How unsafe abortion ring is putting women’s lives at risk

An investigation has uncovered an underground system involving self-styled nurses, unlicensed practitioners, informal drug sellers and brokers allegedly arranging unsafe abortions in rented rooms, private houses and through social media contacts.

Health experts warn the network is expanding amid fear, social stigma, legal uncertainty and limited access to reproductive healthcare, pushing desperate women into dangerous situations.

Under Tanzania’s Penal Code, abortion remains illegal except when necessary to save the mother’s life. Sections 150, 151, 152 and 219 criminalise procuring or assisting abortion through drugs or other means.

The government’s Comprehensive Post-Abortion Care Guidelines acknowledge unsafe abortions remain common and are often carried out by untrained individuals, exposing women to severe complications.

The guidelines warn against unsupervised use of drugs such as Misoprostol, saying misuse may result in excessive bleeding, infection, uterine damage and death.

When contacted for comment, Director of Reproductive, Maternal and Child Health Services, Dr Ahmad Makuwani, said the law remains clear.

“The post-abortion care guidelines explain that terminating pregnancy for non-medical reasons is illegal. The legal framework and penalties are clearly outlined,” he said.

“At the moment, the ministry has not received formal cases involving abortion services being offered through rented houses or social media networks. If such cases emerge, the law and guidelines will be applied accordingly.”

Statistics suggest the scale of the problem is growing.

According to the 2023 Tanzania Demographic and Health Survey, around 23 percent of pregnancies in Dar es Salaam end in miscarriage or termination — the highest rate recorded among all regions.

Between January and June 2023, the Medical Stores Department purchased medical supplies worth more than Sh245 million for treating women suffering complications after miscarriage or abortion.

A 2018 national study estimated that about 2.9 million pregnancies occur annually in Tanzania. Of those, 1.3 million were unintended, while around 430,000 ended in abortion or miscarriage. Unsafe abortion was linked to nearly one in five maternal deaths.

The journey begins online

Posing as a relative of a six-week pregnant girl seeking help, this reporter contacted several individuals whose numbers were shared in private online discussions.

Within minutes of sending a WhatsApp message, a woman identifying herself as a nurse responded. “There is nothing to fear. It takes only a few minutes and I help many girls every day,” she said. She claimed to have worked at a government hospital, although she provided no proof.

The woman quoted Sh150,000 for an early pregnancy termination, saying the amount covered medication and “cleaning” in case complications arose.

“If the pregnancy is more advanced, the cleaning procedure starts from Sh250,000,” she explained. Over several days, at least six other individuals offered similar services — discreet, fast and payable only in cash.

Some suggested meeting in Buguruni, Sinza and Kinondoni Mkwajuni, while others promised home visits carrying medicines and equipment.

None requested medical records, pregnancy scans or laboratory confirmation before discussing treatment.

Visits to some locations revealed rented houses and rooms allegedly being used for the procedures.

In Yombo, one resident who requested anonymity said young women are frequently seen entering a particular house during the evenings.

“Most of them arrive late at night. Sometimes you hear someone crying inside, but people here mind their own business,” the resident said.

The investigation also found some pharmacies were known among customers as places where abortion-related drugs could be obtained without proper procedures.

At one pharmacy in Tabata Segerea, this reporter was quoted Sh60,000 for Misoprostol after simply asking for the drug by name.

Another pharmacy in Kinondoni later offered the same medication for Sh150,000 — again without requesting a doctor’s prescription.

“Many girls fear going to hospital because they are ashamed and scared of being judged,” one pharmacy worker said.

Doctors warn of grave risks

Medical specialists insist that unsupervised use of abortion drugs can lead to severe complications.

Consultant gynaecologist Dr Elias Kweyamba of Ifakara Mission Hospital in Morogoro said Misoprostol is medically used to manage incomplete miscarriage or post-abortion complications under professional supervision.

“The dosage and method depend on the patient’s condition and the judgement of a qualified clinician. These medicines should never be used carelessly,” he said.

Another obstetrician and gynaecologist, Dr Ali Said of Muhimbili University of Health and Allied Sciences, said many women using the drugs privately fail to determine the correct pregnancy age or dosage. “As a result, some experience incomplete abortion while others suffer excessive bleeding,” he explained.

Doctors say hospitals continue receiving women in critical condition after unsafe procedures carried out in secrecy.

“Some arrive with severe infections and dangerous blood loss. Others delay seeking treatment because they fear embarrassment or prosecution,” Dr Kweyamba said.

According to the World Health Organization, unsafe abortion remains one of the leading contributors to maternal deaths globally.

Survivors speak out

For Naomi, a 19-year-old student in Manzese, the experience nearly cost her life. “I was told it was simple and that I would just take medicine,” she recalled.

“But afterwards I started bleeding heavily and felt like I was dying.”

She said friends rushed her to hospital where doctors managed to stabilise her condition.

“The doctor told me that if I had delayed any longer, my life would have been in danger,” she said.

Another woman, 24-year-old Neema, said she avoided hospital after developing complications.

“I was afraid people would find out. I stayed indoors for two days until the pain reduced,” she said.

Asha, 27, said the psychological impact stayed with her long after the incident. “For years I feared I had damaged my womb because I could not conceive again,” she said.

Legal confusion fuels secrecy

Senior pharmacist Aloyce Gregory of the Pharmacy Council said policy gaps between hospitals and community pharmacies have worsened the situation.

“Dispensing medicine without a doctor’s prescription amounts to professional misconduct,” he said.

Lawyer Peter Majanjala said Tanzanian law permits abortion only where the mother’s life is at risk, but many citizens remain unclear about the exact legal position.

“The uncertainty has increased fear among both healthcare workers and women seeking help,” he said.

He added that legal ambiguity has helped fuel a secret network operating without medical or legal oversight.

“Many women fear arrest or social condemnation, so they delay seeking proper medical attention after complications occur,” he said.