Illicit abortions on the rise despite health risks and legal hazards

When a woman is faced with an unwanted pregnancy, she has few options in many parts of the world.

In Kenya, terminating the pregnancy may land her in jail or she might die at the hands of backstreet doctors.

Statistics show that unsafe abortion is on the rise despite Kenya’s restrictive laws.

An estimated 46 million women worldwide take that risk each year by having illegal abortions, and nearly 20 million of these are unsafe.

And as many as 300,000 of these take place in Kenya.

According to the World Health Organisation, 500,000 women die annually from abortion-related causes and 13 per cent suffer injuries resulting from unsafe abortions.

Most abortions take place in developing countries, which account for 95 per cent of unsafe abortions compared with five per cent in developed countries — a disparity that largely reflects the relative death occurrences.

WHO estimates that between two million and seven million women each year survive unsafe abortion, but sustain long-term damage or disease.

The death toll is especially high in sub-Saharan Africa countries where abortion laws are very restrictive. According to WHO, 44 per cent of deaths occur in Africa.

In Kenya, although termination of pregnancy is highly restricted, unsafe abortions are especially rife in the countryside, putting women at risk of death or severe health complications.

According to Prof Joseph Karanja, a senior gynaecologist at Kenyatta Hospital, lack of skilled medical practitioners to carry out safe abortions has led to deaths and complicated injuries.

He attributed the increase in abortions to lack of education, economic and socio-cultural factors.

Adolescents and young unmarried women cited the stigma attached to bearing a child outside marriage, their inability to support the child, and the realisation that they would have to quit school for having abortions.

Among older and married women, common reasons included economic hardship and the desire to space their children.

Maternal deaths

Unsafe abortions are usually obtained clandestinely outside established health facilities.

Crude methods such as insertion of foreign objects like wire, knitting needles and forceps are employed in the back street operations.

Tragically, those who survive the unsafe abortions are left with permanent disabilities and most will require additional corrective or resuscitative operations.

According to Guttmacher Institute, a think tank that advances sexual and reproductive health worldwide, an estimated 14 per cent of all pregnancies in Kenya end in abortion and nearly one in five maternal deaths are a result of unsafe abortion.

Statistics from the Demographic Health Survey of 2003 show that 30 to 50 per cent of all maternal deaths are directly attributed to unsafe abortion.

A subsequent assessment on unsafe abortions conducted in May 2004 by researchers from the Kenya Medical Association, Federation of Women Lawyers of Kenya and Ipas, a non-profit organisation dedicated to improving women’s lives internationally through focusing on reproductive health, also showed an increased rate in unsafe abortions in the country.

The study, which covered 65 public hospitals, shows that an estimated 20,000 women are hospitalised with abortion-related complications in the public health sector alone each year.

Last year when Parliament debated the Reproductive Health and Rights Bill of 2008, it sparked protests from religious groups and the Catholic Church led hundreds of followers into the streets to demonstrate against the Bill, which they said sought to legalise abortion.