Research findings
The new research has revealed that in 2015, an estimated 60 percent of women who had an abortion experienced complications that required medical treatment in a health facility. “Our study found that in 2015, more than half of all pregnancies in Malawi were unintended, and almost one-third of those unintended pregnancies ended in abortion,” said Dr. Chelsea Polis, senior research scientist at the Guttmacher Institute and lead author of the study. She added: “Helping Malawian women avoid unintended pregnancy is critical to reducing the incidence of abortion and the complications and deaths that often follow unsafe, clandestine procedures,” The study co-author Dr. Chisale Mhango, a senior lecturer at the University of Malawi’s College of Medicine said unsafe abortion is one of the major causes of maternal death in Malawi. According to recent estimates, complications from abortion are the cause of 6–18 percent of maternal deaths in Malawi. “Restrictive abortion laws do not stop abortion from occurring, they just drive it underground, forcing women to resort to clandestine procedures, which are often unsafe…Addressing unsafe abortion is an urgent public health priority,” observes Mhango. Key Facts- Malawi’s maternal mortality ratio remains one of the highest in the world—574 maternal deaths per 100,000 live births in 2014—and maternal deaths present a major public health challenge for the country.
- The majority of induced abortion procedures in Malawi are performed under clandestine and unsafe conditions. Complications from abortions have been estimated to account for between 6 and 18 percent of maternal deaths in Malawi.
- Abortion is only legal in Malawi to save a woman’s life. Obtaining an abortion for any other reason is punishable by 7–14 years in prison.
- A national debate is currently under way on whether or not to liberalize Malawi’s abortion law by providing more exceptions under which an abortion could be legally obtained.
Incidence
- In Malawi, an estimated 141,000 abortions were performed in 2015. This number translates to a rate of 38 abortions per 1,000 women aged 15–49.
- Within Malawi, abortion rates vary widely by region, from 29 per 1,000 women in the Central region to 61 in the Northern region.
- In Malawi in 2015, 39 percent of pregnancies ended in planned births, 30 percent in unplanned births, 16% in abortion and 15 percent in miscarriages.
- Malawi’s abortion rate is similar to other countries in the region, including Tanzania (36 per 1,000 women) and Uganda (39), as well as to the regional rates for Eastern Africa (34) and Southern Africa (35).
- A 2009 study estimated a substantially lower abortion rate in Malawi than the new estimated rate for 2015. Due to several methodological differences between the two studies, it is not possible to infer a trend on the basis of these two studies.
Post-abortion care
- Out of the estimated 141,000 abortions performed in Malawi in 2015, approximately 60 percent resulted in complications that required medical treatment in a health facility.
- An estimated one-third of the women who experienced complications from an abortion did not receive the medical treatment they needed.
- The annual treatment rate for complications from abortion was estimated to be 14 per 1,000 women aged 15–49 in 2015.
- A 2009 study estimated that more than one in four women who reached a health care facility for postabortion care had severe or moderate complications.
- The majority of Malawi’s postabortion care cases are treated at district hospitals (35 percent), health centers (22 percent and clinics (20 percent).
- Treating complications of unsafe abortion represents a significant financial burden for the national health system in Malawi. A 2009 study estimated that a liberalized abortion law and access to safe abortion in public health facilities would yield a 20–30 percent decrease in postabortion care costs for the health system.