Abortion as a Contested Right in Occupied Palestine

Whether by law, social order, or culture, limitations on abortion continue to have support in many parts of the world, including within health care systems and among health care providers. Women seeking abortions in Occupied Palestine similarly face legal, social and procedural barriers that deprive them of dignity and force them into keeping unwanted pregnancies. Most Palestinians understand abortion as killing and associate it with a colonialist rather than a nationalist agenda. In this reading, Palestinians should oppose abortion as part of steadfast support for the national cause. Criminalization of abortion in Palestine and other violations of women's health rights are forms of gender-based violence legitimized by society and the Palestinian Authority and reinforced by Israeli colonial aggression. This violence includes coercion of women seeking abortions, denial of resources and services, and infliction of harm. Even information about and access to prepregnancy emergency contraceptives are withheld. A reproductive justice approach considers reproductive rights to be part of social justice.

This essay is based on my analysis of five focus groups as well as fifteen individual interviews I conducted with health care providers, social workers, policy makers, and legal service providers between June and August 2016. The study included seventy-eight participants.

Abortion laws and policies in Occupied Palestine are restrictive. A country assessment on sexual and reproductive health and rights identified six priority issues for the Palestinian government to invest in at the levels of policy and strategy, including access to safe abortion services, postabortion care, and contraceptive information and services (Abu Duhou, Al Botmeh, and Alawneh 2015, 19). However, Article 8 of the Public Health Law passed in 2004 considers abortion medically acceptable only if a pregnancy threatens a woman's life, a condition that two physicians must certify. The Palestinian Penal Code criminalizes abortion without a medical reason. According to Articles 321–25 of the Jordanian Penal Code of 1960, which applies in Occupied Palestine, such penalties apply to the woman seeking the abortion and all individuals and health care professionals who assist her in terminating the pregnancy. The Palestine Criminal Code of 1936, promulgated by the British Mandatory Government, was the first to make abortion illegal in Palestine, in Articles 175–77, and is the basis of the Jordanian Penal Code. However, Article 324 of this code allows exceptions for the woman and her family members if the reason for the abortion is "honor" related. In cases of extramarital pregnancies, the Jordanian Penal Code provides for a more lenient punishment if the motive is to protect the woman and her family from "dishonorable" conduct. These laws apply to all Palestinian institutions, including in Occupied East Jerusalem, as well as the Qalqilya Hospital, run by the United Nations Relief and Works Agency. Palestinian women born in Occupied East Jerusalem and living there as "residents" of Israel have access to abortion services in Israeli health institutions, although we do not have the data on how many use them.

Even when women seeking an abortion manage to overcome legislative hurdles, health care providers stigmatize them and subject them to pseudoreligious shaming. As a result, many turn to unsafe clandestine abortions in peripheral clinics.

More generally, the health care system and providers in Occupied Palestine do not disseminate information about available emergency contraception (EC) or abortion services and thus Palestinian women rarely use them. Even though EC medications are legal, they are not widely available as part of reproductive control services. An unmarried woman cannot acquire EC medications. While the Palestinian Family Planning Association provides such medications at no cost to married women at its service points, Palestinian government hospitals do not offer them and discourage their availability in pharmacies. Some physicians instead prescribe intensive dose administration of available contraceptives within the first seventy-two hours after unprotected sexual intercourse.

Some informants noted that because of these restrictions and the lack of information on reproductive control services, women believe that spontaneous abortions do not require health care. No national studies are available on the number of women who receive an abortion in Palestine formally or informally. However, two studies shed light on the subject. The...