SIN OF OMISSION
Dr. Fred Gbagbo recognized the woman right away, even though the blood had drained from her face and was instead pooling between her legs. There was no trace of the pushy, even demanding young woman in this listless body lying semiconscious in front of him. During their first encounter just hours earlier, he’d concluded that she was a devil trying to tempt angels. Now, seeing her so pale, he wasn’t so sure.
That morning, she had interrupted a pre-work prayer he was conducting with other student doctors in the gynecology unit of a teaching hospital in Ghana; she was pregnant, she said, and she wanted an abortion. Gbagbo and his colleagues, devout Christians all, knew what to do. They told her no, preached her the Gospel, and sent her on her way, proud they had so uncompromisingly cast her out, certain they had deterred her from sin.
But here she was back again, and Gbagbo couldn’t shake the nagging, nauseating feeling that perhaps it was he who had sinned. Their examination revealed a perforated uterus, the likely result of an attempt to perform the abortion herself, or the botched efforts of a local freelancer; either way, she wasn’t talking, and her body told only the worst of the story. They took her to the operating room, but it didn’t matter. She died there hours later, a first-year medical student and her parents’ only daughter.
A decade later, one question still haunts Gbagbo: “Who killed this poor girl?”
The possible answer—that in refusing the woman care, it was Gbagbo who was culpable for her death—branded a mark of guilt on his heart so deep that it set him on a new path. Not long after, he started his work as an advocate for safe abortion, which led him to become a leader in developing Ghana’s national policy on comprehensive abortion care. Now, he is the national director of medical development in Ghana for Marie Stopes, an international NGO, overseeing private facilities that provide family planning, infertility treatment, prenatal care, and safe abortions for women in need.
In many ways, Gbagbo’s personal journey mirrors the evolution experienced across this coastal West African nation. Alarmed by research showing that unsafe abortion was the second-leading cause of Ghana’s startlingly high maternal death rates, since 2006 the Ghanaian government has embraced a more liberal policy on reproductive health, slowly working to integrate both safe abortion and effective contraception into the formal health care system. The past decade has brought significant progress in making abortion safer and more accessible across Ghana, coming hand in hand with easier access to family planning measures than ever before—putting the country ahead of the many other African nations where abortion remains illegal and disturbingly unsafe. Though abortion is still stigmatized and often clan-destine, people in big cities are increasingly aware of where to get access (if not quite yet in the country’s rural reaches). As a result, more women are able to get procedures performed by trained medical professionals.
But that progress may have just hit a wall in the form of an American president bowing to domestic anti-abortion forces and implementing a restrictive new policy that will cut off U.S. aid to any foreign organization that so much as talks about abortion.
This policy, an executive memorandum also known as the Global Gag Rule or the Mexico City Policy
