Introduction

Except for limited access to the sea through the River Shire, Malawi is largely a landlocked country in southern Africa. It shares borders with Mozambique, Zambia, and Tanzania. According to the United Nations Population Fund (UNFPA, 2022), the country as of 2021 had an estimated population of 19.6 million, which is expected to double by 2038. The health sector in Malawi is significantly underfunded by the government, with 70 per cent of funding accessed from foreign donors (WHO, 2015).

In common with many countries, abortion is one of the most polarising moral issues in Malawi (Levandowski et al, 2012). It is considered sinful and heavily stigmatised (Storeng et al, 2019). Political and religious leaders often refer to the country as a God-fearing nation, although the Constitution stipulates that Malawi is a secular state. Before colonialism, abortion was regarded as a women's issue handled by traditional birth attendants. However, the situation changed during British colonial rule when the Penal Code, with provisions prohibiting abortion, became operational in 1930. Specifically, the provisions on abortion were modelled on the by then outdated UK Offences Against the Person Act 1861 (OAPA) (Kangaude and Mhango, 2018). Abortion law was later reformed in Britain, with the 1967 Abortion Act providing exemptions to the OAPA, and in Northern Ireland related sections of OAPA have been completely removed, allowing for decriminalisation (Aiken and Bloomer, 2019). Malawi, however, has maintained the 1930 colonial abortion law, which it inherited at its independence in 1964; this was further maintained during the amendment of the Penal Code in 1999 and 2015. As was the case during the colonial and one-party eras, sections 149, 150, 151 and 243 of the Malawi Penal Code (Penal Code, 2015, fourth edition) still prohibit procurement of induced abortion, with the only exception being the provision of the service to save the pregnant woman whose life is threatened.

Specifically, section 149 reads: