Tadala Zindawa (not her real name), a 21-year-old, sought an abortion due to an unwanted pregnancy while in form 1 at a secondary school at Tata Village, Traditional authority Chitukula in Lilongwe.
Fear of parental disapproval and the illegality of safe abortion options, led her to consider traditional methods.
This situation highlights challenges related to adolescent reproductive health, access to safe abortion, and the influence of cultural factors and misinformation regarding family planning methods within this community.
In Malawi, abortion is illegal except when the life or health of the pregnant woman is at risk. Performing or obtaining an illegal abortion can lead to criminal charges, including imprisonment for both the woman and the provider.
Harmful traditional practices persist in rural areas despite ongoing efforts to eradicate them, increasing complications and mortality among women and girls.
“I felt uncomfortable at school after becoming pregnant. I confided in a friend, who suggested using Aloe Vera or Surf Soap to induce an abortion. Following her advice, I experienced severe abdominal pain and profuse bleeding, prompting me to call for my mother. My mother and aunt took me to the hospital, where I received post-abortion care. I am now continuing my studies,” said Tadala
Unlike Tadala who survived, Maliam Funsan, a 72-year-old from Ntchisi district, recounts the February 2024 death of her 25-year-old daughter due to a late-term (7 months) unsafe abortion,
“She went to a traditional healer who gave her herbs to drink, leading to an abortion. The healer advised her to wait five days for complete expulsion, but she experienced severe pain. I then took her to Kamuzu Central Hospital, where she died the next day,” she said.
Funsan added that her daughter, wanting to get married, viewed the pregnancy as an impediment to her plans.
Kabudula Community Hospital situated in Lilongwe north has reported multiple cases of women and girls seeking medical care due to complications from traditional abortion methods.
In 2023, two women died after using cassava stems to terminate pregnancies, according to Chancy Msongole, a technician at the hospital.
Msongole added that women and girls often resort to unsafe abortion methods and avoid post-abortion care, increasing their risk of maternal complications and death.
He added that blood clots, if retained too long in the uterus, decompose and turn to pus, which can be fatal in cases of severely delayed treatment.
In the southern region, Nainunje Health Centre in Machinga district which caters for the area of senior chief Chiwalo recorded 1, 214 teenage pregnancies in 2024, according to Disease Control Surveillance Assistant, James Rajab.
In 2023, 13 girls aged 10-24 sought post-abortion care after unsafe abortions; this number increased to 15 in 2024. In the first quarter of 2025, we have registered 5 cases. In 2024, a woman from Chitambi village, Traditional Authority Chiwalo, died due to an unsafe abortion before arriving at the hospital,” he added.
The Centre for Solutions Journalism survey indicates that poor rural women are likely to seek induced abortion from witch doctors while urban women they seek induced abortion from health providers with a technical background, therefore poor women from the villages are likely to have complications that women on urban.
For example, the survey shows that 67 percent of rural poor women are estimated to have complications compared to 35 percent urban – non poor women.
The Centre believes that abortion is a common health intervention it is safe when carried out using methods recommended by WHO appropriate to the pregnancy duration and by someone with the necessary skills.
It is pressing parliament to expedite Termination of Pregnancy Bill warning that delays may endanger women and girls’ lives.
Dr. Matthews Ngwale, chairperson of the parliament committee on health, reiterated the Centre for Solutions Journalism’s findings that rural women lack awareness about abortion and often seek unsafe procedures from traditional healers, unlike urban women who utilize healthcare providers.
Ngwale stressed the need for public understanding of the Termination of Pregnancy Bill, stating that NGOs should educate villagers on the dangers of unsafe abortions, including mortality, complications, and hysterectomies. He warned that a lack of stakeholder satisfaction with this information could hinder the Bill’s progress.
He urged maternal health organizations to conduct awareness campaigns in rural areas to educate people about abortion.
Ngwale also confirmed that the Termination of Pregnancy Bill remains in Parliament, despite facing opposition from the government, religious leaders, and traditional leaders in 2021.
He clarified that the bill’s fate is not solely determined by the president, parliament, or traditional leaders.
Health Activist George Jobe emphasized that access to contraception, including emergency options, is crucial for women and young women to prevent unwanted pregnancies.
“Increased awareness and accessibility of family planning methods, especially in rural areas, are vital to reducing maternal mortality,” he said
Legal expert Chrispine Siwande clarified that Malawi’s Termination of Pregnancy Act, section 3, permits termination when a pregnancy endangers a woman’s life or physical/mental health.
Religious leaders hold differing views. Reverend Martin Kalimbe of the Religious Leaders Network for Choice stated that abortion is justifiable when the mother’s life is at risk or in cases of severe fatal malformation.
Conversely, Billy Gama, Chairperson for the Malawi Christian Council Churches (MCC), maintains his opposition to abortion, except when necessary to save a woman’s life.
He emphasized the need for clear legal language, specifying that abortion is only acceptable when the woman’s life is in danger, rather than a blanket legalization.
“Clarity regarding Malawi’s abortion laws is essential to ensure that women and girls whose lives are at risk receive necessary medical care without being denied access due to legal ambiguity,” he said
