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Malawian opinions on the Termination of Pregnancy Bill

14 March 2017

The March 2017 issue of the MMJ will include a special section devoted to expert opinions regarding the Termination of Pregnancy Bill discussion in Malawi. Owing to the prominence of this discussion in Malawi at the moment, this section has been published below in advance of the issue, along with an online-only feature, for which Malawi Medical Journal Intern, Fanuel Bickton, asked a few members of the general public in Malawi to share their opinions on the matter. The public opinions (click the expandable link below) are followed by links to the MMJ editorial that introduces the topic and three opinion articles authored by key figures in the debate.

Public Opinions


F. Kalinde, barber • Chilobwe, Blantyre:

“I understand that liberalisation of the abortion law can help reduce maternal mortality, but personally, I don’t agree with the idea because doing so will make the use of contraceptive methods—that the government advocates—valueless. I also think that liberalising this law will increase spread of HIV/AIDS, because people will be confidently having unprotected sex knowing that if the woman gets pregnant she will visit the hospital for abortion.”


Ken, tailor • Chirimba, Blantyre:

“My opinion is that legalising abortion is not good because the Bible doesn’t accept it. So it is a gross sin before God.”


Neliya Masika, grocer • Chilobwe, Blantyre:

“I agree with the idea of legalising abortion. If I have already enough children, say 4 of them, but it happens that I have another pregnancy unexpectedly, I need to have the right to go for abortion without any fear of imprisonment.”


Margaret Nazombe, banana vendor • Thyolo:

“I disagree with the idea of legalising abortion because abortion is murder.”


Angel Masauli, hair salon owner • Nancholi, Blantyre:

“I don’t support legalising abortion because even when a pregnant woman goes to the hospital for abortion, there is no guarantee that complications like death will not occur. Sometimes a doctor can work under exhaustion whilst others are just incompetent. After all, aborting a child can attract a curse of being infertile later.”


Beatrice Kazembe, grocer • Naperi, Blantyre:

“I had an awful experience of my friend in 2010. When she got pregnant she went to a certain government hospital for abortion because her boyfriend denied responsibility over the pregnancy. The medical personnel assured her that she had aborted but five months down the line she felt that she was still having the pregnancy, so she went to another government hospital, where the presence of her pregnancy was confirmed. They performed another abortion on her but three weeks later she started feeling stomach pain so she went to another government hospital for screening. Medical personnel found that she was still pregnant, and they operated on her. Unfortunately she delivered a stillborn. A few hours later, nurses discovered that the child was making movements signalling life. Doctors quickly put the child on oxygen, and he survived. In remembrance of this experience, the name of the ward in which the child was born was named after him. Today the child is about six years old. When I think of this experience, there is no way I can support the idea of legalising abortion at all.”


Martin Thulu, police officer • Mbayani, Blantyre:

“I personally don’t agree with the idea because doing so is like legalising murder. The values of murder charges will be lost. Also, maternal mortality due to abortion will increase.”


Christian Pita, cobbler • Chimile Village, Blantyre:

“Liberalising abortion law will dilute its effect. Take, for example, the issue of women wearing trousers. Before multiparty era, women were not allowed to wear trousers. The coming of democracy allowed women to wear trousers, and it wasn’t bad in itself. Some are abusing this privilege by putting on skinny trousers that reveal their private parts. My point is that, if the abortion law is liberalised, some will still abuse this in the long run. Others will start hiding behind the liberalised law, and most of them will be aborting unnecessarily. The best solution is that the government should just increase, through health facilities, its counselling services about contraceptive methods so that women should not conceive in the first place.”


Dolika Mafuleka, student at Alice Gwengwe Secondary School • Dedza:

“Abortion is bad. Many Malawians are dying every day, and so others should be born and live—period.”


Chief Msumani • Manase, Blantyre:

“I don’t support the idea of liberalising abortion law. Abortion is a gross sin. Liberalising abortion law will make people have unprotected sex, knowing that they will abort at the hospital if they conceive. Dignity for human life will be lost. Imagine a woman having an abortion each year—will she remain healthy?


Dr Kapena Kazimbe, herbalist • Chadzunda, Blantyre:

“I agree with the idea of liberalising the abortion law. During my 28 years of practice I have received few cases of women who would want to abort, and I help them basing on condition that the pregnancy has to be not more than 2 months old. Some years ago, when a woman has an unexpected and unwanted pregnancy, midwives and herbalists were able to successfully help such women abort right in our communities without fear of imprisonment. But later, when the government started giving the law more attention, we stopped helping women abort. However, this has just increased the practice of unsafe abortion because many women continue getting unwanted pregnancies. Most of them are poor and cannot afford to pay K10, 000.00 at Banja La Mtsogolo for safe abortion. As a result, we should expect occurrence of more and more deaths among such women. So I think, if the government liberalises the law, women will be able to go to hospital for safe abortion, and deaths due to unsafe abortion will decrease.”


Sheikh Alhaj Alubi • Naperi, Blantyre:

“It is the will of Allah that a woman should be pregnant and give birth to a child. It is Allah, and not the woman, who will provide for that child. So we don’t accept abortion under any ground, except in cases where the pregnancy is threatening the woman’s health. In addition, if the abortion law is liberalised, women will be aborting unnecessarily. I have seen cases where women become pregnant deliberately with the confidence that they will go to asing’anga or private hospital for abortion. We don’t accept this in Islam. By the way, liberalising the law will increase abortion-associated complications.”


Mair Mwale, student at Blantyre International University • from Mzimba:

“I agree that the abortion law be liberalised because sometimes women become pregnant unwillingly, like in cases of rape. Also, you get pregnant at a tender age, it can cause social stigma, and it’s embarrassing to tell parents that you are pregnant. Sometimes we are afraid that we will be beaten. And if you become pregnant while at school, a girl’s academic future can be doomed, as she may end up dropping out of school. Additionally, it happens sometimes a man can choose to deny responsibility of your pregnancy, and this may result in affecting the girl psychologically. With these reasons, I agree that the law be liberalised.”


Treighcy Banda, student at College of Medicine • from Mangochi:

“I think it shouldn’t be legal, not because I don’t believe in people’s rights, but because my belief for the sanctity of human life is greater. And if they say a woman should be allowed to terminate the pregnancy if she got raped, what measures are they going to put in place to ensure that those women terminating the pregnancy on those grounds were really raped?”


Editorial


Fanuel Bickton (Intern)Background on the Termination of Pregnancy Bill debate in Malawi
Fanuel Bickton, Thengo Kavinya

Despite the legal restrictions in place on abortion in Malawi, the practice still occurs and is usually performed by untrained personnel or induced by pregnant women themselves. Unsafe abortion has been estimated to contribute to 17% of maternal deaths in Malawi.

 Malawi Med J. 2017 Mar; 29(1). Published online 2017 Mar 14.

Expert Opinions


Mhango 150x150Proposed Termination of Pregnancy Bill in Malawi: Doctors use the best of what they have
Chisale Mhango

Obstetrician-gynaecologist, Chisale Mhango, asserts that “the issue is not about the rights and wrongs of abortion. It is about women dying from unsafe abortion in increasing numbers… The only way to eliminate such deaths and save the MOH more than US$1 million annually, is to legalise abortion on demand.”

Malawi Med J. 2017 Mar; 29(1). Published online 2017 Mar 14.

CMDF logoThe proposed legislation on termination of pregnancy does not protect women or children in Malawi and is not fit for the intended purpose
Beatrice Mwagomba, M. Jane Bates, Reynier G. Ter Haar, Martha Masamba, Sekeleghe Kayuni, Isaac Chirwa

According to the Christian Medical and Dental Fellowship (CMDF Malawi),  “the emphasis on maternal mortality reduction has been misleading, Malawi has inadequate regulatory frameworks to verify police reports and ensure that consent is informed, Malawi has insufficient capacity in expertise to ensure the accurate diagnosis of non-survivable congenital abnormality, the proposed legislation provides inadequate protection against abortion on demand, and the prevailing culture of tolerance towards gender based and intimate partner violence leaves women and girls with little choice in areas of reproductive health.”

Malawi Med J. 2017 Mar; 29(1). Published online 2017 Mar 14.

Mfutso-Bengo 150x150An ethicist’s thoughts on the Termination of Pregnancy Bill debate in Malawi
Joseph Mfutso-Bengo

“Ethicists don’t give you answers; rather they ask questions to help you think and reflect more before deciding, judging and acting.” Bioethics professor, Joseph Mfutso-Bengo, asks: “Will the new proposed changes in the abortion law be fair to all Malawians?… What measures will the government put in place to ensure that safe abortion services are accessible to all?… Is it right for Christian leaders to be talking about criminalization of abortion or is it something outside their jurisdiction?”

Malawi Med J. 2017 Mar; 29(1). Published online 2017 Mar 14.

 

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