The situation on abortion services in Uganda

 

Over 2 million pregnancies are recorded in Uganda annually, however over 800,000 of these end up in abortions often unsafe.

The World Health Organization defines unsafe abortion as a procedure of terminating a pregnancy performed by an individual lacking the necessary skills or in an environment that does not conform to minimal medical; standards or both.

The abortion rate for Uganda is slightly higher than the estimated rate for the East Africa region as a whole,

Makerere School of Public Health estimates that Kampala records the highest abortion rate of 77 abortions per 1000 women.

Abortion in Uganda is illegal unless performed by a doctor who believes pregnancy places a woman’s life at risk.

The Penal Code Act Section 142 deems an attempt to procure an unlawful abortion punishable by imprisonment of seven years, and Section 143 states that anyone who aids a woman in performing an unlawful abortion can be imprisoned up to three years.

However many continue to procure unsafe abortions due to socio- economic and geographical barriers to safe abortion.

Jane Doe (not real name) suffered Hemorrhage following a botched unsafe abortion  after conceiving out of rape while in a her Senior two.

“I was raped by a soldier who was my elder brother’s close associate and conceived. I was afraid to tell my brother being that he was my legal guardian. I sought the services of a herbalist.”

A herb was inserted into her vagina and she was told to go back home and wait for the fetus to come out. She developed severe cramps after she reached home and started to bleed profusely for hours on end. “The bleeding was so heavy that I could no longer clean up after myself. I became so weak and alerted the neighbors who took me to hospital. I had started turning purple”

Bleeding, also known as a hemorrhage, haemorrhage, or simply blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a wound in the skin.

According to the Association of Obstetricians and Gynecologists of Uganda AOGU, over 95000 abortions end up with severe complications such as heavy bleeding, damage to the womb, or sepsis.

AOGU President Dr Charles Kiggundu a renown Obstetrician and Gynecologist, reveals that 800 abortions occur daily in Uganda with 6 to 8 women dying daily as a result of complications.

Post Abortion Care

Post abortion care (PAC) is an integrated service delivery model that includes both maternal health and family planning interventions that are both curative and preventative. Curative interventions respond to the signs of complications that threaten a mother’s life: hemorrhage and sepsis.

In spite of the legal framework surrounding abortion, Post Abortion Care is legal in Uganda.

In fact, healthcare providers who treat women for bleeding, infections or other post-abortion complications are forbidden by law from interrogating their patients or reporting them to the authorities according to the Centre for Reproductive Rights.

However, only 89% of healthcare facilities with the capacity to provide post-abortion care actively treat post-abortion complications.

The Ministry of Health says Uganda loses 25 billion shillings annually on post-abortion care and treatment from unsafe abortions.

Figures capturing actual abortion incidence in Uganda are scarce. Most of the data captured is by private and foreign agencies.

Sexual and Reproductive Health and Rights advocate Bakshi Asuman says this makes planning hard for both government and private interventions.

Dr Livingstone Makanga, the acting commissioner reproductive health at the Ministry of Health admits there are challenges in curbing abortion related deaths.

He however says focus should be on strengthening access to post abortion care and providing age appropriate information to adolescents.

 

Story By,

Leah Kahunde