I procured an abortion, I think I need help from a good doctor

What you need to know:

  • The horrific experiences of a naive first-year university student in a backstreet abortion clinic, traumatic aftermath and quest for healing amid stringent laws on reproductive health rights.
  • Women worldwide continue to fight to be granted a say in reproductive health matters and rights

  • Marie Stopes, one of the institutions that offers such services, told the Saturday Nation that last year it offered post-abortion care services to thousands of women.

Having received assurance that we will not publish details that may betray her identity, KK opened up about the day in December 2018 when she had an abortion.

She revisited the searing pain she experienced after a man operating a backstreet clinic at the Coast gave her four pills: two to be swallowed and two to be shoved into her genitalia.

HORRIFIC

She recalled the casual attitude of the man who used seemingly unsterilised tools to pull out a three-month-old foetus from her womb in an badly-lit room. To make matters worse, she said, this was not the same man who had given her the pills.

She then bled to the point where she felt her organs were preparing for shutdown, in what would have been recorded as the death of a first-year university student just one semester into her tertiary education. KK also discussed the regret that has been weighing her down since.

“I should have carried the pregnancy to term. It is 100 times better,” she told the Saturday Nation.

Today, the world marks the International Safe Abortion Day, with KK still having many fears even after recovering from the horrific procedure.

“To date, I wonder whether they extracted everything in the womb or they left things inside,” she said.

“During periods, and sometimes even when not on periods, I experience some abdominal pains. Had I the (financial) ability, I would have gone to a professional to see whether anything remained inside,” she added.

NAIVE

Her decision to abort seemed the best option in the circumstances she was in. She was hardly a month old in university when she missed her period. Joining university in September had given her the freedom any young person craves — spending more time with her boyfriend, who was not in the same university but not far away. When she missed her period, at first she thought it was due to the change of environment.

October came and went. It did not help matters that she was very naive on matters sexuality.

“I called a friend and explained the situation to her. She told me to buy a pregnancy testing kit at a pharmacy. That shocked me a bit: What if I was pregnant? I am the firstborn of a single parent. A lot was expected from me now that I was in university,” KK narrated.

Two unflinching red lines on the test kit stared back at her. Thoughts raced in her mind. She thought about her mother; how she had sacrificed a lot to educate her. She thought about her neighbourhood; the many people who would be shocked to hear that she, of all people, was pregnant.

SCARRED

Her boyfriend declined to take responsibility. “He asked if he was the only one I was seeing and told me to ask the others. I wondered who ‘the others’ were,” said KK.

Against that backdrop, she thought abortion would be the best alternative.

December 4, 2018, was the set date for the procedure. The man at the clinic had asked for Sh4,000, which she haggled down to Sh3,500.

From 10am when she was given the four pills, it was a day of excruciating pain up to around 5pm, when she was allowed to go home in the company of the friend who had recommended the pregnancy test.

She would bleed for four days before it stopped, during which she was shell-shocked, fearing the worst.

A year later, KK is a scarred woman. Her boyfriend cut ties with her and she has gone slow on dating.

“I just abstain,” she said.

She hardly talks about the abortion experience: “You (this writer) are the second person I am telling this, apart from the female friend.”

COMPASSION

There is also one lingering doubt in her mind: What if the procedure damaged her reproductive system?

“We sometimes believe that, that (aborted pregnancy) may be the only child you were given. So, there is the worry as to whether I can conceive again. It still perturbs me,” she said.

Hearing KK’s story, one wonders whether she could have walked into a mainstream health facility and requested an abortion.

It has been three months since the High Court issued a judgment on abortion, in which five judges were unequivocal that “abortion is illegal in Kenya, save for the exceptions provided under Article 26(4) of the Constitution.”

The judgment, however, reinstated a hitherto-withdrawn document that offers guidelines on how women should be helped in case they procure unsafe abortions. It provides uterine evacuation (removal of all components in a woman’s womb) as one of the solutions. The document titled Standards and Guidelines on Reduction of Maternal Mortality from Unsafe Abortion was released by the Ministry of Health in 2012. It was suspended through a memo from the Ministry in February 2014, but reinstated by the High Court judgment of June 12, 2019.

The document says that if women like KK were to go to a health facility seeking medical attention due to complications arising from abortion, they should be treated with “compassion, respect and dignity”.

DANGER

Marie Stopes, one of the institutions that offers such services, told the Saturday Nation that last year it offered post-abortion care services to thousands of women.

“In 2018, Marie Stopes Kenya provided over 100,000 comprehensive post-abortion care services, thus saving lives of women,” said Ms Roselyne Ouso, the marketing manager.

The services included managing complications of induced abortion, counselling and providing post-abortion family planning “to help clients prevent future unwanted pregnancies and repeat abortions to reduce morbidity and mortality from unsafe abortions”.

Ms Ouso noted that from a 2012 report of the African Population and Health Research Centre, an estimated 464,690 induced abortions occur every year in Kenya.

With the guidelines on unsafe abortion in place, one would argue that they open the floodgates for women to terminate pregnancies then rush to mainstream health facilities for further medical attention. This is more so because of a declaration by the High Court that pregnancy out of rape that will be adjudged to be a danger to the mother may be terminated under the exceptions in the Constitution.

But Evelyne Opondo, senior regional director for the Centre for Reproductive Rights — which represented petitioners in the case that was finalised by the High Court in June — says it is ill-conceived to think that women would use rape or other excuses to make it easy to procure abortion.

TRAININGS

“People don’t want to pretend that they have been raped. And in any case, termination of pregnancy is still dependent on the opinion of a doctor. So, it is not just a woman walking in and saying, ‘I am pregnant, I have been raped.’ The medical provider — as allowed by the Constitution — will determine that,” said Ms Opondo.

She also called on the Health Ministry to issue guidelines to eliminate quacks who conduct abortions.

“They should regulate it so that only people who are qualified, and who do not further harm women, are providing these services. Two, the Constitution allows for mid-level providers such as nurses and clinical officers to provide these services now. But they’ve not already been trained in medicine. It’s important for the Ministry of Health to expand these trainings and train middle-level providers,” said Ms Opondo.

 Among those who oppose assertions for women’s freedom to choose is the Catholic Church. In the case determined in June, the church submitted through the Kenya Catholic Doctors Association that rape is not a medical illness but a “social problem” and, as such, it should not justify abortion.

REGRETS

“The church submitted that the right to life is the most sacrosanct right upon which all other rights under the Constitution are hinged, hence there is no use for the Bill of Rights where there is no life,” reads a summary of the proceedings.

And while opinions are divided on the choices a pregnant woman has, KK — who has witnessed first-hand the horrors of abortion — advises women to simply carry the pregnancy to term unless it poses a serious risk.

“It is 100 times better to carry it rather than be injured. You can never be sure if you were properly cleaned after the event. There are regrets. It is a bad thing, like you face death; like you are attempting to kill yourself,” she said.

She added: “The pain of giving birth might equal the pain of having an abortion, but the pain of giving birth is natural. For abortion, you see someone right there cutting you up, and you don’t leave with a child.”