Victoria Atieno was waiting at a Nairobi bus stop when she felt blood spurting from her body, the result of a secret self-induced abortion – a method used by thousands of Kenyan women, with potentially fatal consequences.
Kenya’s constitution made it easier to access abortion in 2010, but entrenched stigma about the procedure means many women resort to traditional practices or clandestine clinics that are life-threatening.
Even a reproductive health counselor like Atieno – her mind covered with fear – ended up swallowing a herbal concoction to induce an abortion in secret.
Hours later, as she underwent a public and extremely traumatic termination, she faced a flood of abuse from onlookers, experiencing the very nightmare she had tried to avoid.
“People are going to condemn you, criminalize you, try to kick you out of the community,” the 35-year-old mother of three told AFP.
Many women will do anything to avoid this fate, from drinking bleach to using knitting needles or hangers to terminate their pregnancy.
The results are horrific, ranging from a ruptured uterus, cervical tears and vaginal cuts to serious infections, bleeding and death.
Every week, 23 women die of failed abortions, according to a 2012 Kenya Ministry of Health study – the most recent government data available.
Activists say the real number is even higher.
A report released last year by the nonprofit Center for Reproductive Rights (CRR) estimates that seven women and girls die every day in Kenya due to unsafe abortions.
In the slum of Dandora, on the eastern outskirts of Nairobi, where Atieno works with the Coalition of Grassroots Women Initiative, sanitation workers sometimes find abandoned fetuses in the neighborhood’s huge dump.
Volunteers tasked with cleaning up the Nairobi River in 2019 recovered 14 bodies from its garbage-clogged waters, most of them babies.
Cultural and religious beliefs in this deeply Christian country have helped create such a strong stigma that even women who obtain safe abortions believe they have committed a sin in doing so.
More than a year after Susan aborted with a pregnancy following gang rape, the church-going mother of four still struggles with intense guilt.
“People see you as a murderer … it makes me feel like I’ve done something very wrong,” the 36-year-old told AFP.
– De facto prohibition –
Kenya’s constitution states that abortions are illegal unless “in the opinion of a qualified health professional, emergency treatment is necessary, or the life or health of the mother is in danger, or any other written law allows it ”.
No other condition or condition is specified.
The loosely-worded document places decision-making power entirely in the hands of health care providers.
So when the health ministry stopped training abortion providers in 2013, access to these services took a hit, and women paid the price.
The ministry’s decision came a year after its own study warned that a “disproportionately high” number of women were dying in Kenya from unsafe abortions.
“The ministry’s decision was not based on scientific evidence, it was taken against that evidence, evidence that was gathered by the ministry itself,” Martin Onyango, senior legal adviser to the ministry, told AFP. CRR for Africa.
Ministry officials refused interview requests, and a ministry reproductive health expert told AFP: “We are not allowed to talk about abortion at all. It is the policy.”
The ministry was dismantled by the Nairobi High Court in 2019 for violating the right of women and girls to physical and mental health by stopping the training of legal abortion providers.
Yet little has changed on the ground since then, leaving the field open for unscrupulous underground clinics to exploit women’s need for secrecy.
Ken Ojili Mele’s niece has died aged 26 after a botched abortion.
Long opposed to abortion, the 48-year-old carpenter told AFP he was filled with regret after his untimely death on his way to hospital.
“Maybe she didn’t want to tell me because she knew I would have been angry,” he said.
“I wish she had shared it with me, maybe I could have helped her find a safer hospital.”
– Silence and tears –
Abortions are extremely difficult to access in public hospitals. Some private health providers perform the procedure, for which costs start at around 3,000 to 4,000 Kenyan shillings ($ 27 / 23.5 euros). The pills are used to reduce short term pregnancies.
For women who turn to these sources, the fear of disapproval and shame can run deep. The silence persists even in the waiting rooms of the doctors.
“In Kenya, it’s not easy to say you want an abortion,” said Samson Otiago, a doctor specializing in reproductive health.
Dozens of women visit her clinic in Nairobi each month and most need to be brought in to tell her that they intend to terminate a pregnancy.
Some start to cry before they even say a word, he told AFP.
Many cannot afford his fees, which start at 4,000 shillings ($ 36), so he sometimes offers his services free or on credit.
“Once a woman decides to have an abortion, she will do it as best she can.
“So we’d rather do it (for less money) than expose her to charlatans and see her again with complications,” he said.
In Dandora, as rape survivor Seline waited for the results of a pregnancy test, she had little doubt what to do next.
Barely surviving on a monthly salary of 5,000 shillings, the 38-year-old domestic worker told AFP she was determined to have an abortion if the test was positive.
“If the hospital refuses, I will do it the traditional way, with herbs,” she said, her voice barely rising above a whisper.
“I’m ready for anything, as long as I don’t need to have this baby.”
amu / txw / kjm-ri