A case of failed abortions, what if it was legalized?
“I was with my boyfriend for a month when I found out I was pregnant. I was only 16 and I wasn’t ready to have a baby then, I just had a voice tell me “Take a test.” When I took the test I came up positive, when I told my boyfriend he told me he was not responsible and asked me to look for the man responsible,”
“I was in Senior three then, I could not tell my parents, I thought about committing suicide, then abortion, then chose the latter to abort in order to continue with my studies,” said Ms Amina Nakayenze as she constantly would be taken up deep thoughts, tears would roll then she would recover then shortly keep quiet for some time before resuming to narrate.
She told Daily Monitor that she chose to have an abortion locally.
“I then moved to a traditional birth attendant to see advice and she gave me a mixture of herbs in a mug to take at about 7.00pm, she urged me to take a mug of this mixture of very many things I did not understand and I took,” said Ms Nakayenze.
Ms Nakayenze, now a banker said after about six hours deep in the night, she started feeling abdominal pain, then a very sharp pain.
“Nothing came out, I bent on the floor as if to ease myself, I was heavy, the bleeding eventually started, for the moment I remained alone but then later I called my mother when the pain intensified,” said Ms Nakayenze.
“And when my mother walked in, she found me in a pool of blood and without speaking a word, she called our neighbours who put me on a local stretcher and took me to the Bududa district referral hospital,” She added.
She said she lay unconscious in bed and that when she woke up, it was difficult to know what exactly had happened.
“I was treated for a ruptured uterus, spleen and some stomach complications. My body has healed, but my psychological scars will take longer to mend. And I am constantly struggling with depression, I can’t imagine dealing with such intense emotions whenever I recall what I went through as a teenager,” said Ms Nakayenze.
She revealed that after treatment the doctor then pronounced before her mother that she might never have a baby because the uterus was ruptured then my mother turned to me and said “It is up to you, I have played my part as a parent”
“My question is can I still get pregnant this was about eight years ago. Now I am at the point of my life were I am settled in my home with my husband we have really good jobs and my husband wants a baby, I also feel I want a baby but I can’t get pregnant gain because my uterus was ruptured,” said Ms Nakayenze
Ms Nakayenze’s case however is just amongst the many cases of many abortions done in rural areas by quacks and wrongly by medical workers not supposed to perform abortions in clinics.
Prof Dr Seggane Musisi Department of Psychiatry school of medicine at Makerere says every year about one million teenagers get pregnant and 40% of these abort because they did not plan to have the children.
He revealed that although this is the number which is recorded in the health facilities, there are many cases that undergo abortions and have died in the villages silently because they fear to be stigmatized and victimized by the colonial law that condemns abortion.
“Moral condemnation and intimidation makes taking a decision to abort very difficult for a woman. And unsafe abortions are very much linked to laws prohibiting abortion in Uganda,” said Prof Musisi.
He revealed that Ms Nakayenze was a victim of quack methods of chemicals prepared by TBA [Nanda] which very many girls have fallen prey to because the qualified medical workers shying away from doing for fear of being arrested.
Prof Musisi said many young girls are suffering sepsis Gangrene, pyometia, pelvic inflammatory diseases, infertility, obstetric fistula, embolism, ectopic pregnancy, incomplete cervix and incomplete removal of products just because government has failed to legalise abortion to be performed in hospitals by qualified medical workers.
Dr Charles Kiggundu, a consultant Gynecologist/Obstetrician at Makerere University medical school said it has been observed in Uganda that six women suffer severe morbidities- anaemia, infertility, pelvic pain and obstetric fistulas that lead to ill health caused partly by deliveries and unsafe abortions carried out in rural areas.
“Unplanned pregnancy is the root cause of most abortions. Preventing unintended pregnancy, and thereby the abortions that often follow, would eliminate nearly all injury and death resulting from unsafe abortion,” said Dr Kiggundu.
Dr Kiggundu said recent studies have shown that the cost to the healthcare system of treating complications from unsafe abortion is US$130 per patient.
He revealed that Maternal Mortality Rates in Uganda have moved down from 506 to 438/100,000 live births, abortion has become the silent killer of Ugandan mothers that has moved from 20% in 2001 to about 31% in 2012/2013 pausing a great obstacle to achieve of MDGs two by 2015 that stands at 143/100,000 live births.
“One thing government should know is that post abortion care is estimated to cost nearly $14 million annually in Uganda. And two-thirds of this amount, or US$9.5 million, is spent on non medical costs (overhead and infrastructure), and the remaining third (US$4.4 million) is spent on drugs, supplies, labor, hospitalization and outpatient fees, which far expensive than procuring an abortion itself. The question here is why doesn’t government legalise abortion to save mothers and save money budgeted for and spent every year on post abortion complications treatment,” said Dr Kiggundu.
He said most costs of post abortion care arise from treating incomplete abortion and a significant proportion is spent treating more serious complications, such as sepsis, shock, lacerations and perforations and yet an abortion would cost about Shs 200,000 or even less $80.
The abortion law and policy in Uganda
The executive director of Center for Human Rights and Development [CEHURD] Mr Moses Mulumba said the Ugandan law allows abortion under some circumstances, but laws and policies on abortion are unclear and are often interpreted inconsistently, making it difficult for women and the medical community to understand what is legally permitted.
“The Ugandan Constitution states in article 22 on protection of life that no person has the right tp terminate the life of an unborn child except as maybe authorized by law, this means that abortion is permitted if the procedure is authorized by law, but many of the medical workers cant perform abortions because of failure to interpret the law,” said Mr Mulumba.
He revealed that under the 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights, pregnancy termination is permissible in cases of fetal anomaly, rape and incest, or if the woman has HIV.
He said because the interpretations of the law are ambiguous, medical providers may be reluctant to perform an abortion for any reason for fear of legal consequences. Ends