Kenyan health professionals push for safe abortions

When police officers arrested Dr John Nyamu on allegations of performing abortions illegally, they could hardly have predicted the series of events that would follow and put Kenya to task over an issue often talked about in hushed tones.

When police officers arrested Dr John Nyamu on allegations of performing abortions illegally, they could hardly have predicted the series of events that would follow and put Kenya to task over an issue often talked about in hushed tones.

But May 27th 2003 will forever remain etched in many people’s minds as the day the fazed divide between physicians and policymakers over the procedure was questioned, leading to a new law that put expert, mother and child on the same plain.

A lengthy stretch after Dr Nyamu’s charges for murder and his eventual acquittal, the nation sobered up for the dialogue which led to the flexible legislation that recognizes the medic’s role in performing an abortion today.

Although religious hardliners still rally for the law to be repealed, and abortion to be banned, Article 26(4) of the new constitution explicitly permits abortion when “in the opinion of a trained health professional, there is need for emergency treatment, or the life or health of the mother is in danger, or if permitted by any other written law”.

It further states that a ‘trained health professional’ should be interpreted to include doctors, clinical officers, nurses and midwives who have the appropriate training.

Observers say the new legislation eased the suspicion with which the subject of abortion was regarded, but if previous trends are anything to go by, dissenting undertones still continue to flare tensions about the procedure.

Perhaps, it is from such a backdrop that physicians have seen the wisdom in carrying out new research and developing guidelines about abortion, activities that appear to have won the support of the Kenya Obstetrical and Gynaecological Society (KOGS).

For the last four years KOGS, Kenya Medical Association (KMA), National Nursing Association of Kenya (NNAK), the Federation of Woman Lawyers (FIDA), and more, have been working on guidelines that protect safe termination of pregnancy.

Dr Boaz Otieno Nyunya, KOGS Chairman, said: “The safe abortion standards and guidelines have been adopted by the division of reproductive health. They will be used as a reference document and developed to become a training manual.”

The guidelines, he says, will for instance specify under what circumstances and stage in terms of months of gestation an abortion should be carried out.

Dr Nyunya said: “This will differentiate between an abortion and a premature delivery.”

They will also recognize whether abortion should be carried out by a trained healthcare provider, a gynaecologist, a medical officer, a clinical officer, or a nurse.

He added: “Those authorized to carry out the procedure will have to be trained in terms of competence, knowledge, skills and attitude. In cases where a patient is being handled by someone not authorized the guidelines require them to refer the patient to a qualified physician.”

This move, which aims to give the profession a fresh lease, does not stop here. Researchers have united to conduct studies on some of the modern technologies useful for safe abortion.

Under the Reproductive Health and Rights Alliance (RHRA), physicians are certain that technologies such as mysoprostal, or what is described as medication abortion, will soon gain acceptance in Kenya.

In a paper presented during February’s KOGS Annual Scientific Conference, mysoprostal was described as a chemical that causes the genital tract to soften when applied, hence the contracting of the uterus.

According to Professor Joseph Karanja a researcher at the University of Nairobi and one of the authors, mysoprostal is used as a pregnancy management drug and is registered as a reproductive health drug in Kenya.

Professor Karanja said: “It is available, safe and can even be used for preventing postpartum haemorrhage after delivery.”

The silver lining, however, should not obscure the cloud. The Kenya Catholic
Doctors Association (KCDA) argues there is no such thing as ‘safe’ abortion.

Dr Stephen K Karanja, KCDA chairman, said: “It does not matter what method is used but the psychological damage and effects on the mother lingers forever for every woman whose baby is lost through abortion.”

According to Dr Karanja, research in Kenya has shown that more than 80% of all the unsafe abortions are committed by trained doctors due to the lure of money.

The medic, who is also a consultant obstetrician and gynaecologist practicing at Upper Hill Medical Center, says Kenyan society condones the practice by allowing doctors to act as activists rather than for the welfare of the poor.

Dr Karanja said: “This country has a bigger responsibility to focus on the real health issues of mothers and children which is delivery of quality care.

“But asking to be allowed to kill babies for the greed of money is not only a sin but it is criminal.”

The hands of a doctor are healing hands, not killing hands, he says.


  • comment-avatar
    Jane Godia 6 years

    A good story. Captures the essence of the topic.

  • comment-avatar
    Carol 6 years

    Well done
    Good article and accurate with facts as they occurred at the conference.