Unfinished business: Abortion Laws in Mozambique and Uruguay

The first serious investigative journalism I did was a five-part series on abortion in Uruguay, for the weekly BUSQUEDA, back in 1982.

Thirty years later, I am coaching Mozambican reporters doing stories on illegal abortion in Mozambique.

Africa in 2012 is a world apart from Latin America in 1982 – but I find similarities between the stories of women here now, and there, then.

Now, as then, women who don’t want a pregnancy will do anything to interrupt it – even dangerous procedures. I just returned from Inhambane province, 500 kms North of Maputo. We interviewed a primary school teacher who introduced an 8 centimeter long root into her vagina, perforated the uterus, developed sepsis and required a hysterectomy. See her story here.

Now, as then, middle-class women can interrupt their pregnancies safely and discreetly. Poor women resort to gruesome methods and unscrupulous individuals perform atrocities on their bodies.

One big difference is Misoprostol. The pills, sold in Mozambican pharmacies as Cytotec with a prescription, or under the counter without one, have made pregnancy interruption much safer. That is, for urban, informed women who know about it and live near well-stocked pharmacies in the anonymity of towns.

For rural women like the teacher, there are virtually no safe options.

Every day, an average of six women are admitted in the clinics of Inhambane province, with complications from unsafe illegal abortion. In 2011, there were 2,300 cases, resulting in seven deaths. The numbers are similar in Mozambique’s other provinces. In 2011, hospitals in Maputo province admitted 9,400 women with complications from unsafe abortions. Of these, eight died.

These cases are just the tip of the iceberg.

In the rural areas, where 17 million of the 22 million population live, and only 7% of women use modern contraception, women with botched abortions have little chance of reaching a hospital in time to be saved. They die without being counted, the collateral cost of the country’s antiquated legislation from 1886.

This is about to change – as it recently changed in my home country, Uruguay. In September, a new law passed authorizing abortion in the first 12 weeks, although flawed and restrictive due to political compromises with conservative representatives.

In Mozambique, before the end of the year, the National Assembly should discuss a new law decriminalizing abortion, already approved by the Council of Ministers.

In fact, Mozambican central hospitals already provides safe abortion in some cases. Concerned with the number of deaths from unsafe abortion, Dr. Pascoal Mocumbi, a former health Minister and Prime Minister, allowed central hospitals to provide safe abortion in the mid-1990s.  But, because abortion is illegal according to the Penal Code, the Ministry of Health cannot inform women openly about this safe option.

Inhambane’s provincial hospital provides such services but few women know and uptake is very low.

I hope Mozambican women do not have to wait 30 years, like Uruguayans, for a law to protect their autonomy and their right to make a safe choice. A luta continua!

Mercedes Sayagues, a Uruguayan journalist, is a Knight Health Fellow in Mozambique.

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