A young Kenyan woman lay with her legs held and spread wide on stirrups. She’s covered in newspapers. The equipment is stored in a bucket of bleach. A backstreet doctor prepared to put medicine inside her uterus to help her remove her pregnancy. She told BBC Africa Eye she needed the procedure because she couldn’t afford to leave work to deal with a pregnancy. She’s already a single mother of three and is HIV-positive. She’s three months pregnant. An unsafe abortion is her only choice.
She spared Ksh. 4000 for the procedure. The doctor providing it stated that he performs up to 150 procedures each month. The procedure was painful for her. So, she worried she would die alone. What would become of her children?
A safe abortion is a medical procedure that ends a pregnancy. While contraceptives prevent women from becoming pregnant, safe abortion helps ensure that women who have already become pregnant, who don’t want to or can’t carry a pregnancy to full term retain control of their bodies and their lives. In Kenya, abortion is restricted but legal provided that a healthcare professional determines that a woman’s health or life is in danger. When a country restricts access to safe abortion, it can force women to seek unsafe abortions. The most commonly used safe abortion methods are medical abortions, which include prescribed pills and surgery.
Why women get abortions.
Kenyan women get abortions for the following reasons:
Poverty- many Kenyan women struggle to support their families and would be unable to manage with new babies.
Health complications- health complications such as pre-eclampsia, ectopic pregnancy, kidney disease, blood disorders, sepsis, foetal abnormalities, or cancer.
Mental health complications from carrying a pregnancy when they didn’t want to.
Pregnancy resulting from sexual assault or incest.
Lack of awareness of sex education.
Lack of access to contraceptives.
Not wanting children.
Regardless of whether abortion is legal or not, when women don’t want to or can’t carry a pregnancy to term, they will acquire an abortion. When there are too many restrictions, such as cost, stigma, or legality, women end up getting unsafe abortions which is one of the leading causes of maternal mortality.
The legality of abortion
The Kenyan constitution states in Article 26(4) that abortion is not legal unless, in the opinion of a trained healthcare provider, the health or life of the mother is at risk. This is unclear and makes it difficult for doctors to provide abortions even when the mother’s life is at risk.
In Kenya, 17% of mothers die because of unsafe abortions. These women would also not have survived or been guaranteed a better quality of life if they’d carried the pregnancy to full term. Unsafe abortions can be carried out by practitioners who aren’t trained in providing safe medical procedures. This can include quack pharmacists who sell placebos to desperate women, incorrect dosages of correct drugs, and untrained surgeons.
Seven Kenyan women die each day from unsafe abortions. These are women whose lives would be saved if they had access to safe and affordable abortion. Unsafe abortions can also be self-inflicted by using sharp objects inserted into the cervix, drinking bleach, vaginal herbs, or hitting the abdomen. These methods may also fail to successfully end the pregnancy, leading to lasting health complications, including infertility, internal bleeding, infections, sepsis, and internal organ damage.
In 2014, JMM got into Form One at a school in Kisii County. While attending school, she was raped by an older man. She got pregnant but didn’t know until she missed her period for two months. In December 2014, JMM’s roommate introduced her to a quack doctor who conducted two unsafe abortions leading to vomiting, severe stomach pains, and heavy bleeding. Eventually, JMM was transferred to a Level 5 hospital where they managed to remove the foetus but had to transfer her again because her kidneys were failing. After being transferred between two hospitals and finally going to Kenyatta National Hospital, JMM got treatment. The unsafe abortion led to sepsis, haemorrhagic shock, and chronic kidney disease. In 2018, JMM died because she couldn’t access adequate post-abortion care.
The need for safe abortions
Legal restrictions and moral stigma can lead women to get unsafe abortions even if they qualify for a legal abortion. However, society can support women in accessing safer care. By making safe abortion resources more accessible, women will be able to verify which clinics are safe and which hospitals provide safe abortions. are inaccessible to poor women.
Whereas stigma makes it difficult for women to seek out options that are best for their health, if we are more empathetic, young girls will seek out medical advice from trained professionals. If we are supportive and affirming then the Kenyan doctors who are capable of providing safe abortions will be able to help more patients, who feel empowered to seek their advice.
Women should not be forced to bear a pregnancy to term when they don’t want to. This includes married mothers as well. Having access to safe abortions makes it easier for them to try again for a pregnancy when they’re ready to do so.
It’s our responsibility to demand that the government makes safe and legal abortions more accessible, and therefore make it possible for girls and women to lead healthy, more fulfilling lives. Together, we can save women’s lives.
Gloria Mari is a culture writer based in Nairobi, Kenya. She writes on art, film, literature, health, and the environment. She has previously written for Kenya Buzz, People Daily, The Elephant, and Kalahari Review.