The same decision could mean death or life for women with varying levels of access, information and income in Uganda. At the end of last year I spoke with a lady in Kamuli (eastern Uganda) district and a teenager in Kampala who had nearly died after drinking a concoction of herbs and medicinal roots believed to end a pregnancy. For both, it had been recommended by peers and prescribed by a local birth attendant at a cost of UGX 60,000. Their reaction to the mixture had been similar – profuse bleeding, sweating, headache, intense abdominal pain and loss of consciousness. Fortunately, they both returned to full physical health after two weeks in the hospital. Many women and girls have not been as fortunate with reports that over 1000 women die every year from complications resulting from unsafe abortion related complications such as fistulas, haemorrhage and sepsis.

Like most African countries, the legal environment for abortion is restrictive in Uganda. Abortion is criminalised in the penal code with exceptions for when a woman’s life is at risk or in cases of rape, incest, defilement or any other cases of foetal anomaly. Even then, regulation is subject to misinterpretation by health workers who have been alleged to turn women away, barring them from receiving medical attention for post abortion care too. Further, the religious, social and cultural norms held both by health workers and society stigmatizes and relegates women and girls to back door, clandestine abortions which puts their lives at risk.

Uganda has several maternal health concerns and undoubtedly, unsafe abortion is one of them. The government, NGOs and civil society have taken great strides to improve maternal health and advance SHRH and their efforts do not go unnoticed. It is commendable that post abortion care is readily available in hospitals and medical centres despite the high costs attached to it. However, there are still glaring gaps that would require participation on the legal, societal and personal level. As the time to commemorate commitments towards women’s reproductive health and rights at the 25th anniversary of the International Conference on Population and Development draws closer, efforts towards full SRHR for every woman should be intensified by acting on the key actions of the programme of action developed in 1994, especially action 3 that states; “elimination of preventable maternal by integrating a comprehensive package of sexual and reproductive health interventions including access to safe abortion to the full extent of the law, measures for preventing and avoiding unsafe abortions, and for the provision of post-abortion …To protect and ensure all individuals’ right to bodily integrity, autonomy and reproductive rights, and to provide access to essential services in support of these rights.”

It is easy to ask women not to have abortions. To do the “right thing” despite their circumstances and convictions, however, women reserve the right to fully exercise their sexual reproductive rights and make their own decisions. With adequate information and support, women must be empowered and granted access to the full range of sexual reproductive interventions. Abortion is highly attributed to unintended pregnancies as a result of low sexuality education, defilement, teenage pregnancy, incest rape and commonly, contraception fail. Braam and Hessini (2004) cited economic hardship as a leading cause for unintended pregnancy and resulting abortion.[1] Rather than stigmatizing and demonizing abortion, focus should be placed on reducing unintended pregnancies through increased access to and uptake of family planning, sexuality education, conviction of sex offenders and empowerment of women to fully exercise their choice and rights.

[1] Braam, T., & Hessini, L. (2004). The Power Dynamics Perpetuating Unsafe Abortion in Africa: A Feminist Perspective. African Journal of Reproductive Health / La Revue Africaine De La Santé Reproductive, 8(1), 43-51. doi:10.2307/3583304