Unsafe abortion is hurting Malawi women: Pregnancy Termination Bill is important piece of legislation

State House confirmed on Monday that the Termination of Pregnancy Bill will be tabled in the current sitting of Parliament. As expected, voices against this bill are already soaring.

For instance, the Malawi Council of Churches, Episcopal Conference of Malawi, Muslim Association of Malawi, Evangelical Association of Malawi and Qadria Muslims Association of Malawi have all spoken against the proposed bill.

But before we stand against this proposed bill, have we really understood what this bill is all about and what problem it intends to solve?

We have a serious health challenge facing our women in form unsafe abortion. Law or no law, our women and girls, every day, are indulging in unsafe abortion and it’s destroying their wombs, some are dying and, of course, the country is losing a lot of money in post-abortion care.

For instance, according to a 2009 government study, there were about 70 500 induced abortions in Malawi. Of these, almost half are younger than 25 years old, four out of five are married and about two-thirds live in rural areas.

According to the study, an estimated one in five women had severe complications, seven percent had moderate complications and 73 percent had low or no complications.

Economically, unsafe abortion is rearing its ugly head on the country’s thin purse. In providing post-abortion care, government loses between $300 000 (K120 million) and $500 000 (K200 million) every year.

Arguably, this is a challenge we must handle as a nation. There is no way we can look otherwise when our women are facing a problem.

In solving this problem, we need, in the first place, to ask: What is driving our women to indulge in safe abortion?

There are two major reasons why most women and girls opt for unsafe abortion. One, because safe abortion is costly and, two, because there is a perception that abortion is illegal.

To address this, government has come up with a Pregnancy Termination Bill with a goal to, one, make safe abortion free and, two, expand the grounds of procuring abortion.

But let us face facts, first.

Contrary to popular views, abortion, under Section 243 of the Penal Code, is legal in Malawi.

The section says performing an abortion is not a crime if it is done “for the preservation of the mother’s life, if the performance of the operation is reasonable, having regard to the patient’s state at the time, and to all the circumstances of the case.”

At the same time, under Sections 149-151 of the Penal Code, abortion legislation is very restrictive.

Section 149 says “a person who assists a woman to abort is guilty of a felony and may be imprisoned for up to 14 years” while Section 150 provides that “a woman who aborts or attempts to abort is guilty of a felony and may be imprisoned for up to 7 years.”

In addition, Section 151 says “any supplier of items, drugs etc is guilty of a felofny if he/she was aware that the item is intended to be used for abortion, and may be imprisoned for up to 3 years.”

What this means is that despite abortion being legal, the law is very restrictive in the sense that it demands that abortion should be carried out by “any person with reasonable care and skill to carry out an operation to preserve the mother’s life.”

What we have is that there are no standards and guidelines to guide policy makers, NGOs, the Ministry of Health and medical professionals on how to apply Section 243 of the Penal Code.

This section is vague. For instance, it fails to answer questions such as: who makes a decision that the pregnancy should be terminated between doctor and patient? At what stage can this decision be made? At which health facility? What are the counseling guidelines? What about religious beliefs? What about family planning awareness?

The net effect of this is that there are free-for-all abortions being carried out by many unskilled people. The result is that we have a situation that all complications related to unsafe abortions are ending up in hospitals.

So, hospitals are spending a lot of time and resources providing post-abortion care from unsafe abortions. This is in form of providing space in the wards and ICU, operations in theatre and provisions of necessary drugs.

The country needs to open up and start talking about the issue, scale up family planning and reform the law on abortions.

This current situation is fueling a lot of unsafe abortions. It is costly to the nation, and the space to access safe abortion is very limited.

If you can ask Malawians now whether women are having abortion almost everybody will say ‘yes’. But if you go further and ask them as to ‘how’ and ‘where’, there will be a lot of murmuring and hiding of information.

If you go to the hospitals especially gynecological wards they will tell you that 30 percent of the space is being occupied by unsafe abortion patients.

Then you realise there is chaos which should not continue where women are injured and killed. It is time to put in place a proper law that will address the problem and stop women from dying.

This is what the bill, to be tabled in Parliament, wants to address. That is why this bill is important and we should all support it.

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