In 2014 the Kenya Demographic and Health Survey (KDHS) found that 36 per cent of births in the preceding five years were reported as unintended or mistimed and this figure rises to 47 per cent among adolescents. The study also found unsafe abortions are estimated to account for 35 per cent of maternal deaths – a figure significantly higher than the global average of 13 per cent.
This equates to an average of seven women daily or 2,600 deaths annually. An unsafe abortion is defined as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both.
Abortion is an emotive and extremely divisive issue all over the world, and it is no different in Kenya. Previously, the 1970 Penal Code stated that any person who intended to procure the miscarriage of a woman would be guilty of a felony, liable to imprisonment for 14 years.
It was not until the 2010 Constitution when this was changed with Article 26 (4) stating:
“Abortion is not permitted unless in the opinion of a trained health care professional, if there is need for emergency treatment or the life or health of the mother in in danger, or if permitted by any other written law.”
While therefore legal, there was a lack of guidance which has meant that the circumstances in which abortion was permitted were uncertain. This uncertainty meant that there were three court cases every week where women were charged with having an illegal abortion, and studies showed that 10 out of 20 cases examined involved schoolgirls – some of whom were minors.
According to research conducted by Ipas Health Alliance in Kenya, nearly 500,000 abortions are conducted in Kenya every year, with 20,000 of them in government health centres.
There are a number of reasons why women seek abortion services.
For girls between the ages of 10 and 24 it is often the stigma of childbirth outside of marriage, the inability to support a child financially and being compelled to drop out of school. For older women, tough economic conditions are usually cited as their reasons for an abortion.
It is this stigma that leads desperate women to seek dangerous illegal abortions. It was found that among the nearly 500,000 induced abortions, over 120,000 women were hospitalised for complications from unsafe abortions each year – 45 per cent of those that had severe complications were under the age of 19.
In addition to the stigma of having a procedure, those suffering from complications caused by an unsafe abortion may not even take themselves to a clinic for help, should problems arise. A report by the Kenya National Commission on Human Rights (KNCHR) found unsafe abortions rampant among adolescents and youth, especially in universities and technical colleges. One Nairobi University student says, “Foetuses are collected from dustbins in universities…most girls do not seek safe abortion services, including post-abortion care, as they fear being known to have aborted.”
In a report published by safeabortionswomensright.org, it was found that not only are women dying from complications but health professionals are also being affected.
Whereas fear of being stigmatised for having an abortion leads to having it done illegally, because there is no after care and because the consequences of doing it are so high, women are less likely to seek medical help causing more deaths. Not only is there a significant loss of life, but there is an additional strain on the already burdened health system. According to a report by the Ministry of Health and the African Population and Health Research Center, Kenya has spent Sh533 million treating complications of unsafe abortions in public health facilities. It is important to remember that there are many more unreported cases.
Studies demonstrate that it is far more affordable to prevent unwanted pregnancies than it is to treat the complexities that emerge from unsafe abortions. Specialists recommend tending to the drivers of unsafe abortions by upgrading the access to contraceptives, comprehensive sexuality education and honest discussions with adolescents about the best way to avoid unwanted pregnancies. We should be operating on a “children by choice, not chance” ideology.
Various organisations offer pregnancy crisis counselling services which can assist women and girls in desperate situations so that they avoid endangering themselves. This matter therefore needs to be brought to the fore, otherwise we shall continue to lose more women and girls over an issue that can be resolved.