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Black Market Abortions: The Bare Facts

The death of Kenyan activist Caroline Mwatha sent shock waves across the continent for several reasons. She initially went missing, and it was suspected that she had been abducted in a case of foul play related to her advocacy work. Her body was however found 1 week to the day of the date she went missing in the Nairobi City Mortuary. The lifeless body had been booked into the mortuary under an alias by an unknown person in the early hours, the day after she went missing. The report released by Kenya’s National Police Service investigation stated that she had lost her life whilst undergoing an abortion, and the doctor responsible for the procedure which is illegal in Kenya, had made the arrangements to discard her corpse. The post mortem reveals her cause of death as excessive bleeding from a ruptured uterus.

Only four African countries — Cape Verde, South Africa, Mozambique, and Tunisia — permit elective abortions, while Zambia allows them for health and socioeconomic reasons, the Guttmacher Institute explains on its website. In every other African country, voluntary abortion not associated with saving the life of the mother is a criminal offence. Statistics show that the illegality of the procedure is doing nothing to curb women from finding ways to get it done. For example, it is estimated that 456 000 abortions are performed in Nigeria per year. In Kenya 7 women die per day from unsafe abortion related complications, and 320 are hospitalized per day for the same cause according to Marie Stopes.

We all secretly know someone, or have heard of someone who wanted to terminate a pregnancy, and it is increasingly shocking how the lack of legitimate options means women feel forced to turn a blind eye to the discernment normally used when trying to get medical assistance. Women are asking friends for their recommendations, which normally lead to a number of different places depending on one’s financial situation.

At the highest tier, many women know doctors who will sell pills to induce a miscarriage, and do so off the record. The risk factor behind this: so many are falling into the hands of individuals who have probably never completed their medical studies anywhere reputable, nor would they know where to begin if anything were to go wrong. The most common drug used is called Misoprostol, which is safe if administered by a trained physician with the requisite follow up checks. But lets be honest, this is the black market – you’re given a drug, and discretely instructed about how to use it and what is likely to happen when you get home. They will probably leave out the part about profuse bleeding and excruciating stomach pain, which will often require the intervention of a trained medical personnel to be safely managed. Yet women are still being referred to these doctors, and even looking for ways to cut the doctor out of the process. Google reports that the highest searches for Misoprostol in Africa occur in Ghana and Nigeria.

Gaining access to abortion pills is still not a feasible option for many, with a large percentage of women turning to local concoctions of herbs, powders and even dry gin (yes, the alcohol) to end pregnancies. You still hear reports about girls inserting coat hangers into themselves, and those who think that having someone stand on their stomach may terminate the pregnancy!

So where do we go from here? Caroline Mwatha died whilst trying to terminate a 5 month pregnancy. While it is medically possible, it is obviously a procedure that has to take place under the requisite medical conditions. In the process of her uterus being ruptured, the foetus was also destroyed - found with a missing hand and a damged skull. Reports say that the New Njiru Community Centre where she died is not registered with Kenya Medical Practitioners and Dentist Board, nor are any of the practitioners who are alleged to have performed the procedure after a price negotiation. Caroline's family continue to raise their suspicions about the entire police report as they conduct their own investigations. However, this story is all too familiar in Africa, and not just where black market abortions are concerned. Caroline was married, and her husband was living in Dubai. She allegedly fell pregnant as a result of an extra-marital affair, which her husband vehemently denies to be plausible. These facts will not help her case before the morality court, but the sad reality is that she is one of many who will elect to choose death as a necessary possible outcome.

Most of Africa stands against abortion from a cultural, moral and religious stand point – but how many more lives of young women are going to be sacrificed for our righteousness? Even if abortion is not to be condoned or encouraged, surely there are ways to save these lives? Until then, it is up to us to be vocal about the real consequences of underground procedures and the very urgent commitment we need to make to our bodies to avoid unwanted pregnancies (where they can be avoided).

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