Article 26(IV) of the Kenyan Constitution regulates abortion, which is prohibited unless, in the opinion of a qualified medical professional, there is a need for immediate medical attention or the mother's life or health is in danger, or if it is permitted by another written law of the land.
Over time, different studies have shown that safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion are high. Women in informal settlements have faced substantial barriers to regulating their fertility and lacked access to safe abortion. Unsafe abortion complications have left millions temporarily or permanently disabled. Inadequate healthcare resources and infrastructure, restrictive laws and policies, and stigma have contributed to abortion-related mortalities.
Unsafe abortion is a major consequence of unintended pregnancy which in turn is a major consequence of the high unmet need for contraception. Unmet need for contraception refers to women who do not want more children or want to wait for two or more years before having another child, but are not using contraception. Kenya is one of the Sub-Saharan African countries that have the highest unmet need for contraception and unintended pregnancy rates in the world.
Improved access to effective contraception will reduce the number of unplanned pregnancies and consequently the number of would-be unsafe abortion while adherence to quality standards assure better outcomes. Properly performed quality post-abortion care procedures will end up preventing most maternal morbidities and mortalities. These entail improved access to high-quality comprehensive care, community-provider partnerships, counseling, timely treatment of incomplete abortions, contraceptive and family planning services, together with other reproductive health services at all levels of health care. The need to involve community health workers and community health extension workers in the treatment and detection of complications from unsafe abortion will be important.
Policymakers and reproductive healthcare advocates need to support programs that employ harm reduction strategies and increase women’s knowledge of and access to medication abortion outside the formal healthcare system so as to not leave any woman behind that would benefit from the same.