Unsafe abortion: The silent driver of Malawi’s maternal mortality

TITHA- There are various reasons women induce abortion

ZOMBA, Malawi

Unsafe abortion is among the major drivers of maternal mortality in Malawi, a health worker has said.

Currently, 439 women die per every 100,000 that give birth due to pregnancy and birth complications, according to Malawi Health Demography Survey conducted in 2015 and 2016.

Zomba District Safe Motherhood Coordinator Titha Office said besides hemorrhage,

sepsis and obstructed labour, unsafe abortion is another major cause of maternal deaths.

“Just between January and March this year, here in Zomba, we have registered 1064 unsafe abortions,” she said.

She attributed the problem to various factors, including the desire of girls with unplanned pregnancies to remain in school, the refusal of men to take responsibility for extra-marital pregnancies, defilement, rape, incest and poverty.

Magnitude

“With research done by the College of Medicine in 2015 showing that over 141,000 women induce abortions in Malawi every year, almost half of them doing so unsafely, we have a silent pandemic,” Titha said.

“The problem of the silent epidemic of unsafe abortions is that it mostly haunts women and girls of reproductive age,” she said.

She explained that due to religious and cultural beliefs, it is difficult for many people to openly discuss the issue of unsafe abortion and its consequences on maternal health.

She said studies show that the problem was rampant in rural areas among people with low education and literacy levels.

Recent statistics from both urban and rural health facilities indicate that abortion in Malawi is rampant.

Data from the Blantyre District Health Office shows that the majority of people seeking post-abortion care are young girls.
Of the 2003 reported cases that were treated for post-abortion care from unsafe abortions in the last quarter of 2023, a staggering 1003 were under the age of 20, while 1000 were slightly over 20 years old

Internationally, over 56 million induced abortions take place every year and about 25 million are unsafe, according to World Health Organisation statistics.

Solutions

The provision of youth friendly services, contraceptives and post-abortion care in health facilities are among the interventions that the government is currently implementing to reduce maternal deaths in Malawi, a medical expert has said.

“It is the government’s wish to reduce maternal deaths, which are higher in the rural areas than in the urban areas through various interventions,” said Dr Alinafe Kalanga Mjojo, Zomba District Health and Social Services Director.

She urged journalists to report professionally on sexual and reproductive health issues as part of promoting the prevention of unwanted pregnancies.

KALANGA MJOJO – We are scaling up youth friendly services and family planning

Making his presentation to journalists, Legal Researcher and Consultant Mateyu Sisya said the enactment of the Termination of Pregnancy Bill would help in reducing maternal deaths.

According to Sisya, the limitations on legal abortion have resulted in a proliferation of unsafe abortion practices, which pose a significant risk to the health and lives of women.

“The restrictive laws not only jeopardize women’s health but also hinder their reproductive rights and autonomy. Denying women who have been raped and girls who have been defiled is at odds with reproductive health rights.

“The law needs to be changed so that raped women and defiled girls should access safe abortion in hospitals without challenges,” he said.

His comments come after the Malawi Government, through the Law Commission, drafted the Termination of Pregnancy Bill.

Legal Consultant: Mateyu Sisya

The government’s proposition, according to the report on the review of abortion laws, is that, if enacted, the Termination of Pregnancy Bill will liberalize abortion by extending grounds to:

  • To save the life of the woman;
  • To prevent injury to the physical or mental health of a pregnant woman;
  • There is a severe malformation of the foetus; and
  • The pregnancy is a result of rape, incest or defilement.

Malawi’s current abortion laws are among the most stringent in the world as the government simply copied wholesale the colonial law of 1930 without any review.

Currently, abortion is only permitted when the life of the pregnant woman is at risk, but the archaic law does not even define or explain the risk.

Benefits

Reforming abortion laws in Malawi could have several benefits, explained Sisya, saying it would enable women to access safe and legal abortion services, thereby reducing the incidence of unsafe abortions.

“The abortion law reform implemented through the enactment of the Termination of Pregnancy Bill will also contribute to reducing maternal mortality rates,” he said.

Sisya added: “It will enhance women’s reproductive rights and autonomy, allowing them to make informed decisions about their bodies and lives.”

Centre for Solutions Journalism organized the media training to empower journalists from Balaka, Machinga and Zomba with skills on professional media coverage of abortion issues.