When restriction on abortion turns a human rights issue
What you need to know:
- Abortion is illegal in Uganda.
- According to the Penal Code, a doctor who thinks that an abortion is justified to save the life of the mother, must write to the director general of medical services in the health ministry, seeking approval to terminate the pregnancy.
- Upon receipt of the letter, the director general is supposed to convene a medical board, composed of experts, to scrutinise the case and, if satisfied, appoint a specialist to carry out the procedure.
When we meet Asyiah Nagudi, at her a single roomed rented house in Mukono District, tears flow down her cheeks as she recounts the economic hardships she has gone through in the past one year.
Nagudi says her husband abandoned her in 2015 on learning that she was pregnant with their second child.
“I cannot afford two meals a day for my two children,” she says.
The 25-year-old says she conceived six months after her first birth, something that irritated her husband leading to their separation.
But Nagudi has since blamed the disputed pregnancy on an injectable hormonal contraception that failed her.
“I was shocked to find that I was pregnant again,” says the mother of two regrettably adding; “I would have aborted but I did not have an opportunity. I had no choice.”
Dr Charles Kiggundu a consultant gynaecologist and obstetrician at Mulago National Referral Hospital agrees with Nagudi’s claim on contraception failure.
He says although most contraceptives are safe, they can fail if not used appropriately.
“The users (of contraceptives) should be able to tell health workers which other drugs they are using because some drugs tend to react with hormones in the contraceptives, rendering them less effective,” says Dr Kiggundu.
Unlike Nagudi, 21-year-old *Jane Nankya* is at crossroads. As an orphan, Nankya was raped by her uncle under whose guardianship she was left and conceived at the age of 16.
Her uncle later took her to a nearby clinic where a clandestine abortion was conducted.
Five years after, the price of unsafe abortion has come to haunt her. “I cannot conceive again. The doctors say my uterus was injured,” she sobs.
The two cases mirror the scenarios under which young girls and women in the country get unwanted pregnancies.
Although some girls like Nagudi who fall victim are brave to carry the baby, they never live to love their children due to the psychological torture and economic hardships that come with the unwanted pregnancies.
They live to curse the day they conceived as other victims who cannot stand the humiliation stealthily proceed to terminate the pregnancies since abortion in Uganda is illegal and punishable by law.
As a result, the rate of maternal mortality has gone high in the past as a result of unsafe abortion.
Abortion-related cases account for 26 per cent of maternal deaths, according to Ministry of Health.
Dr Kiggundu suggests: “More lives would be saved if a safe window would be opened for women to procure safe abortion conducted by experts.”
His suggestion is also supported by a comprehensive global collaboration study conducted by scientists in 2007 from the World Health Organisation (WHO) and Guttmacher Institute.
The report found that abortion was safe in countries where it was legal but dangerous in countries where it was outlawed and performed stealthily.
Denis Kibira, a pharmacist and deputy executive director of the coalition for Health Promotion and Social Development (HEPS-Uganda), says health workers are discouraged from administering post-abortion care given the stigma around it.
“And this has a very big impact on the uptake of medical attention by abortion seekers,” Kibira said.
Cases. Erias Kisawuzi, the spokesperson of Judiciary, admits that most abortion cases that are handled come as a result of rape and other forms of gender-based violence. “They [abortion cases] come in different cases,” Kisawuzi says.
Constitution. Article 22(2) of the 1995 Constitution (1995) provides for the protection of right to life stating: “No person has the right to terminate the life of an unborn child except as may be authorised by law.”
Punishments. Severe punishments are also spelt out in the Penal Code Act (Cap 120) for anyone who contravenes the law in sections 141, 142 and 143.
Penal Code Act. Under Section 141, any person who unlawfully administers to any woman any poison, noxious substance or uses any force or any means on her with intent to cause a termination of a pregnancy can be punished upon conviction with imprisonment for 14 years. This includes health service providers.
Section 142 states that any woman who unlawfully administers to herself any poison or noxious thing or uses any force or any means on her or even permits such a thing to be used on her can be punished upon conviction with imprisonment for seven years.
Any person who supplies anything knowing that it will be used unlawfully to terminate a pregnancy can be punished upon conviction with imprisonment for three years, under Section 143.