Advocates of safe abortion have urged government to amend laws on abortion and thus reduce the number of abortion-related deaths in Uganda.
The call was made by Suzan Baluka (in featured photo) from Human Rights Awareness and Promotion Forum (HRAPF) during the presentation of a national research report on Induced Abortion and Post Abortion Care Among Adolescents in Uganda at Hotel Africana today.
In her submission of research findings on “Enforcement of Criminal Abortion Laws in Uganda”, Baluka noted that even with restrictive laws in place, abortions still take place. She explained that restrictive laws often make abortion procedures clandestine and often unsafe.
“Abortion laws are being implemented across the country but the number of arrests are very low compared to the estimated number of abortions carried out in Uganda every year. Existing laws and policies on abortion are interpreted inconsistently by law enforcement and the judicial system, which makes it difficult for women and the medical community to understand when abortion is permitted and because of this ambiguity, medical providers are often reluctant to perform an abortion for any reason, out of fear of legal consequences,” Baluka said.
A 2010 report by the Ministry of Health estimated that 8% of maternal deaths were due to unsafe abortion.
Baluka explained that there is need to clarify Uganda’s abortion law and policies, and raise awareness of the content and scope of Uganda’s abortion law among the medical community, the judicial system and women.
Dr. Dinah Nakiganda, the Assistant Commissioner Reproductive Health Ministry of Health noted that the policy framework doesn’t allow clinical officers to carryout abortions because they risk having their certificates cancelled.
According to a research by U.S based Guttmacher Institute and Makerere University, at least 57,000 abortions took place among Ugandan adolescents in 2013. The researchers also found that adolescents seeking post abortion care for complications resulting from an unsafe abortion or miscarriage did not face greater disadvantages in their abortion care experiences, compared with women older than 20. However, among those seeking post abortion care, unmarried women, including unmarried adolescents, were more likely than married women to experience severe complications.
Although Ugandan law allows abortion to save a woman’s life and national guidelines permit abortion under additional circumstances—including in cases of fetal anomaly, rape and incest, and if the woman is HIV-positive, safe and legal abortion is difficult to obtain. As a result, many women resort to unsafe abortion, which accounts for more than 10% of all maternal deaths in Uganda. An estimated 314,300 abortions occurred in Uganda in 2013 among all age-groups, and more than 93,000 women were hospitalized for complications from unsafe abortion.
“These findings challenge the perception that adolescents as a group fare worse than older populations when it comes to abortion-related care,” says Elizabeth Sully, senior research scientist at the Guttmacher Institute and the study’s lead author. “Still, sexual and reproductive health services tailored to adolescents’ unique needs remain vital.”
As of 2013, the adolescent abortion rate was lower than that among all women of reproductive age (28 per 1,000 women aged 15–19 vs. 39 per 1,000 women aged 15–49). Among women who were recently sexually active, however, adolescents had the highest abortion rate (76 vs. 56, respectively). Adolescents are less likely to be sexually active than older women, but they often face more barriers to obtaining high-quality contraceptive services.
“We need to better understand how marital status and other social factors influence adolescents’ sexual and reproductive health experiences,” says Lynn Atuyambe, a researcher at Makerere University and one of the study’s authors.