Even as politicians fight to shut down Planned Parenthood and other family planning facilities across the U.S., many African women are fighting their own battles when it comes to sexual health and are often dying as a result. Thanks to a failing health care and education system in many nations, as well as a ubiquitous stigma against the use of contraceptives or abortions, an increasing number of women are turning to unsafe abortions across the continent to terminate unwanted pregnancies.
One result of the proliferation of these unsafe abortions is the rise in the maternal mortality rate across many parts of Africa. According to the World Health Organization (WHO), of the 6 million unsafe abortions that occur each year in Africa, 29,000 result in death and a further 1.7 million in hospitalizations. These statistics contribute to many countries’ high maternal mortality rates and the practical effects of so many complications are a financial burden on the government and health care system.
One example of this occurrence is Uganda, where some 85,000 women are treated each year for complications after undergoing an unsafe abortion procedure. "Post-abortion care is estimated to cost nearly $14 million annually in Uganda ... The epidemic of unsafe abortion takes a tragic toll on women and their families. It poses a significant, avoidable economic burden on Uganda's already under financed health system," Moses Mulumba, director of the Kampala-based Centre for Human Rights and Development (CEHURD), told IRIN.
As in the U.S., many African countries have strict limitations on abortion. In 14 countries, it is entirely illegal, while in some, women many only have access to abortions if their lives are in danger or if the birth presents a threat to the mother’s health. In many cases, women may turn to homemade cures, such as drinking bleach, which could successfully kill the fetus but often also cause complications or even death of the mother.
According to the Global Post, 97% of all abortions in Africa are unsafe; the Lancet estimates that 38,000 women die each year from these procedures. These deaths are often due to abortions that occur in unclean and unregistered clinics which are easily accessible in spite of their illegality rather than a clinic with trained doctors and staff. Moreover, according to a report on unsafe abortions, “The countries most affected with high maternal mortality and morbidity are those with restrictive abortion laws.” Most often these women are also those who are most vulnerable: the youngest and poorest.
Aside from the stigma against abortions which drive women to go to unsafe alternatives, it is important to consider the underlying causes for many of these procedures. It is well known that both the education and health care systems are failing in many places across Africa. Even if a woman does have access to education past primary school, it is rare for her to receive any family planning education in terms of sexual health and the use of contraceptives in order to cut back on unwanted pregnancies. Improvements in these systems may be one step closer to reducing the number of unsafe abortions in Africa.
According to a blog post in the New York Times, another solution to the high rate of maternal mortality because of these unsafe procedures is the legalization of abortion. According to the South Africa Medical Journal, it took just two years after legalization for the number of deaths among pregnant women who underwent abortion to fall by 90% between 1998 and 2001. While this result is promising for South Africa, it might be difficult to reproduce in other countries where the discussion over abortion legality is mired in religious and legal obstacles.
Unfortunately, at least in the near future, cultural taboos and insufficient access to proper health care or quality education will likely leave many African women forced to choose unsafe abortions as their only option when faced with an unwanted pregnancy. Changing the restrictive laws that many countries currently have in the books may effect a shift in outcomes, but until that time comes we very well may see an increase in the number of unsafe abortions across Africa and the developing world.