Posted by: rhoban | March 7, 2009

Day 6 – From Malawi to Zambia

From hope to desperation

Malawi Children’s Village is an example of how some determined people are pulling hope out of despair. But my next story takes a measure of the desperation of many African women when they find themselves with an unwanted pregnancy.

Zambia has one of Africa’s highest rates of HIVabout 16 percent of adults are infected with the virus. In addition, the country has one of the highest rates of maternal mortality in the world – 750 women die for every 100,000 live births. That number has increased since the mid-1980s. On average, women have about six children, their first frequently before the age of 18.

This means that over a lifetime of childbearing, a Zambian woman stands about a one in twenty-three chance of dying due to causes related to pregnancy and childbirth. The UN has estimated that about 30 percent of all the death due to maternal causes is as a result of unsafe abortions. (That’s from a report titled: Ministry of Health & Family Health International, Safe Motherhood in Zambia – A Situation Analysis (Lusaka, Zambia: Ministry of Health, 1994). I’m getting an online copy of the report from the authors.)

No one really knows for sure if that mortality estimate is on target. That’s because unsafe abortion is such a hidden phenomenon. Is the pregnant woman who arrives at the hospital bleeding because she’s having a miscarriage, or is it because she went to a traditional practitioner who inserted ground glass into her vagina, or a cassava stick into her cervix? These women who arrive bleeding don’t reliably get counted into those numbers.

What’s unfortunate, though, is that these unsafe, illegal abortions are unnecessary – Zambia has one of the most liberal laws regarding safe, legal abortion in Africa. The law’s been in place since 1972. Safe abortion is ‘legal’ and unsafe abortion ‘illegal.’ But most women don’t know that safe methods of terminating a pregnancy even exist. So they ask neighbors, local healers, their sisters – anyone – who might help them terminate an unwanted pregnancy.

And… every single woman I spoke to in Zambia knew someone who had died from an unsafe abortion.

That’s why I decided to do a story about the work of Ipas. I know abortion’s a difficult topic to write about, fraught with landmines. I also know that women are not going to stop seeking them out, despite what lawmakers put into legislation and despite what many people of good will would like to happen. That much was obvious in a place like Zambia.

In doing this story, I wanted to try to cut through the rhetoric and look at what it’s really like in a place where access to safe abortion isn’t readily accessible.

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