When I was in primary school I remember the staff decided to show us a film in order to help us understand our bodies (or so they said.) We were in class 6 or 7, and this is around the time that most pupils had already hit or were going through puberty. In the movie a high school girl in Form 3 went for a party with her boyfriend over the holidays, who then pressured her into having sex with the false reassurance that she could not get pregnant since it was her first time. The girl wound up pregnant and her boyfriend abandoned her so she went to seek an abortion. The film graphically detailed the different methods in which the procedure could be done, and I remember being just as terrified as the girl in the film. She eventually decided against it, dropped out of school and delivered the child. This film was shown to us to educate us about the risks of pregnancy and unprotected sex. In high school just as we were about to sit for our K.C.S.E. exams, the teachers also organised an afternoon where we sat and watched the ‘infamous’ Raphael Tuju videos, where people suffering from various STD’s were documented. These too were used as an education tool, especially considering that we would be back in the outside world making our own decisions.
Now that I am older I realise how unhelpful these videos really were. Instead of actually teaching us about our bodies and how to navigate them safely, educational institutions resort to graphic scare tactics in order to keep children in line. I could name abortion methods and their respective side effects before I could name the parts of my vagina. Even when we studied reproduction in Biology, the information was limited to naming the parts of the reproductive system and the diseases one could get. Any information on contraceptives was stapled together and classified as unnecessary information. But now that information is readily available on the Internet, young adults can now access images and information that was once hidden from them. But what about the youth who don’t have the resources to access this information? While these scare tactics may have worked in the past, we can no longer pretend that they can work now or that they are helping in any way for that matter.
With the poor state of sex education in the country, it is not a surprise that the rate of abortion is as high as it is. In 2012, it is estimated that there were nearly 465,000 induced abortions procured in Kenya. (An induced abortion is an abortion that was not spontaneous (e.g. not miscarriages); this refers to both safe/legal and unsafe/illegal abortions.) Majority of induced abortions are unsafe. Unsafe abortion is one of the leading causes of maternal mortality in Kenya, with approximately 266 deaths per 100,000 unsafe abortions. This contributes to the unacceptably high maternal mortality rate in the country. Out of these alarming numbers, almost half of these women were 25 years or younger. This is an indication that education is very much needed.
In Kenya, along with the national laws, archaic cultural perceptions and heavy religious influences create a deep stigma around abortions. Article 26(4) right to life states “abortion is not permitted unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law. The Catholic Church is exceptionally vocal in their pro-life stance and Pope Francis has condemned it severally in the press, as well as other religious leaders in the country. Be that as it may, unsafe abortions remain a massive problem in the Kenyan society. Reports go as far back as 1995.
A 2012 Kenya Ministry of Health study found there are approximately 465,000 induced abortions every year, most of them unsafe. Of course these numbers range because of the difficulty involved in tallying the secret procedures. In 2012, one-quarter of the women and girls who underwent an unsafe abortion had to be hospitalised as a result of serious complications such as uterine perforation, cervical damage, and septic shock.
Unsafe abortions are part of a shadowy economy, run by poorly trained physicians who operate under no regulation whatsoever, sanitary or otherwise. Abortions may be hidden from the public eye, but happen all the time regardless of socio-economic status or educational background. The more wealthier Kenyans may have access to more skilled doctors, however poorer women are left to seek cheaper and more dangerous options and are often taken advantage of. There are herbalists and witchdoctors that sell home-made potions and concoctions and these desperate women will spend thousands of shillings on something that is either completely useless or will cause strange side effects. Poorly trained physicians run back alley clinics that are in unhygienic and substandard facilities. Most do not offer anaesthesia during the procedure nor do they offer post abortion care. Women who sought out these options eventually develop severe complications after the poorly performed procedures. Some of them include perforated uteruses and intestines, anaemia due to blood loss and heart, renal and kidney failures. These subsequent issues cause even more strife to the affected woman. For example in the case of kidney failure, it can only be managed at the Kenyatta National Hospital or Moi Teaching and Referral Hospital in Eldoret. These hospitals are already swamped with cancer cases and other people who cannot survive without dialysis. The rest are private hospitals which are too expensive. All this could be easily prevented.
In order to understand the need for better policies on abortion and post abortion care we must be aware of the conditions under which Kenyan women have abortions. According to a study led by the Kenya Ministry of Health and the African Population and Health Research Center (APHRC)., the highest rates of abortion are seen in Nyanza-Western region and the Rift Valley regions, which are attributed to poor women’s health, higher poverty levels, gender based violence and poor access to family planning services. Most women procure abortions in order to continue with their education (in the case of school going girls) or employment and to avoid the stigma that comes with being a young/unwed pregnant woman. Others do it to avoid the financial burden that comes after raising a child, which can be unbearable to some.
As it stands abortion is legal in limited circumstances in Kenya, though we have previously questioned whether the country’s approach to women’s reproductive rights are truly in the best interests of Kenyan women. While the government does not seem interested in relaxing their pro-life stance, there are other ways in which they can intervene and reduce the high maternal morbidity rates. There must be interventions such as comprehensive sexual education in school. Young girls still believe that they cannot get pregnant during their first time, even if they have been exposed to school counsellors, as demonstrated in this heartbreaking story ran in the Daily Nation a few weeks back. Educators must stop resorting to scare tactics such as the Tuju videos and actually sit down with their students and explain what is happening to their bodies. We must teach children from a young age how to care for their bodies, we must teach them the importance of consent and sexual agency. If we empower girls and women with this information, it could help to alleviate unintended pregnancies. There is also need for social support systems for girls with unwanted pregnancies, who most times seek unsafe abortions to avoid being chased from home and school or even worse consequences. We must stop shaming girls and calling them all sorts of names and instead open up our hearts and embrace both them and their child.
There must be increased access for BOTH men and women to effective family planning methods. Women must be educated about their rights to contraception, safe abortion and post abortion care. Men must also be involved in family planning, since in some cases the family planning methods recommended to women could have terrible and adverse effects on their bodies. The government should engage with and educate communities on the risk of unsafe abortion, what is allowed under the Kenyan constitution and the detrimental effects of abortion stigma, as well as countering the misinformation about family planning and contraceptives.
As part of the implementation of the 2010 constitution the Ministry of Health developed standards and guidelines for reducing morbidity and mortality from unsafe abortion. They were adopted then withdrawn in unclear circumstances. In Feb 2014 the Director of Medical Services issued a memo to all health workers stating that the constitution of Kenya 2010 is clear that abortion on demand is illegal. The memo did not clarify under which grounds abortion actually IS legal. This ambiguity now makes it extremely difficult for women to get post abortion care, regardless of whether their abortion was induced or a miscarriage. This directive will limit women’s access to quality health services and expose women to untrained workers which will risk their lives.
Join the campaign to #KeepWanjikuSafe. There is currently an ongoing petition to ask the President to make possible the urgent medical care necessary to treat health complications that may arise in the case of unsafe abortions while tackling the problem of unsafe abortion as a whole. The petition also requests that the President direct the Ministry of Health to reinstate the standards & guidelines for reducing maternal mortality and morbidity, resume training for abortion providers, and make safe, legal abortion services accessible to all Kenyan women, regardless of geographic location or socio-economic status. There is an urgent need for concerted efforts to combat the impact of unsafe termination of pregnancy on women in Kenya, at an educational, social and institutional level. Add your voice to the petition to #KeepWanjikuSafe.