Of the 150,000 unwanted pregnancies in Sierra Leone each year, 90,000 end in illegal abortions. And eight out of every 10 abortions end in complications or death. The people performing these abortions are often untrained, ill-equipped, and unregulated.

Sierra Leone’s Ministry of Health is on a mission to reduce unwanted pregnancies and unsafe abortions. Their solution is a new “Safe Motherhood” bill that promises comprehensive healthcare for adolescent girls and women. 

At the reading of the “Safe Motherhood” bill in parliament on December 17, 2024, Deputy Minister of Health, Dr. Jalikatu Mustapha, said the reported cases hide the full scale of the problem. 

“Countless other abortions go unreported.”

While the bill’s focus has been on early terminations, the reforms promised in the bill would drastically improve reproductive health care service delivery. The bill would protect and enshrine existing policies, including free healthcare to pregnant and lactating mothers and children under five; provide reproductive health education; and provide cervical cancer screening and treatment for STIs, among others.

Sierra Leone has made great strides in maternal health care in recent times. Thanks to changes in policy at the Ministry of Health. Maternal mortality decreased from 717 to 413 deaths per 100,000 live births between 2019 and 2023. Infant mortality also decreased by 12% between 2022 and 2023. Dr. Mustapha said these improvements are encouraging, but why stop there? 

“We are striving for zero preventable maternal deaths,” she said on a virtual panel discussion hosted by Vickie Remoe on Facebook. 

What’s in the Safe Motherhood and Reproductive Health Care Bill?

At the 10th African Conference on Sexual Health and Rights held in Freetown in 2022, President Julius Maada Bio said he and his cabinet would “unanimously” support this bill. 

“This bill will include a range of critical provisions to ensure the health and dignity of all girls and women of reproductive age in this country,” he said.

The Safe Motherhood and Reproductive Health Care Act 2024 provides for the formulation and implementation of “a comprehensive national strategy and plan of action to promote the realisation of the right to safe motherhood and reproductive healthcare services throughout Sierra Leone.”

Besides safe termination of pregnancy up to 14 weeks, the bill also provides for preconception care, support through pregnancy, adolescent-friendly health services and treatment of HIV and other Sexually Transmitted Infections (STIs).

It also provides for the prevention, detection and management of reproductive cancers and sexual and gender-based violence. This, Dr. Mustapha said, makes the bill complementary to other laws such as the Gender Equality and Women’ Empowerment Act 2022 and the Sexual Offences Act 2019.

The bill also makes provision for the prevention and treatment of obstetric fistula, a neglected health condition that is currently affecting women and girls’ health, rights and empowerment in Sierra Leone.

Religious and Other Concerns

Members of IRCSL gather outside the Well of Parliament to oppose the passage of Safe Motherhood bill
Photo credits: Flaming Evangelical Church on Facebook

Despite the political will shown so far for the bill, it has faced push back from traditionalists and religious groups.

Members of the Inter-Religious Council – Sierra Leone (IRCSL), among them Pastor Francis Mambu of Flaming Evangelical Church, held a protest outside Parliament during the bill’s reading.  The “Anti-Child-Murder” campaigners brandished banners that argued for the rights of the unborn.

Similarly, the Sierra Leone Islamic Website Tv  made a post Facebook on the “Dangers of this Abortion Bill“. They say abortions endanger the lives of women.

The protest resulted in the suspension of the reading of the bill. The Inter-Religious Council also followed this with their position paper. The religious group expressed opposition to the bill, citing religious, moral, ethical and constitutional concerns. It also recommended that changes be made to the legislation.