Summary
- Liberia's stalled Public Health Bill has revived debate over abortion. One former lawmaker and advocate for the bill says it would make abortion available for life-saving emergencies such as ectopic pregnancy, severe pregnancy complications, fetal malformity and mental illness.
- Liberia faces a serious maternal health crisis. World Bank data shows 628 maternal deaths per 100,000 live births, one of the highest rates in the world. A 2021 Ministry of Health and Clinton Health Initiative study found 14,555 women sought care for abortion related complications.
- Senator Darblah Varpilah, Senate Health Committee chair, said abortion remains the main obstacle to passing the bill. The numbers will not be clear until the bill reaches the Senate.
When a pregnancy turns dangerous, doctors do not always have time to debate words. Liberian pharmacist and former politician Joseph Somwarbi told a recent workshop in Monrovia that abortion opponents have taken advantage of the issue to score political points at the cost of thousands of Liberian women's and children's lives.
Somwarbi, who said he lost his seat as representative from Nimba County and his role as chairman of the House Committee on Health over his support for the bill, said the abortion provision is designed to give doctors, women, and their families the chance to save women's lives when pregnancy is threatening to kill or injure them and the unborn child.
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"When a pregnancy poses a threat to the life of the woman, do you really call that just abortion? No." Somwarbi said, "This is the point where pregnancy is a death sentence."
Somwarbi condemned the actions of politicians and religious leaders who have opposed the bill, saying they have framed it as "abortion on demand," rather than a life-saving measure.
The contentious clause in the Public Health Bill would make abortion legal until the 14th week of pregnancy. It would replace the existing law that prohibits abortion in all forms except in the case of serious harm to the mother and only with the written consent of two doctors and the Ministry of Health. Sowarmbi said this was impractical, especially in rural areas where there are few doctors.
Somwarbi detailed multiple instances where the life of the mother was seriously threatened unless an abortion took place, including conditions including pre-eclampsia and ectopic pregnancy, when a fertilized egg implants outside the womb, often in the fallopian tube. He said this kind of pregnancy cannot survive and can rupture, causing heavy bleeding and death if not treated quickly.
Somwarbi also mentioned serious heart disease and cases of uncontrolled diabetes or hypertension. He said some women cannot safely carry a pregnancy when their hearts and other organs cannot handle the additional strain, including kidney or liver failure. Pregnancy can worsen these conditions and increase the risk of death.
Victims of rape and incest were also committing suicide or murdering their babies because trauma had overwhelmed them.
Somwarbi told journalists that many women were dying and becoming maimed. Many infants were being born and suffering from deformities and other conditions that meant they would not survive.
"Women were dying unnecessarily because of the existing law," Somwarbi said. "So, should we let the mother die when there are means for us to save her so she will have another child thereafter?"
The bill contains a raft of other measures that take into account improvements in technology and other advancements in healthcare that have come into place since the public health bill was written in 1974. But it has been held up in the Senate since 2022 because of resistance to the abortion clause.
Liberia is debating the bill at a time of deep concern about maternal deaths and unsafe abortions. World Bank data shows Liberia's maternal mortality rate at 628 deaths per 100,000 live births in 2023, one of the highest in the world.
Thousands of Liberian women and girls are also suffering and dying after they have felt forced to resort to illegal abortions in a range of dangerous methods. A 2021 study by Liberia's Ministry of Health and the Clinton Health Initiative reported that 14,555 women sought care for abortion related complications.
Civil society advocates said the numbers show why lawmakers should move.
"Every time we delay this bill, women remain at risk, especially women in rural Liberia," said Amelia Siaffa, acting executive director of Sister Aid Liberia. "Without clear law, doctors may hesitate in emergencies. Unsafe abortions continue in secrecy, and women keep dying from preventable causes."
The organization is a women-led national non-governmental organization that promotes the rights of women and girls.
Siaffa said she supports safeguards. She said there should be "a precise structure" for how services can be accessed, and when they can be accessed.
She also tied her position to personal experience. "I nearly lost my life eight years ago from an abortion done in secrecy," she said.
Delayed Bill Designed to Modernize Liberia's Health System
Supporters of Liberia's proposed Public Health Bill say it is primarily an effort to bring the country's health laws into the present. Joseph Somwarbi said the bill is intended to replace Liberia's 1976 public health law, which predates many of the systems and challenges that now define modern public health practice. He said the existing law offers little legal guidance for today's health institutions, leaving gaps in how outbreaks are managed, services are regulated, and health workers are protected.
Somwarbi said the bill goes far beyond the abortion provisions that have dominated public debate. It sets out clear rules for core public health systems, including vaccination programs, biosecurity and disease surveillance, occupational health standards, environmental health regulations, and sexuality education. These provisions, he said, are meant to strengthen the government's ability to prevent and respond to health threats while establishing consistent standards for public and private health services across the country.
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Where the bill stands in the Senate
Somwarbi said he has met with religious leaders, including Catholic bishops, to explain what the bill is trying to do, but they have been resistant. Communication continues to be an issue, according to Darblah Varpilah, senator and current chair of the Senate Health Committee. She said the issue was not fully explained to lawmakers and the public at the start.
"From the conversations we've had, it was not communicated clearly to those who could vote," she said. "The way the Legislature works, you can't just sit and say you've got the numbers. You have to test the flow until you get on that floor and take the vote."
Varpilah rejected calls to remove abortion from the bill, saying that the option has been discussed, but reproductive health is part of the wider health law and should remain in the bill.
Somwarbi urged advocates to push now. "Now is the time for advocates to push for the passage of the bill," he said. "If you wait closer to the (2029) election, it will not get passed."
This story was a collaboration with New Narratives as part of the "Investigating Liberia" project. The Swedish Embassy provided funding. The donor had no say in the story's content.
