Deadly ‘solution’ for unready mums

She was 15 and in Form Three at a community day secondary school in Lilongwe when Ephrida Banda found out she was pregnant.

She panicked. “I was not ready to become a teen mother,” she says.

Like other women who find themselves in similar situations, Ephrida decided to abort and her peers helped with ideas.

“They told me to swallow 10 brufen pills to get rid of the pregnancy. Some advised me to prod the foetus with a hanger or cassava stem, while others said I should drink as much aloe vera juice as I could,” she recalls.

The cassava stem idea seemed easy and cheap for her, but regrettably, it landed her in hospital having dilation and curettage (D and C)— a procedure to remove tissue from her uterus.

At least she survived the ordeal. And unlike others, she was not injured for life and she lives to tell the story of how she escaped death.

Her story embodies thousands across the country facing unsafe abortions.

In an interview, renowned gynecologist Dr. Chisale Mhango indicates that abortion is the commonest cause for admissions in gynaecology wards in Malawi and other countries within the region.

“We have done two studies which indicate that abortions are increasing. As more women reach adulthood, more of them are getting unwanted pregnancies. The commonest problem the women come with is infection from the use of unsterilised stuff to prod the foetus and most of them die from such infections. Bleeding is another problem, but it only happens if the pregnancy is big — if small, the bleeding is not very serious,” Mhango explains.

He adds that when the womb becomes infected and the infection moves to the rest of the body, women die. Consequently, doctors just remove it before the infection spreads into the blood system.

“It is sad when young women go back without a womb because it means they will never have babies,” he observes.

Abortions are the result of unintended pregnancies. A 2015 study, Incidence of Induced Abortion in Malawi, found that 53 percent of pregnancies in 2015 were unintended and almost 30 percent of them ended in abortion.

This is evidence of high unmet need for contraceptives, which is critical in reducing rates of unintended pregnancies which lead to unsafe abortions and maternal deaths and injuries.

In relation to this, youth activists note that many of them are distressed when it comes to accessing sexual and reproductive health services.

National coordinator for Alliance for Youth Sexual, Reproductive and Health Rights (SRHR) Organisations (AYSO), Prisca Kunsida says many local health care facilities are not youth friendly — often manned by adults who condemn the youth seeking SRHR services.

This in turn discourages the youth from even going. She thus believes that young people should be assisted by other young people in health care facilities.

She notes that most facilities prioritise older and married women for contraceptives due to inadequate medical supplies.

This means that the youth’s only option is to pay for such services in private facilities, and most of them cannot afford.

Kunsida also observes that health care facilities are far in most hard to reach areas, forcing the youth to walk long distances to access SRHR services.

As a result, the youth engage in unprotected sex which end up in unplanned pregnancies.

Abortion sometimes follows unplanned pregnancies from rape, incest, defilement, myths and misconceptions, among other things.

Some of these misconceptions include myths that urinating shortly after intercourse or taking Panadol tablets or soda solution prevent pregnancy.

Kunsida highlights that in the case of incest, rape and defilement, reporting the incidence shortly after, helps prevent pregnancies as victims receive appropriate treatment from hospitals.

However, she contends that there is huge information gap on issues of SRHR and services among the youth which could be key in preventing unwanted pregnancies and reducing unsafe abortion rates.

SheDecides head of communications Annette Nalikungwi notes that sex talk between parents and children remains taboo in society, leaving the youth unequipped with the right SRHR information.

She feels more civic education on SRHR is vital. She also agrees that the attitude of most health personnel in clinics is derailing.

Nalikungwi says: “It is her body; she has the right to decide what happens to it. When we look at the millions spent on post abortion care in the health sector, it is important for the government to reconsider because such expenditures would tremendously drop if safe abortion was an option to Malawian females”.