Unsafe Abortions, A silent Crisis among Adolescent Girls in Kenya

In the dusty lanes of informal settlements and the quiet rural clinics tucked away from the public eye, a silent crisis brews, one that claims the lives, dreams and futures of adolescent girls across Kenya. Unsafe abortion continues to be a leading cause of maternal morbidity and mortality, particularly among teenage girls who often find themselves trapped between stigma, lack of information and inaccessible reproductive health services.

According to the Ministry of Health, nearly half of the estimated 465000 abortions in Kenya annually are unsafe and adolescent girls account for a significant proportion of those cases. The 2012 Standards and Guidelines for the Reduction of Maternal Morbidity and Mortality from Unsafe Abortion, though briefly withdrawn in 2013 and reinstated after a 2019 court ruling, were introduced to address this grim reality.

A legal yet controversial terrain

The Kenyan Constitution 2010 offers a clear framework for reproductive health. Article 43(1)(a) guarantees every person, “the right to the highest attainable standard of health, which includes the right to heath care services.” Furthermore, Article 43(2) affirms that “a person shall not be denied emergency medical treatment.” Importantly, Article 26(4) outlines the legal grounds under which abortion is permitted, when the life or health of the mother is in danger, or in emergency situations as determined by a trained health professional.

Despite this, access remains a challenge. The 2013 withdrawal of the national guidelines created confusion among health workers and fear among young girls. “we were seeing many cases of incomplete abortions and severe complications,” recalls a nurse at a Kisumu-based youth clinic. “without clear guidelines, many health providers were unsure of what they could or couldn’t do. It took a landmark court case by Fida Kenya and others v Attorney General, Petition 266 of 2015 to re-establish the importance of the guidelines. The court ruled that their withdrawal was unconstitutional and had jeopardised the lives of countless women and girls.

For adolescent girls, the consequences of unsafe abortion are dire. Many lack access to Compressive Sex Education and youth friendly services. Cultural taboos around sexuality and teenage pregnancy further isolate them. Those who fall pregnant, often as a result of sexual violence, coercion or lack of contraception, turn to unskilled providers or attempt dangerous self- induced methods.

A 17 Year old girl from Siaya County (name withheld for privacy) shared her harrowing story.

“when I found out I was pregnant, I was too scared to tell anyone. I went to someone in the village who gave me herbs. I almost died. That’s when my mother took me to the hospital.”

Dr. Wilson Oduor a reproductive health specialist, emphasizes that

“unsafe abortion is not just a health issue, it’s a social justice issue. These girls are failed by the system at every turn, from education to healthcare to legal protection.”

What needs to be done

Reducing unsafe abortion among adolescent girls requires a multifaceted approach that addresses both medical and social dimensions of the issue. First, schools must provide Comprehensive Sexuality Education (CSE) that is age-appropriate and fact-based to equip young people with accurate information about their bodies, relationships and reproductive health.

Alongside education, health facilities should offer youth friendly services that are confidential, non-judgemental and specifically tailored to meet the needs of adolescents. This includes access to contraception, counselling and post-abortion care.

Equally important is the need for the Ministry of Health to fully Implement the 2012 Standards and Guidelines for the Reduction of Maternal Morbidity and Mortality from Insafe abortion across all counties and health facilities to ensure consistency and clarity in service delivery.

Community engagement is also vital. Parents, religious leaders and local influencers must break the silence surrounding adolescent sexuality and foster open supportive conservations.

Finally, both adolescents and healthcare providers need to be fully aware of the legal rights and protections related to abortion and reproductive health as outlined in the Kenyan Constitution. Without legal clarity, policy enforcement and societal support, adolescent girls will continue to bear the brunt of unsafe abortions and their devastating consequences.

Moving forward

As Kenya grapples with high rates of teenage pregnancies, exacerbated by poverty, early marriages and gender-based violence, addressing unsafe abortion must remain a national priority. The Constitution provides a solid foundation and the reinstated guidelines offer a path forward. What is now needed is the political will, community support and investment in adolescent-friendly health services. “protecting the reproductive rights of our girls is not a privilege. It is a constitutional duty,” says Emilly Owino a youth advocate from Tembea Community Based Organisation in Ugunja. “we must stop criminalizing their choices and start listening to their voices.

Until then, unsafe abortion will continue to claim young lives quietly, painfully and unnecessarily.