On International Safe Abortion Day, Parliament Must Choose Life

…..Malawi Cannot Afford Silence on Unsafe Abortion

By Noel Mkwaila

Today, on International Safe Abortion Day, as a Malawian and as a journalist who has followed reproductive-health debates for years and covered stories to do with survivors of unsafe abortions, I want to be blunt: Malawi is failing many women and girls when it comes to safe, timely abortion care. That failure is not only a health problem; it is a legal, political and moral one. We have laws that criminalise people for seeking care, policies that promise rights on paper but leave women stranded in practice, and health systems that treat the consequences of clandestine abortion rather than prevent them. I write this because silence costs lives.

Let me start with the legal reality. Malawi’s Penal Code still criminalizes attempted abortion and those who assist in it, with heavy sentences for providers and for women who procure abortions — while an exception exists only to save the life of the woman. These provisions are the reason most providers and facility managers treat abortion requests with fear and often refuse care.

At the same time, Malawi has progressive instruments that should protect sexual and reproductive rights. The Gender Equality Act (GEA), passed in 2013, explicitly grants “every person … a right to adequate sexual and reproductive health,” and directs health officers to respect those rights and provide family-planning and reproductive services without discrimination. Those twin facts — a penal code that criminalises and a GEA that guarantees SRH rights — create legal confusion that harms patients and scares clinicians.

The mismatch between law and practice has real human costs. Studies and estimates show that abortion in Malawi is common — and most of it is unsafe. Research published by the Guttmacher Institute and national partners estimated roughly 141,000 abortions in 2015, most secret and many with complications that burden our health system and put women’s lives at risk. Complications from unsafe abortion have been estimated to account for a significant share of maternal deaths in Malawi.

We also have recent, hard evidence of systemic failures in practice. In 2025 the High Court heard a landmark case brought on behalf of a 13-year-old rape survivor who was denied an abortion at a public facility. The litigation asked the court to clarify whether the Gender Equality Act and related laws entitle minors in such circumstances to safe, legal care. That case exposes how unclear law and hesitant providers force desperate women into the margins.

Against this grim backdrop, there have been important advocacy and programmatic efforts. Ipas and other civil-society partners have worked in Malawi for years to improve post-abortion care, to build clinical capacity, and to push for clearer legal standards so clinicians are not punished for providing life-saving treatment. These efforts have reduced some harms in facilities that can offer care, but they cannot reach women who never make it to a clinic or who are turned away.

Malawi’s international obligations add another layer. As an African state party to the Maputo Protocol, we are bound by Article 14’s reproductive-rights obligations — which include authorizing medical abortion in cases such as rape, incest and where the pregnancy endangers a woman’s physical or mental health. Those international commitments do not sit comfortably with an unchanged, colonial-era penal code.

The politics is raw, and reform attempts have repeatedly stalled. A Termination of Pregnancy bill — intended to clarify legal grounds for safe termination such as rape, incest and major health risks — was introduced and later withdrawn in the face of strong opposition and misinformation in 2021. That political defeat did not erase the evidence: women continued to seek unsafe abortions, and advocates and some faith leaders continued to press for change.

So how is Malawi performing? In short: partial at best. We have pockets of good post-abortion care; a clear national SRHR policy framework and a Gender Equality Act that affirms rights; active civil society; and some judicial engagement that may clarify the law. But we lack legal clarity, we punish seekers and providers in our Penal Code, and our health system does not reliably offer safe abortion services — especially to adolescents, the poor and survivors of sexual violence. The result is preventable morbidity and mortality, plus the social trauma of criminalization and stigma.

What must our new cohort of parliamentarians and the government do? Parliament should introduce (or reintroduce) a clear, narrowly-framed Termination of Pregnancy law that aligns with Article 14 of the Maputo Protocol and the Gender Equality Act’s guarantees. At minimum the law should allow termination in cases of rape, incest, severe fetal anomaly, and where pregnancy endangers a woman’s physical or mental health — and it should remove criminal penalties for women who seek care.

While Parliament debates law reform, the Ministry of Health and the Attorney-General should issue binding clinical guidelines that explain how Section 243 (the life-saving exception) and the Gender Equality Act operate in practice — so clinicians know how to act without fear of prosecution. At the same time, we must decriminalize and destigmatise. This means removing criminal penalties for women and reducing provider penalties where the care is evidence-based and medically indicated. It also means launching a national stigma-reduction campaign that engages health workers, religious leaders, traditional leaders and young people.

We must invest in services and contraceptives. Safe abortion care (where lawful) and quality post-abortion care should be part of the essential package under universal health coverage. Family-planning commodities and outreach should be properly funded, because preventing unintended pregnancy is the simplest way to reduce unsafe abortion.

Protecting minors and survivors must be non-negotiable. Laws and clinical protocols should prioritise survivors of sexual violence, including minors. Administrative barriers such as forced spousal consent must be removed. Survivors should be guaranteed confidential, timely care and forensic services.

Providers also need protection. We should invest in provider training on manual vacuum aspiration (MVA), medical abortion (where permitted), post-abortion care, and non-judgmental counselling — and ensure legal protections so clinicians who follow guidelines are not prosecuted. Alongside this, we must improve data collection on abortion-related complications, maternal deaths, and contraception uptake. Transparent data helps counter misinformation, demonstrates need, and builds political will.

To the new MPs: your constituents are not abstract voters; they are mothers, daughters, sisters and neighbours. You campaigned on improving health and protecting families. The evidence is clear: better reproductive-health law and services save lives, reduce health-system costs from emergency treatment of complications, and protect the dignity of women and girls. You will be judged by whether you let ideology stand where evidence is required. It must be registered in the minds of parliamentarians that not all pregnancies come out of choice. Some come out of coercion and even criminal conduct.

To government leaders: meeting our obligations under the Gender Equality Act and the Maputo Protocol is not optional. The law already says: “Every person has a right to adequate sexual and reproductive health.” That sentence must be translated into clinical guidelines, funding allocations and a legislative agenda that respects both conscience and health.

Finally, to my fellow citizens and civic actors: this is not a foreign script imposed on Malawi. This is a domestic crisis. Malawian women are suffering here, right now. Reform will require humility from faith leaders, courage from politicians, and sustained advocacy from civil society. If we keep the conversation honest, evidence-driven and compassionate, we can reduce avoidable deaths and uphold the rights our laws already, in parts, promise.

On International Safe Abortion Day, I ask the new Parliament to choose life — not through criminal law, but by enabling safe, timely and respectful health care. The issue of unsafe abortion must be taken as maternal and safe motherhood issue.

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