Eyebrows will be raised regarding your religious affiliation if, as a private medical practitioner, you advertise your health facility as a centre offering comprehensive abortion care.
This is because of the stigma associated with abortion.
Unsafe abortion is the leading cause of maternal mortality and morbidity.
A 2015 study revealed that more than 300,000 abortions are performed in Kenya annually while 488 maternal deaths per 100,000 live births were a result of unsafe abortion.
But must these women die?
Several factors are responsible for unsafe abortion.
One is lack of awareness on the circumstances permitting abortion in Kenya.
The Constitution permits abortion when the life or health of the woman is in danger or if a written law permits.
However, stigma associated with unintended pregnancy, poverty and denial of responsibility results in many young girls and women seeking unsafe abortions.
Abortion is a highly stigmatised issue — right from the community to the health sector.
Many health workers, mainly due to their faith, decline from offering the service.
Becoming pregnant while in school derives much stigma from peers and the community.
It is associated with sexual immorality.
Pregnancy-related stigma often results in secret termination of pregnancy or even suicide.
Due to poverty, child-bearing by teenagers dependent on their parents is seen as an additional burden to the family; hence abortion is considered as the first option.
Sexual activity — and, therefore, possibility of pregnancy — starts as early as nine.
Adolescents find it difficult to bear a child at such a tender age.
Denial by family, and peer pressure, make young girls resort to terminating pregnancy.
Besides, many women are not aware of the legality of abortion; many still consider it a crime.
Service delivery also depends with the geographical phenomenon.
In rural areas, health facilities are under-equipped in terms of drugs and medical personnel, distance to the facilities is long and transport costs high and there is lack of adequate youth-friendly services and centres that offer pregnancy care and contraceptive counselling.
MEASURES TO PUT IN PLACE
Then there is lack of comprehensive sexuality education in schools.
Information offered to learners for preventing pregnancy may not be what they want.
Several strategies are necessary to address unsafe abortion.
The community must be educated on the constitutional legality of abortion.
We must offer age-appropriate information to adolescents.
Health workers must be trained on value clarification and attitude transformation to enable them to respond to pregnancy-related emergencies and not base their practice on religious affiliations.
Health is devolved. County health facilities must be provided with resources, including personnel and commodities, to respond to emergencies.
We must equip and also increase the number of youth-friendly centres to respond to the needs of young people.
We must sensitise the community on the dangers of stigmatising teenage mothers.
It’s time the society accepted the reality that women’s health is given the dignity it deserves.
Daniel Otieno, Nairobi.