OPINION: Safe abortions will save our future
By Alvin Mwangi
Every year almost half of all pregnancies – 121 million – are unintended. This is according to the World Health Organization report that was released in September last year.
Between 2015 and 2019, on average, 73.3 million induced (safe and unsafe) abortions occurred worldwide each year.
There were 39 induced abortions per 1000 women aged between 15–49 years. Three out of 10 (29%) of all pregnancies, and 6 out of 10 (61%) of all unintended pregnancies, ended in an induced abortion.
Among these, 1 out of 3 were carried out in the least safe or dangerous conditions. Additionally, 3 out of 4 abortions that occurred in Africa and Latin America were unsafe.
The risk of dying from an unsafe abortion was the highest in Africa and each year between 4.7% – 13.2% of maternal deaths can be attributed to unsafe abortion.
The WHO report also found that around 7 million women are admitted to hospitals every year in developing countries, as a result of unsafe abortion with the annual cost of treating major complications from unsafe abortion estimated at USD 553 million.
In Kenya, high abortion figures continue to raise concern: a Reuters report published in August last year stated that thousands of women are dying every year in Kenya due to botched backstreet abortions.
Reuters cited a report from the Centre for Reproductive Rights (CRR) which found that almost half a million abortions were conducted in Kenya in 2012 – the most recent data available – with one in four resulting in complications such as fever, sepsis, shock or organ failure, according to health ministry data.
An estimated 2,600 women and girls die annually in Kenya, amounting to seven deaths every day, from complications related to unsafe abortions, said the CRR report.
Most victims are women and girls from impoverished urban and rural settlements who cannot afford private healthcare, and face stigma and discrimination seeking treatment in public hospitals.
Evelyne Opondo, CRR’s senior regional director for Africa, said widespread conservative attitudes stigmatizing abortion had driven women and girls to unregulated clinics run by untrained medical practitioners.
In Kenya, abortion is regulated by Article 26 (4) which states that: “abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law” and the 2010 revised version of the 1970 penal code which describes different punishments regarding abortion laws.”
In 2019, the High Court in Nairobi further clarified that health workers permitted to make an opinion if abortion is necessary include, nurses, clinical officers, obstetrician gynecologist, midwives and doctors.
This means that when a girl or a woman is at physical, mental or psychological health risk, a health care provider will assess and provide an option to terminate the pregnancy along with comprehensive and accurate information on abortion.
In 2012, the Ministry of Health in Kenya had made progress by adopting the standards and guidelines for managing unintended and risky pregnancies and post-abortion care which provided technical guidelines for health care workers to offer lifesaving assistance to the extent allowed by law.
However, one year later, the ministry withdrew the guidelines and the national curriculum for management of risky and unintended pregnancies which instilled fear among health workers and resulted in constant harassment by police.
Access to quality and correct information and services on safe abortion will ensure that young girls and women’s future is better secured as they will be able to choose when to have a baby and consequently invest in their education and employment.
Young girls and women continue to face life threatening situations and even loose their lives from this acts of violence.
Survivors of rape or any other form of sexual violence that leads to pregnancy are entitled to safe and legal abortion without any form of further victimization.
In a move to safeguard human rights and protect gains made thus far, a section of civil society and human rights organizations challenged the withdrawal of abortion guidelines, terming it as unlawful and demanding that they be reinstated immediately.
What is the government doing to ensure we all save lives? Kenya has witnessed an increase in cases around gender based violence for both men, children and women, and lives have been lost. We have an opportunity to make a difference for the better and everyone of us has a role to play.
As we mark and celebrate the global She Decides Day on March 2, 2021, the government through the Health Ministry should immediately reinstate and effectively operationalize the standards and guidelines for abortion and ensure implementation across all counties.
This will ensure that we do not lose more girls and women to unsafe abortions.
Alvin Mwangi is a sexual reproductive health and rights advocate in Nairobi, Kenya. Twitter:@alvinmwangi254