Kenya joins the world in marking International Safe Abortion Day to raise awareness about the importance of it as part of health and human rights.
The day is marked to promote access to safe and legal abortion care, which is recognised as a fundamental aspect of health and human rights.
The day highlights the global issue of unsafe abortions, which remain a major public health concern, and advocates for abortion to be treated as essential healthcare.
The World Health Organization says unsafe abortion continues to be a major public health concern.
Globally, nearly half of all abortions or 45 per cent are unsafe, leading to preventable illness and death.
WHO said that ensuring access to abortion care reduces maternal mortality, improves health outcomes and protects the dignity and rights of women and girls worldwide.
According to the African Population and Health Research Centre report, between 2015 and 2019, 121 million unintended pregnancies occurred annually worldwide, with 61 per cent of these pregnancies ending in induced abortions.
In much of Africa, abortions are legally restricted and only allowed under a limited set of conditions.
In Kenya, abortion is similarly restricted and only permitted if, in the opinion of a trained health professional, there is a need for emergency treatment, the life or health of the mother is in danger, or if permitted by any other written law.
The most recent national study on abortion in Kenya (2012) suggested that the vast majority of women needing abortions resort to clandestine and mostly unsafe abortion methods.
The 2012 study reported a relatively high case-fatality rate at; 266 deaths per 100,000 unsafe abortions.
Survivors can suffer lifelong severe morbidities, and some require treatment, prolonged hospital stays and intensive care, and attendance by highly skilled, yet scarce, health providers.
According to APHRC, recent changes in the abortion landscape may be influencing abortion-related morbidity and mortality, as well as care-seeking behaviours.
Over the past decade, access to medication abortion (MA) from pharmacies, drug shops, or other informal sources has increased dramatically, even in contexts where abortion is highly legally restricted.
APHRC said available research suggests high levels of safety among abortions induced using MA, with the vast majority of cases resulting in complete abortions with little evidence of severe health complications.
According to them, the progress towards reducing the maternal mortality rate (MMR) has been slow in Kenya.
Twelve years ago, a study by the Ministry of Health, the African Population and Health Research Center (APHRC), and the Guttmacher Institute reported close to 464,690 induced abortions in Kenya in 2012 (7), and about 75 per cent of women experienced complications that needed care within health facilities.
According to the International Federation of Gynaecology and Obstetrics, unsafe abortion remains a catastrophic public health problem accounting for up to 13 per cent of maternal mortality worldwide, or around 47,000 deaths, with hundreds of thousands of survivors living with long-term complications, including infertility and chronic pain.
Of these unsafe abortions, 97 per cent take place in South and Central Asia, sub-Saharan Africa and Latin America.
FIGO said it regards reproductive choice, including access to safe abortion services, as a basic and non-negotiable tool for ensuring the human rights of every woman and girl, not just in one region or country, but globally.
According to them, access to safe abortion is a human right and a critical component of the sexual and reproductive health and rights (SRHR) of women and girls.
When women and girls are denied timely access to safe and effective abortion services, they are more likely to resort to unsafe means, FIGO said in a statement on their website.
Unsafe abortion occurs when a pregnancy is terminated either by those lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both.
FIGO said that access to safe abortion is contingent on legal, regulatory, policy, programmatic and socio-economic systems, which are complex and interconnected.
These systems often cause barriers, which may determine if and when women and girls can terminate their pregnancy safely.
Barriers to safe abortion
Barriers to safe abortion include stigmatisation of those seeking care, restrictive abortion laws, ineffective implementation and lack of awareness of abortion laws and lack of access to information about regulatory frameworks and methods of abortion.
Others are medically unnecessary tests that delay care, lack of social support and agency and decision-making ability and harmful social and gender norms.
According to FIGO, people can work with respective stakeholders, including governments, to implement abortion as a human and reproductive right and to remove legal, regulatory and policy barriers that criminalise and restrict the provision of safe abortion.
They can also inform women and girls about the availability of safe abortion services, as unwanted pregnancies and unsafe abortions can have a wide-ranging impact on the health of women and girls.
According to FIGO, every pregnant woman and girl who is contemplating abortion should receive evidence-based information and be offered voluntary, non-directive counselling from a trained health care professional, community health worker or volunteer with comprehensive knowledge and experience of different methods of abortion.
People should advocate for, promote and adopt new and innovative ways of providing safe abortions.
They said that telemedicine and task sharing with trained and competent staff are safe and private ways to have an abortion in early pregnancy without having to visit a clinic.
According to FIGO, evidence shows that women can manage abortions with safe and effective medicines during early pregnancy.
Self-care is an effective option for people seeking abortion care and is 95–97 per cent effective up to 12 weeks of pregnancy, with rare chances of complications.
