Abortion in Mali

In [[Mali]], [[abortion]] is [[Abortion law by country|illegal]] except in the cases of risk to health or life or [[pregnancy from rape]] or incest. The [[gestational limit]] is thirteen weeks. Most abortions in the country are illegal and [[Unsafe abortion|unsafe]]. Most abortions are received by unmarried women, often motivated by the stigma against pregnancy outside of marriage. Legal providers perform both [[Surgical abortion|surgical]] and [[medical abortion]], and [[post-abortion care]] has been available since 2006.

Mali's abortion law was originally based on [[Abortion in France|that of France]], with a 1920 French abortion ban being included in Mali's penal code. This was replaced by a 2002 reproductive health law, permitting abortions on the grounds of rape, incest, or risk to life. The country ratified the [[Maputo Protocol]] in 2004 and published abortion guidelines in 2012. The 2024 penal code permitted abortion on the existing legal grounds as well as risk to physical or mental health.

== Legislation == The 2024 [[penal code of Mali]] prohibits abortions except if the pregnancy risks the mother's life or physical or mental health or it [[Pregnancy from rape|resulted from rape]] or incest.<ref name="Haïdara" /> The country's medical code of ethics says abortion is permitted if three physicians say that it is necessary to save the mother's life.{{sfn|Tembely|Koumare Tembely|Ludot|Moro|2022|p=168}} [[Medical abortion]] is approved up to a [[gestational age]] of thirteen weeks.{{sfn|Sorhaindo|Castle|Flomen|Lathrop|2023|p=5}}

Article 321-20 of the penal code says illegal abortion is punishable by a prison sentence of five years, a fine of 1,000,000 [[West African CFA franc|francs]], and a {{ill|residence ban|fr|interdiction de séjour}} of ten years. The prison sentence is increased to ten years for [[forced abortion]]s or up to twenty years for abortions resulting in death. Article 321-21 says a medical professional who performs an illegal abortion may lose their license and be imprisoned for up to five years.<ref name="Haïdara" />

== History == During the [[French Sudan|colonial era]], Mali inherited [[Abortion in France|France's abortion law]], with a 1920 law banning abortion. Mali modified this law in 1972.{{sfn|Knoppers|Brault|Sloss|1990|p=892}} The country's penal code specified that abortions are punishable using any methods and at any stage of pregnancy.{{sfn|Knoppers|Brault|Sloss|1990|pp=899, 901}} The legal defense of [[necessity (criminal law)|necessity]] excused abortions done if the pregnancy poses a serious threat, although the cases in which this applied were unspecified.{{sfnm|1a1=Knoppers|1a2=Brault|1a3=Sloss|1y=1990|1p=908|2a1=Rahman|2a2=Katzive|2a3=Henshaw|2y=1998|2p=57}}

The 1920 law existed until 2002,{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}} when a reproductive health bill, Law {{Numero|02-044}} of 24 June 2002, legalized abortion if a pregnancy is life-threatening or if it [[Pregnancy from rape|resulted from rape]] or incest. Abortions in other cases remained punishable under the penal code.<ref name="GAPD">{{Cite web |date=7 May 2017 |title=Country Profile: Mali |url=https://abortion-policies.srhr.org/country/mali/ |access-date=25 July 2025 |website=Global Abortion Policies Database |publisher=[[World Health Organization]]}}</ref> This law was in line with the recommendations of the [[International Conference on Population and Development]].{{sfn|Hessini|2005|p=93}} Mali ratified the [[Maputo Protocol]], which provides for a right to safe abortion, on 26 October 2004. The abortion law and other laws on [[women's rights in Mali]] are not in line with this treaty.<ref name="Haïdara">{{Cite news |last=Haïdara |first=Boubacar |date=7 February 2025 |title=Avortement médicalisé : Un droit reconnu mais peu appliqué au Mali |trans-title=Therapeutic abortion: A right that is recognized but rarely applied in Mali |url=https://www.journaldumali.com/avortement-medicalise-un-droit-reconnu-mais-peu-applique-au-mali/ |access-date=26 July 2025 |work=[[Le Journal du Mali]] |language=fr}}</ref> The National Standards and Protocols for Abortion Care were published in 2012.{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}} The same year, Mali's plan for implementation of [[United Nations Security Council Resolution 1325]], an agreement surrounding women's rights, provided for "medical assistance for women with non-desired pregnancies".{{sfn|Thomson|Pierson|2018|p=329}}

In 2017, US President [[Donald Trump]] enacted the [[Mexico City policy]], which withheld government funding from organizations that provide abortion services. Family planning organizations in Mali lost 600,000 US dollars upon its enactment,<ref>{{Cite news |last= |date=3 February 2017 |title=Au Mali, premières conséquences du décret anti-avortement de Trump |trans-title=In Mali, the first consequences of Trump's anti-abortion decree |url=https://www.rfi.fr/fr/afrique/20170302-mali-premieres-consequences-decret-anti-avortement-trump |access-date=26 July 2025 |work=[[Radio France Internationale]] |lang=fr}}</ref> and the group {{langr|fr|Association Malienne pour la Protection et la Promotion de la Famille}} lost its source of funding from [[Planned Parenthood]] until the policy was rescinded.<ref>{{Cite news |last=Porter Robbins |first=Claire |date=28 January 2021 |title=End of US 'global gag rule' raises hopes for women's healthcare at crucial time |url=https://www.thenewhumanitarian.org/news/2021/1/28/global-gag-rule-abortion-access-biden-mexico-city-policy-haiti-namibia |access-date=26 July 2025 |work=[[The New Humanitarian]]}}</ref> The Strengthening Abortion Research Capacity in Sub-Saharan Africa Program (STARS)—a group aiming to increase abortion research from African researchers—was launched in 2019 in Mali by the Mali Center for Vaccine Development and the [[International Center for Research on Women]].{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=113}} The program, which published studies and held discussions with the [[Ministry of Health (Mali)|Ministry of Health]], academics, and medical professionals, increased interest in research on abortion in Mali.{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=115}} The [[COVID-19 pandemic in Mali]], which occurred amid [[Mali War|a national crisis]], led to the unavailability of health facilities and reproductive healthcare, and community groups worked to provide safe abortion access.{{sfn|Sorhaindo|Castle|Flomen|Lathrop|2023|pp=4, 11}} The penal code enacted in December 2024 continued to criminalize abortions, with exceptions for therapeutic abortions.<ref name="Haïdara" />

== Prevalence == In 2015–2019, the estimated annual incidence of abortion in Mali was 92,600, equating to 33% of unintended pregnancies or 9% of all pregnancies. The abortion rate had remained stagnant since 1990–1994, during which time the unintended pregnancy rate had decreased by 18%.<ref>{{Cite web |date=2022 |title=Country profile: Mali |url=https://www.guttmacher.org/regions/africa/mali |access-date=25 July 2025 |website=[[Guttmacher Institute]]}}</ref> There is little research on abortion in Mali, and the country has no organizations dedicated to abortion research.{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}}

About four-fifths of abortions in Mali are performed outside of health facilities, and most are [[Unsafe abortion|unsafe]]. Abortions are often provided by illegal providers with unsanitary conditions; women seeking abortions find these providers through [[social network]]s. Unsafe abortion is the fifth-most common cause of [[maternal mortality]] in the country, {{As of|2022|lc=y}}.{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}} Many abortions are performed by untrained providers. [[Self-induced abortion]] is commonly performed by inserting objects into the uterus, consuming excessive doses of medication,{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}} or consuming poisons such as soap, dye, or [[methylene blue]].{{sfn|Diallo|Hami|Maiga|Coulibaly|2013|p=365}} [[Traditional medicine]] workers believe abortions can be induced with bitter plants such as ''[[Khaya senegalensis]]'' and ''[[Opilia amentacea]]''.{{sfn|Nordeng|Al-Zayadi|Diallo|Ballo|2013|p=4}} Many [[Prostitution in Mali|sexual slavery camps in Mali]] have clinics for traditional abortion providers, according to the [[National Agency for the Prohibition of Trafficking in Persons]] in 2010.<ref>{{Cite news |last= |date=29 September 2010 |title=Thousands of Nigerian women 'found in Mali slave camps' |url=https://www.bbc.com/news/world-africa-11438341 |access-date=26 July 2025 |work=[[BBC News]]}}</ref> {{As of|2020}}, illegal abortion services cost between 40,000 and 110,000 francs, depending on the gestational age.<ref>{{Cite news |last=Fatoumata |date=15 January 2020 |title=Mali : Pratique de l'Avortement : Le Coût Financier à Supporter |trans-title=Mali: Abortion Practice: The Financial Cost |url=https://maliactu.net/mali-pratique-de-lavortement-le-cout-financier-a-supporter/ |access-date=27 July 2025 |work=Mali Tribune |via=MaliActu |lang=fr}}</ref>

Legal abortions are available with both [[Medical abortion|medical]] and [[surgical abortion]].{{sfn|Sorhaindo|Castle|Flomen|Lathrop|2023|p=5}} Abortion care is more available at private facilities, according to the 2013 [[HeRAMS]] survey by the [[World Health Organization]] and the Ministry of Health.{{sfn|Tunçalp|Fall|Phillips|Williams|2015|p=7}}

Women with unintended pregnancies often have abortions to avoid negative reactions from family members or society. Abortions are typically the result of [[premarital sex]], as pregnancy outside of marriage is viewed as dishonorable for a family, whereas high birth rates are encouraged for married women.{{sfn|Tembely|Koumare Tembely|Ludot|Moro|2022|pp=168–169}} In 1981–1982, 82.1% of pregnancy terminations were among unmarried women.{{sfn|Bankole|Singh|Haas|1999|p=73}} According to some estimates, abortion is common among young women and adolescents.{{sfn|van de Walle|Maiga|1991|p=85}}

== Post-abortion care == Since it first became available in Mali in 2006, [[post-abortion care]] (PAC) has been managed through decentralized local authorities with local funding.{{sfn|RamaRao|Townsend|Diop|Raifman|2011|p=43}} Many women with abortion complications only receive PAC through informal providers or self-medication, as revealing abortions risks legal punishment and stigmatization.{{sfn|Sow|Izugbara|Diarra|Djiteye|2022|p=112}} The NGO [[Population Services International]] has trained public and private facilities to provide PAC using [[manual vacuum aspiration]] and [[misoprostol]].{{sfn|Sorhaindo|Castle|Flomen|Lathrop|2023|p=5}}

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[[Category:Abortion by country|Mali]] [[Category:Abortion in Africa|Mali]] [[Category:Health in Mali]] [[Category:Women's rights in Mali]]