# Abortion in Togo

In Togo, abortion is only legal in the cases of pregnancy from rape or incest, risk to the mother's health or life, or risk of birth defects. The law requires abortion to be performed by a doctor.
In 1920, Togo banned abortion. Reproductive rights organizations have worked to raise awareness of abortion. In December 2006, it became one of the first African countries to reform its abortion law.
Access to abortion is low due to stigma, lack of knowledge, and lack of doctors. Abortion has increased in frequency in Lomé, and is more common among younger women. Illegal vendors provide abortion drugs. Post-abortion care has been available in hospitals since the 2000s.

## Legislation

In 2006, Togo passed a law that says, "The voluntary interruption of pregnancy is only authorised when prescribed by a doctor and on request of the woman in cases where the pregnancy is the result of rape or of an incestuous relationship [or] if there is a strong risk that the unborn child will by affected by a particularly serious medical condition." Abortions without medical prescriptions are punishable up to ten years in prison or fines between 500,000 and 3 million CFA francs.

### Legislative history

When Togo gained independence, it inherited the French Penal Code of 1810, which banned abortion. A law from 31 July 1920 banned abortion unless it threatened the life of the mother and banned birth control propaganda. When Togo re-enacted its criminal code in 1981, it intentionally omitted mentions of abortion. By 1990, the lift of abortion restrictions had not increased the availability of services. On 16 May 1984, a law banned providing an abortion to a girl enrolled in school.
In October 2005, Togo ratified the Maputo Protocol, which provides for a right to abortion under certain grounds. On 22 December 2006, the National Assembly accepted the law legalizing abortion. The law had 46 articles, including legalization of medical assistance in contraception. Togo was one of the first countries in Africa to legalize abortion in the case of rape and the first Sub-Saharan Francophone to reform its abortion law. Women's rights organizations influenced the law reform.
The Episcopal Conference of Togo opposed the law, saying "It punishes the innocent: the unborn child." The head of prenatal care at the Tokoin Teaching Hospital in Lomé, Boukari Amina, said the law "will fix a lot of things."

## Prevalence

In 2015–2019, Togo had 60,300 abortions per year. Between 1990–1994 and 2015–2019, Togo's rate of unintended pregnancy decreased 26%, while the abortion rate remained level.
Legal issues and social taboos lead to low access to abortion. Abortions must legally be prescribed by a doctor, which is a limitation as the country has few doctors. Knowledge of the abortion law is low. Sex workers in Lomé are more likely to experience stigma if they have had abortions.
Lomé has undergone an increase in abortion, similar to other African cities. As of 2016, 32.4% of women in the city who have ever been pregnant reported having abortions, and 43.2% of people know someone who has had an abortion. Almost 40% of abortions are performed in hospitals, 14.9% are by doctors, 36% are performed at home, and 17.9% are induced with drugs. Abortion rates are highest among Kabye people and Catholics. Abortion is a factor in reduction of birth rates in the city. From 1988 to 1998, abortion rates rose from about 12.2 to 62.2 per 1,000 women. Younger women are more likely to have abortions.
Medical abortion is commonly available from unsafe providers, who sell on the street. Drugs such as paracetamol, acetylsalicylic acid, quinine, chloroquine, and indomethacin are used. Usage is high among women who are young or unmarried.

### Activism

The non-governmental organization L'Association Togolaise pour le Bien-être Familial (ATBFE, transl. Togolese Association for Family Well-Being) has worked in sexual and reproductive health since 1975. It has worked with journalists to raise awareness of abortion.
In countries including Togo, U.S.–linked anti-abortion groups have set up centers disseminating misinformation related to abortion.

### Post-abortion care

The cost of post-abortion care (PAC) is between US$18 and $20, as of 2016. Though manual vacuum aspiration (MVA) is the recommended treatment method, many facilities lack equipment and training for it and instead use manual removal. Facilities offer post-abortion contraceptives for an additional fee. Most patients opt for oral contraceptive pills. Some facilities face shortages of supplies.
Many PAC patients are young. Barriers to PAC for adolescents include lack of provisions for young patients, high cost, and poor organization leading to low privacy.
In 2004, ATBFE began an experiment providing free post-abortion care kits to poor women in two hospitals. Decentralized PAC services were introduced in 2006. USAID's Virtual Fostering Change Program began in 2008 to assess and improve PAC services in Togo, Burkina Faso, Guinea, and Senegal. In 2014, the USAID-funded Evidence to Action project began working with the Division of Family Health to increase access to post-abortion family planning. After the program trained health providers, facility managers delivered services more efficiently, clinics offered more contraceptives, and MVA became more common than manual removal. PAC access for young people improved. In 2017, Togo updated its national family planning policies based on the recommendations.