City women using extreme methods to abort

By David Odongo

The worrying revelations that married women lead in procuring illegal abortion also paints a grim picture on the drugs used to induce the process.

We can now establish that most Nairobi women are readily using livestock hormonal growth drug, Estradiol to induce abortions.

Estradiol is available in many vet clinics for Sh200 per dose. But there are women who prefer Stilboestrol, a drug used to terminate pregnancies in bitches (female dogs), which is available for Sh150 per dose.

According to vet Kenneth Wameyo these drugs are sometimes sold over the counter.

“Well, from the chemist counter it is known as diethyistilboestrol but the common name is Stroel. A pack of 30 tablets costs about Sh500 although one cannot misuse the entire thirty tablets,” says Wameyo.

But for those women who cannot get the vet drugs, prefer to use ulcers tablets. The most common being Cytotec and Misoprostol that can be easily bought over the counter for Sh90 per tablet at various city pharmacies. Only three tablets are needed to procure an abortion.

Mioprostol is not used orally but inserted into the private parts to avoid deadly side effects.

“The drug has very unpleasant side effects, including nausea and vomiting. So, to reduce side effects, they insert it to be absorbed into the bloodstream,” says Wameyo.

Medic Polin Karimi explains that some women place Misoprostol under the tongue.

“When used this way, no remains of the drug can even be traced when one goes to the hospital incase of complications. There is no way to prove that one tried to induce abortion and doctors will assume it’s normal miscarriage,”

 She adds, that thereafter, the doctors will just do a procedure known as curettage, or vacuum aspiration, which will remove remaining tissue from the womb.

The success rate of using misoprostol under the tongue is 95 per cent and when inserted, the success rate is 93 per cent

According to the latest research by Ministry of Health, African Population and Health Research Centre, Ipas, and Guttmacher Institute an astonishing 465,000 women procured illegal abortion last year.

Over 64 per cent of married women or those living with their partners sought post-abortion care in health facilities while 27.8 per cent have never been married and 7.5 per cent were divorced.

The highest sub-group of women who sought after-abortion care was that of unemployed housewives at 41.7 per cent.

How women abort using Misoprostol

When one swallows a dose of Mifepristone tablets by mouth, it causes the placenta to separate from the endometrium. It also softens the cervix and increases uterine contractions to allow the uterine contents to pass.

Within four hours of taking the second misoprostol, many women have vaginal bleeding and cramping, and the pregnancy is terminated.

Most pregnancies end within the first 24 hours after the Misoprostol dose. If not, then typically a second dose is given.

Signs of complications

Karimi advises that one should see a doctor immediately if she has any of these symptoms after taking Misoprostol.

 “Severe bleeding which may include passing clots that are bigger than a golf ball, lasting two or more hours or soaking more than two large pads in an hour, for two hours in a row or just bleeding heavily for 12 hours in a row,” she said.

She said the swelling or redness in the genital area, vomiting lasting more than four to six hours is not also a good sign and sudden abdominal swelling, rapid heart rate and vaginal discharge that has increased in amount or smells bad is a sign to go seek treatment.

Confession from an abortion addict

Mama Kevevia has had six abortions in the last five years and has procured two abortions for her daughter, now aged 17.

Mama Kevevia, who has a shop in the sprawling Mathare slums, sees nothing wrong with abortion.

Her only worry is about us using her real name and taking her photos. Once we promised to keep her information confidential, she talked freely.

“I don’t think I regret it. I already have four children. Three are teenagers. I don’t want any more children, we simply can’t afford it,” Mama Kevevia says.

She lives in a single-room on the ground floor of a five-storey building in Mathare North, Area Three. Half of the room is set aside for the shop, portioned with a papyrus reed mat. She stays with her husband, a driver, and four children on the other portion.

 “Mzee alishasema hataki watoto wengine. Namimi sitaki kumkasirisha. Inabidi tuu nifanye hivyo (My husband said he doesn’t want any more children and I don’t want to annoy him by going against his wish),” she says.

Her daughter, who was not present during the interview, dropped out of school in Form Two, and has been doing casual jobs.

“She helps me at the shop. I bought some kerosene that she retails outside the shop. But she can only do that in the evening. She spends the whole day with her friends and only comes back home in the evening,” Kevevia says.

What would drive a woman to procure an abortion, not once, but six times and also twice for her daughter? And why can’t she use other methods of family planning to avoid getting pregnant in the first place?

“We have meagre resources,” she says.

“My husband’s job doesn’t pay much and if he found out that our firstborn was pregnant, he would throw her out. I am only praying that she gets a nice man who can marry her and take care of her. For me I can’t use those pills or injectables. I hear they are dangerous.”

She says she has always gone for abortions at a private clinic, a few metres from her shop.

To demonstrate this, she leads The Nairobian team to a huge ugly building in her neighbourhood. It is a four-storey building that houses a driving school and a cyber café. On the ground floor is a gas cylinder retailer, tucked in the corner, and almost hidden from view, is a small pharmacy.

“That is the place. It’s a pharmacy, but it’s got a room in the back where they ‘treat’ us. It used to be the only one in this area, but there is competition nowadays,” she says, as she points to another pharmacy, a few metres from the first one.

 Confession of an abortion doctor

For obvious reasons, we can neither name his place of trade or his name, but a medic confesses that he carries a minimum of 10 abortion procedures every month.

“Some months it rises up to 20 or more, but the least we have ever had here is 10 cases per months,” says the doctor.

He reveals that out of every 10 women who walk in to procure abortion, one will come with the husband.

“Either the men don’t want to know what’s happening, or they don’t know at all that their wives are having abortions. You can’t tell how rich a person is but when you look at the women, they are educated, and well dressed, so I can say majority of my clients are affluent, and well to do, upper middle class on the very least,” says the doctor.

The clinic gets most clients through referrals.

“Women tend to tell each other, because when one comes, they say they were referred by a sister or a close friend. They share this information”