When 37-year-old Aketch Aimba had her first abortion, it provided the instant relief she was seeking. She was 18 years old at the time; she had just finished high school and was waiting to join the Kenya Institute of Mass Communication to study journalism.
Raised by over protective parents, she had lived the sheltered life of a good girl and stayed out of trouble. When she finished high school she found that all her friends were in relationships and because she didn’t want to miss out, she got into one with an older man. She fell pregnant the first time she had sex.
“My first instinct was to go upcountry and tell my mother that I was pregnant but when I told a friend of my plans, she suggested an abortion instead, and she told me she would show me where to get one,” Aketch says. “Aketch figured this would be the solution that would allow her to go to college and continue her life.
The post-abortion relief lasted a short while before the guilt started. “I kept thinking to myself, ‘Who can marry a woman who has had an abortion?’ I tried immersing myself in my school work but still, the feelings of emptiness and worthlessness were there,” she says.
Four years later, she got into another relationship. This time, overwhelmed by feelings of worthlessness, she gave sex to keep the relationship. Soon enough, she was pregnant again. This time the abortion came as a more natural choice, spurred by her role in church that she had earlier joined, seeking solace from the guilt of the first abortion. “I was a youth leader and a member of the worship team. How could I admit that I was pregnant outside wedlock?” she recalls.
The second time round, the feelings of guilt came immediately. She decided to tell her pastor, who told her that God loved her regardless. Still, the feelings wouldn’t go away.
Aketch sank into depression. She had fits of rage and crying spells. She even attempted suicide twice. In between these spells, she would be mesmerised by pregnant women and small babies.
CRISIS IN PREGNANCY
“It was when I volunteered with Crisis Pregnancy Ministries and disclosed my history that the counselling and my healing journey began,”
Aketch, who is trained in post-abortion recovery counselling, now runs Pearls & Treasures, a foundation that provides post-abortion support for both men and women, and psycho-social support for women and teens in the midst of crisis pregnancies. She reckons that every woman needs to understand what happens after you have an abortion. “I have seen it all, from women getting hooked to drugs following an abortion to women caught up in the cycle of having one abortion after the other because they never recovered the first time,” she says.
Abortion is illegal in Kenya unless the pregnancy is a danger to the life or health of the mother. Still, Kenyan women are having abortions. A 2016 World Health Organisation study found that 49 out of 1,000 pregnant women in Kenya have abortions. That’s an astounding number. Why are women having abortions?
“First, there is the stigma that is associated with being pregnant and unwed,” Aketch says. Then there is the fact that very few clinics that do provide have the capacity to provide pre- and post-abortion counselling, given the nature of their function in this country.
What the experts think
A 2013 study by the University of California in the US states that up to 90 per cent of women experience relief immediately following an abortion. Kennedy Owuor, a Nairobi-based psychologist, agrees and attributes this feeling to the fact that most women seeking abortion are usually in a crisis situation. This feeling however, he says, doesn’t always last. Some women experience Post Abortion Stress Syndrome (PASS) following an abortion.
“It can happen within hours while sometimes, it takes even years to come. It can be triggered by physical reminders of the pregnancy or the procedure, by a woman who has had an abortion losing someone later in life or by an inability to conceive,” he says.
What does it look like? “It can be severe and characterised by depression, tearfulness and suicidal tendencies. Some women do not even know they are experiencing it because it can be mild and she will just have this overwhelming desire to get pregnant again – she won’t even know what to make of it.”
Unsurprisingly, women with strong religious backgrounds are more susceptible to PASS, as are women who have a strong maternal instinct and women who were pressured to undergo the procedure.
“A woman who chose to have an abortion without knowing all the facts is also likely to be more affected psychologically after an abortion,” he says.
INSIDE AN ABORTION CLINIC
It isn’t hard to find a facility that offers abortions in Nairobi. The one I was referred to is a half hour drive from the central business district. It is about 4.30pm when I walk in, in the guise of a pregnant women seeking an abortion. There are five women in the reception area, none of them older than 40. Two are heavily pregnant and two are accompanied by men. On one bench, a young woman is sobbing quietly on the shoulders of another who looks like her mother.
US President Donald Trump may have withdrawn funding for foreign NGOs that support abortions in January, but it seems like business as usual in this clinic.
The receptionist doesn’t blink an eye when I tell her that I want to have an abortion. She asks me to pay the lab fee for a pregnancy test but I ask to see the doctor first.
While waiting, I begin a conversation with one of the other patients. She looks about 28, and she’s here because she’s just gotten a job. She can’t be pregnant in those early days, she says.
When it is finally my turn, the doctor, a middle aged woman, seems in a hurry to start and finish my case. She asks general questions about my health. How old am I? When was my last period? Do I have children? She does not ask my marital status or why I am having an abortion, and does not mention any other options open to me.
When I say that I am afraid, she pats my hand in impatiently and tells me that I have nothing to worry about. “It is not very painful and it will be over fast.” She says I can come in early the next morning with Sh12,000. The whole process is completely mechanical.
36-year-old Belinda Gachagua* worked as a programmes coordinator at a reproductive health facility that also offers abortions four years ago. She remembers being asked whether or not she supported abortion during her job interview. “I was 23. I’d just had an abortion and I had no one to talk to – not even my family who had taken me to have it. So this place felt very welcoming at first,” she recalls.
For the next seven years, she saw more women than she can count walk in to have abortions. She went on to have four more abortions in this facility herself. The service was accessible, she says. The last one was particularly bad. She was given a pill to abort her five-month-old pregnancy from home and it didn’t quite work. Some of the womb contents were not expelled and they began rotting in her womb. There was no counselling offered before or after the procedures. Finally, after seven years, it all began taking a toll on her.
“I would go home and see my child and feel very bad thinking that at work, I had denied another woman a chance of having her child,” she recalls.
To cope, she and her colleagues would do a lot of heavy drinking. There was also a lot of sex but the reprieve would only be temporary so eventually, she quit.
“It was not a good place to be. A lot of these medical practitioners have gone so down the rabbit hole. The justification used was that if we denied these women abortions, they would have them anyway under unsafe conditions. So they kept doing it.”
It took months of counselling for her to begin recovery. Now, she is a counsellor for other post-abortive women who are struggling. “I think that women should be given all the information, about what will happen to them both physically and emotionally before they are told that abortion is an option,” she says.