By Mandipa Machacha and Tsidi Leatswe
When Tadala Zindawa**, (21) from Tata village in Lilongwe’s Chitukula area, fell pregnant while in secondary school, she was overcome by fear and panic. Scared of her parents’ disapproval and with abortion criminalized in Malawi, Tadala resorted to unsafe methods using Aloe Vera or Surf Soap to induce abortion. The procedure not only failed, but it led to severe pain and heavy bleeding. She survived after post-abortion care, but the psychological and physical scars are lifelong.
Nevertheless, Tadala is one of the lucky ones.
Every year, hundreds of women and girls in Malawi die or are injured from pregnancy and childbirth-related complications. According to the Malawi Ministry of Health and the Guttmacher Institute, about 141,000 abortions occur annually in Malawi, the vast majority unsafe and accounting for 6–18% of maternal deaths.
“Every year, hundreds of women and girls in Malawi die or are injured from pregnancy and childbirth-related complications.”
Mandipa Machacha and Tshidi Leatwe
Preventing such deaths and injuries through timely access to care has been increasingly recognized around the world as a human rights issue, and not solely a public health concern.
In October 2025, the Human Rights Council adopted by consensus Resolution A/HRC/60/L.20/Rev.1 on Preventable Maternal Mortality and Morbidity and Human Rights. The resolution urges states to eliminate legal, structural, and social barriers that deny women and girls access to life-saving sexual and reproductive health services by repealing discriminatory laws, combating gender stereotypes, and ensuring access to comprehensive sexuality education.
The resolution’s strength lies in its comprehensive framing. By linking maternal health to the right to life, health, equality and non-discrimination, the resolution obliges states to ensure maternal care is based on human rights, health workers are protected, and sexual and reproductive health are integrated into universal health coverage. In doing so, it reminds the global community that maternal deaths and injuries are not inevitable – they are preventable when rights are respected and systems are accountable.
Yet, in Malawi, these commitments remain far from reality.
When law and policy fail women and girls
Malawi’s abortion law, inherited from colonial legislation and provided for in the Penal Code (Cap. 7:01) permits abortion only to save the life of the mother, with no exceptions for rape, incest, or severe fetal anomaly. This restrictive framework violates international standards, including the African Commission on Human and Peoples’ Rights’ General Comment No. 2 (2014) on Article 14 of the Maputo Protocol, which recognizes women’s right to medical abortion in cases of sexual assault, rape, incest, and where pregnancy endangers life or health.
“Malawi’s abortion law, inherited from colonial legislation and provided for in the Penal Code (Cap. 7:01) permits abortion only to save the life of the mother, with no exceptions for rape, incest, or severe fetal anomaly.”
Mandipa Machacha and Tshidi Leatswe
Many women and girls, like Tadala, resort to unsafe and clandestine methods – ingesting harmful substances, inserting objects, or seeking untrained providers. Fear of prosecution deters them from seeking post-abortion care, which is legal under Sections 19 and 20 of the Gender Equality Act No. 3 of 2013.
This stark reality was reflected in a recent ruling by the High Court in Blantyre. On 28 October 2025, the High Court of Malawi ruled that denying a 14-year-old rape survivor access to a safe abortion violated her rights to sexual and reproductive health under the GenderEquality Act (AC (a minor) v Attorney General & Others, Civil Cause No. 162 of 2023).
Reform deferred, lives lost
For nearly a decade, advocates, medical professionals, and civil society organizations have pushed for the adoption of the Termination of Pregnancy Bill, which would expand access to abortion in limited cases such as rape, incest, and severe fetal anomaly.
Yet it remains stalled in Parliament, trapped between political hesitation and moral panic. Public opposition has been fueled by misinformation and religious fundamentalism that frames abortion as a moral transgression rather than a human rights and public health imperative. This rhetoric not only distorts the issue; it costs lives.
“For nearly a decade, advocates, medical professionals, and civil society organizations have pushed for the adoption of the Termination of Pregnancy Bill, which would expand access to abortion in limited cases such as rape, incest, and severe fetal anomaly.”
Mandipa Machacha and Tshidi Leatswe
Pregnancy complications in childbirth remain the leading cause of death among girls aged 15–19 worldwide, according to the WHO. In Malawi, adolescent pregnancies are associated with higher risks of obstetric complications, school dropout, and social exclusion. Denial of sexual and reproductive health information and services perpetuates gender inequality and violates Malawi’s obligations under the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the Convention on the Rights of the Child (CRC), and the Maputo Protocol.
Every maternal death and injury from a preventable cause violates the right to life. Every unsafe abortion is a failure of justice. Malawi to must act now, because the cost of inaction is measured in lives lost, those living with injuries and futures denied.
This opinion piece first ran in the Malawi Nation Online.
Mandipa Machacha is a Researcher and Advisor on Gender at Amnesty International.
Tshidi Leatswe is a Regional Campaigner on Malawi, Zambia, and Zimbabwe at Amnesty International.
*names have been changed to protect her identity.
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