Over 2 900 miscarriages reported in 2024

Public health and policy concern
Mamsey Musweu
  • 1 Day Ago
Abortion in Namibia remains tightly restricted under the Abortion and Sterilisation Act of 1975, which only permits termination in limited circumstances: to save the life of the mother, protect her physical or mental health, in cases of severe foetal abnormality, or when pregnancy results from rape, incest, or unlawful intercourse with a cognitively disabled woman.

The law also requires written certification from at least two medical practitioners and confines the procedure to state-approved facilities. These requirements make legal access rare, forcing many women to resort to unsafe methods.

The consequences are starkly visible in Windhoek’s hospitals. In a Ministry of Health report dated 19 September 2025, Dr David Emvula, Head of Obstetrics and Gynaecology at the Windhoek Hospital Complex, outlined the scale of the crisis. The report shows that in 2024, 2 953 patients presented to state hospitals with miscarriage-related complaints, making miscarriage one of the most common gynaecological emergencies.

These cases accounted for nearly 40 per cent of all gynaecological admissions, averaging eight patients per day.



Who is affected

The majority of affected patients were women of reproductive age, most commonly under 35 years old. This younger age profile is concerning, as international benchmarks show lower miscarriage rates in this demographic, raising suspicions that some of these cases are in fact induced terminations disguised as natural miscarriages.

Of the 2 953 patients, 1 462 cases - around half - were classified as incomplete miscarriages, where part of the pregnancy remained in the womb. These women required uterine evacuation procedures, commonly referred to as “cleaning,” and were successfully discharged after treatment.

However, complications were severe for some. At least five women required emergency hysterectomies to save their lives. While the surgery was life-saving, it left them unable to carry a pregnancy in the future. Other patients fell into categories such as threatened or inevitable miscarriages. In some instances, pregnancies continued to viability and resulted in live births.



Evidence of unsafe terminations

Emvula noted that while unsafe abortions are difficult to measure, doctors sometimes find evidence of interference. Foreign objects, such as a “green stick,” and the insertion of pills inside the genital tract have been observed in patients. In 2024, three maternal deaths, of women aged 22, 24 and 37, were directly linked to unsafe abortions. This year, two further deaths, of women aged 30 and 38, have already been recorded.

Overall, the miscarriage rate at Windhoek hospitals was 11.3 per cent in 2024, higher than the expected global average of 10 per cent. For a younger patient population, this elevated figure suggests a significant number of induced terminations.



Policy gaps and prevention

Emvula stressed that there is no clear legislation or protocol guiding health workers on whether to report suspected cases of unsafe termination to law enforcement. “Any future framework should carefully balance public health responsibilities with patient confidentiality,” he said.

He further outlined preventive strategies, including:

• Community education on the dangers of unsafe abortion, including the risks of infertility and death.

• Public education about the legal status of abortion in Namibia.

• Promotion of safe sexual practices, delayed sexual debut, and increased contraceptive use to prevent unwanted pregnancies.

• Awareness campaigns in schools to provide young people with accurate information and empower them to make safe choices.