Eddie Mhlanga, the devout doctor who reconciled faith with abortion

In October 1996, as South Africa’s National Assembly found itself embroiled in bitter debate over a bill to legalize abortion, a soft-spoken doctor from the country’s Department of Health stood up to speak.

“I am a born-again Christian, amen,” began Dr. Eddie Mhlanga, the department’s director of maternal health. And then he began to tell a conversion story of another kind.

As a young doctor in the early 1980s, he explained, he had operated on a colleague following a botched informal abortion. Then, he said, he asked for help.

“Every day I was at her bedside praying that God would have mercy on her,” he explained to the members of Parliament, who had gathered to consider whether South Africa should roll back an apartheid-era law that had made abortion almost entirely illegal in the country.

Two weeks later, Dr. Mhlanga’s colleague died, one of around 400 women that year to die after informal abortions. “It was my road to Damascus,” he later wrote.

The grief from watching a colleague die in such a way propelled Dr. Mhlanga to become a key advocate for the bill that would become South Africa’s Choice on Termination of Pregnancy law.

Today, it’s one of Africa’s most comprehensive abortion laws, and an international model, but high rates of deaths from unsafe abortions persist because of stigma and a lack of access.

Dr. Mhlanga, who died Feb. 5, spent the rest of his life trying to hold his country to the promise it made that summer to a nation of women whose choices about their bodies were often policed and criminalized. In a country where, like in the United States, faith and reproductive choice are often seen as opposing corners, he walked a middle road, and did what he could to bring others along with him.

“He saw his practice of medicine as an act of love and devotion – his patients felt it and his students learnt it,” Dr. Tlaleng Mofokeng, a doctor and abortion-rights activist who studied under Dr. Mhlanga, wrote in a tribute to his life.

“Professor Mhlanga did the work of caring for the most marginalized – adolescents, women, sex workers and those seeking abortion – because of his faith.” 

The defiance of becoming a Black doctor

Roland Edgar Mhlanga was born in 1953 in Acornhoek, a town in what is now the Mpumalanga province of northeastern South Africa. His father worked as a gardener at a local hospital, which became his introduction to the medical field. 

But to become a doctor in apartheid South Africa as a Black man wasn’t just a career choice. It was also an act of political defiance. The country had one medical school for “nonwhites,” at the University of Natal, which, by the time Dr. Mhlanga arrived there in the early 1970s, had become a hotbed for anti-apartheid activism.

Then, in 1976, the apartheid administration passed a law prohibiting abortion in almost every instance. The government saw a “moral crisis” for the country if white women didn’t continue to give birth to enough white babies, Susanne Klausen, a historian of abortion under apartheid, told the Monitor in 2018.

For Dr. Mhlanga, who described his background as “conservative and religious,” the law was a good one. As a medical student, he remembered hearing about a Black woman who died from an illegal abortion after she was impregnated by a white man and thinking, “It serves her right.” But when he began to work as a doctor and saw the toll of unsafe abortions on Black South African communities, which suffered the most under the former legislation, his views began to shift. 

“I didn’t want to be a gynecologist, but when I saw the many women and children who were dying, I said, ‘Lord, if you placed me here to see this tragedy, I guess you are sending me,’” he later recalled. 

When apartheid finally toppled in the early 1990s, Dr. Mhlanga took a post in the new country’s Department of Health, where he joined forces with activists interested in liberalizing the country’s abortion law.  

“We had just achieved the biggest miracle – we had gotten our democracy, and in that space, nothing felt impossible,” recalls Daphney Conco, an academic and activist for reproductive health in South Africa. 

“So we said, everything that does not work for Black women, for Black people, it has to be left behind,” she says.

It was with that energy that Dr. Mhlanga approached the parliamentary committee meeting that day in October 1996. “I saw women dying every day” in pregnancy and childbirth, he testified, speaking of his experiences working as a doctor in the 1980s. 

Outraged by his testimony, an MP for the National Party, which had been the ruling party under apartheid, stormed out. After several days of fraught debate, the bill passed, granting South African women the right to abortion on demand in the first trimester, and in many cases during the second as well.

Over the next five years, deaths from pregnancy terminations in South Africa fell by 90%.

“Eddie was an absolutely fearless leader in that space,” recalls Yogan Pillay, his former colleague at the Department of Health. 

Activism with reassurance

Throughout his career – which spanned work in government, academia, and international abortion activism – Dr. Mhlanga used his own story to reach across the divide. He frequently spoke at conferences on how, for him, abortion and faith were not opposing sides of a coin, recalls Marion Stevens, a South African health activist and a longtime friend and colleague of Dr. Mhlanga’s. He didn’t frame it as a conflict, she says, but rather “just affirmed that this is not contested, and not an issue for him.”

In a speech at a 2019 conference, he recalled admitting a young refugee woman into hospital after she miscarried. The nurses and doctors caring for her were whispering: Why had she gotten pregnant to begin with? She must have aborted the baby herself. This was no accident. 

“I went and sat by her bedside and I put my arm around her shoulder and said, ‘How are you doing, my dear?’” Dr. Mhlanga recalled. The woman began to cry. No one had asked her what had happened, she said. “I wanted this pregnancy so much.”

In a society that was often deeply polarized, Dr. Mhlanga reassured others struggling to reconcile their faith with a desire to help women. He led with an ethos of compassion, recalls his student, Dr. Mofokeng, who was herself inspired to become an abortion provider. “No one chooses to be in a difficult situation, but we are chosen to be in that space to provide the necessary care,” she remembered him telling her. 

At a conference she attended with him last year, she recalled that “he spent a lot of time barefoot. He said he wanted to feel the earth.” 

But until his death, Dr. Mhlanga was also deeply haunted by the law’s failed promises. In 2019, the Department of Health estimated that at least 50% of abortions in the country were still informal and unsafe. Many doctors and nurses in South Africa still refuse on moral grounds to provide the procedure, despite a mandate to do so. And women frequently report being humiliated and shamed for requesting terminations. 

Many times throughout his life, his colleagues had asked, “How can you support abortion when you are a Christian?” Dr. Mhlanga recalled in a speech in 2019. “But I found that in the end, it is all about love. When I look at you ... I see the image of God in you. I know I’m not perfect. Therefore I cannot judge anyone, but only serve and show love.”