recognized as a leading cause of death and injury to women—deaths and
injuries that are preventable. Under the new Kenyan constitution,
induced abortion can be provided for certain indications. However, the
law has not yet been fully operationalized and many providers have not
been trained to provide safe abortion care. This means that many of the
induced abortions taking place continue to be unsafe and that
complications are common.
A recently published study, conducted by the African Population and Health Research Center, with other Kenyan partners and technical support from Ipas and the Guttmacher Institute, examines the severity of abortion complications and associated factors.
The researchers used data from a nationally
representative sample of 326 health facilities, including all regional
and national referral hospitals and a random sample of lower level
facilities. More than 2,600 women presenting with abortion complications
during a 30 day period were included in the study.
More than 75 percent of abortion clients
presented with moderate or severe complications, including high fever,
sepsis, shock, or organ failure, which require extensive treatment. Most
severe complications were among women who had late gestation abortions,
unsafely induced abortions, and were delayed in reaching a health
facility for care. The odds of moderate or severe complications for
unintended pregnancies were significantly higher, which points to an
unmet need for contraception in Kenya. In fact, 70 percent of women
seeking postabortion care in 2012 were not using a contraceptive method
before becoming pregnant. And young women were disproportionately at
risk for complications—45 percent of women 19 or younger who sought care
at a facility experienced severe complications.
The researchers note that although most
complications for earlier abortions are treated appropriately, there are
gaps in treatment and care management. In the Rift Valley and in
Eastern provinces, dilatation and curettage—a method not recommended by
the World Health Organization—is widely used for uterine evacuation.
Slightly more than 15 percent of women in the study did not receive any
pain management, which is recommended for all women, and around 35
percent of women with mild complications remained in the treatment
facility for more than twelve hours when their care should not typically
require that length of stay.
“Ipas was pleased to be part of this
collaboration and will use this data to continue our work to expand
access to safe abortion in Kenya and save women’s lives,” says
Hailemichael Gebreselassie, Ipas senior research advisor.
“Taken together, says Chimaraoke Izugbara, one of the study’s authors from APHRC, “these findings call attention to the urgent need for concerted efforts to combat the impact of unsafe termination of pregnancy on women in Kenya. Unsafe abortion continues to post a serious threat to Kenyan women’s health.”
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