ZIMBABWE this week joined the rest of the world in commemorating the Safe Abortions day albeit the country is still operating under a 43-year-old Termination of Pregnancy ACT which prevents women from accessing safe abortion at health institutions even though evidence suggests that majority of the country’s maternal deaths are as a result of haemorrhaging due to unsafe abortions, a legal expert has said.
By Michael Gwarisa
The country’s existing Termination of Pregnancy Act (TOP ACT V (No. 29 of 1977) was adopted in 1977 and only permits women to access safe abortion if the physical health of the life of the mother is at risk, if there is a possibility that the child will be born with either a mental of physical disability and if the pregnancy was as a result of unlawful sexual intercourse. Unlawful sexual intercourse is defined as rape, incest or sexual intercourse with someone with a mental handicap.
In an interview with HealthTimes on the side-lines of the Safe Abortion Day commemorations in Harare, Katswe Sisterhood Programs Manager and legal expert, Advocate Debra Mwase said prior to 2013, Zimbabwe’s constitution did not speak about the right to life for the unborn child, however, the current constitution protects the right to life for unborn children and directs that there should be an ACT of Parliament of Termination of Pregnancies.
In Zimbabwe, the pregnancy can be terminated by a medical practitioner and the medical practitioner is defined as a medical doctor. The pregnancy is to be conducted in a designated medical institution or state hospital and the procedure for getting a termination is that for the first first two instances, you need the opinion of two doctors who are operating at two different establishments to say yes, a termination is needed.
“The third procedure is that you report to the police and then the magistrate issues a certificate satisfied that on a balance of probability, the sex was unlawful. There are instances of an emergency where there is an emergency and you need to terminate without the opinion of two doctors and the life is at risk. At this juncture, you can terminate but then you need to inform the secretary for health and also the superintendent and you need to write explaining why you need to terminate the pregnancy,” said Adv Mwase.
She added that there was also a problem with grounds from which a woman can be permitted to get a safe abortion which only speak to the physical health of the mother and there is not mention of the mental health of the mother.
“The other issue is on unlawful sexual intercourse, there are other acts of unlawful sexual intercourse that are not covered, for instance sexual intercourse with a minor which used to he called statutory rape, that is actually a gap. In terms of the procedure, the procedure is cumbersome if you look at the first instances. If you look at our patient, doctor ratio it is very difficult to get two doctors. You can think of your rural home and to think how many doctors are there. And then the costs for scanning to ensure that the baby has a physical disability, the tests among others.”
She added that the procedure within the magistrate court was a problem as there are no set time limits and normally in procedural issues there are time limits where its said within three days or 72 hours of receiving a report, the police should take a docket to the magistrate and the magistrate shall make a determination within 24 hours.
[pullquote]“We don’t have those time limits in the current Act. That is why at times a person gives birth and then the order comes when the baby has already been born. The issue of the designated institution which is a state hospital, it limits where services can be accessed.[/pullquote]
“And then we have the issue around a medical doctor, when a medical doctor was suggested, it was in 1977 when the thought the procedure was very complicated however with the advanced technologies, it can even be self-managed and does not still need t be performed by a doctor alone, even a nurse can do it,” said Adv Mwase.
Outside the TOP, the Minister of Health and Child Care (MoHCC) can make regulations on certain things. According to Adv Mwase, after realising that women were dying the health ministry made reservations and allowed post abortion care with no questions asked.
“Post Abortion Care is permissible in Zimbabwe; one can walk into any hospital and get a post abortion care without even getting reported to the police and there are national guidelines from the ministry of health and child care.
“However, we are still stuck as a nation. Abortion is still stigmatised, abortion is still criminalised and even where post abortion care is permissible, health service providers, some of them are not aware of those guidelines and some are still reporting women to the police and even some medical doctors are ignorant.”
Meanwhile, Civil Society Organisations (CSOs) in Zimbabwe have come together to advocate for access to Sexual and Reproductive Health Services including safe abortion for Young girls and women. The team of CSOs in running under the banner Access Taskforce and consists of various CSOs including the SRH Africa Trust (SAT), The PITCH Consortium, MY AGE, Zimbabwe Young Positives among others.
SAT Country Director, Dr Mildred Mushunje said a lot of young girls in Zimbabwe were dying as a result of maternal related causes and this can be prevented by making SRH services available.
“As SAT, we continue to advocate for young people’s access to comprehensive reproductive health and services. This allows them to be able to have control over the decisions that they make, In essence, we are saying if a young person feels ready to consent to sex, they should be to access contraceptives, they should be able to access services.
“Even if they are not ready, we are saying that if they know what services are available out there, at least they make an informed choice. Right now we have a situation whereby young people are becoming pregnant not because out of choice but because they don’t have the understanding or the knowledge of where the services are or at times the services are stigamtised, they are frowned upon so young people feel a bit frightened to access these services, in the end they end up getting unprotected sex and making uniformed decisions,” said Dr Mushunje.
