The Lack of Adequate Information and Awareness on Safe Abortion Services among Young Women and Girls is Promoting Continuous Clandestine Abortions
By Mufaro Musiyazviriyo
The term abortion, generally makes people uncomfortable!
In my work as a Sexual and Reproductive Health Rights (SRHR) Program Officer, often times, I conduct awareness raising trainings and focus group discussions on SRHR issues with young women and girls in tertiary institutions and communities, where incidents of unsafe abortions have been reported. I have made it a habit to begin my introductions by mentioning the term abortion publicly, in a loud tone. The observations I make of people’s expressions and immediate reactions to the word are quite interesting (I do need to invest in a less odd pastime). A quick survey of the faces and expressions in the room will denote displeasure. Discomfort. Uneasiness. Shock. Surprise. A sort of Agitation. Disagreement. A quick glance in my direction and immediately eyes cast down to the earth, for how does one look in the eyes of one speaking such profanity openly? Hence alluding to the popular connotation that people are generally uncomfortable conversing about abortion, despite the context of the subject matter.
My observations and findings have shown that these behavioural tendencies, are influenced by values, attitudes, prior experiences, and beliefs, and these have significantly added to and impacted the notable gap in awareness and knowledge on abortion-related issues by young people. Additionally, they have fueled societal stigma and discrimination towards the phenomenon and those who have or wish to seek the medical service. Research conducted by the National Library of Medicine in 2018 shows that Zimbabwe has one of the highest maternal mortalities in the world and the Guttmacher research in 2016 stated that over 65 000 women had induced abortions.
One of the teaching tools is the “Cross the Line Activity” which is used to measure how many people in a room know about abortion and its legality in Zimbabwe and how many are affected by moral, societal and or religious values and attitudes when it comes to abortion. Using this activity on the programs we have conducted with university students we have found that over 300 young girls out of the 500 trained in 2022, do not have information on abortion. A more specific evaluation of this fact has shown that the information is lacking from the very understanding of what abortion is (in terms of process, occurrence, and procedure) to the legal provisions that are stated in the Termination of Pregnancy Act of (1977). Majority of the training participants perceive abortion as murder or killing and this belief is stemmed in two reasonings, one the literal dictionary definition and the second one being religious fundamentalism.
What is Abortion/ Definitions of Abortion
The lack of information stems from failure of understanding what abortion is. I have observed in the trainings that participants engage in a debate over dictionary definitions of abortion. Literature shows that existing definitions of abortion vary and there is often controversy surrounding what abortion means, as the definitions reflect not only scientific knowledge but social and political opinion. A dictionary explanation of abortion describes it as the expulsion of a foetus from the uterus before it has reached the stage of viability (Britannica 2022). Data I have gathered from focus group discussions show that, that is the most popular definition of abortion. Furthermore, literal translation and interpretation of the definition, based on the (…before it has reached the stage of viability) support popular belief that conducting an abortion is carrying out a murder or killing, hence explaining the intended or unintended discrimination against the act and towards those who have carried it out.
According to a fact sheet by the World Health Organization (WHO 2021), abortion refers to pregnancy termination prior to 20 weeks gestation. An extension of this definition specifies abortion as an essential health care service (WHO 2020) which encompasses care related to miscarriage (spontaneous abortion), induced abortion (the deliberate interruption of an ongoing pregnancy by medical or surgical means), incomplete abortion as well as foetal death (intrauterine foetal demise). The difference between the two definitions noted above is that the latter is more extensive in scope and offers a more scientific explanation and findings show that this makes it less popular. Due to its more explanatory nature, the definition by WHO can be interpreted to speak on abortion based on different scenarios thus making it difficult to allude to it as killing or murdering. Thus, the recommendation, in an analysis of definitions of the term abortion alone, will be, that using the more extensive and scientific descriptions paint a broader perspective of abortion that does not relegate it to the negative conclusion that it is an act of murder. Therefore, raising awareness of this nature among citizens will effectively address the lack of accurate and comprehensive information on the subject and subsequently attract less discrimination towards the procedure or those who seek the service.
Awareness Raising in Relation to Legality of Abortion
A research paper published by McKenzie and Magondiwa (2019) shows that at least 1 in every 10 people are aware of the legality of abortion in Zimbabwe. The vast majority are of the belief that it is illegal attracting jail time. Dialogue with participants has resulted in finding that this belief is centred on the fact that they have seen poster signs in the streets of Harare, both residential and industrial, which show evidence of poster signs labelled ‘abortion is murder’ or ‘abortion is a crime’ and these stern warnings have been internalised by the people, without sound knowledge of the legal environment that supports these warnings. Results from research-based discourse with Zimbabwean citizens on the legality of abortion in the country show that termination of pregnancy is illegal and upon asking where they base this on, they allude to the warning posters and oral modes of communication that have been passed down from generation to generation. To remedy this one of the more feasible remedies would be structured trainings to raise awareness on the Termination of Pregnancy Act of Zimbabwe of 1977.
Vigorous publicising of this law will ensure that people have knowledge on the lawfulness of abortion and the grounds of its legality and this in turn will address issues of fear related to speaking about abortion, abortion-related stigma as well as instances where unsafe abortions of pregnancies conceived unlawfully are terminated using unsafe abortion methods. Furthermore, the lawfulness of seeking abortion services will result in knowledge generation of where the services are accessed, timeliness of accessing the services and how these can be accessed. The overall effects of this on the lives of young women will be that they will reduce the frequency of indulging in unsafe abortion practices and consequently reduction in the maternal mortality rates.
