Facts you need to know.
The abortion debate is one of the hot topics that has been going on for a while, not only in Kenya but also worldwide. Various human rights groups, non-governmental organizations, and governments all over the world have not been shy when it comes to stating their stand on abortion. However, what we all ask ourselves when it comes to this topic is, “Is it ethical to legalize abortion?” and what amount of say does the government have over the personal decisions of its citizen. Let us delve deeper into this debate, mainly using abortion in Kenya as a case study.
One thing that is for sure is that there are quite varying opinions when it comes to abortions. The clear cut answer when asking about abortion is either a pro or an anti. nothing in between. On 11 September 2018, the Kenya Film Classification Board banned an advertisement by Marie Stopes Kenya from being aired. The advert that was directing teens on where they could seek safe reproductive health services, was, according to the board, encouraging teenagers to procure abortions. Later on, in November, Marie Stopes was officially banned from conducting abortions in Kenya. After all this, what all Kenyans want to know is, “What is the stand on abortion in Kenya?”
THIS BRINGS THE QUESTION TO THE READER, OPINION WISE ARE YOU ANTI OR PRO ABORTION.
Abortion is illegal in Kenya, and that is what everyone should know before going on with this article. However, what everyone has been asking is, “Are there provisions when one is allowed to procure an abortion in Kenya?” Well, let us take a look at abortion laws in Kenya to find out. The following are the laws talking about abortion in Kenya:
According to the Constitution of Kenya (2010), Article 26(4): Article 26(4). Right to Life 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. According to The Penal Code, Laws of Kenya, Cap. 63, Revised Edition 2009 (2008), Articles 158-160, 228 and 240, the following laws surround the legality of abortion in Kenya:
Attempts to procure abortion. Any person who, with intent to procure miscarriage of a woman, whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, is guilty of a felony and is liable to imprisonment for fourteen years.
The like by woman with child. Any woman who, being with child, with intent to procure her own miscarriage, unlawfully administers to herself any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, or permits any such thing or means to be administered or used to her, is guilty of a felony and is liable to imprisonment for seven years.
Supplying drugs or instruments to procure abortion. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman whether she is or is not with child, is guilty of a felony and is liable to imprisonment for three years
Killing unborn child. Any person who, when a woman is about to be delivered of a child, prevents the child from being born alive by any act or omission of such a nature that, if the child had been born alive and had then died, he would be deemed to have unlawfully killed the child, is guilty of a felony and is liable to imprisonment for life.
Surgical operation. A person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon any person for his benefit, or upon an unborn child for the preservation of the mother’s life, if the performance of the operation is reasonable, having regard to the patient’s state at the time and to all the circumstances of the case. As such, abortion is illegal in Kenya. It is, however, important to take note of the abortion statistics in Kenya in order to get a better view of the situation on the ground
SO WITH THIS KNOWLEDGE LETS DELVE INTO SOME QUESTIONS.
1. What is abortion?
Abortion, also known as termination, is defined as the ending of a pregnancy by removing an embryo or foetus before it can survive outside the uterus.
2. What are the causes of abortion?
The reasons for abortion vary from age group to the next. The motive behind procuring an abortion is also different depending on literacy levels among different women. Here are the main causes of abortion:
- Unwanted pregnancy is the biggest reason for abortion. Such unwanted pregnancies are usually caused by the failure to use contraceptives which may be caused by ignorance or lack of access to contraceptives..
- Inability to support a child financially. This is the main reason for abortion, especially among the youth. This may be caused by tough economic conditions in the country. Lifestyle choice. This is especially common in urban areas where women prefer to go after their career rather than have children.
- The stigma of childbirth outside marriage. Many women are afraid of being looked down upon by society because of conceiving before getting married. In some communities, furthermore, this is considered a taboo. In other communities, single mothers are isolated from the rest of the community and stigmatized.
3. How many types of abortion are there?
There are three main types of abortion: Safe, unsafe, and threatened abortion. Let us explain them further:
a) Safe abortion:
This is termination of pregnancy that is performed by qualified medical personnel. Safe abortion must be performed by a capable person in a medically conducive environment.
b) Unsafe abortion:
This is the termination of pregnancy by people who lack the necessary skills, or in an environment lacking minimal standards, or both. Unsafe abortion is characterized by counterfeit abortion drugs and quack doctors. Items commonly used to conduct unsafe abortion include knitting needles, small bottles filled with improvised explosives which are inserted into the uterus, and many more. Consumption of concoctions and tea leaves has also been known as one of the unsafe abortion practices widely used.
The main contributors that push women to procure this unsafe abortions are:
Restrictive laws that do not allow safe abortion .
- Unavailability of safe abortion services. In most rural areas, women do not have access to safe abortion.
- The high cost of safe abortion
- Stigma surrounding abortion
- Unnecessary requirements so that one may procure an abortion.
c) Threatened abortion:
Threatened abortion is defined as vaginal bleeding that occurs in the first twenty weeks of pregnancy. It is also known as threatened miscarriage. It is usually accompanied by abdominal cramps. The symptoms of threatened abortion include: Vaginal bleeding during the first twenty weeks of pregnancy At times, abdominal cramps or lower back pain. Who is at risk of suffering threatened abortion/miscarriage? Women who have had bacterial or viral infections during pregnancy Women who have experienced trauma to their abdomen Women of an advanced maternal age (women over 35 years of age) Those suffering from obesity Those who have uncontrolled diabetes Those who have had exposure to certain chemicals or medication.
To avoid threatened abortion or miscarriage, one should do the following:
- Avoid alcohol, cigarettes, and illegal drugs.
- Take a minimum amount of caffeine
- Exercise at least two hours a week
- Take prenatal vitamins, for example, folic acid Promptly treat any viral or bacterial infections when they occur
- Avoid exposure to toxic chemicals and harsh cleaning solutions.
d) What are the methods used for abortion?
There are two main methods used for safe abortion: medical and surgical.
The World Health Organization (WHO) recommends that medical abortion be carried out in the early stages of pregnancy, usually up to nine weeks of the pregnancy. Medical abortion is characterized by administering pills to the patient. It is a safe, non-evasive alternative to surgical abortion. It is also advantageous as the woman has control over when and where the treatment takes place.
Medical abortion is usually completed in two visits to the hospital on two different days. On the first visit, the woman is usually given mifepristone, an oral medicine that blocks progesterone, a hormone which is critically needed for the pregnancy to continue. After taking this drug, the woman may experience vaginal bleeding. The second visit is usually made one to two days after the first visit. During the second visit, the woman is given prostaglandin. The prostaglandin may be administered as tablets. Alternatively, prostaglandin may be placed inside the woman’s vagina as a pessary. Prostaglandin makes the womb contract. After four to six hours of having the prostaglandin introduced to her system, the woman experiences vaginal bleeding and cramping which is similar to that experienced during menstruation. This vaginal bleeding is because of the fact that the lining of the woman’s womb starts breaking down, effectively terminating the pregnancy. In case abortion does not occur within four hours of taking the prostaglandin, the woman might need another dose of the medicine, either as a tablet or as a pessary. Medical abortion may be completed surgically. Usually, the patient is given ibuprofen for pain relief.
If the woman was over twelve weeks pregnant, she might need to be admitted in the hospital until the abortion is complete.
Surgical abortion is safe and effective when performed by a qualified doctor. Usually, surgical abortion is performed when the woman/patient is in the later stages of pregnancy. When it comes to surgical abortion, there are two ways to go about it: vacuum aspiration and Dilation and Evacuation (D&E). Before the operation, the patient may be given prostaglandin as a tablet or as a pessary in order to make it easier for the doctor to open her cervix. This also reduces the risk of damage during the operation. Here is the procedure for the two types of:
Vacuum aspiration is generally carried out under local anaesthetics, although it can also be carried out under general anaesthesia, where the patient is asleep during the whole procedure.
To carry out vacuum aspiration, the doctor first injects the local anaesthesia into the entrance of the patient’s womb in order to reduce pain or discomfort. The doctor may also give the patient a sedative to help her relax and generally feel less anxious. Next, the doctor inserts a tube into the patient’s womb and applies gentle suction, hereby ending the pregnancy. The vacuum aspiration process takes about ten to fifteen minutes, and the patient is usually able to go home a few hours after the procedure.
Dilation and Evacuation(D&E) is usually done when the patient is more than twelve weeks pregnant, or when the patient is between twelve to fourteen weeks pregnant. Local or general anaesthesia is used for this procedure. For D&E, the doctor opens the patient’s cervix and terminates the pregnancy with a suction tube and a pair of forceps. In case there is any tissue still left in the womb, it will be removed by suction with vacuum aspiration as detailed above. Throughout the surgery, the patient will be administered ibuprofen through a drip in her arm. She will also be given the tablets to take home. Dilation and Evacuation(D&E) usually takes less than thirty minutes, and the patient is usually able to go back home on the same day of the surgery. However, if the surgery was conducted under general anaesthesia, the patient will be required to stay in the hospital overnight. While recovering from surgical abortion, the patient will be given antibiotics to prevent or treat infections.
e) What are the side effects of abortion?
What are the risks associated with procuring an abortion? There are several risks that come with procuring an abortion. They are:
- Vaginal bleeding – For medical abortion, the bleeding may last for several weeks while for surgical abortion, the bleeding lasts for about two weeks. Please note that this should only be light bleeding. In case of heavy bleeding, the patient is normally advised to seek immediate medical attention. Spotting and discharge may also accompany the bleeding.
Pain in the abdomen – The patient may experience abdominal pain that is likened to strong period pains. This is normal and expected. Apart from these side effects of abortion, there are other complications that may arise after procuring an abortion. These are: Acute damage to the womb or cervix – This can lead to bleeding and infections. To treat this, the patient might require further surgery or a hysterectomy (although this is very rare). Infection of the patient’s reproductive organs, such as Pelvic Inflammatory Disease – Pelvic Inflammatory Disease (PID) may lead to infertility or ectopic pregnancy. It may be treated with antibiotics. Infections of the reproductive organs are characterized by heavy bleeding with large clots, high temperatures, severe abdominal pain, generally feeling unwell, and unusual and unpleasantly smelling vaginal discharge.
Complications due to incomplete abortion – Incomplete abortion occurs when some tissue is left in the patient’s womb after medical abortion. This tissue is usually surgically removed through vacuum aspiration.
f) Are there abortion pills in Kenya?
There are certain drugs taken by Kenyan women to procure abortions. They include:
a. Mifepristone (200mg) Mifepristone is also known as RU-486, Mifegyne, Mifeprex, and Zacafemyl. It terminates pregnancy by stopping the progesterone hormone from working. Ladies who take Mifepristone are advised to avoid alcohol after taking the drug.
b. Misoprostol This drug is also known as Cytotec, Arthrotec, Oxaprost, Cyprostol, Mibetec, Prostokos, or Misostrol. It is usually taken after Mifepristone. Misoprostol, taken together with aspirin, is used to prevent the formation of ulcers in the stomach. It is also used to reduce blood loss by mothers during childbirth. However, Kenyan ladies have found another use of the drug, as it is used to procure abortions. The drug is not sold over the counter by pharmacies in the Central Business District in Nairobi, but it can be found in River Road pharmacies for about 150 Kenyan shillings a pill. Misoprostol terminates pregnancy by causing contractions in the womb, causing bleeding and cramping and eventually ending the pregnancy. A woman who takes this drug usually experiences bleeding and cramping minutes or hours after taking it. The side effects of Misoprostol include cramps, bleeding, and nausea.
g) Which abortion clinics are functional in Kenya?
Up until November 2018, Marie Stopes was the well-known and functional abortion clinic in Kenya. Marie Stopes Kenya had been providing reproductive services in Kenya since 1985. It had 22 clinics and 15 mobile outreach clinics. Among the services offered by Marie Stopes included medical abortion, surgical abortion, and Post Abortion Care (PAC) and family planning.
h) What are the possible solutions to the problem of criminal abortion in Kenya?
What are the possible solutions to the problem of criminal abortion in Kenya? What can be done to stop unsafe or criminal abortion in Kenya? The government can do the following: Reinvigorate family planning programs Organize for civic education on reproductive health all over the country The church also has its part to play in stopping criminal abortion. The church should: Teach moral values to the youth – Such moral values include abstinence. Organize guidance and counselling for members of the society The school system can do the following: Explain the dangers of risky sexual behaviour to students Teach and advise students on sexual matters. As abortion in Kenya is illegal, the major steps that need to be taken to avert the need for abortion include promoting the use of family planning methods and promotion of abstinence among the youth. Apart from that, there is very little that can be done to reduce the cases of unsafe abortion in the country. All in all, it is safe to say that the debate on abortion in the country is one that will probably never come to an end. However, one thing is as clear as day: women need to take control of their reproductive health to ensure that the need for abortion is averted. Still, this cannot be termed as the best solution to preventing criminal abortion. What of those women who are raped and have no one to turn to? Hopefully, better days are coming for such cases. At least, we hope so.