Unsafe abortion: The silent killer of young women

Monday June 17 2019

 

By Salome Gregory

Abortion in Tanzania is illegal. Being the case, it makes it harder for girls and women to get access to safe abortion. But even then, women still find their own ways to terminate unwanted pregnancies.

Have you ever asked yourself, what women and girls go through when trying to end unwanted pregnancy? A simple survey by Your Health confirms that girls and women go through a lot of pain and suffering that sometimes leads to deaths or permanent reproductive health issues.

Unsafe abortion is defined as unsafe when it is performed by either an unskilled person or in unapproved premises or both. According to Dr Anna Temba from Population Service International (PSI) says, worldwide there are over 20 million unsafe abortions occurring every year.

She says, various methods have been used to perform abortions, including the administration of herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques. Amina Ismail* is one of the girls who underwent unsafe abortion, that was 25 years ago.

She still recalls the scaring incident during her first year at the college. She found herself pregnant and had no idea on how to go about the pregnancy.

It was unwanted pregnancy and she could not go for safe abortion as abortion is restricted in the country.

She recalls how she and her boyfriend came to an agreement to go for an abortion. Since Amina was new in town the boyfriend had to look for a doctor in one of the dispensaries. They had an abortion which came with heavy pain as it was done with no anaesthesia.

“I had never gone through such pain since then. I was screaming and the doctor would stop me from screaming. I couldn’t take it. I jumped out of the bed and walked out. The abortion was not complete. We had to go to another hospital the following day,” says Amina.

She says, again next day pain was just the same as it was at the dispensary but she had to bare it just to serve the purpose.

The Penal code provisions on termination of pregnancy are frequently misunderstood as a total prohibition on abortion. Under section 230, it is stated that termination of pregnancy is lawful where it is done to preserve the life or health of the pregnant woman.

But Sections 150 -152, criminalises only unlawful acts related to termination of pregnancy. And this act can be done by any person attempt to procure an illegal abortion, the pregnant woman who induces and the supplier who provides drugs or equipment used to induce an illegal abortion.

Dr Temba quotes the information from guttmacher.org, that 13 per cent of maternal mortality rates in Tanzania are caused by unsafe abortions. Each year 405,000 Tanzanian women have abortions almost all clandestine. 40 percent result in complications that require medical treatment and 60 percent of them do not receive needed medical care.

Raheli Richard, 37,* says she is also a victim of unsafe abortion. She is calling upon the government, parents and other health stakeholders to invest more in educating women and young girls the importance of family planning from an early stage and make sure they clear the doubts that come along with family planning methods.

She says, since abortion is restricted in Tanzania it doesn’t mean people are having enough education on how to avoid unwanted pregnancies. Women are ready to use family planning methods but they always come with so many complications that leave women with dilemma on which are the right methods for them.

Rahel has tried two of family planning methods and all of them never worked for her. She started with an injectable, she missed her monthly periods for two years. On visiting the hospital she was told everything is okay. When it was the right time for her to get a baby she had to try for three years with no success.

“Previously I had unwanted pregnancy. With the fear of disappointing my parents I had to go for an abortion. I used some pills from the pharmacy but they did not help. I had to also use what was recommended by friends and it never helped. Three days later I experienced stomach pain and was rushed to the hospital where I had access to post abortion care,” says Raheli.

If I had to get the right family planning method for me I am sure I wouldn’t have gone through a horrible experience. And by now I am still struggling to get a child but in vain. The doctors are telling me I have no problem but I don’t know why until now I cannot be pregnant.

Josephine Mugishagwe is the Advocacy, Communication and Public Relations Officer at Family Planning Association of Tanzania (UMATI). She says, at UMATI they have copied a method called the harm and risk reduction model against unsafe abortion with two main objectives.

She says the objectives are reducing morbidity and mortality among pregnant women caused by unsafe abortions. Reducing future unintended pregnancies, by offering access to contraceptive options.

The model wants to bring women to the health services make sure that they feel entitled to access health services when faced with an unintended pregnancy. At the health services they will be able to get more information that might help them to decide keep their babies instead of going for unsafe abortion that will endanger their lives.

She says, the harm reduction model is not a mechanism to cover the implementation of abortions that are not permitted under the law. The model recognizes that a more progressive regulation is required to ensure that women have access to the services they need. However, through implementing the model, an organisation makes the conscious decision of operating within the legal framework of the country. Adding to that she says, in 2014 Buguruni became the first fact operational research on the implementation of the harm reduction model against unsafe abortion in Tanzania. A total of 110 women received harm reduction services at Buguruni health centre between February and October 2014 while 50 women underwent quantitative surveys.

Majority of women 82.7per cent were between the ages of 19 and 35 years, had primary education 56.4per cent were married or living with a partner 61.8 per cent, were petty traders 56.4 per cent and had a gestation age of 8 weeks or below 66.4per cent.

The mean clients age was 26.5 years with the youngest client aged 13 years and oldest 42 years, she says.

The mean gestation age was 7.9 weeks. Despite the fact that the 50 women who underwent quantitative surveys were interviewed depending on whether they accepted the invitation to be interviewed; their background characteristics were similar to the bigger group.

Information available from the Causes and Magnitude of Maternal mortality in Tanzania presentation by Dr Temba shows that, maternal mortality is amongst the leading public health concern nationally and globally.

Unsafe abortion is 2nd leading direct cause of maternal mortality in Tanzania and women have used various methods to perform abortion inclidung herbs and sharp instruments.

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