Zambia is one of just a few African countries to have a fairly liberal abortion law that allows pregnancy terminations on social and economic grounds. This means that a woman’s actual or foreseeable socioeconomic circumstances and/or age can be considered as legal justification for seeing an abortion. In 2012, the Zambian government also approved the medical abortion combination pack, Medabon (misoprostol and mifepristone) for use within the country.
With such a liberal law, why are many Zambian women still unable to access safe abortion services?
Challenges & Ambiguity Around Abortion Law
The Zambian abortion law, or the Termination of Pregnancy Act 1972 is what is known as a ‘paper’ law i.e. a law that looks and sounds great on paper but in reality, has proven extremely challenging to implement.
According to the Act, a legal abortion can only be performed if authorized by three medical practitioners and can only be carried out by a registered physician. In a country where there is a huge shortage in trained physicians, there is a need for policies that allow nurses, midwives and other health care workers to perform safe abortions.
The Act is also in direct contravention of the country’s Penal Code, under which abortion remains illegal. The discrepancy between these two legal frameworks continues to be a barrier to service provision and access as both providers and women are unclear as to which law takes precedence.
And if that wasn’t ambiguous enough for you – the Act enshrines both the rights of women to receive safe abortion services and the rights of health practitioners to object to providing services that contravene their religious and moral beliefs.
In addition, safe abortion services are only available at the country’s main hospitals and private clinics which are located in the big cities. Rural and marginalized women who often need the service the most are left completely uncatered for.
Abortion Stigma, Stigma, Stigma
Despite a progressive law, there is still a negative connotation associated with abortion in Zambia. Young women, particularly those that are unmarried, face multiple barriers to accessing safe abortion services and many healthcare providers have prejudicial attitudes not only towards abortions, but also the general provision of SRH services for women and girls.
In addition, health care providers that do offer abortion services are themselves the subject of judgement and discrimination leading to an unwillingness to provide the service completely or a general secrecy around provision. Many providers also choose to conscientiously object to abortion provision based on religious and moral grounds – an act which is allowed the law.
Women either have to search high and low to find a willing provider or fork out huge sums of money to go to a private physician. Oftentimes they end up either visiting a witch doctor or attempting to induce an abortion themselves using unsafe and harmful methods.
The Clueless Constituency
One of the biggest yet easily remediated barrier facing abortion in Zambia is a widespread and complete and utter lack of awareness regarding the legal grounds for an abortion.
Women are unaware that the law allows them to access and receive safe abortion services and care.
Health practitioners are unaware that they have a legal responsibility to advise and treat women seeking safe abortion information and services.
Abortion resources in Zambia
Zambian women will continue to face barriers to safe abortion access due to provider bias, limited awareness of their legal rights and social and cultural stigma.
A liberal abortion law is only worth its weight in gold if it is accompanied by a robust, organized and politically supported implementation plan.
In the meantime, Zambian women can visit websites such as howtouseabortionpill.org , womenonweb.org and womenhelp.org to receive accurate and comprehensive information on how to use medical abortion pills accurately and safely. For a more specific list of safe abortion resources in Zambia, including trusted hospitals or referral networks, you can visit our Zambia country profile.