Hazardous Abortions in Uganda: Systemic Flaws Costing Thousands of Lives
The 85,000 women in Uganda who annually experience severe or fatal health complications from poorly performed abortions(Singh:2006), prove that regardless of the political or religious boundaries surrounding unplanned and unwanted pregnancy, women all over the country continue to find themselves in the dangerous and desperate position of seeking professional and often nonprofessional medical aid in pursuing an operation that is banned and punished in their society. However, the danger of unsafe abortions or post-abortion mistreatment does not simply stem from the illegality of this practice in Uganda, or its conflicting ethical relationship with religious practices within the country. Rather, the consequences of this operation primarily arise from systemic issues. Namely, the lack of implementation of medical policies and legislation for post-abortion care and the lack of proper medical resources available, particularly to the rural poor, who are the most vulnerable to unsafe abortions and who currently make up for 86% of Uganda’s population(Singh:2006).
According to the Guttmacher Institute, doctors perform close to one-fifth of illegal abortions in Uganda, while nurses, clinical officers, and traditional healers make up for similar numbers. The rest of these abortions are induced by the women themselves through methods such as: orally digesting laundry detergent, gasoline or bleach, sodium chloride, vaginally inserting a catheter, or objects such as sticks, cassava, clothes hangers, metal, or reed, among various other methods(Singh:2006). The consequences of poorly executed abortions include but are not limited to: mortality, excessive bleeding, incapacitation, infection and injury to reproductive organs, and chronic pelvic inflammatory disease. It should come to no surprise that women revert to induced or homemade means, when practicing abortion is kept incredibly secret out of fear of consequences like imprisonment. Women are often too afraid to approach a doctor or trained professional that they do not know, because they face the possibility of jail if their doctor disapproves and exposes them, “She finds it easer to approach the traditional provider than to approach a modern provider,” Says a middle aged urban woman to the Community Abortion morbidity Study, “The traditional provider may be welcoming. . . If you go to a modern provider, even if you have [brought] money, first they neglect you and then abuse you. . .” Turning to untrained caretakers is a direct result of fear of health facilities and lack of financial means to hire a doctor, this is why the implementation of accessible health policies for women who suffer from post-abortion complications are essential.
There is a thin line between critiquing the illegality of abortions in Uganda, and advocating for adequate health facilities and policies to care for women who face health complications from induced or poorly performed abortions. However, interviews with Ugandan women conducted by Guttmacher have shown that local women fully understand the health risks connected to induced abortions, which makes the thousands, if not millions when considering those that go undocumented, of women annually having this operation that much more alarming. These numbers suggest that the desperation women feel to avoid having a child is justified enough for them to knowingly risk their lives to avoid having a child. It is essential to analyze this issue not only through a political or legal lens, but through a gendered lens when giving a closer look to contraceptive use among women in Uganda.
Guttmacher conducted a separate study where they interviewed Ugandan women both in rural and urban areas regarding contraceptive use. According to their research, 14% of the women claimed that their significant others refused to use contraception, while 13% said they had no knowledge as to where they could access contraception. This suggests that education and access to information on women’s sexual health and reproductive cycles is a factor to the the four in 10 pregnancies in Uganda that are unplanned(Singh:2006). Additionally, gender inequality is undoubtedly another underlying factor to unwanted pregnancy. Domestic violence and sexual abuse are among the most problematic household dynamics that result in severe lack of power a woman has over her own body.
Research shows that a woman will pursue an abortion regardless of its legal status and its threat to her life. Research shows that these operations are done in desperate contexts of poverty, domestic issues, or gaps of sexual health education. This is not necessarily a matter of freedom of choice, this is a matter of a country taking responsibility for the livelihoods of its citizens.
Hannah Gerber, WOUGNET
Student, McGill University