First published in the November 2012 issue of Destination Magazine

(By Rose Odengo) Abortion is a hard topic for any nation, but in Kenya it’s done, not spoken of. Hundreds of thousands of women have them each year, but they rarely speak of it. Worse still, many seriously harm themselves with unsafe methods, all in an effort to keep the secret.

A Public Health Concern

But Janet’s experience is entirely separate from that of most women seeking to end their pregnancy. They opt for the quick, secretive and cheap methods – the ones that can kill them.

While stigmatism makes information on unsafe abortions hard to come by in the region, the WHO released statistics for East Africa in 2008. The region, according to their low estimate, accounted for nearly 2.4 million of the world’s 21 million unsafe abortions – the only regions with more were South America and Southeast Asia. But when population is factored in, East Africa is tied for the highest rates.

Deaths, on the other hand, are easier to count. According to a 2009 report by the Centre for Reproductive Rights, 2,600 women die each year from unsafe abortions in Kenya. That is seven women each day. The report further states that 21,000 women visit hospitals each year to receive treatment from complications sustained through an unsafe abortion.

Salma* is part of the statistics. She was gang raped in her first year of high school and conceived. She hid it from her father, who was strict, believing that he would see her pregnancy as shameful according to Islamic culture and punish her.

Salma’s mother had separated from her father when she was young, so her only source of advice was her friend, who recommended juice concentrate. Salma drank two bottles, but it didn’t work. Then her friend suggested concentrated black tea. Salma bought three packets of tea leaves, brewed them and drank it.

“After 30 minutes it began to work. I felt as if my stomach was being sliced. I felt pain and then I saw blood,” she recalls. Salma says that most women from slums, such as herself, cannot afford to get proper treatment. “We use traditional means to have abortions. We don’t have the money to go to [the] hospital.”

While any unmonitored abortion has the potential to turn deadly, the real dangers start when women ingest chemicals, like bleach, or have an object inserted into their uterus. Damage is often a result of sharp objects, such as knitting needles, pens, coils, pipes or wires, inserted into the uterus. And without sterilisation, some women contract gas gangrene and tetanus.

The Centre for Reproductive Rights report reveals that unsafe abortions can result in chronic pelvic pain, fallopian tube blockage, upper genital tract infections and infertility, among other complications. Additionally, they greatly increase the risk of problems during subsequent pregnancies, like ectopic pregnancy, premature delivery or even miscarriages.

Miriam* blames her unsafe abortion on causing a subsequent miscarriage. “I guess this [is] maybe the side effects of the abortion,” she says. “I had wanted to go to hospital and get that checked. But my friends told me that that would be expensive.”

Miriam has a 10-year-old son, but two years after giving birth to him she got pregnant again and had an unsafe abortion at a neighbourhood chemist when she was seven months pregnant – it took her that long to get the money. “It just looked like that was the work she specialises in,” Miriam says with an eerie look, recalling the woman who performed her abortion.

She was told to lie down on a stretcher. The woman did not have electricity, “She was using a candle and was burning my thighs,” Miriam says – there was no assistant so she held the candle and

performed the procedure. “The woman used some metal to open my cervix and a pipe she inserted inside of me,” she recalls. “It was a painful process, but I had already decided.”

At seven months, Miriam’s abortion wasn’t a standard procedure. Essentially, the woman left a bit of metal inside her, saying, “That metal is to strangle the child.” Then she gave her an injection to induce labour. At midnight, Miriam’s water broke, and that morning she started bleeding. She went back to the woman, who pulled the baby out and sent her home with painkillers.

What’s Left Behind

Whether an abortion is conducted legally or illegally, every woman experiences a series of emotions that they live with. After undergoing her legal abortion, Janet is still not quite settled. “I just kept thinking what if I would have died, who would have raised my children?” she asks. Janet and her

husband eventually separated and he is now re-married.

Margaret relies solely on her mother because she does not have a source of income and is filled with concern after aborting her fourth child. She just wants the children she has to grow up normally, like children should. “I don’t know what else to do,” she says.

Miriam blames her deliberate abortion for the miscarriage of her following pregnancy, a child she wanted and was ready to welcome into the world.

These profound psychological effects are transcendent. Unsafe abortions are physically horrible, and even safe ones can have lasting effects. But one of the biggest challenges women in Kenya face is that no one talks about abortions. They happen, obviously and in large numbers, but even the safe and legal ones are a taboo topic. For the women, it means they are undertaking the painful, emotional process alone and often in shame.

This makes the aftermath harder to overcome. “I have trouble imagining being happy about pregnancy,” says Jane*. “My first pregnancy – and I have trouble thinking of it like that – has so much guilt around it that I think I’ll have trouble ever feeling good about the situation.”

Abortion is a divisive topic around the world, but Kenya has been slow to join the conversation. It is tragic that women are dying to maintain the silence, so whether it’s for further legalisation or to shout our alternative options, more dialogue is needed.

* Names have been changed

Pull Quotes

In Kenya, unsafe abortions are far and away the more common choice

Her husband was not interested in having another child, but she was

“It was a painful process, but I had already decided”

Originally published in the November 2012 issue of Destination Magazine, authored by Rose Odengo.

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