The hidden epidemic claiming seven Kenyan lives daily
Unsafe abortions, driven by restrictive laws and pervasive stigma, continue to claim lives and destroy futures.
What you need to know:
- In Kenya, unsafe abortions are a hidden crisis, with an estimated 500,000 performed annually, leading to numerous complications and deaths.
- 17-year-old Mercy Njoki survived a harrowing unsafe abortion experience, but others who weren't as fortunate.
- Legal restrictions, societal stigma, and lack of access to safe services drive women to seek dangerous backstreet procedures, often with devastating consequences.
- The financial and human costs are staggering, with Kenya spending over 500 million shillings annually on treating complications from unsafe abortions.
International Safe Abortion Day
On a quiet night in Nairobi, 17-year-old Mercy Njoki faced a decision that would change her life forever. Pregnant, scared, and living with her parents, she turned to a friend for help. The solution seemed simple: abortion pills from a local chemist. For Sh600, she received unmarked tablets with no instructions and was told to place them under her tongue when she got home.
"I did exactly that," Mercy recalls, describing how she took the tablets as instructed.
What followed was far from the easy fix she'd hoped for.
"But soon after, I felt an unsettling chill coursing through my body. I was shivering even in a sweater, and my joints... especially around my waist... were in intense pain."
Mercy's story is not unique. As Kenya marks International Safe Abortion Day today (September 28), her experience highlights a grim reality faced by countless women across the country. Unsafe abortions, driven by restrictive laws and pervasive stigma, continue to claim lives and destroy futures.
A desperate decision
Heavy bleeding began shortly after, accompanied by mild cramps that gave her a glimmer of hope that the abortion had worked. She went to bed feeling somewhat at ease. But at 3am, a sharp, excruciating pain jolted her awake.
"It felt as though someone was tearing my womb apart," she remembers, shuddering at the memory.
Hearing her cries, her mother rushed to her side. In a moment of desperation, Mercy lied, claiming it was just severe menstrual cramps. Her mother suggested seeking medical help in the morning. "I couldn’t tell her the truth," Mercy admits. "I had to endure the pain until dawn."
The next day, she arrived at Korogocho Health Centre, still bleeding profusely and unable to sit from the agony. As she slumped to the ground in the waiting area, a nurse eventually approached her and asked if she had undergone an abortion. Initially denying it, Mercy eventually confessed when pressed further.
The nurse quickly referred her to a doctor who confirmed that Mercy needed urgent treatment that the health centre couldn’t provide. However, fear gripped Mercy as she faced the stigma surrounding abortion and realised she had no money for hospital fees.
"As I left the doctor’s office... large clots started pouring out," she recalls with a mix of fear and shame. "They were so big that my pad couldn’t hold them—they spilled onto the floor." People began to gather around her, and in that moment, her secret was exposed.
A stranger from the crowd offered to pay for a taxi to Mama Lucy Hospital. On the way there, Mercy passed out from blood loss. When she regained consciousness, she found herself in a hospital bed receiving post-abortion care. The pain had subsided, and relief washed over her—she was grateful to be alive. "I thought I was going to die," she said softly. "I’ll never forget the kindness of that stranger who got me to the hospital in time."
Though physically healed now, Mercy still battles emotional scars from that harrowing experience, including Post-Traumatic Stress Disorder (PTSD).
"I lost friends because... word spread very fast that I had procured an abortion," she reflects. "Parents even used me as an example of what not to do."
Crisis in numbers
Mercy's harrowing experience is far from isolated. An estimated 500,000 unsafe abortions are carried out in Kenya annually, with around 100,000 women requiring treatment for complications. According to a 2012 report by the African Population and Health Research Centre (APHRC), at least a quarter of these women succumb to complications.
"The real number is likely much higher," remarks Ritah Anindo Obonyo, Executive Director at Collective Voices Network (CVN).
"By the virtue of abortion being illegal in Kenya, the country does not have actual statistics on unsafe abortions. Our government does not track and keep a record of these numbers and this makes it even more difficult to tackle the issue of unsafe abortions."
CVN is a youth-led community-based organisation that inspires to scale up and mobilise more community action for sustained development with their main thematic areas being health (sexual reproductive health and rights and mental health), education and livelihood.
Ritah Anindo Obonyo is the executive director at Collective Voices Network. She says at least two foetuses are collected by the shores of Nairobi River every week.
“We are located in Korogocho slums, which boarders the Nairobi River and every week, at least two foetuses are collected by the shores of the river. This definitely shows that people in this area are constantly seeking abortion services from quacks and this is definitely not recorded,” Ritah defends her assumption.
The financial cost is staggering. A 2018 report by the Ministry of Health and APHRC revealed that Kenya spent Sh533 million that year treating complications from unsafe abortions in public hospitals. Nearly 75 per cent of all unsafe abortion-related admissions were handled in post-abortion care wards at public health facilities.
Legal ambiguity and its consequences
Kenya's legal framework surrounding abortion is restrictive and punitive. Under Article 26(4) of the Constitution, abortion is only allowed when a trained health professional determines that the life or health of the mother is at risk, or if emergency treatment is required. Despite these limited provisions, the Penal Code imposes harsh penalties, with Article 158 stipulating a 14-year jail term for offenders.
This legal ambiguity has created a climate of fear and misinformation. Many women are unaware of their rights, while healthcare providers remain hesitant to offer services, even in legally permissible cases. The result? Women seeking help from unqualified individuals in backstreet clinics, where unsanitary conditions and poor medical practices often lead to severe complications or death.
A doctor and his patient. As Kenya joins the rest of the world in marking International Safe Abortion Day on, the issue of unsafe abortion remains a grim reality for many Kenyan women.
Not everyone who seeks backstreet abortion services is as fortunate as Mercy. Joan Kwamboka's life came to a tragic end in 2015 after an unsafe abortion left her anaemic and with kidney failure at just 15 years old
Before her passing, Kwamboka shared her harrowing experience. Afraid to tell her mother about her pregnancy, she turned to a neighbour who introduced her to a "doctor" operating out of a chemist shop. "The procedure was carried out in the back room of a chemist shop, not a hospital," Kwamboka recalled.
"I lay on a dusty bed while the doctor inserted metal rods, telling me the pregnancy would end in a few hours."
But by the following day, she was in severe pain and bleeding profusely.
She was rushed to a local hospital in Kisii County, and eventually transferred to Kenyatta National Hospital in Nairobi, where she was diagnosed with anaemia and kidney failure caused by the procedure (it pricked her kidney). She was immediately put on dialysis but she did not make it.
In her final reflections, Kwamboka expressed deep regret, saying she wished she had known the actual cost of the Sh1,500 abortion. She worried for other girls who might follow the same dangerous path and called on the government to take more decisive action against those responsible for unsafe abortions.
Celine Owino's account is equally chilling. At 19, faced with an unwanted pregnancy, she fell into the hands of a quack doctor who exploited her vulnerability.
"I had no money, and I was desperate. I wasn't ready to birth and nurture a child then," she painfully recounts.
"The guy told me not to worry about the payment because he would do it if I agreed to get intimate with him. I was at my lowest and desperate to get rid of the pregnancy and I gave in. It was a very undignifying moment. I received no counselling or any other form of emotional support. I just had to pick up the pieces alone,” she says regretfully.
A community in crisis
The impact of unsafe abortions extends beyond individual tragedies. Ritah paints a grim picture of the situation in Korogocho slums.
"Every week, at least two foetuses are collected by the shores of the Nairobi River. This definitely shows that people in this area are constantly seeking abortion services from quacks, and this is definitely not recorded."
Even more disturbing is the apparent complicity of some local authorities in protecting quack abortion providers.
"There are known backstreet abortionists in Korogocho, but even when they’re arrested, they’re released shortly after. Not so long ago, my neighbour, a known backstreet abortionist was arrested after a girl she had ‘worked on’ almost died.
Ritah recounts a recent case where a known backstreet abortionist was briefly arrested after nearly killing a girl, only to be released days later. "It's disheartening," she admits.
Africa Director at the International Centre for Research on Women, Evelyne Opondo, during an interview at her office in Nairobi in 2021.
Despite these challenges, advocates for safe abortion access continue their work. Evelyne Opondo, Africa Director at the International Centre for Research on Women (ICRW), remembers a watershed moment in 2015.
"We filed a petition against the government after a 14-year-old girl was detained at Kenyatta National Hospital. She'd undergone an unsafe abortion after being raped, and her kidneys failed as a result. Unfortunately, she died before we could get justice for her."
*This case led to a 2019 High Court ruling in favour of Opondo's petition, marking a small but significant step forward. However, progress remains slow, and the debate around abortion continues to be deeply contentious, particularly among religious communities.
A pastor's perspective
Pastor Johnson Bukachi offers a nuanced view on the subject.
"It is wrong to illegalise abortion," he says. "There are genuine reasons that warrant the procedure, but even then, it should only happen in hospitals."
Acknowledging the rising number of deaths due to unsafe abortions, especially in rural areas, Bukachi believes education is critical.
"We need to raise awareness in villages, schools, and churches about the dangers of unsafe abortion," he explains.
"As a pastor, I believe that if a pregnancy is discovered, the community should support the mother. If complications arise, the issue should be resolved in a hospital, not by some quack in the village."
However, advocating for safe abortion access as a religious leader comes with its challenges. "It's not easy," he admits. "There's a lot of stigma around talking about abortion, especially in churches. People are often judgmental, and it's difficult to convince them that safety should be the priority."
Breaking the stigma
Unintended pregnancies continue to rise in Kenya, from 34 per cent in 2014 to 41.9 per cent in 2020. While unsafe abortions claim an estimated 2,600 lives each year — seven deaths daily — the stigma persists, driving many women and girls to risk their lives to avoid public shame.
Organisations like the Kenya Communications Hub (KCH) have launched campaigns like #7toomany to raise awareness about the dangers of unsafe abortion.
"Our goal is to reduce the number of women dying from unsafe abortions each day," says Mumbi Kanyogo, Lead Consultant at Well-Made Strategy, a partner in the campaign.
Mumbi explains that the campaign aims to debunk myths around abortion, particularly the idea that only promiscuous women seek abortions.
"This stigma is pervasive, but it's completely untrue. Women from all walks of life — educated and uneducated, married and single, rural and urban — seek abortions for a variety of reasons."
The campaign also seeks to dispel the misconception that abortion leads to long-term infertility.
"Unsafe abortions can have serious consequences, but safe, legal abortions are healthcare procedures that, in most cases, pose minimal risk to a woman's reproductive health," she asserts.
Steps toward progress
In February 2019, the Ministry of Health approved post-abortion care (PAC) guidelines, marking a critical step toward addressing the high rates of complications resulting from unsafe abortions. The guidelines provide a pocket reference for healthcare providers, equipping them with the necessary knowledge and skills to prevent post-abortion deaths.
However, the guide's impact remains limited by the overarching legal restrictions surrounding abortion. While it provides essential information for managing complications, it does not address the root cause of the issue—the criminalisation of abortion itself. For healthcare providers, the fear of prosecution often outweighs their willingness to offer PAC services, leaving many women to fend for themselves.
A call for change
As we mark this day, the stories of Mercy, Joan, and Celine serve as stark reminders of the human cost of unsafe abortions. Their experiences underscore the urgent need for comprehensive reform—not just in laws and healthcare systems, but in societal attitudes and support structures.
The fight for reproductive rights in Kenya is far from over, but with sustained efforts from organisations, religious leaders, and the healthcare sector, real change is possible. By replacing stigma with understanding and providing women with the resources they need, Kenya can move toward a safer, healthier future for all.
In the words of Pastor Bukachi, "We need to reach out to people in the villages. Too many lives are being lost daily."
