Fighting unsafe abortion: the myths, perceptions and interventions
By, Florence Nabweteme
More than four in 10 births are not planned leading to unintended pregnancies which on many occasions end up in abortion – according to the 2011 Uganda Demographic and Health Survey (DHS). Over 900,000 of Uganda’s annual 2.2million pregnancies are unintended and unplanned. About 400,000 of the unintended pregnancies end up in abortion. Government spends 7.5 Billion Uganda Shillings of taxpayers’ money on treating complications from unsafe abortion every year, which could be avoided at very little expense.
According to a study carried out by Guttmacher institute “Unintended pregnancy and abortion in Uganda” 2013, one in three never-married women aged 15 to 24 years admitted to having had sex and similarly one in three married women are not using contraceptives even though they do not want to get pregnant, this has resulted into increased numbers of unwanted pregnancies. This has been attributed to limited or sometimes lack of reproductive health choices such as contraception hence resorting to abortion which is mostly unsafe.
Other causes of premarital sex among the adolescents is the secrecy surrounding sex as a topic that has left young people mostly those in problems related to reproduction seeking for this information from social networks like Facebook, YouTube and Twitter. When these adolescents get pregnant they resort to unsafe abortion because of lack of choices.
Abortion in Uganda is widely regarded as illegal and condemned both culturally and religiously. Religious moral codes provide that life begins at conception and should never be terminated and that no circumstance would warrant an entitlement to terminate a pregnancy. However, the Ministry of Health National Policy Guidelines and service standards for Sexual Reproductive Health and Rights provides for circumstances where an abortion maybe permitted like in instances of sexual violence, coercive sex, rape and incest and illnesses which would endanger the health and life of the mother.
According to Dr. Charles Kiggundu, a gynaecologist at Mulago National Referral Hospital while making a presentation during a meeting convened by the Centre for health Human Rights and Development (CEHURD) within the Coalition to Stop Maternal Mortality due to Unsafe Abortion (CSMMUA) pointed out that, “most women resort to aborting as it seems risky giving birth in Uganda as two out of every three pregnancies are high risk and any woman who decides to have a baby has put one leg in the grave and the other is fighting not to join.”
Despite campaigns on abstinence and use of contraception, unsafe abortion remains a big problem and as such, there is need for interventions to save lives of young women. Media plays a great role in dissemination of information, but the question still remains, “What kind of information are they giving the public?”
In response to that question, CEHURD trained and continuously mentor media fellows to report on Sexual Reproductive Health and Human Rights issues with an informed point of view and with objectivity. This fellowship targets all media houses – print, broadcast and social media users. The participants have managed to report and create more awareness of the issue of unsafe abortion and interventions to reduce the incidents among young people, which has changed people’s perception on various issues.
CEHURD also organized a lawyers’ meeting to unpack the legal and policy framework on abortion in Uganda. The meeting was attended by different legal and health professionals.
According to Justice Damalie Lwanga, majority of the judicial officers are conservative and bent on enforcing archaic laws that were imported from the colonial era and are sometimes clouded by their moral values which influence their decisions. Abortion is a complex issue and sometimes needs someone to review the cases with a human rights perspective.
In addition to the commitment by the Ministry of Health to address unsafe abortion with the Post-abortion Care training being rolled out in different health centres, there’s need for legal backing and Sensitization of judicial officers to harmonize the laws in place and interpret them in a progressive manner. The WHO definition of health of the mother includes the mental and physical health of the mother and the Maputo protocol ultimately entitles every woman to a safe abortion if they need one.
As such there is still need for reform in the legal and policy regime to include reproductive health rights and progressively realize economic, social and cultural rights which will in turn increase access to safe abortion as we work towards a Uganda where no woman will suffer or die due to lack of reproductive health choices.