Abortion dilemma . . . unwanted pregnancies give rise to maternal mortality

28 Aug, 2018 - 00:08 0 Views
Abortion dilemma . . . unwanted pregnancies give rise to maternal mortality Part of the crowds attending one of WAG’s focus group discussions on abortion

The Herald

Paidamoyo Chipunza Senior Health Reporter
Tatenda Chimuka, 19 (not real name) is a survivor of rape. She has a moderate mental disability and was raped by a 15-year-old boy and her uncle on different occasions.

To compound her situation, Tatenda fell pregnant. A pregnancy she neither planned for nor wanted.

Ordinarily, one would think that upon hearing her ordeal and pleas to terminate the pregnancy, the courts would quickly issue a certificate of termination.

But alas, it took her up to 20 weeks, coupled with intervention of a local non-governmental organisation, Women’s Action Group (WAG), to have the pregnancy terminated.

“Initially, they were questioning her sanity and she had to go through medical assessments to prove that she had a mental disability. Then there were financial obstacles to get required scans done and transport money to enable her to travel to Bindura General Hospital from Mafarikwa Village in Guruve, where she hailed,” said WAG programmes officer Ms Maria Chiwera.

While Tatenda eventually managed to get a legal abortion, faced with a similar predicament, many other girls of her age opt for unsafe ways of terminating the unplanned and unwanted pregnancy, thereby exposing themselves to reproductive complications.

Complications of unsafe abortions include excessive bleeding and infections, which may lead to hysterectomy (complete removal of the uterus) or death in worst case scenarios.

According to the 2016 national adolescent fertility study, at least 16 percent of maternal deaths in Zimbabwe are due to unsafe abortions, half of which occur among adolescents.

The same study, which was conducted by the Zimbabwe National Family Planning Council further revealed that nine percent of adolescents between the ages of 10 and 19 years fall pregnant and a majority of them are from rural areas.

“These pregnancies sometimes end up as unsafe abortions. We know that these statistics are just a drop in the ocean with a lot of backyard abortions and loss of lives going unreported,” said Family Health director in the Ministry of Health and Child Care, Dr Bernard Madzima.

Dr Madzima said in light of these challenges, Government initiated post-abortion care in all its health facilities aimed at reducing abortion complications.

He said these services were available to all women of all ages without any questions asked.

However, according to a recent study conducted by WAG in partnership with the Ministry of Health and Child Care on knowledge and attitudes on abortion among key stakeholders in Harare, Bulawayo and Masvingo showed that some women were not aware of existence of the Termination of Pregnancy Act, which allows women to terminate pregnancies in specific circumstances.

The circumstances allowed by law include the pregnancy posing serious threat to the woman’s health or when the foetus was conceived as a result of rape or incest.

The study, which was funded by the Safe Abortion Action Fund (SAAF) showed that a majority of women interviewed preferred assistance from traditional healers to terminate unplanned and unwanted pregnancies.

“Abortion is a highly sensitive and often stigmatised practice in Zimbabwe. The Zimbabwean legislation on abortion is restrictive.

Part of the crowds attending one of WAG’s focus group discussions on abortion

“Moreso, obtaining a legal abortion is a long and fraught process,” reads part of the research.

According to the study, the most common method of terminating pregnancy is medical tablets for stomach ulcers.

Although these tablets are used to prevent and treat stomach ulcers, and treat postpartum bleeding they can also be used to start labour and cause an abortion.

According to the study, these tablets are often given by elderly women in communities.

“The use of pills and drugs by elderly women who are well known and consulted in secrecy is common across the research sites.

“It was, however, not clear where and how these elderly women got these drugs,” further reads the study findings.

Other harmful methods noted in the study for abortion include washing powder, physical removal of the foetus using sharp objects, boiled roots and ashes.

Realising these challenges, as well as their contributory effect to high maternal deaths in Zimbabwe, WAG’s executive director Mrs Masiyiwa said there was need to educate women on existence of legal abortion and post abortion services available in the country to avoid continued loss of lives.

“NGOs also need to carry out advocacy not only in terms of the restrictive law but also the lack of access to those that should having legal abortions under the current law and this include access to information on the abortion law,” said Mrs Masiyiwa.

She said in Chimuka’s case, she could have been forced to keep the unplanned and unwanted pregnancy had it not been of her organisation’s intervention.

Mrs Masiyiwa said lack of information on what the law permits coupled with negative attitudes and stigma surrounding abortion mean that women with unplanned and unwanted pregnancies end up seeking clandestine services.

“These services usually end up being unsafe leading to high levels of maternal mortality and morbidity,” she said.

She said the knowledge and attitudes on abortion study together with another one on abortion incidences in the country being carried out by Government of Zimbabwe, Guttmacher Institute and the University of Zimbabwe is expected to give more evidence for advocacy on abortion.

Parliamentary portfolio committee on women and youth affairs chairperson Hon Mrs Priscilla Misihairabwi-Mushonga who is also proportional representative legislature for Matabeleland South province said current legislation on abortion needed review as it creates a “class scenario”.

“We know that those who afford get abortion in private clinics and the poor carry through the unwanted pregnancy to birth. Current terms of termination even refer to the justice system, a route which also seem to be difficult for the poor to pursue,” said Hon Misihairabwi-Mushonga.

She said although the abortion debate has not yet been brought before the House, conversations have already began within the gender portfolio committee as well as within communities.

Hon Misihairabwi-Mushonga said the current law came into effect in 1977, hence its relevance has also been weakened with realities on the ground.

She said apart from review on provisions of the law, its applicability in its current state has also been problematic.

“Many women who are permitted by the law to terminate pregnancies are failing to do so due to the processes involved, yet termination itself has become even easier with advances in medicine,” said Hon. Misihairabwi-Mushonga.

Although some sectors of society have criticise legalisation of abortion arguing that it might increase the number of teenagers getting pregnant and seeking abortion services, others argue that no major change in statistics have been noted before and after legalisation in countries that have taken that route.

These countries include South Africa, Kenya and Zambia.

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