New abortion guidelines expand choice in Zimbabwe 

Zimbabwe is one of the riskiest places in the world to be pregnant. Even though the rate of pregnancy-related deaths has dropped dramatically since 2016, unsafe abortion remains the third leading cause of death, with as many as 70,000 cases every year. 

Tens of thousands of women make the desperate choice to end their pregnancies under unsafe conditions each year because restrictive laws keep safe care out of reach. 

We’re working to change that—and this year, we saw results. For more than 18 months, the MSI Zimbabwe advocacy team pushed for updated abortion care guidelines that would make abortion accessible for more women. Now, the Zimbabwean Ministry of Health and Childcare has passed revised guidelines. 

Expanding access within the existing law 

The new abortion care guidelines clarify existing law. They include several important updates that will expand access for women and girls. 

The guidelines also cover how safe abortion can be performed, bringing Zimbabwean medical practice in line with World Health Organization recommendations. One significant change is that nurses and midwives will be allowed to provide abortion services in the first trimester of pregnancies. In regions where there aren’t many doctors available, increasing the number of providers available will make it easier for women to get the safe, legal care they need. 

Women at an MSI outreach site in rural Zimbabwe learn about their healthcare options.

How we pushed for change 

Our MSI Zimbabwe program, known as Population Services Zimbabwe (PSZ), worked with the Ministry of Health to convene a task force to work on the guidelines. Professional organizations like the Zimbabwe Confederation of Midwives, Association of Obstetricians and Gynecologists, and Zimbabwe Doctors for Human Rights were consulted. Their first-hand experience brought the dangers of unsafe abortion to life and illustrated the need for guidance that supports women’s rights and saves lives.  

Our global partnership was at work in our advocacy: MSI was able to share recent Comprehensive Abortion Care guidelines from Nigeria and Post Abortion Care guidelines from Malawi, documents with language that helped expand the definition of existing legal indications for abortion and increase the operating space for providers.

MSI also supported with technical guidance on specific medical issues, drawing on their deep experience providing post-abortion care to women in Zimbabwe. 

Methods of family planning on display at an MSI outreach site in Zimbabwe.

What’s next for abortion care in Zimbabwe? 

The process took over 18 months and had several delays, including the 2023 election. Initially, the Ministry of Health was skeptical that the guidelines were needed. Through persistent advocacy, MSI successfully made the case for updating the guidance—and ultimately, women and girls will benefit. 

Our work isn’t done: The next step is ensuring that the guidelines are implemented. That means preparing trainers who can work with healthcare workers to build competency. MSI is developing new trainings to encourage the adoption of the new guidelines, as well as working with the National School of Nursing to make sure the curriculum aligns with new standards. 

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