Unsafe Abortion Leads to Maternal Death


In many parts of the world, women who have an unwanted pregnancy often find themselves caught up in an isolated and agonizing situation, left alone to decide whether to have a child that they may not be able to support or have an abortion.

According to the UN, although abortion is commonly practiced throughout most of the world and has been practiced since long before the beginning of recorded history, it is a subject that arouses passion and controversy.

In Zimbabwe, as in many sub-Saharan African countries, abortion, except in cases of rape, incest, fetal impairment, or to preserve a woman's health, is illegal – and if caught, women face jail terms. As a result, many women resort to clandestine, unsafe and life-threatening abortion methods.

Backyard abortions are so rife in Zimbabwe in spite of the laws that prohibit the practice, putting the life of women, particularly young women, at risk. UNICEF estimates that 70,000 illegal abortions take place in the country every year. In sub-Saharan Africa, 70% of women who end up in hospital after an unsafe abortion are under 20.

Marie Stopes International reports that the risk of death from unsafe abortion is higher in Africa than any other region: nearly half of global maternal deaths related to abortion occur in the region.

"Unsafe abortion has the highest impact in developing countries whose citizens lack widespread access to high-quality medical care," the group reports.

Given the high rates of HIV infection among women in the region – the majority of people living with HIV in sub-Saharan Africa (61% or 13,1 million) are women – governments will have to adopt progressive pro-adoption policies.

In the absence of Prevention of Parent to Child Transmission (PPTCT) methods, there will likely be an increased demand for abortion services. And, thus, there is need to set up abortion clinics and ensure access to safe abortions.

"Women living with HIV seek abortion care for the same myriad reasons as all other women. Additionally, the same factors that make some women vulnerable to HIV also often increase their need for access to safe abortion services," says Barbara Crane, Ipas executive vice president for technical leadership and advocacy.

Having said that, young women – in particular – left with little choice, face immense pressure to terminate unwanted pregnancies. Traditional and cultural norms highly stigmatize and discriminate against children born out of wedlock further putting pressure on young women who fall pregnant before marriage to opt for abortion – either conducted by untrained persons or self-inflicted.

Abortions are usually conducted in unregulated and unsanitary conditions and with methods that kill the young women or render them infertile for the rest of their lives. To put it bluntly, clandestine abortions are a leading cause of maternal mortality in the country.

According to a UNICEF report, illegal, self-inflicted abortion methods are thought to include the consumption of detergents, strong tea, alcohol mixes and malaria tablets; other methods include the use of knitting needles, sharpened reeds and hangers.

The termination of the pregnancy is permitted in circumstances where a pregnancy endangers the life of a woman or where there is a serious risk that if the child to be born would suffer from a physical or mental defect of such a nature as to be severely handicapped.

In addition, the termination of pregnancy is permitted if the fetus is conceived as a result of unlawful "intercourse," defined as rape, incest or intercourse with a mentally handicapped woman.

Given the high rates of maternal mortality attributed to unsafe abortions in the country, there is need for treating abortion as an issue of health and welfare as opposed to one of crime and punishment in order to save women's lives.

The fact is that even though abortion is criminalized, young women affected by high levels of poverty and the social undesirability of children born out of wedlock, resort to abortion as a way to manage their lives and livelihoods.

According to analysts, abortion laws which are traceable to colonial regimes in sub-Saharan Africa need to be reformed in order to safeguard the rights of women.

However, removing women's criminal liability for abortion is only but one part of the solution. There is need for widespread educational campaigns about contraceptive methods that are available to women. Access to the methods must be made as easy as possible to women who may face social condemnation for using contraceptives within their communities.

Also, evidence in countries such as Nepal shows that provision of comprehensive care and support and approving clinics where women can have an abortion safely can significantly reduce the number of women that die due to pregnancy-related causes.

All in all, a liberalized law in Zimbabwe can help to avert the high rates of injury and death among women associated with unsafe abortion.

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