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Ministry of Health Obstructs Abortion Law
Dear Editor,
May 4, marks 31 years since the National Assembly passed the Medical Termination of Pregnancy Act and in so doing empowered mid-level healthcare workers to provide, early term, non-surgical abortions.
Our doctor-centered, top-down Ministry of Health has opposed that provision from day one.
We took the Ministry to the High Court and in 2016 won an unequivocal declaration establishing that indeed “medexes, midwives, nurses, pharmacists and any other appropriately trained and registered mid-level member of the health profession” could lawfully provide the service. FPAG v AG, 2013 No. 849/SA Demerara.
That was ten years ago. Yet the Ministry of Health continues to refuse to implement this important provision.
This provision is irrelevant to women who can afford access to private physicians. But it is exceedingly important to the poor women who live in any of several hundred remote villages in the hinterland.
In 2022, more than a quarter of a century after our law, the very conservative and very cautious World Health Organization issued its Abortion Care Guideline, https://www.who.int/publications/i/item/9789240039483. In that evidence-based document they urged member states to do exactly what our law allowed 27 years earlier: empower mid-level healthcare professionals to provide medication abortion.
But apparently our distinguished medical leadership in the Ministry of Health has greater scientific sophistication than WHO.
Our great leaders will probably contend that they are more careful than WHO and they are mindful of the risk of ectopic pregnancies. Ectopic pregnancy is a 2% risk. What is the risk of unsafe abortion in the hinterland, 2%, 20%, 30%…?
This is about the status and power of doctors. By radical contrast the central organizing model of the WHO’s Guideline is “client-centred,” the diametric opposite of our doctor-centred health system.
In Guyana, doctors run the show. They intimidate all other health professionals. It is no wonder therefore, that no mid-level health association has sought to exercise its lawful right – not MEDEX, not Pharmacists’, not Midwives’, and not Nurses’. The leaders of these bodies fear that if they tried to assert their rights, doctors would ruin their careers.
And there is another layer. Some of them are themselves ambivalent regarding whether abortion is healthcare, a crime, or a sin. Although Guyana decriminalized abortion a generation ago the stigma of abortion remains as strong as ever. Religious leaders play a major role in sustaining this culture of cruelty.
Only a week ago, the parliament in England expunged the records of all women ever convicted of abortion there going back to the 1800s. https://www.theguardian.com/world/2026/apr/17/law-pardon-women-convicted-abortions-passes-uk-parliament. This is a remarkable public apology. They are admitting what we have always known that the criminal abortion law was ineffective, unjust and harmful. What an admission! What a confession!
Bottom line: whether it is the power of doctors, the fear of mid-level providers, or the power of the church, what we know for sure is that our health service is not client-centred.
Sincerely,
ASPIRE
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