Anna-Kay was 21 years old the first time she got pregnant, in her second year of university, and worried of the shame that would follow if she told her parents.
So Anna-Kay did what about 22,000 women in Jamaica do every year, according to government data, and broke the law. She sold her cellphone to get 20,000 Jamaican dollars (US$153) to pay for an abortion.
“I wasn’t in a position physically, mentally, emotionally, spiritually and financially to be pregnant. It was a very, very lonely time,” Anna-Kay said.
“It was a difficult decision for me,” said Anna-Kay, a now 30-year-old with a young son who asked that her real name not be used.
Having an abortion — or even talking about it with a doctor — is illegal in Jamaica, except to save a woman’s life or to preserve her mental and physical health, according to the country’s Offences Against the Persons Act.
Women can receive a life sentence for having an abortion — although this has never been enforced — and those who assist in the process can be jailed for up to three years.
However, legal discussions under way could change that, with growing acknowledgement that thousands of women do have abortions each year, endangering their lives with backstreet operations or drugs, or paying doctors who will take the risk.
The Abortion Policy Review commissioned by the government in 2007 — the most recent figures — found that unsafe abortions were the third-leading cause of maternal mortality among women in the nation of 2.9 million people.
A bill by lawmaker Juliet Cuthbert-Flynn, of the majority Jamaica Labour Party, aims to decriminalize abortion by repealing sections of the law and replacing it with a new act that would allow for abortions in the case of rape or incest.
The Jamaican Parliament is this month to hear final submissions from the public, then the prime minister’s office is to decide next steps.
This is not the first time that the issue of decriminalizing abortion has been raised in Jamaica, where religion plays a major role in society and culture, but campaigners said they expected that the laws could be relaxed this time with opinion changing.
A survey last year by local firm Johnson Survey Research found that seven of every 10 Jamaicans opposed abortion on demand, but 67 percent of men and 82 percent of women thought that women, not the government, should have the final say on termination.
A separate poll last year found that 58 percent of Jamaicans supported amending the law to allow abortions following incest.
Women need to have safe options, especially poor women, who are disproportionately affected by the law, as they cannot afford to pay for a proper procedure, Cuthbert-Flynn said.
“There is a life sentence attached to [having an abortion], and those are punitive measures that definitely need to be repealed,” Cuthbert-Flynn told the Thomson Reuters Foundation.
“I do know of women who have had illegal abortions, and one woman has died,” she said, while citing another example of a 15-year-old girl left disabled after an illegal abortion.
Joy Crawford, a director of Eve For Life, a non-governmental organization that works with women and children affected by HIV/AIDS, said that not only must the law be repealed, but it must ensure that women have the final choice.
There are many circumstances in which a woman might not be ready or able to carry out a pregnancy, including rape, incest and being too young, she said.
“What I do know is that the majority of the girls we see would rather turn back the clock,” she said of the young women she worked with who became pregnant. “Abortions happen in our country. It is no secret.”
World Bank data showed that Jamaica’s maternal mortality death rate was 89 deaths per 100,000 live births in 2015, with a UN goal to lower the rate globally to less than 70 deaths per 100,000 births by 2030.
“To make amends to the existing law is important from different angles,” UN Population Fund sexual and reproductive health technical adviser Pilar de la Corte Molina said. “There is sufficient evidence that unsafe abortions are among the leading causes of maternal mortality.”
According to the New York-based Guttmacher Institute, a research and policy group focused on sexual and reproductive health, the highest annual rate of abortion globally from 2010 to 2014 was in the Caribbean.
In that period, 37 percent of pregnancies ended in abortion, compared with 25 percent globally, with one in four unsafe.
Legislation regarding abortion varies in the Caribbean’s 25 countries, of which 13 are independent nations, ranging from a total ban in the Dominican Republic to permission when a women’s life or her physical and mental health is at risk in Jamaica.
Kingston-based gynecologist Michael Abrahams said that he saw women every day in his practice who have had an abortion, including those with adverse effects.
“Over 20 years, seeing what women go through, nobody should force a woman to carry a pregnancy,” Abrahams said.
However, religious leaders in the predominately Protestant country have been vocal in their opposition, including Father Richard Ho-Lung, Catholic founder of Missionaries for the Poor, which runs a shelter for pregnant women and girls.
“It would be the beginning of the death culture,” Ho-Lung said. “I prefer myself to die than to see kids aborted and murdered.”
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