Most unplanned pregnancies result from lack of contraceptives

While Kwamboka is lucky to be alive, she is one of the 48 abortions per 1,000 women of reproductive age (15-49 years) who procure abortions in the country.

This is higher than the 2002 rate (45/1000), the 2008 average rate for East Africa (39/1000), and the 2008 rate for Africa (29/1000).

She was fortunate as about 266 Kenyan women die per 100,000 unsafe abortions.

The Ministry of Health noted in 2012, there were over 464,690 induced abortions in the country.

With an estimate of 157,762 women receiving care for complications of induced and spontaneous abortions in health facilities in the same year. Of these, 119,912 were experiencing complications of induced abortions.

The head nurse at KNH Ward 1D Titus Kinyangi Aseno said: “About half of all patients we see were less than 25 years and a considerable between 10-19 years old, who also suffer from severe complications. Cases like that of Kwamboka are on the rise. It is more disturbing when we lose such patients.”

RISKY PROCESS

Mr Aseno further said women who sought abortion-related care included educated and uneducated women, urban and rural women, Christians, Muslims, and women of ‘other faiths’; students, unemployed and employed women as well as married, never-married and divorced women.

As of three years ago, high rates of abortion were seen in Nyanza-Western region and in the Rift Valley region, compared to other regions in the country.

These higher rates according to a report by the Ministry of health on incidences and complications of unsafe abortion, attributed it to poor women’s health, higher poverty levels, gender-based violence, and poorer access to family planning services in these regions.

For Dr John Ong’ech, a gynaecologist, he says women seeking abortion point at a bigger problem. “More than 70 per cent of women seeking post- abortion care were not using a method of contraception prior to becoming pregnant. Why is that so?”

The 2008/09 Kenya Demographic and Health Survey found that 43 per cent  of births in the preceding five years were reported by women as unwanted or mistimed. An illustration of the significant barriers to access and use of effective contraceptive methods in Kenya.

Maria believed that she would not get pregnant with the first sexual act and thus did not use a condom with her partner.

Dr Ong’ech adds: “The reasons for seeking an abortion sometimes blind the risks of the process. Which could be fear, stigma and what their partner thinks. This list is endless.”

He cautions that the treatment of complications of unsafe abortion puts a strain on their already insufficient financial and human resources.

HEALTH COMPLICATION

The former Director of Medical Services Ministry of Health Dr Francis Kimani said unsafe abortion in Kenya has long been recognised as a leading cause of deaths and injuries to women.

The Kenya National Commission of Human Rights in 2012 tackled unsafe abortion as a cause of maternal mortality. Its findings revealed that lack of access to safe abortion services in Kenya resulted in many women resorting to crude and unsafe methods.

Those who testified during the inquiry by the commission described unsafe methods that were used to terminate unwanted pregnancies -- including taking traditional herbs, high doses of anti-malarial drugs, and inserting sharp objects among other measures. These methods caused the deaths of many women or permanently damaged their uterus; with countless women reporting inability to conceive again.

The World Health Organisation (WHO) defines unsafe abortion as a procedure for 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.

Worldwide, unsafe abortion accounts for 13 per cent of global maternal deaths and remains the principal cause of a range of short-and long-term health complications in women.

WHO estimates that there are approximately 22 million unsafe abortions annually, resulting in 47, 000 deaths, and about 8.5 million women globally suffer from complications of unsafe abortion annually. Three million of these women go without treatment.

Major complications from unsafe abortion are:

•  Incomplete abortion (failure to remove or expel all of the pregnancy tissue from the uterus)

•  Haemorrhage (heavy bleeding)

•  Infection

•  Uterine perforation (caused when the uterus is pierced by a sharp object)

•  Damage to the genital tract and internal organs by inserting dangerous objects such as sticks, knitting needles a woman’s private parts.