Get Red Pepper's email newsletter. Enter your email address to receive our latest articles, updates and news.

×

Malawi’s unsafe abortion toll

A recent survey reveals that unsafe abortions are killing three women and girls daily in Malawi

November 9, 2011
6 min read

When she found out she was pregnant after being forced to have sex with her mother’s middle-aged boyfriend, 14 year-old Mercy took his advice. She secretly went to see a traditional healer who gave her a bitter concoction of powdered roots to swallow. Two days later, she began hemorrhaging heavily. She was rushed to the Central Hospital in Lilongwe, Malawi’s capital, where she was given emergency medical care that saved her life.

“I am very happy to be back in school and that my mother has left the man who made me pregnant”, says Mercy with evident relief in her voice.

But others have not been so lucky. A recent survey reveals that unsafe abortions are killing three women and girls daily in Malawi. Its findings show that half of all women seen in post-abortion care are under 25. According to the A Strategic Assessment of Unsafe Abortion in Malawi, poor, rural young women, including girls as young as 12, are bearing the brunt of its deadly unsafe abortion toll.

The report, which was conducted by the Reproductive Health Unit (RHU) at Malawi’s Ministry of Health with the assistance of international bodies including the World Health Organization (WHO) shows that alarming numbers of women and girls continue to die despite loud promises to achieve the United Nation’s Millennium Development Goal (MDG) 5 by 2015. MDG 5 is supposed to reduce maternal mortality by 75 per cent and achieve universal access to reproductive health.

The report notes that in a village near the former capital, Zomba, a local chief reported the death of 8 young girls linked to abortion complications within four months as the survey was being carried out. Another village chief, near Mulanje, reported the death of 5 girls from unsafe abortions in the same period. In a single month, 4 abortion-related deaths were also recorded at Queen Elizabeth Hospital in the commercial capital, Blantyre.

Over 20 women and girls are being killed and maimed weekly because they lack access to legal abortion which is prohibited under Malawian law, a relic of the British Offences against the Person’s Act of 1861. It was introduced when Malawi was under British colonial rule between 1891 and 1964.

Section 49 of the Penal Code says anyone administering abortion is liable to imprisonment for 14 years, while Section 150 indicates that any woman who solicits an abortion is liable to 7 years incarceration. Abortion is only allowed when a woman’s life is in danger. It requires the endorsement of 2, independent obstetricians and the consent of a spouse before it can be performed. It is out of sync with many international agreements.

And the ban is failing to prevent women and girls like Mercy from trying to end unwanted pregnancies. The report shows that there is a well developed black market for abortions in large cities including Lilongwe and Blantyre where they are carried out secretly in both private and public clinics. It estimates that 110,000 women have an abortion every year. Of these, 38,000 are treated for serious complications linked to unsafe abortion methods. The current average cost of a safe abortion is 5,000 Malawian Kwacha (US$33).

The report says, lack of access to information and availability of safe abortions in their regions means rural women and girls would be forced to pay double or triple the average cost of an abortion. As they struggle to even buy basic food, most are left with little choice but to seek potentially life threatening abortions from traditional healers and back street abortionists.

Early marriage and child bearing, inadequate knowledge of sexual and reproduction health, lack of access to health services and low rates of contraceptive use make Malawi’s teenagers particularly vulnerable to sexual and reproductive health problems including complications linked to unsafe abortions.  According to the report, about a third of adolescents aged 15-19 years surveyed reported having a close friend who tried to end a pregnancy. So did a fifth of teenagers aged 12-14. Like most women in Malawi, they have little or no choice over when or how they become pregnant.

According to the report, unsafe abortions account for 18 per cent of all maternal deaths and are the leading cause of obstetric complications. Malawi’s strict anti-abortion law, traditional cultural practices, which subjugate women and expose young girls to unsafe sex and deeply conservative, Christian society where talking openly about sex remains taboo, are partly being blamed for the high botched abortion fatalities.

The costs of unsafe abortions which can include swallowing crushed sisal leaves and fish poison and inserting cassava sticks into the vigina can be high. The healthcare bill to deal with abortion-related complications including perforation, haemorrhage, organ failure, and incomplete terminations can be up to 4 times what it costs to provide family planning services.

Significantly, in rare instances when abortions are reported to the police, cases are frequently dropped without investigation or prosecution. Many police officers interviewed for the report said they did not know what constituted legal abortion in the country.

The survey was carried out because abortion-related complications are the 4th commonest cause of maternal deaths in Malawi after postpartum haemorrhage, post puerperal infection, eclapmsia and severe pre-eclapmsia. The country has one of the highest maternal mortality rates in the world – currently estimated at 607 per 100,000 live births which it is currently tackling with notable success.

“The attempt to address unsafe abortions requires evidence that it is a major problem by giving data on its magnitude. It is our hope that the report will make people agree that there is a problem. Other countries that have had this problem such as South Africa and several countries in Europe, have found that the problem can be significantly reduced by supplementing family planning with the option of safe abortion,” says Dr Chisale, Director of the RHU.

The report makes 3 major recommendations: reform Malawi’s abortion law, provide wider and better sex education and family planning and improve adolescent sexual reproductive health services including post-abortion care.

“We know that this is an election issue. Elections are due in 2014, so it is not our wish to over stretch our luck by pushing too much at this time. The plan is to do advocacy with community members before approaching the presidency. We want the message to the presidency to come from the electorate,” adds Dr Mhango.

Seodi White, Executive Director of Women in Law in Southern Africa-Malawi (WILSA-Malawi) whose mission is to improve women’s human rights legally and socially, argues that the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) implies that the denial of medical procedures needed only by women is a form of discrimination against them. Her organization is advocating for reform of abortion laws and policies in a bid to expand access to safe abortion and increase awareness among stakeholders and within Malawian society.

“The current restrictive legal and regulatory framework is driving women to undertake unsafe abortions that are often fatal. It is contributing to the infringement of women’s right to life as well as their dignity and bodily autonomy. The need to increase women’s access to safe, legal abortion is essential for the reduction of unsafe abortions,” she says.

Red Pepper is an independent, non-profit magazine that puts left politics and culture at the heart of its stories. We think publications should embrace the values of a movement that is unafraid to take a stand, radical yet not dogmatic, and focus on amplifying the voices of the people and activists that make up our movement. If you think so too, please support Red Pepper in continuing our work by becoming a subscriber today.
Why not try our new pay as you feel subscription? You decide how much to pay.
Share this article  
  share on facebook     share on twitter  

What is ‘free movement plus’?
A new report proposes an approach that can push back against the tide of anti-immigrant sentiment. Luke Cooper explains

The World Transformed: Red Pepper’s pick of the festival
Red Pepper is proud to be part of organising The World Transformed, in Brighton from 23-26 September. Here are our highlights from the programme

Working class theatre: Save Our Steel takes the stage
A new play inspired by Port Talbot’s ‘Save Our Steel’ campaign asks questions about the working class leaders of today. Adam Johannes talks to co-director Rhiannon White about the project, the people and the politics behind it

The dawn of commons politics
As supporters of the new 'commons politics' win office in a variety of European cities, Stacco Troncoso and Ann Marie Utratel chart where this movement came from – and where it may be going

A very social economist
Hilary Wainwright says the ideas of Robin Murray, who died in June, offer a practical alternative to neoliberalism

Art the Arms Fair: making art not war
Amy Corcoran on organising artistic resistance to the weapons dealers’ London showcase

Beware the automated landlord
Tenants of the automated landlord are effectively paying two rents: one in money, the other in information for data harvesting, writes Desiree Fields

Black Journalism Fund – Open Editorial Meeting
3-5pm Saturday 23rd September at The World Transformed in Brighton

Immigration detention: How the government is breaking its own rules
Detention is being used to punish ex-prisoners all over again, writes Annahita Moradi

A better way to regenerate a community
Gilbert Jassey describes a pioneering project that is bringing migrants and local people together to repopulate a village in rural Spain

Fast food workers stand up for themselves and #McStrike – we’re loving it!
McDonald's workers are striking for the first time ever in Britain, reports Michael Calderbank

Two years of broken promises: how the UK has failed refugees
Stefan Schmid investigates the ways Syrian refugees have been treated since the media spotlight faded

West Papua’s silent genocide
The brutal occupation of West Papua is under-reported - but UK and US corporations are profiting from the violence, write Eliza Egret and Tom Anderson

Activate, the new ‘Tory Momentum’, is 100% astroturf
The Conservatives’ effort at a grassroots youth movement is embarrassingly inept, writes Samantha Stevens

Peer-to-peer production and the partner state
Michel Bauwens and Vasilis Kostakis argue that we need to move to a commons-centric society – with a state fit for the digital age

Imagining a future free of oppression
Writer, artist and organiser Ama Josephine Budge says holding on to our imagination of tomorrow helps create a different understanding today

The ‘alt-right’ is an unstable coalition – with one thing holding it together
Mike Isaacson argues that efforts to define the alt-right are in danger of missing its central component: eugenics

Fighting for Peace: the battles that inspired generations of anti-war campaigners
Now the threat of nuclear war looms nearer again, we share the experience of eighty-year-old activist Ernest Rodker, whose work is displayed at The Imperial War Museum. With Jane Shallice and Jenny Nelson he discussed a recent history of the anti-war movement.

Put public purpose at the heart of government
Victoria Chick stresses the need to restore the public good to economic decision-making

Don’t let the world’s biggest arms fair turn 20
Eliza Egret talks to activists involved in almost two decades of protest against London’s DSEI arms show

The new municipalism is part of a proud radical history
Molly Conisbee reflects on the history of citizens taking collective control of local services

With the rise of Corbyn, is there still a place for the Green Party?
Former Green principal speaker Derek Wall says the party may struggle in the battle for votes, but can still be important in the battle of ideas

Fearless Cities: the new urban movements
A wave of new municipalist movements has been experimenting with how to take – and transform – power in cities large and small. Bertie Russell and Oscar Reyes report on the growing success of radical urban politics around the world

A musical fightback against school arts cuts
Elliot Clay on why his new musical turns the spotlight on the damage austerity has done to arts education, through the story of one school band's battle

Neoliberalism: the break-up tour
Sarah Woods and Andrew Simms ask why, given the trail of destruction it has left, we are still dancing to the neoliberal tune

Cat Smith MP: ‘Jeremy Corbyn has authenticity. You can’t fake that’
Cat Smith, shadow minister for voter engagement and youth affairs and one of the original parliamentary backers of Corbyn’s leadership, speaks to Ashish Ghadiali

To stop the BBC interviewing climate deniers, we need to make climate change less boring
To stop cranks like Lord Lawson getting airtime, we need to provoke more interesting debates around climate change than whether it's real or not, writes Leo Barasi

Tory Glastonbury? Money can’t buy you cultural relevance
Adam Peggs on why the left has more fun

Essay: After neoliberalism, what next?
There are economically-viable, socially-desirable alternatives to the failed neoliberal economic model, writes Jayati Ghosh

With the new nuclear ban treaty, it’s time to scrap Trident – and spend the money on our NHS
As a doctor, I want to see money spent on healthcare not warfare, writes David McCoy - Britain should join the growing international movement for disarmament


12