As part of my work as Executive Director of Women’s Action Group, I have been conducting Value Clarification and Attitude Transformation (VCAT) workshops on abortion. Through them, I have interacted with more than 500 young people, policy makers and service providers. It is amazing how each and every one of the participants has an abortion story to tell. This shows the extent to which women are having abortions, and mostly unsafe ones. The fact that women are having unsafe abortions was confirmed by a study by Guttmacher Institute (2016) in a study that revealed more 65,000 women had induced abortions in Zimbabwe.
By Edinah Masiyiwa
An observation that I made through the VCAT workshops is that most people think abortion is illegal in Zimbabwe, but that’s not true. It’s restricted. According to the Termination of Pregnancy Act (1977), abortion is allowed where there has been unlawful sexual intercourse (rape or incest), where the health of the pregnant woman is in danger, and when the fetus is grossly malformed. Most workshop attendees were not aware of the law which is supposed to benefit them. Another observation is that even the health workers who are supposed to offer the abortion services are not aware of the law that governs termination of pregnancy in Zimbabwe. A study by Dr Madziyire showed that only 25% of health providers and 47% of experts knew all four reasons under which abortion is legal in Zimbabwe.
One then wonders why there are no efforts by the government to educate communities on the provisions of this important law that benefits women and girls. There are so many women who have not been able to access safe abortions even if they are allowed to do so under the current law just because of lack of information as well as the administrative barriers that exist.
With the recent judgement overturning Roe vs Wade in the United States of America, many voices have called for access to safe abortion for women. This is so because restrictive laws on abortion will not stop women from terminating their pregnancies. There is evidence that restricting access to safe abortion has negative impact on women’s health. According to the World Health Organization (WHO), 23,000 women die from unsafe abortions each year and tens of thousands more experience significant health complications globally. Zimbabwe is no exception to these complications brought about by unsafe abortion.
Despite the restrictions on access to safe abortion in Zimbabwe, the Ministry of Health and Child Care has put in place a post abortion care programme which offers care to women who have had abortions, safe or unsafe. There is an extensive network of health institutions providing post abortion, but again, communities are not aware of this programme. This was revealed in a study by Women’s Action Group (2017). Provision of complete post abortion care treatment is important for reducing maternal morbidity and mortality due to unsafe abortion.
According to International Planned Parenthood Federation, almost all abortion-related deaths occur in low-and middle-income countries, with the highest number occurring in Africa. This includes Zimbabwe where abortion is one of the major contributors to maternal deaths. Unsafe abortion has been referred as a forgotten emergency because no one wants to talk about it despite women dying from complications.
I am not surprised that in Zimbabwe there was not much debate about the Roe vs Wade case. It is just because women’s health is not prioritised, particularly in this period where we are going towards elections which will be held in 2023. Women’s health has, however, become a political issue and given the attention needed for women to access quality reproductive health services.
The role of awareness raising in abortion issues cannot be over emphasised as safe abortion saves lives. With accurate information one can make informed decisions. Stigma on abortion can also be addressed through awareness raising. I saw this firsthand as I observed a shift in attendees’ mindsets at the end of the 10 VCAT workshops . The VCATs have allowed for open discussion on abortion.
The recently published WHO guidelines highlight the following as the three cornerstones of an enabling environment for abortion care 1. respect for human rights including a supportive framework of law and policy 2. availability and accessibility of information, and 3. a supportive, universally accessible, affordable and well-functioning health system.[1] Again we see the importance of information.
I am herby calling upon the government of Zimbabwe to ensure that all the laws passed should be disseminated to ensure that they are used by the intended beneficiaries. My call also goes to civil society organisations, particularly those that promote women’s rights, to disseminate information. This way people will be able to critically look at the laws and offer recommendations for effective implementation of the law.
The government should also consider implementing the WHO recommendation to decriminalise abortion. Implementation of this recommendation should go hand in hand with educating health workers on the Termination of Pregnancy Act. This way it will create an enabling environment for access to safe abortion, thus resulting in a decrease in maternal mortality ratio.
[1] WHO abortion guidelines.pdf
