Maternal mortality burden in Malawi triggers fear and anxiety among poor pregnant women in rural areas, says a reproductive health activist.
"Pregnant women in rural areas who know their friends who died of pregnancy-related causes are never at peace," said Brian Ligomeka, director of the Centre for Solutions Journalism.
He said this in Lilongwe on Friday during training of journalists on professional media coverage of Safe Motherhood issues.
He said without investing in safe motherhood initiatives, including taking a bold step to enact the Termination Pregnancy Bill already drafted by the government, Malawi may not achieve the Sustainable Development Goal (SDG) target of reducing maternal mortality to less than 70 maternal deaths per 100,000 live births by 2030.
Out of every 100,000 pregnant women in Malawi, 439 die before, during, and after delivery due to such factors as hypertension, obstructed labour, infections, and unsafe abortions.
According to Ligomeka, without a strong political will to enact the Termination of Pregnancy Bill, and ample investment in safe motherhood, it would be an uphill task to reduce the maternal mortality ratio for Malawi from 439 per 100,000 live births to the desired 70 maternal deaths per 100,000 live births by 2030," he said.
He added: "Let's end the fear of poor women in rural areas who feel like pregnancy is their death sentence. We should no longer call pregnancy 'pakati' meaning midpoint between death and life because of uncertainty and fear of maternal deaths."
Ligomeka added: "We should be celebrating safe motherhood instead of weeping because of maternal deaths caused by unsafe abortions, which can be addressed through reforms already proposed by the government."
Magnitude
Despite current legal restrictions in the outdated provisions of the Penal Code, unsafe abortions are still widespread in Malawi.
The College of Medicine and Guttmacher Institute research findings reveal that over 141,000 abortions happened in Malawi in 2015 alone.
Upon realizing the magnitude of unsafe abortions, the government tasked the Malawi Law Commission to draft the Termination of Pregnancy Bill, which the Commission did.
"It is time the government considered the recommendations that the Law Commission made on abortion law reform because that can contribute to the reduction of maternal deaths," said COPUA Vice Chairperson Dr. Amos Nyaka.
"We are in a situation where no religion, and no restrictive law have stopped women from procuring abortions when they wish to do so. It seems when a woman decides that she does not want a pregnancy, she does anything to terminate it," said Dr. Nyaka.
Solutions
Speaking at the same training, a human rights activist, Juliet Sibale, said that once the proposed government law is enacted, women and girls would access the services on four grounds only.
"Once the proposed law is in place, termination of a pregnancy would be permissible, where continued holding of pregnancy will endanger the life of a pregnant woman; where termination is necessary to prevent injury to the physical or mental health of a pregnant woman, where there is severe malformation of a fetus; and where the pregnancy is a result of rape, incest, or defilement," she said.
Sibale said the enactment of the new law would reduce maternal deaths as women who meet the criteria would access safe services in hospitals.
"The new law will open an opportunity for women who are raped and girls who are defiled to access services with ease, as the ambiguity of the old law makes it difficult for them to do so now," she said.
Unlike all its neighbours, like Zimbabwe and Mozambique, which reviewed their abortion laws, Malawi is the only country is southern Africa that is stuck with a colonial law from the 1930s.