By Anna Miti
HARARE — Every year, an estimated 65,300 induced abortions take place across Zimbabwe. For many of the women and girls behind this statistic, the procedure is not a medical one but a desperate gamble involving any number of methods. The limited circumstances under which abortion is legally permitted under the Termination of Pregnancy Act of 1977 leave women vulnerable, pushing many to resort to unsafe abortions — a reality in many communities.
Estimates suggest that abortion-related complications account for roughly 25% of all maternal deaths in the country. The UNFPA estimates that 40% of pregnancies are unintended, with at least a quarter ending in unsafe abortion. As a result, medical experts and rights advocates are calling for a bridge between restrictive laws and a mounting public health crisis.
“It Haunts Me”
For many young women, the path to termination begins in secrecy and ends in trauma. A midwife, speaking on condition of anonymity, described a horrific array of methods used by desperate patients, including ingesting bleach or washing powder and drinking excessive amounts of a specific tea brand. Common methods include inserting bicycle spokes or “poking” the uterus with sharp objects and, in extreme cases, using battery acid. In some communities, both urban and rural, young women also use herbs or plants believed to induce abortion.
It is not known whether any of these methods are effective, but there is a widely held belief in some communities that they can induce abortion. Regardless, all of these methods pose significant health risks, including death.
“Precious,” who discovered she was pregnant at just 13, recalls being advised by older girls to drink ballpoint pen ink and ingest a plant she was told could induce abortion.
“It was really painful, but I could not tell my parents,” she says, years after the ordeal. “They did not know why I was so sick … but even now, that pain haunts me.”
Her story is far from unique. “Tatenda” found herself pregnant at 16 and abandoned by her much older boyfriend. She turned to a friend who used a mixture of chilli pepper and aloe vera (gavakava) to induce an abortion. To “speed up” the process, the friend used a chilli plant root to poke Tatenda’s uterus.
“I fell gravely ill and bled profusely,” Tatenda says. “I was too scared to seek medical help.”
Although not scientifically proven, both survivors believe that the bleeding and subsequent abortions were due to these actions.
Mr Itai Rusike, Executive Director of the Community Working Group on Health (CWGH), says many women and girls are driven into the shadows because of restrictive abortion laws and a lack of clarity about their provisions.
“The topic of abortion is taboo within the African context and cultures, as it is not openly talked about, although evidence shows that it happens frequently. Women and girls continue to seek abortion services outside health facilities, with most of these abortions being carried out in unhygienic conditions by people who are not trained to address the complications that may arise, leading to high morbidity and mortality.”
A Legal Deadlock
Currently, the Termination of Pregnancy Act (1977) allows legal abortion only when the mother’s life is at risk, in cases of serious foetal impairment, or when the pregnancy results from rape or incest.
However, even those who qualify face bureaucratic hurdles. Mildred Mushunje (PhD), Country Director for Sexual Reproductive Health and Rights Africa Trust (SAT), notes that administrative requirements can be a barrier to seeking legal termination. For example, a woman requires authorisation from two separate medical doctors and letters from magistrates in cases of rape. Victims may end up incurring additional costs, such as transport, which often forces women to abandon the legal route.
In 2014, a rape survivor won a landmark case after suing the government for delaying her access to a safe abortion, resulting in her giving birth to her rapist’s child.
Efforts to modernise the law have faced stiff resistance. Clause 11 of the recent Medical Services Bill, which sought to allow abortion on request up to 12 weeks, was stripped from the Bill by the Senate following intense pressure from religious groups.
Illegal Providers
While the law remains stagnant, the market for termination services has moved underground and online. On Facebook, unlawful abortions are advertised openly. In the streets of Harare, a grey market for abortion pills and termination services has emerged.
Some doctors are offering the service for a fee, according to Faith (not her real name), an abortion survivor.
“My boyfriend paid US$200 to the doctor who performed my abortion at a private clinic,” she said.
“You can get any pill you want from suppliers,” says a tertiary student in Harare. “PrEP, morning-after pills or abortion pills. All you need is the right plug.”
Although available to some who can access them, so-called abortion pills should not be used without medical supervision. Dr Tich Nyamundaya, Chief of Party at the Zimbabwe Health Interventions organisation, warns that while the combination of mifepristone and misoprostol is safe and recommended by the WHO for medical abortion to end early pregnancies (up to 10–12 weeks) and to treat miscarriages, unsupervised use can lead to life-threatening complications.
Dr Nyamundaya said that whatever method is used, those who undergo an abortion need post-abortion care (PAC).
He further highlighted that unsafe abortions account for between 25% and 30% of maternal deaths in the country and that adolescents account for the majority of unsafe abortions.
“Earlier studies show that 15% of maternal deaths in rural areas and 23% in urban areas can be attributed to unsafe abortion,” he said.
He added that delays in seeking PAC also contribute significantly to maternal health complications and emphasised that women and girls should seek help as soon as possible after an abortion.
Mbuya Dhori (not her real name), who lives in Epworth, revealed that she has assisted an unknown number of women and girls to induce abortions. She says that although her clientele comes from varied backgrounds — from married women to teenage girls and even some in primary school — the trauma and pain are part of the process.
“It’s better if they come in the early stages of pregnancy. I just use this other herb, which is a common plant. But sometimes I use that big crochet needle because the herbs may fail to work, among other methods. Some just bleed and it stops and it’s done, but others need to go to the hospital for blood transfusions if they lose too much blood.”
She said she charges between US$20 and US$100, depending on the circumstances.
“Sometimes I am compassionate when someone is really poor. I can do it for free out of sympathy for an orphan already taking care of siblings. Where can they get the money when the man has already run away?”
The Gap in Post-Abortion Care (PAC)
Under Zimbabwean health policy, PAC is a right. Medical professionals are mandated to treat any woman suffering from abortion complications, regardless of whether the abortion was induced or spontaneous.
“The policy remains that even if a patient walks in with a clothes hanger hanging from her vagina, she has a right to care without fear of being reported,” says Dr Mushunje.
Yet stigma and fear of arrest keep many women in the shadows until it is too late. Mr Rusike noted that recent programming revealed that most women do not know they have a right to receive PAC without victimisation. He added that this lack of awareness contributes to delays in seeking care, resulting in complications that could have been easily resolved if treatment had been sought promptly.
The Economic and Moral Argument
Critics of the current restrictive landscape argue that the status quo is both a humanitarian and financial failure.
“It seems unfair that safe abortion is restricted and illegal, yet PAC is a guaranteed service,” notes Dr Mushunje. “It implies one needs to go through the worst before they can be treated instead of simply being offered termination safely.”
Another midwife, who works at a public health institution and requested anonymity, said she has not only witnessed the consequences of these “backdoor” procedures but has also had to assist survivors.
“If a woman is desperate enough, she will use anything at her disposal. This means that, as midwives, we have more work dealing with complications that would not be necessary if abortions were performed safely in the first place,” she said.
Mr Rusike added: “It is important to note that restrictive abortion laws do not reduce the number of abortions that occur, and permissive laws do not necessarily lead to more abortions.”
