Unsafe Abortions - What is the Position In Country?

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Unsafe abortion has the highest impact in developing countries whose citizens lack widespread access to high-quality medical care. 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 here - Marie Stopes International

Recent reports have indicated that the situation in Malawi has become a concern. Approximately 900 to 1,000 maternal deaths occur for every 100,000 live births, a significant increase from the year 1992. A high percentage of the deaths are related to unsafe abortions.

According to (IPAS) Alliance for Africa, "incomplete abortions caused largely as a result of unsafe abortions are the most common reasons for admission to gynecological wards in Malawi".

In his speech at the International Conference on Population and Development (ICPD) in 1994 the former Vic President of Malawi, Honorable Justine Malewezi said despite the criminalization of abortion in Malawi, nearly 35% of all maternal deaths are due to induced abortions, translating into an increasing rate of clandestine and back-door abortions. He added that unsafe abortions account for 60% of all acute gynecological admissions and is responsible for 30% of maternal deaths.

To address the rate of maternal mortality and other issues that marginalize women, a special Law Commission was appointed under the section 133 of the Constitution to review gender-related laws in Malawi.

The commission has since produced a 3rd report in draft form on the development of legislation on gender equality which was extensively discussed with civil society and other interested parties at a national consultative meeting in September this year.

According to the findings of the commission, recent statistics show that; "the central hospitals in Malawi are attending to high numbers of women seeking post abortion care".

The commission report also states that between the year 1999 and early 2006 Kamuzu Central Hospital (KCH) in Lilongwe registered 2,384 women seeking post abortion care. Queen Elisabeth Central Hospital (QECH) in Blantyre registered 3,178 cases and Zomba Central Hospital registered 1,239 cases.

One of the largest referral hospitals in Malawi, QECH receives an estimated 15 -20 gynecology cases on a daily basis; 50% of the cases relate to abortion complications.

Despite abortion being a crime that carries a stiff prison sentence for both provider and women seeking abortion, some statistics report that nearly 35% of all maternal deaths are due to induced terminations by clandestine back street providers. These abortions are often carried out in unhygienic conditions, using un-sterlised equipment and dangerous objects.

The commission report states that it (the commission) observed that the provisions of the Penal Code 120 in respect of abortion brought into force in 1930 are overly restrictive and inconsistent with the spirit of the Reproductive Health Policy of the country, as well as several international conventions to which Malawi is signatory.

"Malawi has ratified the Protocol to the African Charter on Human and Peoples' Rights on the rights of women in Africa which has progressive provisions on women's reproductive health rights. Further, women are entitled to reproductive health that includes entitlement to medical abortion.

The Protocol to the African Charter also provides the removal of the liability for women who seek, and providers who perform abortions; and for the clarification of the requirements for health facilities offering pregnancy termination. In addition, the Protocol to the African Charter obliges State Parties to protect reproductive rights of women by authorizing medical abortion in the cases of sexual assault, rape, incest and where the mental and physical health of the mother or foetus is endangered," the report states.

Malawi is also signatory to the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) which obliges the country to take all appropriate measures to eliminate discrimination in the field of healthcare including those related to family planning.

Under the Maputo Plan of Action agreed by African Ministers for health as well as high level representatives of the African Union, for the implementation of the Continental Policy Framework for Sexual and Reproductive Rights 2007-2010 to which Malawi has signed, government is bound to reduce the incidents of unsafe abortion.

Part of the strategy in the plan of action for fulfilling this obligation includes enacting policies and legal frameworks to reduce the incidence of unsafe abortions.

Malawi, through Dr. Chisale Mhango , Director for the Reproductive Health Unit in the ministry of health was significantly involved in the development of the Plan of Action.