A new study by Marie Stopes Kenya showed that 20.7 per cent of women seeking abortion services in Nairobi “do not know” whether the process is illegal.
Abortions, the Constitution states, are illegal in Kenya unless a woman’s life or health is in danger.
The researchers spoke to 353 women in six family planning clinics across Nairobi, which were chosen based on client volume and diverse population, amongst other things.
Nearly half (47.6 per cent) knew abortion was illegal, while nearly one third (31.7 per cent) believed it was legal.
In Kenya, the law is muddled. Abortion was mostly illegal until 2010, when a new Constitution essentially made it easier to have one.
The Penal Code, however, was left unchanged. This means you can still be charged with a 14-year prison sentence if you are found carrying out an "unauthorised" abortion, a grey area which allows police to target both women, quacks and health providers.
Unsurprisingly, this confusion has led to uncertainty over when the procedure is - and isn't - allowed.
Published in the journal ‘Plos One’, the study also involved The University of California, San Francisco (UCSF), and Innovations for Poverty Action (IPA). The aim was to assess the experiences of women opting for either pills (medication-induced abortions) or surgical abortions (manual vacuum aspirations).
Little is known about how women’s experiences differ between the two. The results showed that one factor is age; women aged 35 or more were more likely to go for the surgical procedure whereas younger women often opted for the pill. Roughly an equal amount, however, reported being employed.
Nearly a quarter (22.4 per cent) of Nairobi-based women procuring an abortion were either married, partnered or cohabiting. This reflects data from the Kenya National Bureau of Statistics 2014 (KDHS) indicating almost a half of pregnancies among married women in Kenya are unintended.
The study also found the highest number of aborting women were single, aged between 20 and 24 years and likely to be terminating their first pregnancy. Over half had no children, and rated their current health as "excellent, very good or good.’
While high numbers said it was "easy" paying for transportation to a clinic (80.5 per cent), nearly one third, said it was harder getting money for the actual procedure.
In addition to financial worries, stigma is still a big problem. Many women worried other people might find out or gossip about them. They were also concerned that by aborting, they were disappointing their loved ones.
Kenya reports high levels of unintended pregnancies. One 2015 analysis estimated that 41 per cent of the unintended pregnancies in Kenya will end in an abortion, resulting in approximately 500,000 abortions each year.
Overall, the majority of women said they were happy with the services provided at the Marie Stopes clinics.
“Most women felt that they were treated with respect, facility staff cared about them, their information was kept confidential, they were given attention, there was enough staff, and they could trust the staff who were there.”
Yet more can be done, the study argues. Challenges around the quality of abortion experiences in Kenya still remain, particularly around the issues of communication and autonomy.
“Only 61 per cent of MVA (surgical) clients and 57 per cent of medication clients reported that providers called them by their name all the time. Only 60 per cent of MVA clients and approximately 41 per cent of medication clients indicated that providers talked to them about how they were feeling.”
Based on the findings, researchers are recommending important changes, including a need for providers to ensure the abortion experience is personal by using women’s names.