Kenyan health officials say unsafe abortions are common in the east African nation with nearly half a million in one recent year.
Abortion is prohibited unless, in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger.
Advocates for less restrictive policies argue that unsafe abortions contribute to a high level of maternal deaths.
One woman's story
Meet Martha Hope, that's not her real name. She was married with three children when she became pregnant again in 2010. The 33-year-old woman said her husband told her he was not ready to bring up another child in poverty.
At six months, she visited a neighborhood clinic that was willing to provide an illegal abortion. The doctor mixed some concoctions for her to take.
Martha says she started bleeding and that she sat in a bucket full of cold water.
“I was sweating and losing strength, the fetus came out, but now the problem was that the placenta did not. I passed out,” she said.
Martha is now on medication for depression as a result of the trauma she experienced.
Thousands of unsafe abortions
A 2018 report indicated that nearly half a million unsafe abortions occurred in Kenya in 2012.
Josephine Kamau, a nurse at Provide International Hospital in Dandora, says back alley abortions are all too common.
“We get three to four cases in a month in our facility,” she said, “but remember, there are others who die at home, who may have no one to bring them to the facility. Maybe they opted not to tell anybody.”
Maternal health services
For the last 30 years, the Marie Stopes organization has provided a wide range of maternal health services including family planning, safe abortion and post-abortion care in Kenya.
The organization says seven women in Kenya die daily from unsafe abortions.
“There are multiple causes for this,” said Dana Tilson, the Marie Stopes’ Kenya country director, “including restrictions in the law for safe abortion including lack of information on where to get safe services. There are also particularly for young people, limited access to contraception, and when you have a situation where contraception is limited, there is a stigma around younger people getting pregnant and having sex before marriage.”
Last year, the Kenya Film Classification Board banned a Marie Stopes media campaign that sought to raise awareness about unsafe abortions.
According to the board, the campaign encouraged teenagers to obtain the procedure. Marie Stopes was then temporarily banned from providing safe abortions in that country.
Virginia Nehemiah of Crisis pregnancy, a faith-based, Christian organization in Kenya, says her group helps women make a different choice.
“The issue of choice only considers two choices: carry or abort,” she said. “There are other choices, but people don’t always talk about them. There is adoption. How many families are out there not getting babies and they want children…”
Tilson, of Marie Stopes, says women terminate pregnancies for various reasons.
“When they have an unwanted or an unintended pregnancy, they are often desperate and they do not know where to go, and no matter what, they are going to terminate that pregnancy; they will do anything to do that and often they will go to a backstreet abortionist and these quacks are very dangerous,” she said.
Loss of US funding
For decades, the U.S government has been a big donor for family planning services in Africa; however, the global gag rule that President Donald Trump signed when he took office in 2017 bans the U.S. from giving any money in development aid to any overseas organization that promotes or provides abortions.
This has affected operations of NGOs such as Marie Stopes.
When the gag order was signed, Marie Stopes said it lost about $30 million for multiple countries where it had been receiving U.S. funding for family planning.
The World Health Organization estimates 25 million unsafe abortions take place globally each year with almost all in developing countries.