The dangers of selective abortion laws and the case for legal reform

BUHLE, a 20-year-old university student, finds herself in a desperate situation when she discovers she is pregnant. Fearing the consequences of her parents and friends finding out, she turns to a “friend of a friend” who claims to know how to perform an abortion.

The procedure is carried out in a cramped and unsanitary backyard shed. Buhle is given a concoction of unknown substances, and the “practitioner” attempts to perform a dilation and curettage (D&C) without proper equipment or anaesthesia. As soon as the procedure is over, Buhle begins to experience severe abdominal pain, heavy bleeding, and dizziness. She realises something has gone horribly wrong.

Panicked, Buhle’s friend rushes her to the hospital, but they arrive late, and the hospital is ill-equipped to handle emergency abortion complications. The hospital staff are overwhelmed, and Buhle is left waiting for hours as her condition deteriorates.

Finally, after what seems like an eternity, Buhle is seen by a doctor. She is diagnosed with severe haemorrhaging, uterine perforation, and sepsis. The medical team fights to stabilise her, but the damage is extensive. Buhle spends several days in hospital, undergoing multiple surgeries and treatments. She is eventually discharged, but the physical and emotional trauma lingers.

The backyard abortion leaves Buhle with irreparable damage. She is told she will never be able to conceive again due to the extent of the uterine damage.
Unfortunately, Buhle’s story is not unique. Her experience serves as a stark reminder of the dangers of unsafe abortions and the importance of access to safe, legal, and medical abortion care.

Unsafe abortion is defined by the World Health Organization (WHO) as a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills, in an environment that does not conform to minimal medical standards, or both.

This form of abortion is a neglected public health issue, contributing to 13 percent of maternal deaths worldwide. Researchers suggest as many as one in four African women have experienced abortion, with 99 percent of these abortions deemed unsafe, resulting in one maternal death per 150 cases.
Research has shown that the prevalence of unsafe abortion is, to some extent, associated with restrictive abortion laws.

In Zimbabwe, as in most other African countries, the discourse on the legality of abortion remains complex, leaving a substantial number of women unable to access safe abortion care. This has significantly contributed to the proliferation of backyard abortions.

In the streets, a silent struggle unfolds. Behind closed doors, in secret clinics and on the black market, women and young girls are forced to seek illegal abortions. The restrictive law, which only allows abortions under limited circumstances, has driven this underground industry.
Alarmingly, some medical practitioners, including doctors and nurses, are secretly involved in these illicit activities. They sell abortion pills to women and perform illegal abortions, often in unsanitary conditions.

The abortion law in Zimbabwe, the Termination of Pregnancy Act (TOP Act) of 1977, only allows abortions under limited circumstances, such as when the pregnancy endangers the mother’s life, poses a risk to the child’s physical or mental health, or results from rape or incest.

As a result of this law, law enforcement agencies struggle to keep up with the proliferation of backyard clinics, often run by unqualified practitioners in unsanitary conditions. Raids and arrests are common, but the demand for these services ensures that new operators quickly fill the void.
Recently, the Zimbabwe Republic Police arrested a registered nurse after a young woman developed severe complications following an illegal termination procedure.

The young woman revealed to police that she had purchased abortion pills from the nurse, sparking a wider investigation.
According to the police spokesperson for Bulawayo, Assistant Inspector Nomalanga Msebele, the nurse was accused of selling abortion pills. This is not an isolated incident, as numerous reports suggest that some medical practitioners are secretly involved in the illicit trade of abortion pills.
“We warn medical practitioners, including nurses and doctors, who assist in the illegal termination of pregnancy. Some have been arrested, and their licences can be revoked,” said Asst Insp Msebele.

Besides the unnecessary loss of precious lives, the restrictive abortion law in Zimbabwe has far-reaching consequences for girls and young women, shattering their dreams and aspirations.
Unplanned pregnancies resulting from a lack of access to safe abortion services force girls and young women to drop out of school. This disrupts their education, hindering their future career prospects and socio-economic mobility.

Girls and young women who become pregnant are often forced to abandon their career goals. The stigma surrounding teenage pregnancy and abortion can lead to social ostracism, making it difficult for them to pursue their aspirations.
Recently, the police in Zimbabwe arrested a 20-year-old student and her boyfriend for illegal termination of pregnancy. The girl told the police that she committed the crime because keeping the baby would derail her academic and career goals, forcing her to drop out of school.

Her scenario highlights the complexities and challenges surrounding unplanned pregnancies, particularly for young women in academic environments.
The experience of an unplanned pregnancy, followed by the trauma of a backyard abortion or forced motherhood, can have long-lasting psychological effects.
Girls and young women may struggle with anxiety, depression, and PTSD, further hindering their ability to pursue their dreams.
Without access to education and career opportunities, girls and young women may become economically dependent on their families or partners. This perpetuates cycles of poverty and limits their ability to make independent decisions about their lives.
Psychologist Mrs Chenjerai Mbure, who provides counselling to teenage girls and young mothers, highlighted that the societal stigma surrounding abortion and teenage pregnancy can lead to social isolation. As a result, girls and young women may be shunned by their communities, making it difficult for them to access support networks and resources.

“Some girls who become pregnant may be forced into child marriage as a way to ‘solve’ the problem. This further limits their education and career opportunities, perpetuating cycles of poverty and dependence,” she said.
Access to safe abortion care depends on both the legal and health system context within which abortion is provided, as well as the social and economic context surrounding unintended pregnancies.

There are growing concerns about reforming Zimbabwe’s abortion law, the Termination of Pregnancy Act of 1977. Advocates argue that the legislation drives women to desperate measures, putting their lives at risk. They urge policymakers to reconsider the law and provide women with access to safe, legal, and regulated abortion services.
Health sector stakeholders have also called for amending the legislation, arguing that it is outdated and fails to address the contemporary needs of women and their health rights.

Executive Director of Women’s Action Group, Mrs Edinah Masiyiwa, said the Act now needs to be amended to address issues faced in contemporary times.
“When we look at the Termination of Pregnancy Act of 1977, this law has been in place for over 40 years. What we are seeing is that sometimes it is difficult to implement. Firstly, because communities are not aware of the law. Generally, people in Zimbabwe think that abortion or termination of pregnancy is illegal, yet it is legal under various circumstances,” said Mrs Masiyiwa.

Health experts argue that the restrictive nature of this law has led to a significant number of unsafe abortions, resulting in maternal deaths, injuries, and long-term health consequences. In fact, 16 percent of maternal deaths in Zimbabwe are attributed to unsafe abortions.
There is a growing need to amend the abortion law in Zimbabwe. The law is outdated and does not align with the country’s constitutional provisions, which guarantee the right to life, health, and dignity.

Amending the law would help to reduce maternal mortality. By allowing access to safe and legal abortions, the number of maternal deaths due to unsafe abortions would decrease.

Amending the law would recognise women’s autonomy over their bodies and their right to make informed choices about their reproductive health.
By providing access to safe abortion services, the law would help reduce the number of women suffering from abortion-related complications.
Overall, there is a pressing need to re-examine and amend the abortion law in Zimbabwe to ensure that it prioritises women’s health, well-being, and human rights.