By STANSLOUS NGOSA –
THREE months after delivering a baby girl, Tina Mwale became pregnant again because of contraceptive failure and was not ready to care for another baby soon.
The 30-year-old Ms Mwale, could not tell her husband about the next pregnancy, instead she opted to keep taking contraceptive pills and pain killers anticipating to have a miscarriage.
When this failed, she went to a herbalist, who inserted a stick into her womb in an attempt to terminate the pregnancy.
This resulted in severe damage of her uterus and was taken to the hospital for emergency admission where she was treated for complications.
From Ms Mwale’s experience, it is clear to suggest that she did not have information to help her make an informed decision.
Ms Mwale did not only lack information about where she could access safe abortion services, but could also not discuss her need for abortion with close family members or friends due to the fear of stigma.
Although safe abortion services are legally permissible and available in Zambia’s public health system and some non-government facilities, most women wanting to terminate a pregnancy opt for dangerous and unorthodox abortion procedures.
The main reasons for this, according to women treated for abortion complications in a public hospital in the country, are the lack of information on the legality and availability of safe abortion services and the stigma associated with abortion.
The University of Zambia and the London School of Economics conducted a study between 2012 and 2014 which revealed that lack of information and stigma associated with abortion are the main reasons why some women have unsafe abortion procedures.
The researchers interviewed women who had received safe abortion services and those who had received treatment for complications arising from unsafe abortion undertaken outside the hospital.
The main difference between the two groups of women was access to correct and safe information.
The group that sought safe abortion services was aware of the services or had received advice from family members or friends who knew of the availability of safe abortion services at public hospitals.
Another group that opted for unsafe abortion was unaware or received advice from people who did not know that safe abortion services were legally available in public health facilities.
Samson Chisele, a gynaecologist at the University Teaching Hospital (UTH) said, lack of information is a barrier to women accessing safe and legal abortion.
“Some people including learnt ones think that abortion is illegal in Zambia and yet the services are free and legal,” Dr Chisele said.
Another UTH gynaecologist Swebby Macha added that lack of information and stigma associated with abortion are the main reasons why most women have unsafe abortion procedures.
Dr Chisele said there is need to provide information to all sections of society that people could make informed choices and decisions.
IPAS legal consultant Muzi Kamanga said there is need to make abortion law friendlier so as to serve the people.
Mr Kamanga made a reference to the article which states that pregnancy terminations should be conducted by a registered medical practitioner and, unless it is an emergency, requires signatures of three registered medical practitioners, one of whom must be a specialist.
He said the presence of this law has not translated into the provision of safe abortion services in most health facilities because many districts and lower level health facilities, which are the most accessible health facilities to some women throughout the country, are not able to provide safe abortion services due to the lack of trained staff and required drugs.
Mr Kamanga says it is irrelevant to have laws that are not being practised because women cannot continue dying.
“Every woman counts regardless of their background, it is social injustice to allow women to die when there are laws that can help,” Mr Kamanga said, during a stakeholders’ consultative meeting in Lusaka recently on protecting safe and legal abortion in Zambia.
He said the laws need to move with time or revise them to save and serve people.
Mr Kamanga said no woman goes out to have sex and get pregnant just like that as they would abort because the country has liberal laws on abortion.
On the other hand, Dr Macha is concerned with Article 28 in the Draft Constitution which states that ‘every person has a right to life, which begins at conception’ because it would restrict women from accessing reproductive health services.
In the event that the Article is left as it were in the Draft Constitution, Dr Macha said that could lead to restrictions on women’s reproductive health services, including some types of contraception.
He said the Article would not be in line with many human rights treaties to which Zambia is a signatory.
Dr Macha said there was generally no consensus as to when life begins among religious, medical, or traditional authorities and a controversial Article such as article 28 should not find itself in a supreme law of the land.
He said all human rights treaties including the universal declaration of human rights recognises the right to life from birth.
“My strong suggestion is that Article 28 should simply read ‘Every person has the right to life’ subject to clauses (2) and (3) imported from article 12 of current constitution that has provisions in which life can be taken away such as carrying out a capital punishment and termination of a pregnancy as laid down by an act of parliament for that purpose.
Simply put Article 12 (2) of the current constitution which adequately protects the life of an unborn child – it reads ‘A person shall not deprive an unborn child of life by termination of pregnancy except in accordance with the conditions laid down by an Act of Parliament for that purpose,” Dr Macha said.
Kabwe Member of Parliament James Kapyanga says unsafe abortion is a developing social and economic problem which requires serious attention.
Mr Kapyanga says girls and needs to be empowered with information to enable them make an informed choice.
“Information needs to be made available, especially in local languages so that the majority could appreciate what is obtaining. Community radio stations should play a big role to ensure that the masses understand the impact of unsafe abortion,” Mr Kapyanga said.
Vice-President Inonge Wina, said reproductive rights are central to achieving global sustainable development.
Ms Wina said the realisation of reproductive rights of women and girls and achievement of sustainable development were inter-dependent and mutually-reinforcing.
“Achieving universal access to reproductive health and reproductive rights, including family planning, is not only critical for maintaining and achieving good health outcomes and reducing maternal and child mortality, but also positively influence population dynamics including the demographic dividend,” Ms Wina said.
Ms Wina who was recently in New York to deliver a keynote address at a High-Level event focusing on ‘the pivotal role of reproductive health and rights in sustainable development, ’ organised by Permanent Missions of Zambia and Sweden to the UN and the United Nations Fund for Population Activities (UNFPA).
With the second highest office in the country acknowledging that women are entitled to reproductive health rights, why not provide more information to section of society so that people can make their own choices and decisions.
In conclusion, as a saying goes that ‘information is power’, it cannot be disputed that lack of information and stigma associated with abortion are the main reasons why most women have unsafe abortion procedures in Zambia.