“Abortion is permitted only where there are professional medical reasons. In that sense, there is no safe abortion in Tanzania. Since unsafe abortion is not a legally recognised practice, no professional assessment has been conducted on the issue,” he said.

Hidden business chain

Unlike formal healthcare services, the underground abortion market operates without receipts, records, or official accountability. Yet investigations reveal a well-established system linking pharmacies, brokers,s and informal service providers.

Interviews conducted with women who underwent the procedures, pharmaceutical experts, ts and healthcare workers uncovered the existence of a coordinated network operating largely through mobile phones and social media platforms.
“A client does not deal with one person only,” said a broker identifying herself as Rehema, who communicates with customers through WhatsApp groups.

“We handle the process step by step, and everyone takes a share of the money.”
According to her, women may either obtain abortion pills or undergo “cleaning procedures”, often without directly meeting trained medical personnel.
“Most arrangements are finalised through phone calls or WhatsApp conversations,” she said.

She explained that the process usually begins at pharmacies where abortion-related drugs such as Misoprostol are sold, frequently without prescriptions.
Brokers then connect women to individuals offering the procedures.

Investigations established that many women initially spend between Sh40,000 and Sh100,000 on medication, although costs rise sharply when complications occur.
Sources involved in the trade said one of the most profitable aspects of the business is the significant price difference between the formal healthcare system and the illegal market.

“In the formal system, Misoprostol may cost between Sh30,000 and Sh50,000 for five tablets. But in the underground market, prices rise to between Sh50,000 and Sh150,000,” one source said.

Rehema admitted that the expenses rarely end with the first payment.
“If the pregnancy does not terminate completely or the woman starts bleeding continuously, we advise her to undergo cleaning procedures where treatment starts from Sh150,000 to Sh300,000,” she said.

One doctor operating outside the formal healthcare system acknowledged that prices increase sharply once severe complications emerge.
“You may start with Sh150,000, but if heavy bleeding or infections develop, the amount can rise to Sh500,000 or even Sh1 million depending on the seriousness of the condition,” he said.

“If treatment is delayed for too long, reproductive tubes may become blocked and surgery could eventually be required.”
For many women, what initially appears to be a quick solution eventually becomes a costly medical crisis.

“You pay quietly because it remains a secret between you and the person who sold you the medicine,” said one pharmacy worker in Kinondoni.
“And sometimes you end up paying with your life.”

Victims caught in the system

Neema, a 22-year-old university student in Dar es Salaam, recalls discovering her pregnancy as the beginning of a frightening series of decisions.
After visiting a public hospital, she became too afraid to fully explain her situation and eventually left without assistance.

Later, fellow students connected her to a man who promised to arrange the procedure for Sh150,000.

“He told me we should meet at night,” she recalled.
They later met in a small room in Tandik, where she was given medication and brief instructions after making payment.

About 24 hours later, she began bleeding heavily.

“I tried calling him repeatedly, ly but he never answered,” she said.
Relatives eventually rushed her to Mwananyamala Hospital in critical condition.
Doctors reportedly found that she had suffered severe blood loss following the incorrect use of medication and required emergency treatment.

Her family borrowed more than Sh300,000 to cover hospital expenses.
“I realised I had paid twice, first to risk my life, then again to save it,” she said quietly. Healthcare specialists say such cases continue to place pressure on public hospitals.

“Treating these complications is extremely expensive,” said consultant gynaecologist Dr Elias Kweyamba of Ifakara Mission Hospital. “You need blood transfusions, antibiotics, surgery,y and prolonged hospital admission.”
Several reproductive health studies indicate that treating complications arising from unsafe abortion often costs significantly more than preventive reproductive healthcare services.

This leaves the government carrying major treatment costs while underground operators continue profiting.

Health risks

Speaking about the medical consequences of unsafe abortion, obstetrician and gynaecologist Dr Isaya Mhando said many women die before reaching the hospital.
He identified excessive bleeding as one of the leading causes, particularly where pregnancy tissue remains inside the uterus.

“Severe blood infections, or sepsis, can begin in the reproductive organs and spread rapidly throughout the body, leading to shock and death,” he explained.
He added that the use of unsafe instruments may puncture the uterus and damage internal organs, forcing doctors to perform major emergency surgery to save patients’ lives.

According to Dr Mhando, some long-term complications remain even after initial recovery.

“Serious infections may cause scarring inside the uterus or fallopian tubes, eventually leading to infertility,” he said.

He added that many women also develop chronic pelvic pain affecting their work, relationships, and mental well-being.
“Unsafe abortion is not only an immediate medical danger. It can leave long-term health and social consequences,” he warned.

Shadow economy

Economists describe the illegal abortion trade as part of a wider shadow economy driven by demand secrecy,y and risk-based pricing.
“When restrictions increase, prices also rise,” said Prof Abel Kinyondof of the f University of Dar es Salaam.

“The law prohibits abortion except under limited medically approved circumstances.”

“Outside those exceptions, it becomes an illegal market. Once something is illegal, there is no proper oversight because no authority openly supervises that trade,” he added.

While some women survive the underground system without severe complications, others are left with trauma, debt, or permanent medical damage.
For many families, emergency treatment forces them to borrow money or sell property to save relatives’ lives.

Yet despite the dangers, people involved in the network say demand continues growing.

“People keep coming,” one broker admitted.

“As long as the demand exists, this business will not disappear.”
Independent lawyer Peter Majanjala said fear of legal consequences discourages many women from seeking medical assistance early, pushing them towards unsafe alternatives.

He noted that many Tanzanians remain unaware that post-abortion care services are available regardless of whether a miscarriage occurred naturally or followed an induced abortion.

“What many people believe is that once they go to the hospital, they will automatically be reported for terminating a pregnancy,” he said.
“That fear contributes to worsening health complications and, in some cases, death.”