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Viet Nam ABORTION POLICY Grounds on which abortion is permitted: To save the life of the woman To preserve physical health To preserve mental health Rape or incest Foetal impairment Economic or social reasons Available on request Yes Yes Yes Yes Yes Yes Yes Additional requirements: A legal abortion must be performed by a physician. REPRODUCTIVE HEALTH CONTEXT Government view on fertility level: Too high Government intervention concerning fertility level: To lower Government policy on contraceptive use: Direct support provided Percentage of currently married women using modern contraception (aged 15-49, 1997): 56 Total fertility rate (1995-2000): 2.6 Age-specific fertility rate (per 1,000 women aged 15-19, 1995-2000): 27 Government has expressed particular concern about: Morbidity and mortality resulting from induced abortion Complications of childbearing and childbirth Yes Yes Maternal mortality ratio (per 100,000 live births, 1990): National South-eastern Asia 160 440 Female life expectancy at birth (1995-2000): 69.6 Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references. 178 Viet Nam BACKGROUND Limited information is available on the legal status of induced abortion in Viet Nam in early post-colonial times. What information exists suggests that abortion on request was available in the Democratic Republic of Viet Nam (North) by at least 1971 and has been available in the entire country since its unification in 1975. Previously, abortions could be performed in the Republic of Viet Nam (South) only for narrowly interpreted medical indications, owing to the existence of a 1933 decree enforcing a French law prohibiting abortion and the use of contraception. In recent years, the Government of Viet Nam has approved a number of laws that regulate abortion in various ways. The Law on the Protection of Public Health (30 June 1989) clearly provides that “women shall be entitled to have an abortion if they so desire”. Decision No. 162 of the Council of Ministers in January 1989 obligates the State to supply, free of charge, birth control devices and public-health services for abortions to eligible persons who work for the Government, to persons to whom priority is given under policy, and to poor persons who register to practice family planning. Under the regulations of 1991, which deal with pregnancy termination in the context of maternal and child health care, a medical establishment or person may not perform an abortion without the proper authorization. Decree No. 12/CP on the promulgation of Social Insurance Regulations authorizes sick leave for abortions. Most importantly, Viet Nam’s Criminal Code contains no abortion provisions, evidence that the procedure has been decriminalized. Emphasis on family planning varied greatly between the Northern and Southern Provinces of Viet Nam before unification. Beginning in 1962, in the Northern Provinces, the government planning policy was directed to reducing the rate of population growth. The use of certain relatively permanent contraceptive methods, such as the IUD, was promoted. Abortion on request (with the husband’s consent) was available during the first trimester of pregnancy and was usually performed by vacuum curettage. In contrast, the family planning programme in the Southern Provinces began in the late 1960s, largely in response to concern over maternal and infant mortality and the increasing numbers of illegal abortions. However, up until the early 1970s, family planning clinics offered services only to women with at least five living children. Even when family planning services were later expanded to include women with one living child, a marriage or cohabitation certificate was required to obtain services. In the mid-1970s, the Government of the Republic of Viet Nam stated that family planning had been adopted as an official policy, but inadequate medical facilities made it impossible to implement an effective family planning programme. Since the unification of Viet Nam, family planning has been considered a major national priority. In 1982, various family planning measures were adopted by the Government, including the use of abortion and the creation of the National Committee for Population and Family Planning. After 1983, limiting families to two children became obligatory. Incentives for contraceptive and abortion acceptors, as well as penalties for family planning violations, were further increased in 1985, in an effort to promote implementation of family planning. Viet Nam has successfully lowered its total fertility rate over the period 1970-2000 from 5.9 children per woman to 2.6. Abortions rose six-fold between 1982 and 1994 in Viet Nam. The country had an estimated abortion rate of 83.3 abortions per 1,000 women in 1996, the highest in the world for that year according to the Alan Guttmacher Institute. The National Committee for Population and Family Planning reported 1.5 million Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references. 179 Viet Nam abortions in 1998. These figures do not include a growing number of private-sector abortions, estimated at 500,000 or more additional abortions per year. At the same time, the maternal mortality ratio of 160 maternal deaths per 100,000 live births is low, roughly a third of the regional rate of 440. Surveys indicate that contraceptive awareness is very high in the country, particularly in regard to IUDs, the predominant method. The use of modern contraceptives has grown steadily in the 1990s, from 38 per cent in 1988, to 44 per cent in 1994 and to 56 per cent in 1997, according to the most recent Demographic Health Survey. While the IUD remained the most widely used method, supply-based methods and the condom in particular were increasingly used. There appears to be a substantial unmet demand for family planning, given the reliance upon pregnancy termination and menstrual regulation and the significant number of women not using contraceptives that do not desire another birth. Limited contraceptive choice, erratic supply and delivery problems in a largely agrarian and mountainous State are some of the continuing obstacles to family planning in Viet Nam. Source: Population Policy Data Bank maintained by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. For additional sources, see list of references. 180