
4 minute read
Abortion: A medic’s perspective
By Linnette Leyi
Abortion has proved to be a very controversial topic in recent years, with debates arising between pro-life and pro-choice movements.
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The pro-life movement argues that “the government has an obligation to preserve all human life, regardless of intent, viability, or quality-of-life concerns”; hence deeming abortion as wrong. On the other hand, the pro-choice movement believes that “individuals have unlimited autonomy with respect to their own reproductive systems, as long as they don’t breach the autonomy of others.”
The Constitution of Kenya in Article 26(4) states that “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.” The illegalization of abortion has caused many women who have chosen to end their pregnancies to seek the procedure from unsafe avenues.
In Kenya alone, complications from these unsafe procedures account for approximately 13% of all maternal deaths, nearly 50,000 annually. On the flip side, according to the WHO, “abortion is a safe health care intervention when carried out using a method recommended by WHO, appropriate to the pregnancy duration, and by someone with the necessary skills.”
In a bid to understand the severity of the menace of unsafe abortions, Newsline had a sit-down with Dr. Musa Ochieng-Senior Health Officer in Ward 1D (Obstetrics and Gynecology).
What is abortion and what are the types?
The WHO defines abortion as the deliberate termination of a pregnancy prior to 20 weeks of gestation; or the expulsion of a fetus of less than 500g of weight.

PHOTO | MSN
There are various types of abortion based on the method used, whether they occur voluntarily, involuntarily, safely, or unsafely.
Unsafe abortion is a procedure done either by persons lacking the necessary skills or in an environment that does not conform to the minimum medical standards or both.
What are the various reasons for abortion?
While every person has unique reasons for seeking an abortion, researchers have found that those who’ve had the procedure report several common factors that influenced their decision, the main among them being financial concerns. Others include pregnancy time, partner-related issues, future plans, emotional and mental preparedness, health concerns, influences from family, friends, and societal pressures.
Complications and side effects of abortion?
Most complications are considered minor such as pain, bleeding, infection, and post-anesthesia complications. Others are major, including uterine atony (failure of the uterus to contract after birth or miscarriage) and subsequent hemorrhage, uterine perforation, injuries to adjacent organs (bladder or bowels), cervical laceration, failed abortion, septic abortion, and disseminated intravascular coagulation.
Is abortion an essential component of women’s healthcare?
Abortion is indeed an essential component of women’s health care. Since it is illegal in Kenya, many women and girls are faced with the burden of unsafe abortion. Unsafe abortion is a leading but preventable cause of maternal deaths and morbidity. It can lead to physical and mental health complications and social and financial burdens for women, communities, and health systems.
Abortion is illegal in Kenya. How does this affect women’s reproductive and overall health?
Illegality is a broader conversation; regulations should be based on best practices and what the evidence in our setup tells us. That said, the lack of access to safe, affordable, timely, and respectful abortion care and the stigma associated with abortion pose risks to women’s physical and mental well-being throughout their lives.
What medical care does KNH offer patients that suffer from complications that arise from unsafe abortions?
Abortion care is included in medical training, clinical practice, and continuing medical education. KNH offers emergency treatment for complications arising from abortion. Based on the severity of the complications, patients may require admission. Some of these are seen through the Accident & Emergency Department or admitted to Ward 1D. To prevent future unplanned pregnancies, the patients are offered family planning counseling. Some cases also require STI treatment and HIV/AIDS testing and counseling. Approximately 2,600 women die from complications resulting from unsafe abortions annually.
How do you think this can be avoided?
The best way to handle the burden of unsafe abortion is by expanding quality abortion care through a supportive, universally accessible, affordable, and wellfunctioning health system. The current statistics are a reflection of unmet contraceptive needs, hence the need to fill this gap through patient education and community empowerment by mobilizing and creating awareness of contraception.