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Queen Elizabeth Central Hospital (QECH) every month registers at least six cases of teenagers having their uteri removed after developing various complications which include unsafe abortions.
A uterus is a hollow, pear-shaped organ that is located in a woman’s lower abdomen, between the bladder and the rectum. This is where a baby grows after conception until birth.
Malawi News has learnt that out of the 900 to 1,200 births the hospital registers, 30 percent are of women who are below the age of 20.
According to one of the gynaecologists at QECH, Louis Gadama, every month, the hospital records 20 cases of women who have severe sepsis an infection which requires having their uteri removed.
“This is the only way to save the lives of the women. Previously, we lost a lot of women to such infections[sepsis] because people were reluctant to have a hysterectomy but the women need to be saved…These are women of different ages but 30 percent of them are teenagers,” he said.
Gadama revealed that in one day, QECH attends to 10 to 15 spontaneous miscarriage cases most of which involve teenagers.
“Most of them [teenagers] do not even tell us that they have had unsafe abortion. We only get to learn about it after examination… sometimes we find objects in the womb,” he said.
The gynaecologist added: “There is a strong need for teenagers to be encouraged to delay pregnancy and be allowed to use contraceptives. There is also need for more awareness on child marriages because some of these teenagers are married already.”
The Malawi Demographic and Health Survey (MDHS) of 2015/16 indicates that Malawi has recorded an increase in teenage pregnancies from 26 percent (in MDHS of 2010) to 29 percent.
“Nineteen percent of women aged 25-49 have first sex before age 15, and 64 percent before age 18. By age 20, 85 percent of women have had sexual intercourse…Thus women in Malawi may be exposed to the risk of pregnancy and begin child bearing at an even earlier age…” reads part of the MDHS.
National Coordinator for White Ribbon Alliance, Nancy Kamwendo confirmed that teenage pregnancies is a huge problem that the country is facing, attributing it to lack of information and access to contraceptives.
“Teenagers lack access to contraceptives due to stigma. Parents and the society at large do not seem to accept that they also need contraceptives,” she said.
Kamwendo noted that there is a provision of Youth Friendly Health Services (YFHS) but it is not active in most health facilities, leaving the teens with nowhere to go to access information and contraceptives.
“We all have a role to play otherwise this might worsen. Teenagers are resorting to having unsafe abortions because they are not ready for the pregnancies in the first place. There is need to prevent these pregnancies
“I know there are a lot of myths about this which including that contraceptives might promote immorality, but this is not true. Adolescents need to know what to do other than risk their lives through abortions or even ending up having their uteri removed,” she said.
Ministry of Health spokesperson, Joshua Malango said youths who are sexually active can access condoms to protect themselves from sexually transmitted infections, HIV and pregnancy.
“You might wish to know that reducing teenage pregnancies is not only the responsibility of the ministry, everybody [including parents, chiefs, communities, politicians, faith based organisations, media and the youth themselves] need to play their part too,” he said.
Malango further said a number of ministries came together to develop the National Strategy for Adolescent Girls and Young Women which has been finalised.
He then confirmed that the ministry (through its health facilities) provides post abortion care since termination of pregnancy is illegal in Malawi.
Findings of United States based Guttmacher Institute and University of Malawi’s College of Medicine Centre for Reproductive Health indicate that 141,000 abortions occurred in Malawi in 2015—at an annual rate of 38 abortions per 1,000 women of reproductive age.
“All of which indicate that abortion is common in the country. The majority of these procedures were performed under clandestine and unsafe conditions and often resulted in complications,” reads part of the findings.
The 2014 findings of Benefits of Meeting the Contraceptive Needs of Malawian Women conducted by Centre for Social Research and Guttmacher Institute indicate that there is need for more investment in contraceptives.
“Compared with current expenditures on contraceptive services and maternal, new born and post abortion care, meeting just half of the unmet need for modern contraceptives would result in a net saving of K2 billion ($5.5 million),” reads part of the findings, adding that fulfilling all unmet needs would save K4.1 billion ($11.0 million).