Mozambique May Legalize Abortion to Protect Mothers

[This post was written in collaboration with Anna Lucas, coordinator of ISGlobal's Maternal, Infant and Reproductive Health Initiative and published simultaneously in the El País blog 3500 Millones.]

Amelia is 35 years of age. She was admitted to Chicuque Rural Hospital (Inhambane Province, Mozambique) in serious condition with a perforated uterus and a generalized infection after she inserted a root into her vagina to provoke an abortion. Rosa, who is 18 years old, was admitted to Maputo Central Hospital with a perforated uterus and intestines and generalized infection. To save her life, the doctors removed her uterus and part of her bowel, but she can never have children.

Abortion is illegal in Mozambique under the current Criminal Code, a legacy of the colonial era dating back to 1886. It has been over two years since Mozambique’s Council of Ministers approved a bill that would legalise voluntary abortion in the first 12 weeks of pregnancy in July 2011. Since then, while the country waits for the law to be ratified by the National Assembly, more than 5,000 women are dying in the country every year as a result of unsafe abortions. Who are these women? They are mainly young people who have scant resources and knowledge and limited access to contraception. In 2011, the percentage of married women between 15 and 49 years of age using contraceptives in Mozambique was 7.4% in rural and 21.5% in urban areas. In Maputo alone, some 14,000 women receive medical care for complications following unsafe abortions every year, a figure that represents more than half of all women seen by the obstetric and gynecology emergency services in the capital’s hospitals.

Mozambique is not exceptional in this respect. Unsafe abortion is one of the leading causes of maternal mortality and morbidity worldwide and is responsible for the deaths of 70,000 women every year. Unsafe abortions account for nearly half of all terminations performed in the world. Most of them (98%) take place in developing countries, where more than half of all abortions are unsafe (56% compared to 6% in the developed world). Unsafe abortions also represent a serious financial burden: the estimated minimum annual cost of providing post-abortion care in medium- and low-income countries is $341 million.

Several African countries have legalised abortion and achieved encouraging results in the reduction of the associated maternal mortality. After South Africa changed its law in 1997, deaths related unsafe abortion dropped by 91%.

Following municipal elections in November in Maputo, the Mozambican National Assembly is once more in session and the legislature is expected to finally approve the proposed Abortion Law included in the current reform of the Penal Code. The country’s elected representatives have a responsibility to take the final step toward legalising abortion. Legalisation would facilitate the expansion of services for safe interruption of pregnancy and reinforce access to reproductive health services. This would undoubtedly reduce maternal mortality in the country and bring Mozambique closer to meeting the commitments it has made in the framework of the Millennium Development Goals. Mozambique has pledged to increase contraceptive prevalence from 24% to 34 % and to increase institutional deliveries from a level of 49% to 66% by 2015.