Abortion dilemma: Should Zim take S A route?

Shamiso Yikoniko
Unsafe abortions are horrendous; in some cases, the perpetrators do not live to tell their stories. Abortions among young women and girls are now the main cause of maternal mortality accounting for 20 percent of the deaths.

On average, Zimbabwe records between 500 000 and 700 000 pregnancies per year, and in 2016, 514 women died while giving birth.

With these statistics in mind, the debate around whether or not to legalise abortion sounds redundant, but surprisingly it remains a dilemma in Zimbabwe considering the moral, religious and cultural notions tied to it.

Zimbabwe, like most African countries, is highly conservative when it comes to optional termination of pregnancy, unless it is for health reasons.

While the debate rages on, hundreds of women are dying during the process of illegally terminating pregnancies in backyards.

Evidence and statistics overwhelmingly suggest that illegal abortions, which are often conducted under unhygienic conditions, contribute to the maternal mortality.

The question to ask is, presented with the facts at hand, should Zimbabwe take the South African route to legalise abortion?

Some members of the Parliamentary Portfolio Committee on Health and Child Care are pushing for legislation to permit abortion amid revelations that nine percent of adolescents between 10 and 19 years have fallen pregnant before (National Adolescent Fertility study, 2016).

Chairperson of the committee, Dr Ruth Labode, is on record for saying it is only fair to allow safe abortions in unwanted pregnancies.

“We can’t continue denying these young women access to safe abortions, yet we know they will still proceed to abort, whether it’s allowed or not,” she said.

A University of Zimbabwe obstetrics and gynaecology department official who agreed to speak on condition of anonymity said terminating a pregnancy is a woman’s health right.

“Society has no right to dictate what a woman should do about her health. A lot of women risk their lives by being driven to undertake unsafe abortions,” he said.

“In many cases, we have seen sticks and metal hangers protruding from the uterus, and we have lost some women due to unsafe abortions.”

Abortion is illegal in Zimbabwe under the Termination of Pregnancy Act of 1977 [Chapter 15:10].

The new Constitution stresses the need to protect the lives of unborn children.

However, abortion is allowed in certain specified circumstances. For instance, it is permissible when one falls pregnant as a result of rape or incest.

It is also allowed when there is serious risk that the child to be born will suffer from a physical or mental defect or when the continuation of the pregnancy endangers the life of the mother.

Sekuru Friday Chisanhu, a traditionalist, strongly advocates against abortion.

“Since time immemorial, abortion has always been regarded as murder,” he explained.

“It shouldn’t be legalised because it renders the sacredness of murder null and void. In a way we will be giving leeway to murder cases in the country.”

The upsurge in child abuse cases and early sexual engagement among girls contributes to the high incidence of unwanted pregnancies and abortion.

Women’s Coalition of Zimbabwe health cluster leader, Ms Edna Masiyiwa, emphasised the importance of economically empowering young women and girls as a solution to their reproductive and health challenges.

“Studies shows that 20 percent of maternal deaths are due to abortions and they are mainly happening in young women under the age of 24. These die from septic infections, haemorrhage through bleeding of a fractured uterus, septic abortions and hypertension in pregnancy,” she said.

Rampant poverty, unavailability of contraceptives, poor sex education, shift in cultural or religious values, the increased need to limit family size and the general emancipation of women has fuelled this demand.

Given the figures and circumstances, there seems to be a need to revisit the laws on abortion. While it is debatable whether an outright legislation is the answer, certainly there is need to be more practical, efficient and have more affordable ways of achieving legal abortions.

While abortion is illegal, the law requires that health practitioners offer women and girls post-abortion care services without asking any questions.

Dr Labode criticised the Government policy, which provides only for post-abortion care.

“As responsible leaders, we shouldn’t wait to offer corrective procedures when we could actually provide safe abortion as is happening in other countries,” she said.

The most common abortion procedure is taking some medication within seven to nine weeks of pregnancy. These drugs are mostly acquired on the black market.

Sometimes women use sharp objects which damage or perforate the uterus or injure other organs.

Ms Masiyiwa added that one unsafe abortion burdens the already burdened health system.

“The law allows abortion in some circumstances, hence the argument that abortion is murder doesn’t hold any water,” she said.

“If abortion is legalised, it’s not like women will go willy-nilly to abort, but we are saying let there be choices for them.”

Abortion is a punishable offence which attracts a maximum sentence of up to five years imprisonment.

Five countries in Africa have relatively liberal abortion laws.

In South Africa, the Choice of Termination of Pregnancy Act was amended in 1997 to legalise the provision of abortion on demand to any woman as long as the pregnancy is less than 20 weeks.

Mozambique and Tunisia also allow pregnancy termination without restriction as to reason but with gestational limits.

Zambia and Cape Verde permit abortion on socio-economic grounds.

Initial results for the Abortion Prevalence Study indicate that the Southern Africa Development Community regional rate stands at 30 percent while Zimbabwe has a prevalence rate of between 15 and 20 percent.

The director of family health in the Ministry of Health and Child Care, Dr Bernard Madzima, said though they are concerned with the increased numbers of maternal deaths due to unsafe abortions, it is beyond the ministry’s jurisdiction to legalise abortion as several stakeholders must be consulted.

“Abortion is a socio-cultural issue which is beyond the Ministry of Health and Child Care. In the whole equation, we are just but technical partners and not decision-makers,” he said.

“Evidence is there that unsafe abortions are among the top five causes of maternal mortality but the call needs all the relevant moral, religious and cultural stakeholders to be involved.”

For years, the debate has raged, with religious groups saying abortion is murder and anyone who commits this “crime” is a murderer.

Bishop Clarence Nyarire of Glorious Fire Family International said, “Abortion is wrong. lt’s failure to love, appreciate, and care for a human being. It constitutes the deliberate killing of an innocent human,” he explained.

“When people defend abortion, their arguments should always be evaluated in light of the fact that the unborn baby is a human being, a separate individual from its mother. Therefore, deliberately killing it would be just as wrong as killing any other innocent human being.”

Though figures could not be availed, the Ministry of Health and Child Care admits that unintended pregnancies are very high among youths aged between 17 and 24.

“Even in countries were abortion is legalised, it’s still a contentious issue,” Dr Madzima added.

Instead of legalising abortion, another school of thought calls for the promotion of family planning and making contraception more accessible.

Currently, family planning averts approximately 310 000 unintended pregnancies in Zimbabwe annually. By investing in family planning now, the country will increase this number to almost 500 000 per year by 2020.

However, most parents were agitated in 2015 when Parliament deliberated on whether condoms should be made available to pupils and be placed in schools.

In 2016, 4 500 grade seven pupils dropped out of school owing to pregnancies and in the same year, more than 3 000 sexually transmitted infections were recorded between the 10 and 14-year-olds.

The above statistics are an indication that adolescents are indulging in sex even though Government policy does not allow distribution of condoms in schools.

The World Health Organisation estimates that one in every five pregnancies worldwide ends in induced abortion and that around 47 000 women die due to complications linked to unsafe abortions.

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