By Felogene Anumo
Unsafe abortion is defined by the World Health Organisation (WHO) as a process of terminating pregnancy, carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. Evidently, this poses a serious threat to the sexual and reproductive health and lives of women as presented in the recent key findings of a National Study on the Incidence and Complications of Unsafe Abortion in Kenya led by the African Population and Health Research Center (APHRC) and the Ministry of Health, Kenya.
Unsafe abortion continues to be a persistent public health challenge that contributes to 13% of maternal deaths globally and a myriad of short and long term health complications among women in their reproductive age. The largest proportion and highest rate of unsafe abortions currently occurs in Africa. The incidence of unsafe abortions in Africa has been attributed to restrictive abortion laws, limited access to reproductive health services and high unmet need for family planning services. According to the study, there were nearly 465,000 induced abortions in Kenya in 2012 a marked increased from an estimated 300,000 induced abortions in 2002.
The high incidence of induced abortion is related to high levels of unintended pregnancy. More than 70% of women seeking post-abortion care were not using a method of contraception prior to becoming pregnant. Additionally, the women who seek treatment of complications from unsafe abortion in Kenya are extremely diverse: half were less than 25 years of age (48%), while a majority were from rural areas (59%), married (64%), other Christians (64%), and had some education (90%). In the case of young adults and married women, the reasons for procuring induced abortions were that the pregnancy was either mistimed or unwanted.
The findings of the study are thought provoking in that they bring out some very pertinent issues that need to be addressed:
- What is the role of religious leaders in reducing unwanted pregnancies?
- How can empowerment of women help alleviate unintended pregnancies?
- Is it time to introduce comprehensive sexual education in school curriculum?
- How best can the society address stigma associated with access and the effective use of contraceptive methods?
- Is the government doing enough to address the high costs of family planning services and shortages of contraceptive supplies?
Highly restrictive abortion laws are not associated with lower abortion rates. According to the World Health Organisation (WHO), after South Africa liberalised its law, the country saw a 91 per cent reduction in maternal death from unsafe abortions. WHO notes that worldwide, restrictive abortion laws contribute to the high rate of maternal mortality as women tend to end their pregnancies illegally and unsafely. However, it must be noted that a liberal abortion law does not ensure the safety of abortions. To this end, service guidelines must be written and disseminated, providers must be trained, and governments must be committed to ensuring that safe abortions are available within the bounds of the law.
The Constitution of Kenya (2010) provides a new legal foundation for women’s access to safe abortion and is the basis for the Standards and Guidelines for Reduction of Morbidity and Mortality from Unsafe Abortion recently developed by Ministry of Health. In the context of devolution, it is imperative that all 47 counties implement these guidelines and ensure quality abortion care is made available throughout Kenya, in line with what is allowed for under the Constitution. Let us strive to ensure that every pregnancy is wanted by preventing unsafe abortions in Kenya. Women’s Lives Matter!
 World Health Organization, Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2008, 2011: Geneva