Tuesday, January 27, 2015 | News

Unsafe abortion common in Malawi

In Malawi, abortion is legal only to save a woman’s life. Yet despite this restrictive law, women in Malawi seek abortion for a variety of reasons, including poverty, unplanned pregnancy or fear of being forced out of school. In a study published in International Perspectives on Sexual and Reproductive Health, researchers report that more than 67,000 abortions were performed in 2009. The abortion rate in the country (23 abortions per 1,000 women of reproductive age) is comparable to the estimated abortion rate for the African continent (28 abortions per 1,000 women of reproductive age); however, is slightly lower than estimates for the Eastern Africa region (rate of 36 abortions per 1,000 women of reproductive age).

Lead author Dr. Brooke Levandowski,
formerly senior research advisor for Ipas, and co-author Dr.
Hailemichael Gebreselassie, Ipas senior research advisor, note that this
study attempted to fill a gap in critical information: “Only a few
studies on abortion and related morbidity and mortality had been
conducted in the past decade in Malawi.” Co-author Dr. Chisale Mhango,
who at the time of the study was director of Reproductive Health
Services for the Malawi Ministry of Health, adds that the study aimed to
gather evidence to inform policymakers about the health impact of
unsafe abortion.

Unsafe abortion, according to the
study, is common in Malawi. Roughly 18,700 women were treated in health
facilities for complications from unsafely perfomed induced abortions in
the community in 2009. To determine this, researchers primarily
examined data from a nationally representative sample of health
facilities—166 total. Of those 93 were public, 65 were run by
nongovernmental organizations and eight were private. They also
interviewed 56 health professionals from various health facilities and
backgrounds.

The Northern region of the country
experienced the highest abortion rate. In this region, married women
appear to have greater access to contraception than in other parts of
the country. Yet use of traditional methods which have higher failure
rates are more likely to be used, likely accounting for the higher
abortion rate. Related, women in the North seem to have completed more
schooling than in other regions—particularly compared with those in the
Central region, where women tend to have their first birth six years
earlier. The Central region also has little exposure to media messages
about contraception and reproductive health.

Overall, the study found a high
unintended pregnancy rate of 139 per 1,000 women aged 15-44,
illustrating that women need better access to contraceptive services.
Young women in particular need the services; “Half of all women in
Malawi seeking postabortion care are under age 24 and many young women
ages 12-19 report having one or more close friends who have tried to end
a pregnancy,” says Levandowski.

Unsafe abortion is a significant contributor to high maternal mortality in Malawi, with nearly 20 percent of maternal deaths occurring from complications of unsafe abortion.  The time is now, urge the authors, to reduce these preventable deaths, through legal reform of the abortion law and expanded availability of safe services, and increased information about and access to contraception.

For more information, contact media@ipas.org