Agnes is one of the many young women who have been victims of the Malawi abortion law. She had an unsafe abortion earlier this year because the law does not allow her to access safe abortion services at the health facility. She went through excruciating pain, which could have either claimed her life or womb.
She is one of the girls in Malawi that have suffered in silence for using unsafe ways of terminating a pregnancy for fear of seeking safe abortion services from health facilities.
According to her, the method she used was deadly but she had no other choice.
Abortion is an offence in Malawi and punishable by law except when the mother’s life is in danger. The current abortion law does not grant women and girls easy access to safe abortion services, as a result girls and women use unsafe methods of abortion for fear of the law.
It has been found that in their desperate need to abort, some women and girls drink detergents, aloe vera, ginger, termik and other harmful substances in order to induce it. Some even go to the extent of inserting a cassava stem or sharp objects in their uterus to remove the pregnancy which is very dangerous. Some girls and women seek the help of traditional healers.
Agnes said when she got pregnant, early this year she decided to terminate it but because the law does not allow that, she decided to follow what her friend had told her.
‘’I got pregnant unexpectedly and I was not ready to keep it at that time. So I decided to terminate it. I used some concoction which some birth attendants (azamba) gave me, but it was very risky because I had to go through pain because the local medicine does its magic slowly and does not completely wipe off all the remains from the pregnancy,’’ she said.
Agnes said she used the unsafe abortion method which was even deadly because she had no money for the service and on top of that she knew it was difficult for health workers at a health facility to respect her decision because of the law.
One of the traditional healers in Mwanza district (name withheld) said he has been assisting young women to abort using his concoction.
According to the healer, he has a concoction that terminates the pregnancy within two hours from the time of consumption and another one that takes about 24 hours to terminate a two or three months old pregnancy.
‘‘I can confirm that older as well as young women do come to my house to terminate pregnancies. Here, I only help those with one to three months old pregnancy not beyond that. If it is one month old, I do give out a powdered concoction and when it is beyond one month, I do give out another concoction a bit more powerful than the first,’’ he said.
The healer, however, said there are times when the process becomes complicated.
‘‘You know, our medicine has no exact quantity when we are giving out to our patients and this sometimes becomes dangerous because you never know what will the concoction do in the body,’’ he added.
A research that was conducted in 2015 showed that the government spends K 500 million a year for post abortion care services yet offering safe abortion services would be cheaper than that. Post abortion care is a service that is given to women who have had complications due to unsafe abortions and other pregnancy complications.
Mwanza District Hospital is one of the many hospitals that have recorded a high number of post abortion care cases, an indication that unsafe abortions are taking place hence the complications. For example from January to 12th September 2020, Mwanza District Hospital has handled 359 comprehensive post abortion care cases.
James Chatsika, who is a post abortion care clinician at Mwanza DHO, said they receive many women and girls who come for post abortion care at the hospital, a thing he said is costing government a lot of money.
‘‘Mwanza as a district we are dealing with complications that arise from unsafe abortions… for example from January to September 2020 we have treated 359 complications. The complications mainly are the return products of conception, intra-abdominal injuries, bleeding, sepsis, and even death,” he said.
He added that the hospital mainly receives females in the age ranges of 15 to 20 years and 28 to 35 years old.
Chatsika said the cases give the health workers overload since post abortion care needs more attention.
‘’I once found cassava sticks in the cervix, all aimed at terminating a pregnancy. So for such cases to fully recover, they cost us a lot,’’ he said.
Meanwhile, Health Rights activist Maziko Matemba has said it is unfortunate that women and girls are resorting to unsafe abortions, putting their lives at risk in the process.
‘’I think as a country we need to look at the reasons why our girls and women take the risk. If we are able to know, then we should be able to work out ways on how best we can help to reduce the deaths that arise from the complications,’’Matemba said.
Alliance for Youth in Sexual and Reproductive Health Rights Organizations (AYSO) National Coordinator, Prisca Kunsida, said for the mere fact that a lot of women and girls are finding themselves into trouble because of unsafe abortion, there is need to look into the current restrictive abortion law and make it accommodating so that deaths that come from complications are reduced in the country.
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As a way of reducing maternal deaths that arise due to pregnancy complications and unsafe abortions, a bill was made on termination of pregnancy which is expected to be tabled in Parliament in October this year.
The Termination of Pregnancy Bill is an extension of the already existing Malawi abortion law which says that women should be allowed to have safe abortion in order to save the life of the mother, to preserve the physical or mental health of the pregnant woman, in cases of severe fetal malformation which will affect its viability or compatibility with life, in case of rape, incest or defilement provided that this be done within 16 weeks of gestation, with consent and by a trained health personel.