‘Enact Termination of Pregnancy Bill to reduce maternal morbidity and mortality’

* Says Centre for Solutions Journalism as part of commemoration of International Safe Abortion Day tomorrow, September 28

* The Termination of Pregnancy Bill (ToP) was reviewed and completed by Malawi Law Commission and gazetted as a government Bill in 2016

* The issue of unsafe abortion remains significant, and the establishment of Post Abortion Care Units in every government district hospital is one of the testimonies of this problem

By Duncan Mlanjira

As Malawi joins the rest of the world tomorrow, September 28, to commemorate International Safe Abortion Day, human rights media organisation, Centre for Solutions Journalism (CSJ) pleads with Malawi government to enact the Termination of Pregnancy Bill to reduce maternal morbidity and mortality.

The Termination of Pregnancy Bill (ToP) was reviewed and completed by Malawi Law Commission and gazetted as a government Bill way back in 2016 and is gathering dust after it was submitted to the Ministry of Health in 2017.

In a public statement signed by CSJ chairperson, Josephine Chinele and Board member, Rev. Martin Kalimbe, says as they commemorate this year’s International Safe Abortion Day, “statistics from medical facilities regarding the number of women and girls experiencing complications from unsafe abortions show that the nation’s abortion law, which was passed in the colonial era in 1930, is not only out of date but has also utterly failed to lower the number of unsafe abortions”.

“As seen by the rising number of women seeking post-abortion care in government health facilities, the current law has only succeeded in pushing over 141,000 women and girls seeking abortions in Malawi to herbalists, witchdoctors, and certain traditional birth attendants where they suffer grave complications.

“The statistics for the first half of this year show a persistently high number of women and girls experiencing complications from unsafe abortions. In Lilongwe, from January to June, 1,041 women and girls required treatment for complications related to unsafe abortions.

“In Dedza, 830 women and girls sought post-abortion care during the same period, while health facilities in Dowa provided services to 381 women and girls.

“This alarming trend of women sustaining injuries from clandestine abortions and subsequently arriving at hospitals in critical condition, some with ruptured uteruses, is evident across all districts and cities in Malawi.

“The issue of unsafe abortion remains significant, and the establishment of Post Abortion Care Units in every government district hospital is one of the testimonies of this problem.”

Thus CSJ contends that the “solution to the problem of maternal mortality and morbidity caused by unsafe abortion is well-known and is articulated in Law Commission Report No. 29 titled ‘Report of the Law Commission on the Review of the Law on Abortion’ published in the Malawi Government Gazette of 15th March 2016.

“The solution is to enact the proposed Termination of Pregnancy Bill. We, at CSJ, urge the Malawi Government to walk the talk on the commitment it made by signing and ratifying the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (the Maputo Protocol).

“By signing and ratifying the Maputo Protocol, in terms of Article 14(2)(c) the Malawi Government committed to draft and enact the law that makes provision for safe abortions, at least, on the grounds of risk of danger to the life of the woman or foetus, risk of harm to the physical or mental health of the woman, in the case of rape or sexual assault and incest.

“We commend the Malawi Government that it has started the fulfilment of the Maputo Protocol by enacting the Gender Equality Act and by drafting the Termination of Pregnancy Bill.

“The time is now ripe for the Malawi Government to complete the work it began on the review of Malawi’s outdated abortion law by adopting the proposed Termination of Pregnancy Bill which the Malawi Law Commission drafted.

“By drafting the Termination of Pregnancy Bill, Malawi — as a state party to the Protocol — is on the right path to complying and ensuring that its law on abortion is in line with international standards.”

CSJ further emphasises that the passage of the Termination of Pregnancy Bill “is a positive development as it will bring Malawi’s legal position on abortion into conformity with that of its neighbors — particularly Mozambique, Zimbabwe, and Zambia, which are all party to the Maputo Protocol”.

“It is a betrayal of women and girls who suffer from adverse health and psycho-social effects from unplanned pregnancies that occur under various circumstances, including rape and incest.

“The delay in enacting a new law for safe abortion as recommended by the Law Commission, at least, within the standards set by the Maputo Protocol, is a negation of Malawi’s obligations under international law.

“The government should, therefore, seriously consider the plight of the women and girls who require the service, rather than the views of those who are not directly affected but seek to control bodily autonomy and the choices of women and girls.

“A number of women’s and girls’ human rights are being violated by the lack of access to high-quality abortion care. These include the right to life, the right to the best possible standard of physical and mental health, the right to participate in scientific advancement and its realisation, the freedom to choose how many children to have, when to have them, and the right to be free from torture and other cruel, inhuman, and degrading treatment or punishment, as stated by the World Health Organisation (WHO).

Thus CSJ, as part of celebrating the International Safe Abortion Day, urge:

* the government to expedite the enactment of the Termination of Pregnancy Bill;

* the National Assembly to allocate adequate resources to support the prevention of unsafe abortion by scaling up the provision of contraceptives and to continue scaling up postabortion care services;

* the Executive, the Judiciary, the National Assembly, state human rights institutions and civil society organisations to use their power and mandate to protect the realisation of sexual and reproductive health rights;

*Religious and community leaders to vigorously promote abstinence among their members and subjects so that unwanted pregnancies, some of which result in unsafe abortions are reduced; and

* all the citizens to remain steadfast in claiming their sexual and reproductive health rights.

CSJ is a human rights media organisation that advocates for enjoyment of human rights through advocacy, civic education, community outreach programmes, stakeholders’ engagement and behavioural change communications.

The Centre maintains that abortion in one way is illegal but termination of pregnancy is legal — but it goes with it some restrictive conditions, which deny women and girls liberty to abort unplanned pregnancies and they resort to still go ahead through clandestine and unsafe abortion.

This has created a huge crisis in Malawi and from surveys done, each year, over 141,000 women and girls have abortions — almost all clandestine and the figure is likely to be higher because there are no records for those who successfully carried out the process.

The official figures are mostly obtained from government health facilities and from yet to be verified reports, there are many more women of affluent status, who have sought abortion services in private health facilities — again clandestinely.

When the women’s clandestine abortions goes awry, they rush to hospitals, especially the rural poor, who have to be treated for complications since the government allows for post-abortion health care.

CSJ keeps engaging with media practitioners on the need to amplify the abortion crisis in the country to spur the government to enact the Termination of Pregnancy (ToP).

CSJ Director, Brian Ligomeka keeps saying that the first step to be done by Members of Parliament for the ToP Bill to be enacted into law, is to have meaningful dialogue with their constituents on the Bill.

“Members of Parliament should become the true representatives of their people,” he had said in an earlier interview. “Most MPs in Malawi lose their seats because once they are elected they start representing their personal interest and political party interest.

“They completely ignore the interests of the women, the youth and the men who chose them. While their constituents are struggling with reproductive health challenges, the MPs act unconcerned.”

He maintained that with the high maternal mortality rate in the country, the constituents will empower them to support the enactment of the bill, saying: “Let MPs represent the interest of their constituents including rape, incest victims, women who suffer from heart diseases and blood pressures who need good laws and policies on reproductive health that can benefit them when their lives are in danger.”

According to surveys conducted by CSJ partners, data from various health facilities compiled by the Ministry of Health and non-state actors shows that the problem of unsafe abortion is big.

CSJ describes as encouraging development that the government has responded positively to the problem by setting up post-abortion care units and creating positions of its safe motherhood coordinators in all hospitals.