Cablegate: Abortion and Family Planning In


DE RUEHCL #0169/01 2311543
P 191543Z AUG 09




E.O. 12958: N/A
SUBJECT: Abortion and Family Planning in

REF: 08 Casablanca 222

1. SUMMARY: Despite significant advances to
women's legal rights by the passage in 2003
of a new family code (Reftel), pregnant
unmarried women in Morocco still face
intense social alienation and economic
hardships. Contraception is widely
available and heavily subsidized by the
government of Morocco (GOM), but abortion
remains illegal except in cases endangering
a woman's life. Because of stringent
limits on abortion and the shame associated
with unwed pregnancies, women frequently
turn to risky and illegal abortions. For
the moment, neither women's advocacy groups
nor the body politic is willing to discuss
liberalization of abortion laws or the
condition of single mothers. This report,
prepared by Consulate intern, examines
reproductive healthcare in Morocco, the
dangers of illegal abortions, and
challenges faced by unwed mothers. END

Family Planning, Contraception and

2. Contraceptives are widely available and
heavily subsidized with GOM funded Centers
for Family Planning present throughout the
country. According to a 2007 UNCIEF study,
contraceptive use has increased drastically
within the last decade, with a nearly 63
percent prevalence rate in 2007. However,
while the Democratic Association of Women
in Morocco (ADFM) found in a recent survey
that 98.6 percent of Moroccan women have a
basic understanding of contraceptive use,
they noted that contraception promotion
campaigns rarely target men. The onus is
often put on women to guard against
pregnancy with birth control pills, IUD
devices, and spermicide being the preferred
methods of protection. Dr. Zoubida
Ellorhaoui, a gynecologist in Casablanca,
recalled an incident in which boxes of free
condoms in front of pharmacies were
destroyed in protest of a governmental push
to increase their use amongst the general
population. Because of men's antipathy
towards condoms this cultural view on
contraception, women are not adequately
protected from sexually transmitted
infections. In addition, the ADFM also
reported that many women regard abortion as
a birth control option despite its
clandestine and illegal nature.

3. Although contraceptives are widely
available in urban areas many of the rural
areas have limited or no access to
healthcare, despite GOM efforts to provide
mobile health clinics to many rural areas.
A 2000 GOM study showed that over 33
percent of the rural population must spend
more than one hour to reach the nearest
health facility. Morocco has some of the
highest maternal mortality rates in North
Africa, and these figures reflect the
country's many social inequities. According
to a 2004 UNDP study, the maternal
mortality rate, deaths of women related to
childbirth, was twice as high in rural
areas as urban ones. The same study also
found that in rural areas only 48 percent
of women received pre-natal care, and 60
percent did not have a doctor present at

Stigma of Single Motherhood

4. While Moroccan policies acknowledge the
importance of family planning and
contraception, sex outside of marriage is
both culturally forbidden and illegal;

though the prohibition is rarely enforced.
Women face numerous obstacles both judicial
and social to establishing the paternity of
a child born out of wedlock and hence the
ability to sue for child support. Even in
cases where the father is known to the
mother, the hospital will only record the
father's name if the father acknowledges
paternity. Aicha Channa, president of
Solidarite Feminine, a non-governmental
organization that works with single
mothers, explained that a child with no
father listed on the birth certificate will
face a lifetime of discrimination and
hardship as the child moves through the
bureaucracy of the state. In addition,
unwed mothers and their illegitimate
children are often ostracized by their
families and communities, leaving them with
even fewer economic options. Many single
mothers turn to prostitution or begging to
support themselves and their children.

5. Groups such as Solidarite Feminine have
estimated that the majority of the single
mothers that have benefited from their
services are former child domestics, or
"petite-bonnes". Petite-bonnes are young
girls, usually from poor, rural areas, who
are trafficked by intermediaries to work in
the houses of wealthy urban families. They
are paid very little, and the money they do
receive typically goes directly to their
families. Once they reach adolescence, they
are often dismissed with no economic
resources and are particularly vulnerable
to sexual exploitation. These young women
have few options should they become
pregnant outside of marriage.

Abandonment or Abortion

6. Because of social and financial burdens,
child abandonment has been a significant
problem in Morocco. In the past, single
mothers were pressured by hospitals and
relatives to give the child to the
government orphanage. While Channa
stresses that this attitude has changed
significantly in the last decade, putting a
child up for adoption abandonment still
remains prevalent, particularly in large
cities. Abortion is another option that
many women turn to in lieu of facing the
harsh social consequences of pregnancy
outside of marriage.

7. Abortions are legal in Morocco only to
safeguard the health of the mother. The
practical measures to garner permission for
a legal abortion, however, are especially
difficult. In addition to written consent
by the spouse, the region's chief medical
officer must approve all pending abortions.
These stringent procedures mean that legal
abortions are rarely approved beforehand.
However, according to Dr. Ellourhaoui,
doctors routinely perform clandestine
abortions which cost between 400 and 700 US
dollars on average, but can cost as much as
2000 dollars. In some cases the doctors
justify the abortion to a hospital by
falsely claiming an emergency intervention
was necessary. In other instances the
operation is performed in private clinics
and is not reported. According to
Professor Chafik Chraibi, head of the
maternity ward at the Central University
Hospital in Rabat and president of Moroccan
Association for the Fight against
Clandestine Abortion (AMLAC), the price of
an abortion would drop to 150 or 200 USD if
it were legalized.

8. Dr. Chraibi estimates that nearly six
hundred clandestine abortions are performed
daily in Morocco. However, only 250 of
these procedures are performed by doctors.

While the Moroccan Association for Family
Planning (AMPF) has confirmed these
figures, both organizations acknowledge
that it is impossible to determine the
precise number of abortions taking place
outside of hospitals and consider 600 a
conservative estimate. Data collected by
the AMPF in Agadir and Fez determined that
of the 473 women interviewed, 35 percent
had undergone at least one abortion.
However, statistics on this topic are often
hard to corroborate, and this particular
survey only represented a small sampling of

9. Although it is hard to say how many
illegal abortions are performed by
unqualified practitioners, it is widely
known that many women choose to undergo
clandestine abortions outside of hospitals.
Women often turn to herbalists or
unlicensed doctors for abortion remedies
that range from herbal concoctions to the
physical penetration of the fetus with,
often unsanitary, household items.
According to a recent WHO study, nearly 13
percent of the maternal mortality rate is a
direct result of clandestine abortions. The
lack of hospital accessibility has
especially exacerbated the dangers of
clandestine abortions in rural areas,
leaving women who are unwilling or unable
to travel with fewer options.

10. COMMENT: The GOM has taken a relatively
liberal approach to family planning,
particularly with the subsidized
distribution of contraception, but has
failed to target men in their awareness
raising campaigns. Women are expected to
bear the responsibility of protection
against pregnancy, and are expected to
accept the consequences alone should she
fail to protect herself. Additionally, the
government has done very little to
safeguard single mothers against social
stigmatization or economic burden. Because
of conservative social pressures and a lack
of general awareness on the topic, many
women turn to clandestine abortion as a
method of birth control. However, the
illegality of the procedure has led to high
costs for safe abortions and a complete
lack of regulation for the majority of
abortions performed. Reforms of abortion
laws and the overall improvement of
reproductive healthcare are not popular
topics for debate in Morocco's political
sphere. The most vocal proponents of the
liberalization of abortion have been
private organizations, such as AMLAC. Even
women's organizations such as Solidarite
Feminine and others are reluctant to raise
the issue admitting that it is
controversial and low on their list of

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