Abortion is one of the most important health-care services. However, hundreds of people in Kenya risk having unsafe abortions due to strict legislation. Effective methods are available to help people have safe abortions, but barriers, such as high costs, make it difficult for most people to access them. Also, for many years, abortion was illegal in Kenya, which led to fear among health-care professionals providing the service, as they risked arrest.
When the 2010 Constitution was passed, it stated abortions were allowed if the life or health of the woman was at risk. Even so, these services are not provided at health facilities due to the element of fear, silence, and stigma. This situation has created a huge gap between the law and the reality of many women’s lives, especially those in rural areas with low incomes.
According to a report by the Kenyan Ministry of Health, 23 women die every week from nontechnical abortions and complications from unsafe abortions, and this number is likely to grow higher without intervention.
Because of the legal restrictions and prevailing fear regarding abortion, most women and girls prefer to use secretive and natural methods that are ultimately unsafe. In this edit, we highlight the safe abortion options available in Kenya, the cost, and the challenges of accessing them.
Abortion Methods in Kenya: A Guide to Understanding Your Options
Abortion services can be performed in different ways depending on the stage of pregnancy and the woman’s health. The most popular options are medication and surgery. An abortion with pills or medical abortion can be easily self-managed at home, while surgery needs to be done in a health facility by a professional.
These are the safe abortion options:
Medical Abortion
A medical abortion is a popular method used for pregnancies up to 10-12 weeks. It involves the use of two drugs, mifepristone and misoprostol.
Mifepristone works by inhibiting the production of the hormone progesterone, which is essential for the continuation of a pregnancy. Misoprostol causes the uterus to stretch and eject the pregnancy, resulting in an abortion.
This method is especially popular because of its effectiveness, with reported success rates of 95 percent. It also costs less compared to surgery.
Women can also use the pills by themselves, with proper instructions on procedure and usage. When professional guidance is needed, safe2choose abortion counselors offer assistance and information to avoid problems such as infection or excessive bleeding.
Surgical Abortion
Surgery is most commonly used to terminate pregnancies of more than 12 weeks and when the medication has not worked.
Surgery involves several techniques:
Manual vacuum aspiration (MVA). MVA is widely used for pregnancies up to 14 weeks. A silent suction device is used to remove the pregnancy from the uterus. It’s performed while the woman is awake, but local anaesthesia is used. It takes between 5 and 10 minutes. According to the World Health
Organization (WHO), MVA is considered a safe and cost-effective procedure. It is used in Kenya in many public health clinics as well as by nongovernmental organizations, especially for early pregnancies.
Electric Vacuum Aspiration (EVA). This technique uses an electric machine to suck out the contents of the uterus, mainly in early pregnancies up to 12-14 weeks. It is used in health facilities because it requires equipment. The main difference between these techniques is that MVA uses a handheld device whereas EVA uses an electric machine to provide suction. EVA is a safe and quick procedure when performed by a health professional.
Dilation and Evacuation (D&E). For abortions of more than 16 weeks, a D&E is used. For a successful procedure, it needs to be done by a professional. It begins with opening up the cervix (dilating) and then the contents are evacuated using medical equipment. While a D&E is one of the safest methods of abortion, it is not widely available in Kenya due to a lack of professionals and equipment.
Dilation and Curettage (D&C). This is an older method, although it is still used in some areas in Kenya. A D&C is also used to clean the uterus after a spontaneous miscarriage or an incomplete abortion. The process begins with the dilation of the uterine opening, after which a special instrument, known as a curette, is used to scrape the remaining contents of the pregnancy from the uterine walls. It is not the preferred method; however, it is an option if the other methods are not available and it is done by a professional.
Unsafe methods
Although different methods of abortion are available in Kenya, they are not available to everyone due to the cost and location. And some women choose natural or alternative methods of abortion to avoid the stigma of having an abortion. According to the World Health Organization’s 2022 report, unsafe abortions cause an estimated 39,000 deaths each year and cause millions more women to be hospitalized with complications.
Techniques used include over-the-counter medicines, herbal remedies, such as overdosing on tea, and injecting harmful substances. These procedures can lead to serious complications, and in many cases death. Unsafe methods are especially dangerous because of the lack of postabortion care.
The Cost of Abortion in Kenya
Safe abortion services in Kenya are a challenge, especially for women and girls from low-income communities and families, mainly because of cost and access. Although safe alternatives, such as medical abortions, are available, these services are not readily available to everyone.
For pregnancies up to 13 weeks, using drugs such as mifepristone and misoprostol in public facilities or NGOs costs between KES 1,500 and 3,000. However, in private clinics or pharmacies, this price can rise to KES 7,000 or more and sometimes to KES 15,000 if the service includes counselling and monitoring.
For women who require a surgical abortion, such as an MVA or D&E, the cost is higher. An MVA, which is performed up to the 15th week of pregnancy, costs between KES 3,000 and KES 10,000. A D&E, used for pregnancies of more than 12 weeks, can cost up to KES 30,000.
The Challenges of Finding Safe Abortion Services in Kenya
Although Kenya’s 2010 Constitution, as well as the consequent court ruling of 2022, allows abortion under certain circumstances, such as the life or health of the woman being at risk, most women still face barriers in seeking safe care. These challenges are legal, social, economic, and administrative.
The Law and its Indefinitive Points
The abortion laws of the country are not clear to many. While permissible in some circumstances, the lack of a consensus guide leaves health workers fearful of being sued or losing their jobs. This leads many of them to decide not to engage in such services at all. It is something that needs to be clarified and addressed to eliminate the fear of helping women.
Stigma and Social Pressure
In many communities in Kenya, as well as in Africa, abortion is still highly stigmatized. A woman who tries to access these services may be prosecuted, castigated, or even expelled from the home. This situation leads many to seek care in secret and often via dangerous routes. Sensitization is encouraged to get rid of the pressures imposed on society, especially over the previous decades.
The High Cost of a Safe Abortion
Safe abortion services, especially in private clinics, are expensive. Women on low incomes or living in rural areas often cannot afford the cost of medicine, counseling, and access. This leads them to choose unsafe routes.
A Shortage of Services in Rural Areas
Most of the safe facilities are in urban areas. Women in far-off regions have to travel long distances or do not receive any care at all, which delays treatment and increases health risks.
Lack of Accurate Information
Many women are unaware of their rights or the safety measures available. Misinformation about abortion pills, their side effects, and the legal risks make women afraid to seek help.
Primarily, safe abortion in Kenya is hampered by the lack of clear laws, as well as the stigma and fear of abortion. This leads many women to seek unsafe abortion options, and to practitioners being fearful of providing services.
A critical aspect of abortion is the safety of the process, which can be achieved with proper guidance. The challenge is to deliver this service to those who need it at a cost they can afford. Similarly, it is important to stop the stigma and fear in families and in turn, put a stop to secretive and unsafe abortions.
In need of guidance on how to get a safe abortion?
safe2choose offers guidance on procedures for safe and effective abortions. We provide access to counselors to help you with the process of how to get a safe abortion with accurate information. Reach out to our counselors at safe2choose.