The government of Sierra Leone has proposed significant amendments to the controversial Safe Motherhood Bill following extensive consultations with the Inter Religious Council and other stakeholders.

The original bill, which legalized abortion in certain circumstances, faced strong opposition from religious groups and some civil society activists.

Critics of the Bill expressed concerns that it may undermine the cultural values of the country related to the preservation of life. Some religious leaders have characterized the proponents of the bill in a negative light, suggesting a need for a more thoughtful dialogue on the implications of such legislation.

Following engagement with the Inter Religious Council and inputs from various sections of the public, the Ministry of Health has proposed major amendments to the bill, pending the approval of Parliament.

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The proposed amendments aim to address these concerns while maintaining access to essential reproductive healthcare services.  Key changes include:

1. Safe Termination of Pregnancy

Before: Termination allowed in the following cases:

  • Up to 14 weeks of pregnancy, at the choice of the woman.
  • When the pregnancy endangers the life of the woman.
  • To prevent injury to the physical or mental health, or social wellbeing of the woman.
  • Fetal malformations incompatible with life.
  • Rape, incest, or sexual penetration, based on police report and legal advice.

Now: Safe termination allowed only in these exceptional circumstances:

  • When the pregnancy endangers the woman’s life.
  • Fetal malformations incompatible with life.
  • Rape, incest, or sexual penetration, based on police reports or other evidence from appropriate authorities.

2. Right to Access Reproductive Health Services

Before: Access to services was guaranteed without discrimination based on gender, age, marital status, socioeconomic status, physical or other disabilities, ethnicity, religion, tribe, political affiliation, or education level.

Now: The reference to “gender” has been removed. Otherwise, access remains unchanged.

3. Informed Consent for Minors

Before: Consent for minors required approval from a person with parental responsibility or a responsible adult over 21 years acting in the minor’s best interest.

Now: Consent can now be given by a parent, guardian, or someone acting “in loco parentis”.

4. Women’s Rights in Reproductive Health

Before: Women had rights to decide independently about family planning, including the number and spacing of children and whether to continue or terminate a pregnancy.

Now: The right to access family planning and reproductive health services is retained, but the Act emphasizes shared decision-making for married couples, allowing partners to accompany and support each other, with consent.

5. Non-Discrimination and Provider Accountability

Before: Discrimination in reproductive health services was prohibited on various grounds, including sexual identity and reproductive morbidity. Healthcare providers who violated this could face fines and imprisonment.

Now: Discrimination based on sexual identity has been removed from the list. Providers may object to termination services based on conscience or religion and refer the patient to another provider without penalty.