Abstract : In contrast to most sub-Saharan African countries where abortion is severely restricted, Zambia allows abortion in cases where continuation of the pregnancy would involve risk to the life of the mother or the mental health of her existing children or there is a strong likelihood of congenital abnormalities. In 1983, according to the Zambian Ministry of Health statistics, 1164 legal abortions were performed in the country's hospitals. However, the same source reports that 16,977 women were treated at hospitals for complications of illegal abortion in 1983 and this statistic continues to rise. In part, this is due to the inaccessibility of legal abortion services in areas of the country outside of the capital city of Lusaka; other areas lack the hospital facilities and gynecologists to grant legal abortion requests, per the 1972 Termination of Pregnancy Act. To determine whether there are, in addition, differences in the sociodemographic characteristics of legal versus illegal abortion patients, a prospective study compared 199 Lusakan women granted a legal abortion and 65 hospitalized with complications of an illegal abortion. Legal abortion patients tended to be in the 20-29 year age group (55%), have some secondary education (60%), and to be multigravidae (71%); illegal abortion patients were predominantly 15-19 years old (60%), also had some secondary education (55%), were single (80%), and had no prior pregnancies (63%). 81% of the women who resorted to an illegal pregnancy termination were students who did not want to disrupt their education. Only 12% of illegal abortion patients and 27% of legal abortion patients had ever used a modern contraceptive method and 20% of the latter patients had discontinued method use at the time of the unplanned pregnancy. There were 4 deaths in the illegal abortion group and none in the legal abortion group. Insertion of cassava root into the cervix was the most frequently used (33%) method of illegal abortion. It is suggested that reform of the abortion law to eliminate the need for the consent of 3 doctors and to allow outpatient abortions would increase utilization of and access to legal abortion; similarly, elimination of the requirement for spousal consent would increase use of modern contraceptive methods.
Source : Source Popline : http://db.jhuccp.org/popinform/basic.html - PIP 094225.