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Abortion in Singapore

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Abortion was legalised in Singapore in 1969.[1] Prior to this it was legal only when a woman’s health was endangered by the pregnancy.[2] Currently, Abortions can be received by any woman who is a citizen or has an issued work pass under the Employment of Foreign Manpower Act, the spouses of an individual fulfilling one of these requirements is also eligible.[1] Abortions can also be received by a woman who has been a resident of Singapore for at least four months, or whose life is endangered from carrying the fetus.[1] Singapore is one of 67 countries that allows abortion on request.[3]

The legalisation of abortion was not influenced by[4], but helped to regulate Singapore’s high population growth rate in the 1960s.[5] It has since helped to regulate the country’s population.[6] There were 6815 abortions carried out in Singapore in 2017, bringing the number to the lowest it has been since 1973.[7]

History

Further information: Population planning in Singapore

Before 1967, abortion was illegal in Singapore under sections 312-315 of the Penal Code of Singapore[8] unless it was necessary to save the life or protect the health of the pregnant woman.[2] This Penal Code, similarly to other Asian countries such as India, was based on legislation from the United Kingdom in the nineteenth century.[5]

In 1966 the Singapore Family Planning and Population Board (SFPPB) was launched in order to control the high rate of population growth in Singapore.[9] The board was in favour of induced abortion as it would aid in population growth regulation.[5] Soon after its creation it began a review of the government’s abortion policy and its effectiveness. They concluded that induced abortion should be made available to more women. They presented this to the Health Ministry of Singapore in 1967.[5] In the same year, the laws were extended to allow abortions in cases of rape, congenital foetal malformation, failed contraception, or certain eugenics cases.[10] Following this change, the rate of illegal abortions was still high. This raised concerns for the safety of Singaporean women.[5] Parliamentary debate lead to a reform of abortion law in 1969.[11]

The Abortion Act 1969 was passed with a span of four years and the possibility of a fifth.[2] The parliamentary whip was lifted for this vote, allowing votes to accurately represent the members’ opinions.[12] This It was passed in parliament with 32 for, 10 against, and one abstention.[12] As explained in parliamentary debate, the purpose of the bill was to protect the health of women “in the interests of humanity and human progress,” and “to ensure that the children born are wanted children.”[11] Under the bill, a termination of pregnancy could be granted under four circumstances:

  • The pregnancy threatened the health or life of the pregnant woman.
  • The woman’s economic and family circumstances would not be suitable for a child.
  • The child, if born, may suffer from health issues or disability.
  • The pregnancy is a result of rape or incest.[13]

Consent was required to terminate a pregnancy if the woman in question was unmarried and under 18.[13] This bill came into effect on the 20th March 1970.[14]

The Abortion Act 1974, passed to replace the expired act from 1969, was indefinite.[1] It closely resembled the previous legislation. The five circumstances in which a termination of pregnancy would be granted were removed, allowing the treatment on request. Also, the patient was the only person required to give consent for the procedure to go ahead.[1] This bill also closely resembles the Termination of Pregnancy Act put in place in 1985.[15]

In 1986 mandatory pre-abortion counselling was introduced.[10] This applied to all women who had more than two children, had not passed the Primary School Leaving Examination, or were not Singaporean citizens.[16] This was amended in 2015 to apply to all women.[17]

Singapore’s current laws on abortion are considered to be progressive.[12] The Centre for Reproductive Rights placed them in the most progressive category of five: “On request”.[18] In 1996, Singapore was one of 47 countries that allowed abortions on request.[3] In 2020 it is one of 67 out of a total 194.[3] In 1994, Singapore was one of 179 members who signed the International Conference on Population and Development Programme of Action. This programme called for the liberalisation of abortion laws among other demands.[19]

Abortion Laws

According to the Termination of Pregnancy Act, any woman who is a citizen of Singapore, holds a work pass under the Employment of Foreign Manpower Act, or has resided in Singapore for over four months is permitted to undergo a termination of pregnancy. This also applies to women whose spouse fulfils these criteria. These criteria do not apply to “any treatment to terminate pregnancy which is immediately necessary to save the life of the pregnant woman.”[1] The procedure must be undertaken by an authorised medical practitioner in an approved institution with written consent from the patient. Breaches of these guidelines will result in a fine of up to $3000, three years imprisonment, or both.[1]

Unless under special circumstances, the pregnancy may not be terminated if it is older than 24 weeks, unless it will protect the life or health of the pregnant woman. If the pregnancy is between 16 and 24 weeks the treatment must be carried out by an authorised medical practitioner with the correct qualifications.[1] If a patient is undergoing a non-surgical treatment it is not required that the medical practitioner have qualification or that the process be undertaken in an approved institution. There is no consent required for a termination of pregnancy other than that of the pregnant woman. This remains true for minors.[1]

Any person found guilty of coercing or intimidating a woman against her will into terminating a pregnancy will be subject to a fine of up to $3000, three years imprisonment, or both. Conscientious objection is permitted for any member of the treatment process. This is overridden, however, when the health of the patient is at risk. The information surrounding the termination of pregnancy may not be shared without the permission of the patient. [1]

It is required that all women undertaking a termination of pregnancy participate in pre- and post-abortion counselling. After this counselling, they must wait 48 hours before commencing treatment.[20]

Statistics

The Termination of Pregnancy Act guidelines require that all medical practitioners who complete a termination of a pregnancy must submit the details of the patient and the treatment to the Director of Medical Services.[1] This includes the name, date and method of termination, marital status, level of education and the number of children the woman has. This information is kept confidential.[21]

Number of Abortions

Year No. Live Births[7] No. Abortions Rate of Abortions per 1000 women 15-44
1970 45934 1913[14] 4.1[14]
1971 47088 3407[14] 7[14]
1972 49678 3806[14] 7.5[14]
1973 48269 5252[14] 10.1[14]
1974 43268 7175[14] 13.3[14]
1975 39948 12873[14] 22.7[14]
1976 42783 15496[14] 26.3[14]
1977 38364 16443[14] 27.1[14]
1978 39441 17246[14] 27.6[14]
1979 40779 16999[14] 26.5[14]
1980 41217 18219[14] 28.4[22]
1981 42250 18990[14] 28.4[14]
1982 42654 19110[14] 28.6[22]
1983 40585 19100[14] 27.9[14]
1984 41556 22,190[7] 32.2[22]
1985 42484 23512[23] 34.0[24]
1986 38379 23035[7] 32.9[22]
1987 43616 21226[7]
1988 52957 20135[7] 28[22]
1989 47669 20619[7]
1990 51142 18669[7] 22.5[22]
1991 49114 17798[7] 21[22]
1992 49402 17073[7] 20[22]
1993 50225 16476[7] 19.2[22]
1994 49554 15690[7] 18.2[22]
1995 48635 14504[7] 16.4[22]
1996 48577 14365[25] 15.9[22]
1997 47333 13827[7] 17.1[26]
1998 43664 13838[7] 17.7[26]
1999 43336 13753[7]
2000 46997 13754[7]
2001 41451 13140[7]
2002 40760 12749[7]
2003 37485 12272[27] 15[7]
2004 37174 12070[27] 12.6[28]
2005 37492 11482[27]
2006 38317 12032[27] 12[26]
2007 39490 11933[27]
2008 39826 12222[27]
2009 39570 12318[27]
2010 37967 12082[27]
2011 39654 11940[27]
2012 42663 10624[27]
2013 39720 9282[29]
2014 42232 8515[7]
2015 42185 7942[7]
2016 41251 7212[29]
2017 39615 6815[7]

There was a 673% rise in recorded abortions between 1970 and 1975, due to the sudden availability of treatment. This number continued to rise, reaching its peak in 1985 with 23512 legal abortions.[7] This influenced the introduction of mandatory pre-abortion counselling in 1986 for most women.[10] This change caused the number of abortions to regulate,[10] passing under 20000 in 1990.[7] Between 2003 and 2012 between 300-500 abortions were kept after pre-abortion counselling.[30] In 2016 there were 7217 legal abortions carried out.[29]

Other Statistics

Between 1970 and 1983 the proportion of abortions explained by economic limits or existing family size fell from 90% to 39%. They remained the most common reasons. Other reasons included being unmarried, domestic problems, and least common at a maximum of 4% was failed contraception.[14]

Between April 1984 and December 1985, the average age of single women presenting for abortion was 23.6.[31] In 2002 the average age of women presenting had risen to 29.6 years old.[32]

The number of teenagers presenting for abortions is decreasing. In 2005 1279 women under 20 had abortions, followed by 1195 in 2009, 578 in 2013 and 343 in 2016.[29] This is almost equal to the 332 babies born to teenagers in 2016.[29] In 1999 109 patients younger than 16 presented for an abortion, but in 2012 only 59 in this age bracket did.[33] Teenagers are also less likely to have used contraceptives.[31]

In 1985, 69.75% of patients were married.[31] By 2002 this had risen to 75.5%.[32] 58.3% had a secondary school education in 2002.[32]

Opinion

Political Debate

In 2015 MP Alex Yam argued for the period in which an abortion can take place to be moved from the 24th week to the 22nd. His argument was based on the fact that around one percent of abortions in 2018 took place within these two weeks.[34] The bill has not since been amended.

Religious Debate

In 1967 the Archbishop of Malacca and Singapore argued against the legalisation of abortion. Instead, he suggested that religious education could replace the need for abortions.[35]

During the parliamentary debate leading up to the legalisation of abortion in 1969, the Minister of Health, Mr. Chua Sian Chin, argued that the stance of religious groups should not be considered in the debate on abortion. He explained that their input was an attempt to “impose their will on the majority”. He followed this by suggesting that opposition to the Abortion Bill would be considered redundant in the future.[12] The parliamentary whip was lifted during the subsequent debate to allow members of parliament to vote according to conscience, which allowed religious opposition to be represented in the vote.[12]

The debate around religion and abortion continued in 2008 following an article in the Strait Times arguing that Singapore’s abortion laws should be reviewed.[36] Some readers of this newspaper replied, suggesting that restrictions on abortion would not cause an increase in birth rates, and would create more social inequality.[12] There was no review as a result.

Any medical professional may conscientiously object to performing a termination of pregnancy on the grounds of religious beliefs. The only case where personal objection is disregarded is if the patient’s life is endangered by the pregnancy.[1]

References

  1. ^ a b c d e f g h i j k l "Termination of Pregnancy Act - Singapore Statutes Online". sso.agc.gov.sg. Retrieved 2019-11-14.
  2. ^ a b c Kee, Ho Peng (1993). "Abortion in Singapore: a Legal Perspective". International and Comparative Law Quarterly. 42 (2): 382–397. doi:10.1093/iclqaj/42.2.382. ISSN 0020-5893.
  3. ^ a b c Team, The Hindu Data (2020-03-04). "How many countries allow abortion on request, where is abortion completely prohibited, and more". The Hindu. ISSN 0971-751X. Retrieved 2020-05-26.
  4. ^ "MOH | News Highlights". www.moh.gov.sg. Retrieved 2020-05-27.
  5. ^ a b c d e Swee-Hock, Saw (2016-12-31). Population Policies and Programmes in Singapore, 2nd edition. Singapore: ISEAS–Yusof Ishak Institute Singapore. pp. 41–61. ISBN 978-981-4762-20-5.
  6. ^ "Singapore Population". Base. Retrieved 2020-05-26.
  7. ^ a b c d e f g h i j k l m n o p q r s t u v w x y "Historical abortion statistics, Singapore". www.johnstonsarchive.net. Retrieved 2020-05-25.
  8. ^ Gaur, K. D. (1995). "Abortion and the Law in Countries of Indian Subcontinent, Asian Region, United Kingdom, Ireland and United States of America". Journal of the Indian Law Institute. 37, no.3: 307–309.
  9. ^ "Singapore Family Planning & Population Board is established - Singapore History". eresources.nlb.gov.sg. Retrieved 2020-05-26.
  10. ^ a b c d Singh, K.; Fai, F.Y.; Prasad, R.N.V.; Ratnam, S.S. (1996). "Abortion Trends in Singapore: A 25-Year Review". Journal of Pediatric and Adolescent Gynecology. 9 (1): 27–30. doi:10.1016/s1083-3188(96)70007-4. ISSN 1083-3188.
  11. ^ a b Abortion Bill, (1969-04-08). Parliament of Singapore. Parliament 2, session 1.
  12. ^ a b c d e f Tan, Seow Hon (2010). "RELIGION IN THE ABORTION DISCOURSE IN SINGAPORE: A CASE STUDY OF THE RELEVANCE OF RELIGIOUS ARGUMENTS IN LAW-MAKING IN MULTI-RELIGIOUS DEMOCRACIES". Journal of Law and Religion. 26 (2): 505–539. ISSN 0748-0814.
  13. ^ a b "Abortion Bill - Singapore Statutes Online". sso.agc.gov.sg. 1968. Retrieved 2020-05-26.{{cite web}}: CS1 maint: url-status (link)
  14. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab Chen, A. J.; Emmanuel, S. C.; Ling, S. L.; Kwa, S. B. (1985). "Legalized Abortion: The Singapore Experience". Studies in Family Planning. 16 (3): 170–178. doi:10.2307/1967019. ISSN 0039-3665.
  15. ^ "Termination of Pregnancy Act - Singapore Statutes Online". sso.agc.gov.sg. 1985. Retrieved 2020-05-26.{{cite web}}: CS1 maint: url-status (link)
  16. ^ migration (2015-04-13). "Parliament: Pre-abortion counselling to be extended to all pregnant women". The Straits Times. Retrieved 2020-05-26.
  17. ^ "Revised Guidelines on Termination of Pregnancy 2015". moh.gov.sg.https://www.moh.gov.sg/docs/librariesprovider5/licensing-terms-and-conditions/revised-guidelines-on-termination-of-pregnancy-(dated-17-apr-2015).pdf. Retrieved 2020-05-26.
  18. ^ "Abortion Law: Global Comparisons". Council on Foreign Relations. Retrieved 2020-05-26.
  19. ^ "International Conference on Population and Development". www.unfpa.org. Retrieved 2020-05-26.
  20. ^ "Revised Guidelines on Termination of Pregnancy" (2015). moh.gov.sg. https://www.moh.gov.sg/docs/librariesprovider5/licensing-terms-and-conditions/revised-guidelines-on-termination-of-pregnancy-(dated-17-apr-2015).pdf. Retrieved 2020-05-25.
  21. ^ "The Essential Guide to Abortions in Singapore". DoctorxDentist. Retrieved 2020-05-28.{{cite web}}: CS1 maint: url-status (link)
  22. ^ a b c d e f g h i j k l Henshaw, Stanley K.; Singh, Susheela; Haas, Taylor (1999). "Recent Trends in Abortion Rates Worldwide". International Family Planning Perspectives. 25 (1): 44. doi:10.2307/2991902. JSTOR 2991902.
  23. ^ migration (2014-07-27). "Abortions in Singapore fall to 30-year low". The Straits Times. Retrieved 2020-05-25.
  24. ^ Singh, K; Ratnam, S.S (1998). "The influence of abortion legislation on maternal mortality". International Journal of Gynecology & Obstetrics. 63: S123–S129. doi:10.1016/s0020-7292(98)00194-5. ISSN 0020-7292.
  25. ^ Sedgh, Gilda; Henshaw, Stanley K.; Singh, Susheela; Bankole, Akinrinola; Drescher, Joanna (2007). "Legal Abortion Worldwide: Incidence and Recent Trends". International Family Planning Perspectives. 33 (3): 106–116. JSTOR 30039221.
  26. ^ a b c Swee-Hock, Saw (2007). The Population of Singapore: (2nd Edition). Institute of Southeast Asian Studies. pp. 201–202. ISBN 978-981-230-738-5.
  27. ^ a b c d e f g h i j "MOH | News Highlights". www.moh.gov.sg. Retrieved 2020-05-25.
  28. ^ "UNdata | record view | Abortion rate". data.un.org. Retrieved 2020-05-26.
  29. ^ a b c d e hermes (2017-11-15). "Steady decline in abortion numbers". The Straits Times. Retrieved 2020-05-25.
  30. ^ "MOH | News Highlights". www.moh.gov.sg. Retrieved 2020-05-28.
  31. ^ a b c Chew, S. C. (1988). "Disturbing Trends in Abortions in Singapore - Analysis in a Private Clinic". Singapore Medical Journal. 29: 28–29.
  32. ^ a b c Singh, Kuldip; Fong, Y.F.; Loh, S.Y. (2002). "Profile of women presenting for abortions in Singapore at the National University Hospital". Contraception. 66 (1): 41–46. doi:10.1016/s0010-7824(02)00317-7. ISSN 0010-7824.
  33. ^ "MOH | News Highlights". www.moh.gov.sg. Retrieved 2020-05-28.
  34. ^ "MP renews call for review of abortion gestational limit". TODAYonline. Retrieved 2020-05-28.
  35. ^ "Legalised abortion: 'Other solutions must be found'". eresources.nlb.gov.sg. Retrieved 2020-05-28.
  36. ^ Tan, Seow Hon (2008-07-28). "Time for Singapore to Relook Abortion Law". The Strait Times (Singapore).{{cite news}}: CS1 maint: url-status (link)
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