Women's Right to Surgical Self-Consent: A Legal and Moral Imperative for Somalia.

In Somalia, the cultural requirement for male family authorization before surgical procedures even in emergencies remains a silent but deadly barrier to timely care. This practice, particularly in obstetric emergencies such as caesarean section, delays life-saving interventions, heightening risks for mothers and newborns. Evidence from Somaliland shows that nearly half of prolonged caesarean section delays are due to family decision-making for consent, with a measurable increase in severe maternal outcomes. This article is presented as a policy commentary aimed at highlighting the impact of current consent practices on women's health and proposing feasible reforms. Respectfully, this commentary urges lawmakers, healthcare leaders, and community elders to consider a compassionate reform that enshrines a woman's right to make informed decisions about her own health. By aligning policy with both ethical medical practice and Islamic principles of preserving life, Somalia can move toward a safer, more equitable maternal health system. This commentary recommends five key actions: legally affirming women's right to self-consent, enabling emergency presumed consent when delays endanger life, introducing advance antenatal consent to prevent avoidable delays in emergencies, engaging communities to build understanding and acceptance, and strengthening provider training to support respectful and timely decision-making.