More married women procuring legal abortions

A small but increasing number of women are opening up about their experiences with legal abortion in Kenya.

“I was pleasantly surprised with the dignity, respect, and care I received,” said a 28-year-old woman who recently underwent a legal abortion at a private clinic in Thika.

Shivering with fear and apprehension before the procedure, she says the staff was unbelievably polite, professional, and caring which eased her anxiety.

“In fact they called me days after the procedure to find out how I was faring and if I needed any help. I was pleasantly surprised.”

This kind of talk is relatively new in Kenya where most women still believe abortion is totally illegal or otherwise it has to be done under the cover of darkness.

“Legal abortion is available in Kenya to women whose life or health is at risk,” explains the International Planned Parenthood Federation (IPPF).

When it is legal?

The Constitution of Kenya says abortion is permitted if in the opinion of a health professional, there is a need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law.

The definition of health in Kenya, IPPF explains is based on the World Health Organisation where it is broadly defined as ‘physical, mental, and social wellbeing.’

Based on this liberal definition and a less conservative Constitution, an emboldened generation of women in Kenya is increasingly seeking legal abortion and demanding dignity and high-quality services.

These women, a recent study by IPPF and others, shows are likely to be well educated - with college or university qualifications - are in salaried employment, of comfortable financial means, likely to be urban and increasingly independent.

Two recent studies of women receiving legal abortion at private and medical clinics affiliated to Marie Stopes Kenya and Family Health Options Kenya (FHOK) also showed many if not most, are likely to be married and having between one and two other children.

The latest of these studies published this month (16th June 2021) in the journal Health Policy and Planning investigated what kind of services women seeking legal abortion in Kenya are getting.

The study by the US lobby group, Ibis Reproductive Health, IPPF offices in Nairobi and London and the NGO Family Health of Kenya had engaged 24 local women; mainly aged 25-35 with only two above 36 years.

Participants had obtained an abortion in the past six months mainly at FHOK affiliated clinics in Thika and Eldoret. Only one woman had aborted through a private pharmacy.

One-third of women were married, with majority having 1 or 2 children while only four had more than three children.

There was no stay-at-home mother with the majority in salaried employment while only two women reported prior abortions. 15 of the women had undergone a medication abortion while nine underwent surgical procedures.

An earlier study in four Marie Stopes Kenya facilities in Nairobi and two in Kisumu found similar characteristics among their abortion clients.

This study published in February in the journal Culture, Health & Sexuality by the University of California, US, and Marie Stopes Kenya had engaged 19 women who had recently received abortion services at the six clinics.

“We engaged 19 women who had a safe abortion-related service after examination by a trained health professional,” said the study.

In this particular group majority of the women were single and with university of education and likely in salaried employment.

However, in both studies the women were unanimous that they have a right to appropriate abortion care provided by competent and empathetic professionals.

“Nearly half of the women felt that only a qualified doctor or a real doctor who is professionally trained should provide abortion services.”

But also important they said they wanted a provider—nurse, doctor or other clinical worker—who was; encouraging, supportive, concerned, reassuring, and had a heart for assisting people.

“When I was going through the process, I called a doctor because I was having some serious pain in my stomach. The doctor was very concerned. I felt that was the best service I got,” said a 22-year-old participant.

But not everything was bliss, at least not for 21-year-old client who sought the service at a private clinic.

“The attendant didn’t even ask me anything. I just didn’t like that, because he should at least have told me what that medicine does. The only thing he did was to give me medication then told me to wait for eight hours and that was it.”

Side effects

Another client in the Marie Stopes Kenya study told of her frustrations with staff who did not disclose possible side effects from the medication.

“I was angry because that was something breast pain as side effect of medication abortion they were supposed to tell me.  They did not and neither did they give me any pain medication,” she said.

Despite the hits and misses the authors say these are important lessons for a service that is relatively new, hidden, and much misunderstood in Kenya.

Led by Sarah Baum of Ibis Reproductive Health the team encourages women qualifying for legal abortion in Kenya, that they are entitled to high-quality services and should not accept any shoddy business.