Married women top abortions in Kenya - Report

An illustration of a pregnant woman with a bottle placed on the table/AI

Abortion rates have doubled in the last ten years, driven by easy access to abortion pills, which can be taken at the comfort of your home, a survey by the Ministry of Health and its partners suggests.

It shows most women presenting with post-abortion complications nowadays are married.

Additionally, 65 per cent of them have given birth before, some several times, challenging the notion of abortion being a preserve of carefree, unmarried girls.

The survey estimated that 792,694 induced abortions occurred in Kenya in 2023, a staggering increase from approximately 464,690 in 2012.

Although they are officially restricted, abortion pills such as misoprostol and mifepristone are easily available from some chemists in towns.

They cause the pregnancy to pass from the uterus like a heavy period or miscarriage anytime between one to four hours.

The study was conducted by the Nairobi-based African Population and Health Research Centre (APHRC) with the blessings of the MoH.

It was funded by the Guttmacher Institute, a US-based nonprofit that supports access to safe and legal abortion.

The report titled ‘Incidence of Induced Abortions and the Severity of Abortion-related Complications in Kenya’  was launched  by APHRC and Guttmacher in Nairobi on Friday.

“This high number of abortions signals an urgent public health concern and underscores persistent gaps in family planning access and sexual health education,” said Kenneth Juma, an epidemiologist with APHRC, specialising in abortion-related matters.

Kenya’s 792,694 induced abortions translate to 57.3 abortions for every 1,000 women aged 15 to 49 – one of the highest rates recorded in Africa – and 48.1 abortions for every 100 live births.

The national study was conducted between April 2023 and May 2024, where data collectors visited health facilities and interviewed women who had undergone abortions.

Director general for Health, Patrick Amoth, who did not attend the launch, said unsafe abortion remains a public health challenge.

No senior Afya House official attended the meeting, including the host Dr Edward Serem, head of the Maternal and Reproductive Health Division at the Health ministry, who had sent out the invitations.

Dr Amoth said the government has invested in multiple interventions to prevent unsafe abortions.

“The report provides a compelling rationale that expanding access to modern and effective family planning and contraception services is essential to preventing unintended pregnancy and unsafe abortion,” he said in a foreword to the report.

He added: “The report also calls for the full implementation of the existing policies, clinical standards and guidelines for post-abortion care.”

In Kenya, abortion is legally permitted only under limited circumstances, such as when the mother’s life is in danger. However, the study indicates that restrictive laws have done little to curb abortion rates.

“Worldwide evidence shows that liberal abortion laws do not make abortion more common. The results of this study strengthen this argument and suggest that restrictive abortion laws do not regulate the occurrence of induced abortions; they only make abortions less safe,” the report states.

Most abortions in Kenya are now induced using pills. The study found that 61.8 per cent of women used medication abortion (typically misoprostol alone, or with mifepristone), while 26.7 per cent relied on traditional methods such as herbs or massage. 

Known harmful methods, like inserting sharp objects or ingesting toxic substances, were reported at 7.8 per cent.

Researchers cautioned that even safe methods like pills can lead to complications if misused. 

“Many women seek medical confirmation or care for mild symptoms not necessarily needing clinical intervention, driving up postabortion care demand,” the report notes.

The report revealed striking regional disparities. Nairobi and Central regions have the highest abortion rate at 78.3 per 1,000 women, followed by Nyanza and Western at 69.4. 

These regions also recorded the highest unintended pregnancy rates, indicating a strong link between poor contraception access and abortion prevalence.

In contrast, Coast and Northeastern had the lowest rates, possibly due to different cultural, socioeconomic, or access-related factors.

The authors urge a multipronged approach: improve access to modern contraception, strengthen postabortion care services and address stigma and structural barriers that prevent women from accessing reproductive health care.

Notably, six out of every ten women who had an abortion were not using any form of contraception at the time. The most cited reason for non-use was fear of side effects.

Further, nearly one in three women who sought postabortion care had experienced intimate partner violence in the six months before their abortion. 

More than half of the women with complications (50.6%) were treated at public health facilities and 69.3% were managed in lower-level primary facilities. Most cases (53.7%) were classified as having mild complications, while 16.4% were potentially life-threatening.

The study offers a silver lining: the severity of abortion-related complications has declined significantly over the past decade. In 2023, only 1.4 per cent of women who received postabortion care experienced severe maternal outcomes — a drop from 37 per cent in 2012.

“One possible explanation for this finding is that access to postabortion care services in Kenya has increased over the past decade, resulting in more women with less severe complications who are able to present at a health facility for post-abortion care,” the study noted.

Despite rising demand, most health facilities are still not fully equipped to offer quality postabortion care. Only 18.3 per cent of primary-level facilities (such as dispensaries) met criteria for basic care. Just 24.1 per cent of referral hospitals could provide comprehensive care, which includes surgical interventions and long-acting contraceptives.

“The main limiting factors were lack of surgical capacity and inadequate contraceptive options,” researchers found.