Causing more harm to women and society
Advocates of women’s rights have risen to demand for changes in Uganda’s legal regime that governs pregnancy arguing that the current situation endangers the health of women and tramples on their rights to take full control of their bodies.
Citing Article 22 (2) of Uganda’s Constitution, which states that: “No person has the right to terminate the life of an unborn child except as may be authorised by law,” women activists argue that the constitutional limitation is not absolute but rather calls for the making of a law by Parliament to prescribe circumstances under which abortion can be carried out.
Centre for Health, Human Rights and Development (CEHURD) argues that the current legal regime continues to expose women to outdated provisions of the Penal Code that are incompatible with some provisions of the Constitution such as one that regards all persons as equal before and under the law. The organization also argues that the legal limitation goes against several traditions that govern child birth.
CEHURD argues that the delay to introduce a law authorising the termination of the life of an unborn child, threatens the lives of thousands of women who resort to dangerous methods of stopping pregnancy when they consider it untenable because of their mental, health, social or other social and economic considerations.
At the same time, women’s rights activists argue that under the 2012 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights, abortion is allowed in cases such as incest, fetal anomaly, rape and when a woman is HIV-Positive.
For women who must have an abortion, either to save their jobs or their marriages, the current legal regime puts their lives in danger as they find it difficult to procure the service because health workers are fearful of doing so, argues Dr. Charles Kiggundu a senior gynaecologist at Mulago National Referral Hospital.
Heavy cost to society
Many women end up with post-abortion complications that include losing their uterus. According to Kiggundu, the fact that ministry of health budget component dedicated to handling post-abortion care is the first to get used up, is a big indicator of the prevalence and persistence of the problem in the country.
Studies show that more than US$14m, (Approximately UGX50bn) is spent annually on handling post-abortion care. And whereas the average cost of procuring abortion from a qualified health worker is about US$60, post abortion expenditure resulting from mishandled abortion more than doubles to about US$130 per patient.
Largely as a result of the hostile legal and institutional obstacles to having an abortion, more than four women in Uganda die every day while trying to stop unwanted pregnancies. Mostly of them are in their teenage and post teenage years. A number of University lecturers tell horrific first hand tales of losing students to abortion. One them, James Nkuubi, who teaches law at Makerere University, recently revealed how one of his students confided in him how she tied to abort using crude means that forced her to get admitted to Mulago a few years ago. The student later died from endless bleeding.
Although Uganda signed up to international protocols such as the UN Millennium Development Goals (MDGs) and now Sustainable Development Goals (SDGs) particularly those that seek to roll back the number of women dying from pregnancy-related complications, there is almost a lack of progress on this front because of the country’s unwillingness to face up to the realities that lead young girls to die from those complications.
Health experts say that majority of those that take the deadly path of using crude methods of removing fetuses by themselves or with the help of unprofessional people, are young girls in primary, secondary and tertiary institutions who can’t bear pregnancy, or conceive through coercion by relatives, bosses and from rape.
Different studies show that abortion-related complications account for a quarter of all maternal deaths in Uganda. In absolute terms, for example, an estimated 314,304 cases of abortion were carried out in 2013 which puts Uganda on top in East Africa with the highest number of abortions.
Uganda’s anti-abortion laws, studies by Guttmacher Institute and other organisations like CEHURD, add, are some of the main reasons behind the country’s rapid and unsustainable population growth rates.
For example out of every 1.2 million babies born every year in Uganda, about 200,000 of them are either unwanted or mistimed. This raises further human rights violations for women whose freedoms are curtailed by the fact that they have to take care of babies at a time they would have pursued other interests.
And while the harsh anti-abortion laws coupled with the hostile cultural, religious sentiments appear to be aimed at preventing abortions, findings show to the contrary. A new report for example shows that the hostile laws are only pushing women into more risky spots such as seeking care from unskilled, unequipped health workers or do it dangerously by themselves.
Dr. Kiggundu has called for the easing of harsh criminal laws to promote unhindered access to abortion and post-abortion care for those people that must have it.