In Kenya, one in every four women has had an abortion. Another study shows that of the women who had severe complications after abortions, 45 per cent were teenagers.
The estimates comprise those reported within the healthcare system, so the number could be much higher. An estimated 2,600 women die from unsafe abortions annually. This works out to an estimated seven women and girls dying every day, making unsafe abortions one of the major causes of maternal deaths in Kenya today.
Kenya is currently facing an alarming public health crisis in the number of unsafe abortions that have remained unreported for the most part due to the attendant stigma and emotive nature of the abortion issue. Many women and girls in Kenya are losing their lives as they resort to unsafe abortion practices.
Research shows young people living in urban slums are at significant risk of early unplanned pregnancies. A study by the African Population and Health Research Centre in 2012 showed, for example, that in Nairobi’s urban slums, 116 out of every 1,000 girls between 15 and 19 had given birth.
Half of these births were unplanned. And although 50 per cent of the 15- to 19-year-old women had started sexual activity, only 35 per cent were using any method of contraception.
Safe abortions at clinics can cost about Sh20,000, whereas unsafe abortions are roughly a tenth of that price and payments can be made in instalments. It is not uncommon for household goods, such as televisions, to be included in those payments.
Adolescent sexual behaviour has been the subject of a number of recent discussions in the Kenyan media. These discussions have centred on declining moral standards, poor parenting, and a general “blame game” around who bears the responsibility for precocious sexual activity among Kenya’s young people.
The social stigma around abortion and lack of service delivery policies is pushing women to resort to quacks (backstreet or untrained providers). Further to this, the legal provisions seem not to be fully understood.
Unintended pregnancies are the main cause of unsafe abortions. The high number of unwanted pregnancies stems largely from the unmet need for family planning, which currently stands at 18 per cent. Lack of awareness and access to contraceptives and reproductive health services is also a contributing factor to the unmet need for family planning.
Many women and young girls confronted with an unwanted pregnancy, in the face of a law that prohibits abortion on demand, put their lives in the hands of abortionists who use crude and unsterilised weapons.
Both genders must also be able to access information about the most effective methods of contraception to reduce the number of unintended pregnancies, unsafe abortions, and the complications that arise from these procedures.
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.
The Health ministry put out guidelines in 2012 to help doctors determine whether they could legally perform an abortion, before withdrawing them in 2013 after a caustic backlash in this staunchly Christian country.
Among other things, the 2012 guidelines outlined where, how, by whom and under which circumstance an abortion should be performed. Crucially, it also stated that mental health was included in the criteria of ‘health.’
After the retraction, the director of medical services wrote a memo to all health workers, directing them not to participate in safe abortion training.
Every person, irrespective of age, has the right to access quality health services. As Kenya prepares a national response to implement the 2030 agenda for sustainable development, it must make substantial investments in sexual and reproductive health programmes.
This will ensure every young woman is fully supported to make decisions that will ensure their sexual and reproductive health.