Abortion: The alternative contraceptive among youth in Uganda?

Doctors performs checks on a pregnant girl who wants to undertake abortion at a clinic
Doctors performs checks on a pregnant girl who wants to undertake abortion - Courtesy Photo.

Kampala, Uganda | By Michael Wandati | Most of the other girls at the hostel have done it, and at least once. Some have aborted pregnancies a couple of times.

They urged 20-year old Nancy Babirye (pseudonym), a second year Mass Communication student at a renowned public University in Uganda on; why keep the baby and risk facing the wrath of strict Catholic parents; the shame of having sex out of wedlock; and a child to stress and inconvenience her when she was not ready.

“Deciding to abort and finding a doctor to do so, was easy part of the whole idea,what nobody told me was that my abortion would not follow the usual script,” sighs Babirye as she narrates her ordeal to this writer.

Young girls who go to enquire about abortion in cheap medical facilities or unlicensed clinics with untrained doctors, are only given options available for extracting the foetus, and are never told about physical, emotional and spiritual consequences of abortion.

If what Babirye had seen happen with her friends was the standard, she would go to the clinic, have her womb cleaned out, and a few days later, the girls would spruce up and leave for another night of wild abandon.

There would be alcohol, maybe some unprotected sex, followed by the morning-after pill, and if by any chance anyone got pregnant, there would be an abortion to take care of that inconvenience.

Babirye was doomed, things did not turn out usual as in her usual outing sprees — she got pregnant at one of the girls night-out when drunk. She never expected this would happen.

“I was not planning to be a mother when I was still studying, you know how hard it is to balance school and family responsibilities,” lamented Babirye who swears that her pregnancy was unintended.

Her prospects were high; Babirye believed that she would have a fantastic night partying with friends,together with the boyfriend who happens to be a final year Law student at the same university, and later in the wee hours, return at the hostel safe as it was the routine of her previous nights.

Wretched this time round, Babirye’s chronicle was utterly disappointing and different. Health-wise she never returned home the same way she left.

Babirye risked unprotected sex — her boyfriend was not willing to use condoms, while herself beloved using contraceptives at her age and over a long period, would render her infertile.

What these two couples never realised was that prevention is better than cure. Babirye on her side, she was not only at the risk of getting pregnant, but also contracting deadly Sexually Transmitted Diseases (STDs) like Chlamydia, Genital herpes, Syphilis, Gonorrhoea and catastrophically chances of contracting HIV/AIDS were high. Babirye was gambling with her precious life.

After two months of continued binge drinking and chain-smoking in her habitual daily night-out carousing, Babirye’s health deteriorated immensely, showing signs and symptoms of sickness.

She immediately developed a routine to skive out of class lectures — for fear that other colleagues at the college would notice her sudden change. Her plight worsened the moment she was advised by her room-mates to seek medical help.

At the clinic, doctors carried out several tests on her. Babirye was diagnosed with Tuberculosis (TB), and her pregnancy results came out positive. On confirming that she was pregnant and had contracted TB at the same time, Babirye got confused and depressed wondering what she would do at that moment.

Her friends in support of her boyfriend who assisted young Babirye with financial expenses,advised her to undertake an abortion. It was not easy for Babirye to make an instant decision, in her conscious she knew very well the fatal consequences that could happen following the inhuman act she was about to commit.

Being Babirye’s first abortion, things did not turn out as planned. At the clinic, her womb was scanned and she was told to swallow pills that would induce her abortion.

Babirye was then advised to go home and wait for the two-months-old pregnancy to be expelled in form of her menses. At first she was contended on receiving such news from the doctors. Babirye knew that her incontinence (pregnancy) was there no more.

She bled for a couple of days. The pills did not work and Babirye was still pregnant. Her hopes to have the pregnancy terminated declined — she got stressed and confused about what to do next.

Another dose was given to her, which also did no work. But Babirye was determined to have an abortion carried out on her.

Four months later (about six months along), she was still pregnant and decided to see a different doctor who gave her more pills and an injection assuring her that it would not fail. This time, just like the first attempt, the medication was supposed to cut up the foetus so that it would come out as blood.

Surprisingly, what Babirye saw in the lodging that she had reserved with her boyfriend as they waited for the termination, are remains that are permanently etched in her mind.

“At around midnight, I had an excruciating pain. Recalling what the doctor said that the foetus would come out as blood, instead of bleeding out a cut up foetus, I gave birth to a green baby (premature baby). As I held the foetus, it started crying. Fearing that the room attendant would hear the cries, I threw it on the bed trembling. Together with my boyfriend, we smothered the foetus with a pillow and sat on it,” Babirye narrates her horrific ordeal in tears.

She, together with her boyfriend then put the foetus in a plastic bag, and threw it in a dustbin on their way out from the lodging they had booked. “It all happened too fast for me; I am not sure whether I felt relief or dismay after having killed the already mature baby. I wish I had not done it, I have never been ashamed and guilty in my life,” Babirye regrets her illegal and inhuman act that would land her together with the boyfriend in prison if they were discovered.

Babirye regrets that facing her parents would have been easier than the sight of the green foetus, a memory that she can never forget. Now she is tortured by the incident and is on TB drugs.“Even alcohol is not enough to numb the pain I feel,” says Babirye who is always binge-drinking in trying to erase the incident in her memory, though she has never regained her peace of mind since the abortion.

Babirye is not alone in this regretful dilemma. The manner at which abortions are carried out by young school going girls in Uganda may differ, but the motive or rather the action is certainly the same.

Young girls of Babirye’s age (reproductive health) have resulted to unsafe abortion as an ‘alternative saviour’ to their deliberated future. These girls consider pregnancy as a burden of doom — they would do anything at their disposal to terminate what they term as an inconvenience to their future.

Though carrying out an abortion in their situation may be perceived to be right by some of these desperate young girls, no woman who decided against abortion have lived to regret her decision.

Uganda’s Ministry of Health 2016 statistics indicate that 343 per 100,000 girls and women who go to give birth die in the process. 26 percent of these are due to unsafe abortion.

According to Dr. Charles Kiggundu, a Consultant Obstetrician Gynaecologist at Mulago National Referral Hospital, 10,000 abortions are handled every year at the hospital where women and girls who have terminated pregnancies are assessed and treated.

Although Uganda’s law permits induced abortion only to save a woman’s life, many women and girls obtain abortions often under unhygienic conditions. According to the Centre for Health, Human Rights and Development, a Kampala-based research and advocacy organization, each day an estimated 840 girls and women have an abortion in Uganda and on average five die as a result. Annually, unsafe abortion leads to more than 1,500 deaths.

The Ugandan constitution states, “No person has the right to terminate the life of an unborn child except as may be authorised by law,” without elaborating on what the law may be.

A section of the Penal Code Act says abortion is permitted in order to save a woman’s life, but another section says clients who haveabortions, and healthcare providers who perform them, are at risk of up to 14 years in prison. This is a clear indicator that the Ugandan law on abortion is confusing and ambiguous.

The annual number of induced abortions in Africa rose between 2003 and 2008 from 5.6 million to 6.4 million. In 2008, the most abortions occurred in Eastern Africa (2.8 million), followed by Western Africa (1.8 million), and Northern and Middle Africa at (0.9 million)

The increase in number of abortions is due largely to increase in the number of women of reproductive age. Surveys of knowledgeable health professionals suggest that in Uganda, 23 percent of women and girls seeking abortions, go to traditional practitioners any of whom unsafe techniques, and 56 percent go to doctors or nurses, who generally provide ‘safe’ services.

However, since abortion is legally restricted, in most cases even skilled providers must work in clandestine environments, which often compromises the safety of the procedures they perform and frequently leads them to charge a high premium for their services.

The illegal status of abortion has not deterred young girls from choosing it. Even though some fear the risks associated with the procedure; whether safe of backstreet, cheap or expensive, they are willing to take a chance in this noxious act.

Poor and rural girls and women whose access to skilled providers is limited by financial constraints and geographic distance, often result to abortions performed by untrained providers using unsafe methods or attempt to self-induce an abortion.

Some of them try to induce abortion themselves using highly dangerous methods, while others purchase abortion-inducing drugs from pharmacists or other vendors. Some reportedly drink gasoline or take untested combinations of herbs and drugsto induce an abortion.

Others have reportedly inserted sticks into their vaginas without considering the fatal side effects of such risky attempts to terminate pregnancy. Abortion is an issue that affects all societal kinds of girls and women and from all social classes; students who are not ready to have children, married women who had affairs and got pregnant, rape victims and the list goes on depending on the desperate situation called for by the intended victim of this atrocious act of abortion.

Possible side effects of abortion

Physical complications after abortion may not develop at once but in a long run, it may be the reason for frequent miscarriages, cervical incompetence and other abnormalities that develop slowly in women who once carried out an abortion.

This is so as a result of an infection, excessive bleeding, tubal blockage and other complications that resulted in the process of an abortion.

The effects may be severe especially if carried out late in the pregnancy;

  • Heavy or persistent bleeding that soaks more than two pads an hour for more than two hours.
  • Infection or sepsis
  • Damage to cervix leading to future miscarriages.
  • Scarring of the uterine lining
  • Damage to other organs
  • Not only do these women bear physical side effects but they also suffer many emotional or psychological side effects. Among these are; depression, long-term grief reactions, anger, sexual dysfunction, guilt, flashbacks, memory repression, suicidal ideas, and difficulty keeping close relationships.
  • Death.

The alarming rate at which young girls and women in Uganda carry out abortions without fear that they may die in the process, and despite laws enacted to curb abortion; is a matter of disgrace and disrespect to human life. It needs God’s intervention to save Uganda from the escalating abortion cases.