Malawi

Abortion in Malawi: More a class issue than a legal one

Chimwemwe Mlombwa

‘’No woman can call herself free who does not control her own body’’ 

   -Margaret Sagner.

The Global Gag Rule plays a part in the deaths of many women and girls in Malawi who have unsafe abortions. The rule leads to many unplanned pregnancies and contributes to the silencing of women and girls.

In Malawi, a conservative, ‘God-fearing’ nation, the word ‘abortion’ itself is sinful. If you merely utter the word abortion, you are stigmatised. 

“Who are you to think a woman has the right to do what she wishes with her body and life?” people ask. “How dare you fight for the rights that another woman was not entitled to at birth?” This is the attitude towards abortion in Malawi.

The status quo

It is only legal to perform an abortion in Malawi in order to save a woman’s life; obtaining an abortion for any other reason is punishable by a prison sentence of seven to 14 years.

Meanwhile, poverty can be found in all corners of the country. The gap between the rich and the poor is visible in everyday life. Suburbs are situated next to villages and rural areas; so, two girls living within miles of each other are living completely different lives.

Since poverty is a cruel reality for the majority of the population, educating children is a heavy burden for many families. When faced with a choice, parents will often choose to invest in the education of their sons rather than their daughters.

Case study

A decade ago, I found myself with a difficult decision to make. I looked down at the stick with two blue lines and regretted every decision I had made up to that point in my life. Nevertheless, I knew exactly what had to be done: visit the Marie Stopes clinic.

At the clinic, I read about my options. When it came to exercising the option I chose, I did not know what to expect. During the procedure, the male doctor was extremely sympathetic toward me. However, I was disturbed by the attitude of the nurse. As I screamed in pain, begging her to ease up, she said: “Zimakoma mene mumapanga musalile pano.” (It was fun to have intercourse, wasn’t it? So do not cry now.) It was the most painful 15 minutes of my life.

Years later, I ran into a young woman by the name of Lonjezo. Lonjezo was looking for work and I was looking for someone to help me transition into adulthood. Our energies and spirits immediately resonated and we got along really well. One day when we were chatting, she let it slip that she was pregnant.

While we sat there, deep in conversation, Lonjezo confided that she wasn’t ready to have another child. She already had a four-year-old boy. When she said she knew where to go and what she needed to do, I looked at her and remembered my younger self.

What if I hadn’t gotten the money for the procedure?, I asked myself. What if I did not have a strong support system?

A few days later, she came to me with a heavy heart. She had visited the Marie Stopes clinic in her area and could not afford to have an abortion. Later that week, I gave Lonjezo the money to enable her to get the help she needed. Was I proud of myself? I don’t know. But I felt proud that I could help another woman to make her own decision.

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In Malawi, abortion is not only a legal issue that is stigmatised and surrounded by misinformation. Access to safe abortion is a class issue. Although safe abortions cost less than US$20, this is unaffordable for most people in a country where 80% of the population live below the poverty line. As a result, they opt for unsafe abortions. People are satisfied as long as they can stop the foetus from growing. However, if you are a person of means in Malawi, you can access safe abortions at private clinics under the guise of a dilation and curettage procedure.

A national debate is currently under way on liberalising Malawi’s abortion law by providing more exceptional  situations which allow women to legally obtain an abortion.

In our country, 17% of pregnancy-related deaths are due to unwanted pregnancies, and it is girls from poor and rural areas who are most affected. To put this into perspective, 2015 research showed that 140,000 girls and young women terminate pregnancies every year. 11,666 girls terminate pregnancies every month. That is 389 girls every day.

Abortion is taking the lives of young women and girls because their lives are not their own and their bodies do not belong to them. Many people hide behind religious beliefs and play politics with the lives of these young girls when the loss of life can be simply prevented with access to the correct information.

Legal context

Malawi originally acquired its abortion laws from British law which criminalised abortion through the Offences Against the Person Act of 1861. Just as the case was in Britain, abortion in Malawi was also penalised with offenders facing life imprisonment. Interestingly, even after Malawi gained independence in 1964, many of the British laws were maintained, including the laws which criminalise abortion. 

Currently, abortion is criminalised by the Penal Code Cap. 7:01 of the Laws of Malawi. Under these laws, an exception for abortion is only made where it is performed to save the life of the pregnant woman. Section 149 of the Penal Code prohibits the act of providing an illegal abortion. An offence committed under this section is a felony which can be penalised by up to 14 years imprisonment. Section 150 refers to a pregnant woman who procures an abortion. The offence committed under this section is also a felony attracting a penalty of up to 7 years imprisonment.

Section 243 of the Penal Code contains an exception to the prohibition of abortion, allowing termination of pregnancy only in instances where it is necessary to save the life of the mother. The exception is narrow and has called for the reformation of the Penal Code Cap. 7:01 of the Laws of Malawi mainly, to extend Section243 to make the exception for: where the continued pregnancy will endanger the life of a pregnant woman; where the termination is necessary to prevent injury to the physical or mental health of the pregnant woman; where there is a severe malformation of the foetus which will affect its viability or compatibility with life; and where the pregnancy is as a result of rape, incest or defilement.

Evidently, the proposal for reform under the laws governing abortion remains conservative, maintaining the criminalisation of abortion. This fact is reflects cultural and religious context in Malawi that has majorly influenced the discourse on abortion in the country. 

Society 

According to figures established by the American Central Intelligence Agency in 2018, the compostion of Malawi’s society is: 34.3% Chewa, 18.8% Lomwe, 13.2% Yao, 10.4% Ngoni, 9.2% Tumbuka, 3.8% Sena, 3.2% Mang’anja, 1.8% Tonga, 1.8% Nyanja, 1% Nkhonde, 2.2% other and 3%  foreign.

For the whole population, religion is dispersed in terms of the following sects: 33.5% Protestant, 9.4% Seventh Day Adventist/Baptist, 7.6% Pentecostal , 2.3% Anglican, 17.2% Roman Catholic, 26.6% other Christian, 13.8% Muslim, 1.1%, traditionalist, 5.6% other and 2.1% none. These figures explain the tendency of policies in Malawi to be contained within conservative and religious prescripts. Perceptibly, this has been the case with the laws on abortion.

With the 3^rd highest population growth rate in the world, measuring at a rate of 3.31% p/a, rapid population growth and high population density is putting pressure on Malawi’s land, water, and forest resources. This in turn, majorly threatens the sustainability of Malawi’s agriculturally based economy and worsens food shortages; approximately 80% of the population is employed in agriculture and Malawi is considered the 6^th most impoverished country in the world according to the World Population Review 2019. Almost 80% of the population of Malawi live in rural areas.

Economic

The above begins to edify the state of the economy in Malawi. Ranked the 6^th poorest country in the world, the country’s economic performance has consistently affected the standard of living in the country.  Considered an under-developed state, Malawi lags behind in: infrastructure, health, education and service delivery. Rampant corruption and rapid population growth exacerbates the poor economic outcomes.  Agriculture accounts for nearly one-third of GDP but droughts regularly slow down economic activity on this front. As a result, Malawi relies heavily of fiscal assistance from the IMF, the World Bank and other donors including PERFAR which supports 700 000 people in Malawi affected with HIV. The support in foreign aid and donor funding counterintuitively setbacks Malawi’s economy; almost 60% of the country’s GDP is spent of serving national debt. 

On account of the country’s economic position, many Malawians choose to migrant, usually to South Africa to take up domestic work and blue collar jobs.

Health

Poor health outcomes in Malawi have been noted as a consequence of poor economic performance. The following statistics produced by the CIA of the US paint the picture.

• Birth rate: 40.7 births/1,000 population and thus ranked 8^th lowest in the world (2018 est.)
• Maternal mortality rate: 634 deaths/100,000 live births and thus ranked 13^th lowest in the world (2015 est.)
• Infant Mortality: 42.1 deaths/1,000 live births thus ranked 42 lowest in the world.
• Contraceptive prevalence rate: 59.2% (2015/16 est.) 

(This figure gives the percent of women of reproductive age (15-49) who are married or in union and are using, or whose sexual partner is using, a method of contraception according to the date of the most recent available data. The contraceptive prevalence rate is an indicator of health services, development, and women’s empowerment. It is also useful in understanding, past, present, and future fertility trends, especially in developing countries)

• Current Health Expenditure: 9.3% (2015 est. relative to the size of its economy).  
• Hospital bed density: 1.3 beds/1,000 population (2011)
• Adult population living with HIV/ AIDS: 9.6% and thus ranked 9^th worst in the world (2017 est.)
• Population living with HIV/AIDS: 1 million and thus ranked 10^th worst in the world (2017 est.)
• Death by HIV/AIDS: 17,000 p/a and thus ranked 13^th worst in the world (2017 est.)
• Major infectious diseases: degree of risk: very high (2016 est.)

• food or waterborne diseases: bacterial and protozoal diarrhea, hepatitis A, and typhoid fever
• vectorborne diseases: malaria and dengue fever 
• water contact diseases: schistosomiasis 
• animal contact diseases: rabies 

Impact of the Global Gag Rule

Malawi’s societal and economic context taken into consideration alongside the country’s health outcomes initially illuminate the deficiencies realising the right to safe abortions for women. Notwithstanding these outcomes, The Family Planning Association of Malawi (FPAM) has undertaken efforts to provide community-based sexual and reproductive health (SRHR) services. Although, in light of the current criminalisation of abortion in Malawi, the SRHR services provided by FPAM do not include abortion. Nonetheless, GAG rule as still impacted on the provision of SRHR services.

FPAM conducts comprehensive prevention, care and treatment services through both static and moonlight clinics. The Global Gag Rule (GGR) means funds for projects like these are being forced to close. FPAM’s Executive Director, Thokozani Mbendera, fears a range of core services could be hit. “We fear GGR will greatly negatively affect the members of the community,” he says. “Teenage pregnancies, unwanted pregnancies and other health issues will manifest… The one-stop centre will cease to function.”

According to UNAIDS, adolescent girls, young women and sex workers in Malawi are particularly at risk of HIV/AIDS. In the latter group the prevalence of HIV is around 60%. It is also particularly hard to deliver SRHR services in traditional communities. Meanwhile, Malawi lacks a workable system for handling cases of sexual gender-based violence.