Taking stigma out of abortion
The lack of knowledge identified in the study on WAG abortion laws in the country also plays a critical role in shaping society’s perceptions on the same. Without knowledge on circumstances under which abortion is permitted, society tends to stigmatise all acts, labelling them as evil.
At the age of 14, she fell pregnant — a pregnancy she conceived from a forced sexual encounter with a schoolmate.
Feeling humiliated to carry through the pregnancy at her age coupled with fearing to be judged by society as a woman of loose morals, she desperately sought ways of preserving her dignity. For her, abortion was an option. However, faced with a family and community that perceived abortion as “taboo” and “evil”, Rudo Mujati (not her real name) opted for a backyard act to save her face from further ridicule from society as she continued with her education.
“Growing up, abortion as a subject was never discussed with raised voices. Stories on supposed abortion acts would be discussed at the well, at the river or in the woods, and no one would ever own up to having carried out an abortion,” revealed Mujati.
She said because of the sensitivity and stigma associated with abortion, when she chose to get rid of her unwanted pregnancy, visiting a health facility was never an option.
“Besides the fact that I did not know that the circumstances surrounding my case allowed me a legal abortion, I also didn’t have the courage to face my elders or health workers informing them about my choice because of the negative attitudes I grew up hearing,” said Mujati.
However, she said the backyard abortion she had chosen turned sour, when she started bleeding continuously forcing her to eventually seek medical services.
“I bled till I fell unconscious. The elderly lady who was performing the act had no option but to rush me to the clinic, where I was helped to restore the lost blood and eventually regained consciousness,” she said.
Mujati is one of the many girls and women in Zimbabwe forced to seek backyard services to terminate unwanted pregnancies for fear of carrying negative community tags should they seek the services through legal means, exposing themselves to the risk of developing reproductive complications or even losing their lives.
Abortion is taboo in the Zimbabwean context though it is permissible under limited circumstances, which include a pregnancy emanating from sexual abuse or an incestuous relationship, a pregnancy threatening the life of the mother or foetal impairment.
However, still with the existence of the Termination of Pregnancy Act, which provides for abortion under these specific circumstances, women still do not seek these services from health institutions. Stigma associated with abortion has since been identified and cited as one of the reasons preventing women from accessing abortion services under the limited circumstances, even for post-abortion care under any circumstance, resulting in more deaths as a result of complications.
A recent research study by the Women’s Action Group ( WAG) in partnership with the Safe Abortion Action Fund in some districts of the country on abortion knowledge, attitudes and practices revealed
that communities and health workers did not only have little knowledge on the limited circumstances from which they are permitted to abort, but also had negative attitudes on the same.
“There was a negative response when it came to the question on whether abortion should be allowed for any reason,” reads part of the research findings.
Given this fact that communities have negative attitudes on the practice, women intending to undergo an abortion find themselves having an obligation to justify their choice to society for fear of being judged.
Cognisant of this perception by society, some women like Mujati, therefore, opt for secret abortions, the majority of which are done by non-professionals and using harmful methods with potential negative implications on the women’s reproductive health.
The lack of knowledge identified in the WAG study on abortion laws in the country also plays a critical role in shaping society’s perceptions on the same. Without knowledge on circumstances under which abortion is permitted, society tends to stigmatise all acts, labelling them as evil.
This lack of knowledge does not only exist in societies, but also among health workers, whom women pin their hope on for safe abortion and post-abortion services. Some health workers view abortion as illegal in its entirety, thereby discouraging them from providing quality services to women seeking such services.
“Of the 30 health service providers who took part in the study, 89,7 percent thought abortion was completely illegal. More needs to be done in regard to teaching health service providers of what the Zimbabwean Termination of Pregnancy Act allows,” further revealed the WAG study.
It also revealed that some myths associated with abortion, which include assumption that women who have abortions sleep with many men or that they cause other people to get sick contributed to increased stigma around abortion.
It is this stigma that partly contributes to women shunning health institutions for safe abortions and post-abortion care, preferring backyard options. However, the backyard options come with consequences.
Another study by the University of Zimbabwe conducted in conjunction with the US- based Guttmacher Institute revealed that some women opt for backyard abortions, which are usually unsafe, impacting negatively on their health and sometimes leading to death.
According to the research findings, four in 10 women who had clandestine abortions in 2016, experienced complications, such as haemorrhage and infections. It further revealed that only half of women needing post-abortion care received it.
“Forty percent of women, who had an abortion in Zimbabwe, experienced complications that required medical treatment.
“However, only half of women with complications received the treatment they needed,” reads part of the study.
Backyard abortions are often conducted by unskilled people, who use a range of methods from medical tablets to herbs, gadgets and powders.
While culturally and religiously, abortion is considered a sin synonymous with “taking one’s life”, medically it is one way of reducing the number of women who die due to pregnancy or who die from related complications.
The Ministry of Health and Child Care has since revised its policy on treatment of women seeking post-abortion care from its facilities.
Women intending to access these services get them without having to answer any questions.
Family health director in the ministry Dr Bernard Madzima said Government took this decision following the realisation that many women were dying due to abortion complications.
“Women, who would have done abortion, would definitely need post-abortal care services. If they don’t get these services, a majority of them experience complications and probably die,” revealed Dr Madzima.
He said some women lose a lot of blood from illegal abortions, while others develop infections.
Dr Madzima said without medical care, these women could lose their lives.
“As a result, many lives are lost as women shun medical attention fearing to be labelled as criminals or sinners,” he said.
Latest statistics from Government show that unsafe abortions
◆ From Page 5 contribute about 20 percent of maternal deaths in Zimbabwe, half of which occur among adolescents.
In fact, in the first quarter of this year, 71 deaths from abortion complications were recorded.
WAG attributed these complications and deaths to stigma associated with abortion and post-abortion care.
WAG executive director Ms Edinah Masiyiwa said because of this stigma, women are ashamed of associating themselves even with post-abortion care, resulting in complications and loss of lives.
Ms Masiyiwa said there was, therefore, need for increasing awareness on abortion laws in Zimbabwe to avert deaths and complications that come with illegal backyard abortions. She said it was sad to note that some women were dying from these complications, yet they can be managed at any public health institution without one being asked any questions.
“We need to continue with awareness campaigns aimed at de-stigmatising abortion in this country because studies have shown that even in situations where abortion is permitted, women still shun those services unless their condition complicates beyond home care,” Ms Masiyiwa pointed out.
Until knowledge on abortion and abortion laws is enhanced, and attitudes are changed to remove stigma, more and more women will continue dying from complications.
This will ultimately threaten the country’s targets to reduce the number of women who die due to pregnancy or related complications.
Although Zimbabwe’s Maternal Mortality Ratio ( MMR) has declined from 960 deaths per 100 000 live births in 2010 to the current 614 deaths per 100 000 live ( ZDHS, 2014), the rate is still unacceptably high.