are non-virgins and sexually active."
In addition, Arab youths receive little in the way of birth control or sex education, say family planning experts in the Middle East, many of whom work discreetly to provide reproductive health services in conservative Muslim societies that hold women's maternal roles as sacrosanct.
"If access to contraceptives was widely and freely available, abortion wouldn't be necessary," said an official at a Western family planning organization in Yemen. She spoke on condition of anonymity for fear her organization would be targeted. Abortion, she said, is "a last resort."
According to most interpretations, Islam strictly forbids abortion after the fetus has reached 4 months, and allows it before then only in cases of violent rape or when birth poses an extreme threat to the physical or psychological health of the mother.
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According to a poll released this month by WorldPublicOpinion.org, 53% of Egyptians, 57% of Palestinians and 55% of Iranians oppose their governments' policies of making abortion a crime.
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Moroccan family planning experts estimate that 600 abortions a day are performed in the North African country, most involving unmarried women. Only a small percentage are victims of rape or sexual abuse, they say.
Despite the lack of frank public discussion of volatile issues such as abortion in the Arab world, there are signs that some taboos are slowly crumbling. Women are talking about abortions.
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But botched procedures are still widespread.
In the spring of 2007, Iraqi obstetrician Donya Taher was on call, roaming her Baghdad hospital, when she was called to the emergency room.
The patient was bleeding heavily, and her blood was turning pinkish. They loaded her up with 10 pints of blood, six pints of plasma and a heavy dose of antibiotics.
"She was dying," Taher recalled. The woman and her husband, both in their early 20s, said she had had a back-alley abortion. They already had two children and couldn't afford a third.
As soon as the woman recovered, the couple slipped away.
"We wanted to know who did this to her," Taher said. "But she wouldn't tell us. Whoever it was should be punished."
Taher was enraged but not surprised. She said that only a few doctors perform relatively safe abortions in Baghdad, a capital city of at least 5 million people. Although she has not detected any noticeable increase in the number of botched abortions, there is a steady stream of injured in the emergency room, she said.
"They use the feces of animals. There are many unscientific methods, herbal medicine," she said. "Sometimes it will cause septic shock."
Source: LA Times