Zim’s abortion information gap puts vulnerable women at risk

SEXUAL and reproductive health rights (SRHR) activists have decried the information gaps pitting the poor against other vulnerable groups that are at the bottom of the information food chain.

In an interview with NewsDay Weekender, health policy expert at the Health Law and Policy Consortium, Tinashe Mundawarara, said the information gap is resulting in impaired and fettered access to SRHR services, particularly on safe abortion, due to myths and misconceptions of what is legal or permissible.

“The information gaps noted relate to criminalisation, wherein the law is often portrayed as a dragnet, an umbrella provision covering every element and mischief around abortion,” he said.

“Resultantly, access becomes difficult even for women who qualify for legal abortion as they are either afraid of prosecution or are discouraged by the procedural requirements to access legal abortion.”

He said access to safe abortion is disproportionately affecting the poor, rural and socially excluded groups of people, and yet the well to do and financially able individuals are procuring abortion in neighbouring countries or practising self-managed abortion.

This results in grave health inequities, Mundawarara said, and debilitating health outcomes for the most vulnerable in our communities.

“Official pathways to safe and legal abortion are quixotic and hidden under a mountain of red tape.

“They are time consuming, financially taxing and not purposive in a right to health jurisdiction like Zimbabwe.

“The pathways fly in the face of access to justice and are anathema to gender transformative reproductive health.”

Stakeholders have maintained that access to lawful, safe abortion care depends on more than the existence of a statute but requires accurate information, qualified providers, privacy, timely referrals and respectful services across the health system.

Contrary to beliefs, safe abortion care is delivered with methods and clinical support appropriate to the pregnancy and the patient’s circumstances, by qualified health workers operating within the law and applicable clinical guidance.

It includes accurate information, voluntary informed consent, privacy, respectful treatment, appropriate follow-up and referral when a facility cannot provide the required service.

The word “safe” describes more than a medical technique.

It also points to a system in which a person is not misled about eligibility, exposed unnecessarily to disclosure, sent from facility to facility without guidance or denied post-abortion care because of stigma.

Lunia Centre for Youths executive director Tjedu Moyo, however, said it should be known that in Zimbabwe abortion is not illegal in all circumstances.

She said there is a need for more awareness on the subject, to cover the information gap.

She explained instances allowing for safe abortion and also decried the fact that getting access/approval was difficult, a scenario leading to more unsafe and clandestine abortions as people would try to evade the “difficult” and sometimes disappointing process.

“The Termination of Pregnancy Act allows it on three grounds — risk to life/physical health, serious foetal anomaly, and unlawful intercourse (rape/incest). But in real life the pathway is almost unusable.

“It needs two doctors, superintendent permission and in rape cases a magistrate certificate,” she said.

“Many women don’t know this law exists, and designated facilities are few. That’s why we still see thousands of unsafe abortions and why post-abortal care remains critical.

“If we want fewer deaths, we need to make the lawful pathway actually accessible and make information available at community level.

“It is not about legalising abortion for now, it’s about ensuring the existing pathway works for those that need it, because they do need a working pathway.”

Zimbabwe’s Termination of Pregnancy Act establishes a narrow legal route for termination rather than unrestricted access.

Women and Law in Southern Africanational director Isheanesu Chirisa highlighted worrisome statistics on unsafe abortions in the country.

She revealed that studies from 2019 show that 219 abortions occur daily in Zimbabwe, with 80 000 abortions recorded that year.

“Of these abortions, about 185 occur among adolescents,” Chirisa said.

“Without safe abortions being allowed under the law, adolescents often resort to backstreet procedures, which are unsafe and life-threatening.

“This is often due to the medical costs involved.”

Further studies show that between 2016 and 2017, 40% of pregnancies in Zimbabwe were unintended, with 25% of those resulting in unsafe and illegal abortions.