Abortion: why many young women think it is their only option

Despite being an evidently huge problem in the country, liable to punishment, abortion cases are uncommon in Ugandan courts because they are never reported for investigation, due to what the lawyers attribute to the secret nature of the offence, complicity and connivance of the women involved, and incomprehensive laws.

Dr Winfred Nabisinde, a legal consultant with the Uganda Association of Women Lawyers (Fida) says that cases often come to light when women and girls develop or die from post abortion complications, death or injury in the process of a surgical operation. Even when some of the abortion cases are reported, they usually end at the magistrate’s court and are rarely concluded.

However, both medical practitioners and traditional birth attendants (TBAs) can attest that the rate of young women seeking post abortion care and abortion services are rather skyrocketing in the country, with many using cruel and inhumane means to get rid of the unborn baby.

“At least every week I find myself receiving a girl or more with sticks hanging out of their vagina, hot metals in their womb, some have severe damage and are rotting inside,” Berna Nabatanzi, a traditional birth attendant says.

“I mostly get students when they have just got holidays. They are assisted by their friends and by the time they come, they are smelling under and are rotting,” Ms Nabatanzi says adding that since she refers them to the hospital when they come, majority prefer to go to TBAs that will help them out.

Why do they do it?
On her list are also women and girls of low income earnings, widows and those with pregnancies out of incest. Medical doctors from reputable hospitals however say that the patients they receive are even from affluent families and in good schools.

For every one day that passes by, the World Health Organisation estimates that 65,000 women carry out abortion globally. 95 per cent of these occur in developing countries, more so in Sub-Saharan Africa and in Uganda, it estimates that at least 300,000 women carry out unsafe abortions every year, contributing to 20-30 per cent of maternal mortality in the country.

Early sex, promiscuity, discriminatory social practices and limited access to Reproductive Health Services now stand out as major driving factors of unsafe induced abortion among today’s young girls and women, putting several of their lives at risk.

Ms Nabatanzi and several other doctors are now urging for better sex education and access to reproductive health services, if the situation is to change.

“Abortion is not just the case of to legalise or not to legalise. Girls are usually determined to have an abortion whether it is with a medical person’s help or not. The situation is real, there should be a system to prevent unwanted pregnancies, detect unwanted pregnancies and tertiary prevention,” says Dr Eve Nakabembe an obstetrician and gynaecologist at Nsambya Hospital.

Dr Nakabembe explains that abortion, even if it is done in a clinical way can have effects like excessive bleeding, injury of surrounding organs, long term effects of infertility, chronic pelvic pain, fistula and finally death, among other effects and says if a pregnancy is going on well, girls should not be tempted to carry out an abortion.

Ms Nabatanzi, however, puts the blame on what she calls today’s decaying parenthood saying parents no longer play their role of sex education, leaving the young girls and boys to stumble into sex without knowing its consequences.

“In the 1970s, a woman would cheat and pin the child to her husband but now, women who cheat have no way out because of technology and you find that for the young girls, they get pregnant at school and fear stigma from society, their parents and even sometimes their boyfriends deny the child,”Ms Nabatanzi says.

“For us, in those days, once a girl started their periods, they were taught about the importance of remaining a virgin, and parents were also receptive to children born outside wedlock. But today, when a child has no father you find parents encouraging girls to abort and even the girls fear stigma that comes with carrying a child without a father,” she adds.

This, according to lawyers, is escalated by the strict laws pertaining to abortion and even inability to prosecute offenders who deprive an unborn child of their right to life.

“Ugandan law does not state when conception is deemed to have taken place or at what stage of pregnancy the abortion offences can be committed. It does not also state when the foetus/embryo becomes an unborn child capable of being killed,” says Dr Nabisinde.

“We need clear laws and interpretation, taking into account the unmet need of family planning methods. We also need a law reform to allow for abortion in case of rape, defilement and incest if we are to make headway in curbing abortion,” Dr Nabisinde says.

For now, the maternal mortality rate stands at 375 women per 100,000 births and the World Health Organisation wants this number reduced to 131 by 2015. The Commissioner in charge of health services, Dr Mbonye says that funding remains a critical problem to the health sector and that they are banking on Parliament to increase money to the health sector if statistics are to change.

Teenagers affected
• One in every four teenagers has had a baby.
• Government contributes 15 per cent of its budget for contraceptive procurement.
• Girls engage in sex as early as 16 years and boys at 18.
• Only 11 per cent of teenagers use family planning methods resulting into unwanted pregnancies and unsafe abortions.

Source: Reproductive Health Uganda

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