Luh De Suriyani/Denpasar, Indonesia
A dental practitioner in Bali who had been jailed twice before for performing illegal abortions was arrested again this month for the alleged crime with a list, police said, of more than 1,300 patients over two years.
The case underscores the lack of safe and accessible abortion services in Indonesia where the practice is highly stigmatized and largely prohibited except for medical emergencies and rape victims.
Ketut Arik Wiantara, who allegedly did not have a valid license to practice dentistry, was arrested on May 8 at his residence, where he had set up a makeshift abortion clinic equipped with an ultrasound device, curettage equipment and post-abortion drugs, Bali police said.
“The suspect argued that there were many requests for abortion and he was concerned about the future of his patients because they were young,” said Stefanus Satake Bayu Setianto, the Bali police spokesman.
He said Wiantara allegedly charged 3.5 million rupiah (about U.S. $235) per termination procedure. A date for his trial has not been set. A lawyer for Wiantara could not be reached for comment.
Police in other parts of Indonesia have raided similar clinics, including one in Jakarta in 2020 where nearly 33,000 abortions were allegedly performed over a period of three years.
While Indonesian health laws allow abortions for medical emergencies detected early in pregnancy – either threatening the life of the mother or fetus and pregnancy resulting from rape – obtaining legal abortions is not easy, according to reproductive health activists and experts.
The process can be long, bureaucratic and costly, often exceeding the government’s safe abortion requirement.
As a result, many women resort to unsafe methods such as herbal remedies, self-induced abortions or unlicensed providers, they said.
The Institute for Criminal Justice Reform (ICJR), a Jakarta-based NGO, said the challenges faced by women who seek abortions include a lack of designated health care facilities and the social stigma.
This has led to situations where rape victims are denied their right to terminate pregnancies, such as a 2021 case in East Java, where a 12-year-old girl who was raped by a 56-year-old man was refused an abortion by investigators because they had “no experience” in dealing with such requests, ICJR said.
“The word abortion still has negative connotations because of religious reasons, even though it’s a health intervention and related to women’s choices and their bodies,” said Ni Luh Eka Purni Astiti, executive director of the Indonesian Family Planning Association (PKBI) in Bali.
In both Muslim-majority Indonesia and Hindu-majority Bali, abortion is considered a sin.
Astiti said her organization provides counseling and referrals for women who seek abortions or face unplanned pregnancies.
‘Condoms are still a taboo’
Under Indonesia’s new criminal code passed last year, a woman who has an abortion faces up to four years in prison and anyone who assists in the process could be jailed for five years. Additionally, anyone who promotes birth control devices faces six months in jail.
The government argued that this revision was necessary to protect human life and dignity, as well as to uphold moral values and religious norms.
However, rights groups criticized this as a violation of women’s rights and autonomy, as well as an interference in their personal and sexual choices. Other controversial provisions in the code include criminalizing extramarital sex and cohabitation.
A study published in 2020 in the journal International Perspectives in Sexual and Reproductive Health estimated that 1.7 million abortions took place in Java, Indonesia’s most populous island, in 2018. The researchers used a model that combined data from several sources such as surveys, health facility records and expert opinions.
That translates to a rate of 43 abortions per 1,000 women between the ages of 15 and 49.
By comparison, the global abortion rate was 39 per 1,000 women aged 15 to 49, according to the Guttmacher Institute. The regional abortion rate for Southeast Asia was 34 per 1,000 women. And among Muslim-majority nations, the abortion rate varied widely, ranging from three per 1,000 women in Iran to 50 per 1,000 women in Azerbaijan.
The study found that most women who had abortions in Java self-managed, using methods such as traditional herbal medicine or massage.
Only a small fraction obtained a surgical procedure or pills from a health provider, it said. About 12% of women had complications and sought treatment in a health facility.
In Bali, a 2021 PKBI study on perceptions of reproductive health among adolescents found that many young people had misconceptions about sex and pregnancy.
About 36% of the 373 respondents believed they would not get pregnant after having sex for the first time. About 26% said women could use herbal remedies to prevent pregnancy.
Ni Putu Indah Mas Pratiwi, counselor for Kita Sayang Remaja (We Love Youths), a youth outreach program in Bali, said she often receives online queries from young people who are unsure if they are pregnant or how to prevent pregnancy.
“Condoms are still a taboo. People are embarrassed by the mere mention of them,” Pratiwi told BenarNews. Condoms are associated with premarital sex and promiscuity, practices considered vices in the largely conservative Indonesian society.
Made Oka Negara, a doctor and reproductive health activist, said many in Indonesia see abortion “as a moral issue rather than a medical one.”
But the Wiantara case shows that there is a high demand for abortion services and that the government should provide them legally and safely, he said.
“People don’t feel the need to talk about it,” Made told BenarNews.
“[But] not everyone wants to get married [and have children], so they end up doing it unsafely.”
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