THE Lusaka Times this week reported about a recent study that showed that unsafe abortions are costing Zambia $2.4m year – which could have been avoided if women in the country had access to safe termination services.
Zambia is not alone, nor even the most difficult country in Africa for women dealing with unwanted or risky pregnancies. There are only three countries in Africa where abortion is permitted without restriction; Cape Verde, South Africa and Tunisia. What this demonstrates is that not only is Africa extremely conservative when it comes to the early termination of pregnancies, but there has also been a great deal of thought put into the abortion question across the continent with countries creating precise legislation - not adhering to trends according to population size, development or even religion.
According to data from the Guttmacher Institute, there are 14 African countries where abortion is completely prohibited; 36 countries where it is allowed under specific circumstances and three where it is allowed without restriction:
These varying limitations on allowances for abortion, may give a woman more choice on deciding whether or not to end a pregnancy in some situations, but in others there is clearly no room for self-determination. This has led to a high number of illegal and unsafe abortions from occurring in Africa.
Even though over 6.4m abortions happen on the continent every year, only 3% of these happen under safe conditions because of the limitations imposed by legislation. Women, particularly those who are underage or unmarried, are more likely to look for a cheaper rate in a dodgy backstreet clinic or visit a “traditional doctor” to assist them in the termination of the pregnancy.
Then there are those who would attempt to abort the baby themselves by inserting sharp objects into their uterus or by injuring themselves by falling down stairs or jumping from heights. The hope is that they will successfully dislodge the embryo from the placenta, inducing an abortion.
In 2008 the World Health Organisation (WHO) estimated that 14% of all maternal deaths on the continent - approximately 29,000 women - were due to unsafe abortion. For those who survive, there can be complications afterwards - the WHO estimates that about 1.7m women in Africa are hospitalised annually for complications of unsafe abortion. Restrictive laws have also meant that hospitals are not properly equipped to provide post-abortion care, common shortcomings include, delays in treatment, shortages of trained health workers and medical supplies, use of inappropriate procedures and judgmental attitudes among clinic and hospital staff towards the patient.
Abortions in Africa, like all over the world, happen for a variety of reasons; lack of money to raise, feed or even pay for the delivery and hospital costs associated with the child, the stigma of having a child at a young age without being married or perhaps due to instances of rape.
Despite this, 14 African countries would rather a woman’s life be risked than permit her to have an abortion, And though some African countries take these factors into consideration - permitting women to have abortions to protect their sanity, finances or health - women will still choose alternative options, fearing backlash from law or society.
Under Nigerian law, performing an abortion is a criminal offence unless the pregnancy threatens the woman’s life, and penalties for the offence are severe. Because of these legal restrictions and religious and social norms, the practice of abortion is shrouded in secrecy often performed by unskilled individuals in dangerous conditions. As a result 25% of all women who have an abortion report experiencing moderate or severe complications, and only one-third of them obtain treatment.
In Uganda, where abortion is illegal unless it is life-threatening to a woman, statistics show that 23% of women seeking abortions go to traditional practitioners, 56% go to doctors or nurses, 15% try to induce abortion themselves and 7% purchase abortion-inducing drugs from pharmacists or other vendors. Because of this, earlier this year, Dr. Charles Kiggundu, one of Uganda’s leading Gynaecologists and Obstetricians, said that “half of the two million pregnancies that occur every year in Uganda are unwanted and as a result, about 400,000 are aborted, with 90,000 of them resulting in severe complications, which most times lead to death.”
One of the most surprising countries in its approach to abortion is Mauritius. This island nation that is a blend of religions and a melting pot of culture, is known for its high human development and progressive attitude, yet it is one of the African nations that prohibits abortion altogether as a result of a law enacted in 1838. According to a study done by the Mauritius Family Planning Welfare Association in 1997 there are approximately 20,000 secret abortions done per year and according to the Ministry of Health there are also approximately 24,000 reported cases of health problems due to abortion. These are only the official figures given, but many incidents will have gone unreported.
Though the vast governments will continue to ignore the plight of approximately 6m women who have abortions in Africa every year, in many cases the unnecessary loss of their lives could have been circumvented through effective family planning policies. There is a huge lack of family planning initiatives on the continent, which would include services to educate women and men on the use of contraceptives and limit family size voluntarily, minimising incidences of unwanted pregnancy. According to the World Health Organisation, even though the vast majority of women want contraception, only approximately 30% of all women in Africa use birth control - which includes condoms, the pill or the injection. One of the most shocking examples is Senegal where despite having stringent abortion laws contraception use rate is just 8.7%.
So whilst some would point a finger at dinosaur colonial laws, conservative religious and traditional beliefs and morality as reasons for why abortion is still not openly accepted on the continent, the fact that such a high number of women are having them indicates otherwise - that women are willing to terminate pregnancies for various reasons. So the situation is changing and unless solutions are given to them, women will continue to risk their lives in order to induce abortion.