Perception of abortion among people in Saudi Arabia

Running head: PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
Perception of abortion among people in Saudi Arabia
Name of the Student
Name of the university
Author’s note

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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Abstract
Abortion is one of the important topics of research, while discussing about medical ethics. On
the basis of this medical ethics various countries follow various abortion laws. Some of the
Islamic countries have stringent laws when it comes to abortion. Due to the stringency of the
laws, women have been found to be indulged in the unsafe and illegal abortion practices, risking
their own health. In most of the Islamic countries except Turkey, abortion has been considered to
be illegal, unless it is medically justified. In Islamic countries foetus is perceived as a will/gift of
god, termination of which is considered to be heinous crime. Guided by this perception and
stigma, women in Saudi Arabia often indulge in unsafe practices, which results in premature
mortality. In order to review the policies and the legislation related to abortion in Saudi Arabia, it
is necessary to understand the perception of men and women of Islamic community as well as
the viewpoint of the health care professionals residing in Saudi Arabia. In order to collect
secondary data, a literature search has been conducted in CINAHL database and five articles
have been chosen. After the collection of the data, those data are analyzed in codes and patterns.
A thematic data analysis has been done. It has been the found that most of the women are ready
to undergo a prenatal diagnosis in order to find out any genetic disease in the child, but many of
the women are not ready for an abortion, even if any serious complications persist. It has been
found from the study, that most of the public are not very aware of neural tube defects and do not
emphasize in prenatal screening. It can be recommended that public of Saudi Arabia should be
made aware of the effects of abortion and why it is necessary.

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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Table of Contents
Chapter 1..........................................................................................................................................4
1.1. Background...........................................................................................................................4
1.2. Objective...............................................................................................................................8
Chapter 2..........................................................................................................................................9
2.1. Literature Review.....................................................................................................................9
Chapter 3........................................................................................................................................16
Methodology..................................................................................................................................16
Research design.........................................................................................................................16
Research philosophy..................................................................................................................17
Research approach.....................................................................................................................17
Data collection...........................................................................................................................18
Search strategy...........................................................................................................................18
Inclusion and exclusion criteria.................................................................................................19
Data analysis..............................................................................................................................20
Chapter 4: Results and discussion.................................................................................................22
Results........................................................................................................................................22
Discussion..................................................................................................................................28
Chapter 5........................................................................................................................................30
Recommendation.......................................................................................................................30

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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Conclusion.................................................................................................................................31
Study Limitation........................................................................................................................32
Appendix (PRISMA).....................................................................................................................33

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Chapter 1
1.1. Background
There is a growing body of research that have examined the reason why a women seek for an
abortion. There are several reasons, due to which women might seek for an abortion. There are
personal, economic as well as the socio-economic factors that can persuade a women to take the
decisions about abortion. A substantial proportion of abortion can be noticed in young women.
These women might obtain abortions since the lack financial means for raising a child. Apart
from this there are certain physical conditions that can lead woman to terminate pregnancy.
Prenatal diagnosis of the foetus can be used to diagnose any prenatal illness. Prior diagnosis
might lead to termination of pregnancy1. In a study couples were asked to express their feelings
or perception about the prenatal diagnosis and the termination of pregnancy. It has been
unanimously repeated by the couples that they are more concern as their child will not be able to
do the same as other children and would need lifelong support1.
Abortion is one of the most widely discussed topic in the concept of medical ethics.
There are some well-known ethical theories for the various ethical theories that have emerged in
the western world, but the position of ethics of Islam, regarding the abortion in women has been
overlooked largely. Islamic population consists of a large amount of women population. Turkish
republic is the only Islamic county where abortion has been legalised. Abortion in Saudi Arabia
1 Lou, Stina, Kathrine Carstensen, Olav Bjørn Petersen, Camilla Palmhøj Nielsen, Lone Hvidman, Maja Retpen
Lanther, and Ida Vogel. "Termination of pregnancy following a prenatal diagnosis of Down syndrome: A qualitative
study of the decision‐making process of pregnant couples." Acta obstetricia et gynecologica Scandinavica 97, no. 10
(2018): 1228-1236.

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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is generally considered to be illegal and is only considered legal if it saves a women’s life 2 .In
some of the countries, abortion is considered to be illegal at all. Even after the laws of abortion in
Saudi Arabia, most of the women in Saudi Arabia lacks enough knowledge about abortion or the
health conditions pertaining to abortion. Furthermore, stigma and discrimination greatly prevails
among the Muslim community staying in Saudi Arabia3. Although PND is practiced widely in
Saudi Arabia, but there are no national programs in order to screen for any foetal abnormalities
to inform the Saudi women about the conditions when abortion is a real need. Studies have
shown that termination of pregnancy is often seen in foetus with birth defects like failure of the
neural tube to close completely. This is due to the fact that complications related to spina bifida
can even cause death and those who remain alive have to lead their life with varied level of
sensory loss and paralysis4. Some of the other important health conditions that calls for an
abortion are some chromosomal abnormalities that can affect the wellbeing of the child such as
Trisomy, Turner’s syndrome, Down’s syndrome, potter’s syndrome, Tay-Sach’s disease and
Potter ‘syndrome. Even if the medical conditions seek for termination of pregnancy, some
women retain pregnancy risking their as well as the baby’s life. Inability of the service providers
to handle sensitive issues like the termination of pregnancy can cause prolonged suffering for the
parents as well as the affected children. There is a wide number of evidences indicating the pain
and the suffering brought about by the mothers of the anomalous foetuses, but they did not
2 Kosaryan, Mehrnoush, and Khadijeh Rabiei. "Prenatal diagnosis in Islamic countries: A narrative review in 2013."
Journal of Pediatrics Review 2, no. 1 (2014): 47-54.
3 Hawalah, Atrab Y., and Mohammad Othman. "Rate of Different Types of Abortion in Madinah Maternity and
Children Hospital, Madinah, Saudi Arabia." EC Gynaecology 6 (2017): 31-35.
4 Johnson, Candice Y., Margaret A. Honein, W. Dana Flanders, Penelope P. Howards, Godfrey P. Oakley Jr, and
Sonja A. Rasmussen. "Pregnancy termination following prenatal diagnosis of anencephaly or spina bifida: a
systematic review of the literature." Birth Defects Research Part A: Clinical and Molecular Teratology 94, no. 11
(2012): 857-863

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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terminate the pregnancy either due to lack of health literacy or due to cultural reasons5. It is the
duty and the responsibility of the health care professionals to help Arabian pregnant women to
decide on their own pregnancy ad make the patients to understand their health care rights,
contributing to a high quality and safe care6.
In Islam life starts at the time of ensoulment which is considered to be the 102th day from the
moment conception has occurred. And aborting a child is considered to be an offence and against
Allah’s decision7. It has been stated that am embryo becomes an individual and has the full right
to live only after it has been bestowed with a soul, before which, it was just an entity. As per the
views of the four Sunni Madhabs, termination of pregnancy, even at its earliest stage is not
allowed, without any valid medical justification. Abortion is seen as a prima facia Haram as it
violates the Sharia goal of preservation of life. There are two school of thoughts among the
Sunni scholars, who have decided on various time frames to which abortion can be done.
Although it has been claimed by the Islamic authors that Islam in general have a broad guiding
principles to overcome any dilemma related to this. It has been stated that within the 17 weeks
benchmarks as stated in Islamic edicts, a foetus has technically no life and hence abortion will
not cause any termination of life8. In spite of this, there had been a continuous debate in Saudi
Arabia related to abortion. In the Kingdom of Saudi Arabia, there are strongly held cultural
5 Al-Matary, Abdulrahman, and Jaffar Ali. "Controversies and considerations regarding the termination of
pregnancy for foetal anomalies in Islam." BMC medical ethics 15, no. 1 (2014): 10.
6 Al-Amoudi, Samia M., Abdullah A. Al-Harbi, Nasser Y. Al-Sayegh, Basem S. Eldeek, Souzan M. Kafy,
Mahmoud S. Al-Ahwal, and Nabeel S. Bondagji. "Health rights knowledge among medical school students at King
Abdulaziz University, Jeddah, Saudi Arabia." PloS one 12, no. 5 (2017).
7 Chae, Sophia, Sheila Desai, Marjorie Crowell, and Gilda Sedgh. "Reasons why women have induced abortions: a
synthesis of findings from 14 countries." Contraception 96, no. 4 (2017): 233-241.
8 Alkaabba, A. F. "Abortion for a Young Single Female: A Cultural and Islamic Perspective." J Clin Res Bioeth 7,
no. 1000273 (2016): 2.

PERCEPTION OF ABORTION AMONG PEOPLE IN SAUDI ARABIA
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beliefs which are related to the value of honour as chastity9. Every single women is considered to
be virgin and such perceptions are also endorsed in the Islamic teachings. All the laws regarding
abortion has just evolved marginally, but the condition of women has not improved marginally.
It has been stated that the current Islamic edicts are not sufficient to justify abortion and also
does not provide much comfort for the treating physicians to abort a malformed foetus10. Due to
the stringent laws women in Saudi Arabia often suffers from stigma. , since religion plays a
significant role in the bioethical decision making process. The health care professionals also
develop stigma related to pregnancy. In certain cases, women seek help from unauthorised
polyclinics, where the health care workers are unskilled or do not have safe equipment for
carrying out the abortion procedure10. It can be stated that women seek for illegal abortions due
to a number of reasons, like privacy concerns, lack of awareness and high cost11. According to
the reports of WHO, there are about 19 to 22 million of abortions take place all over the world.
The result of abortion is maternal mortality. As per the WHO reports unsafe abortion resulted in
death of 47,000 women in a year. It can be stated that the toll of unsafe abortion can be counted
in terms of complications, disability and morbidity10. Millions of women who undergo these
unsafe procedures some times are left temporarily or permanently disabled with serious
complexities. Some of the worst case is that women might not be allowed to undergo abortion,
due to social stigma even if there are serious health complications. It can be stated that in order
to prevent such unwanted and unsafe abortions, it is necessary that the right to abortion is
9 Almutairi, Meshal. "The Relationship Between Religion and Law in The Sphere of Abortion Regulation; A Case
Study of Saudi Arabia and Ireland."
10 Shapiro, Gilla K. "Abortion law in Muslim-majority countries: an overview of the Islamic discourse with policy
implications." Health policy and planning 29, no. 4 (2014): 483-494.
11 Chemlal, Sonia, and Giuliano Russo. "Why do they take the risk? A systematic review of the qualitative literature
on informal sector abortions in settings where abortion is legal." BMC women's health 19, no. 1 (2019): 55.