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The musings of a disability abortion doula in Kenya 

As part of my work as a social worker and abortion doula in the Kibera slums in Nairobi, I have encountered many people with disabilities in need of reproductive healthcare. I help them to access abortion services either through supporting them with self-managed abortion or walking them through the process of surgical abortion at a clinic.  

Due to the restrictive nature of abortion laws in Kenya, abortion incidences are highly underreported. However, research done by Guttmacher indicates that there are over 1.4 million unintended pregnancies every year in Kenya, and 38% of these end in abortion.  

These figures suggest that there are many girls who find themselves having unplanned pregnancies but only some are able to induce abortion.  I receive many cases of girls with disabilities in need of abortion services and I had to find out why the abortion rates are minimal despite this need.   

Accessing safe abortion in Kenya is challenging for girls and women with disabilities because first of all, abortion is still highly restricted.  

The constitution allows for abortion when the life or health of the pregnant woman is in danger, or in cases of rape and incest. Post-abortion care can also be provided.  

In Kenya we do not have a ‘right’ to abortion except in these circumstances. However, there are some progressive healthcare providers that offer abortion services according to a liberal interpretation of the ‘risk to health’. Or who are willing to support abortion services outside of these legal restrictions. 

Young girls and women with disabilities are at a great disadvantage when it comes to matters of sexuality and abortion.  

Due to the intersectionality of their gender and their disability, girls and women with disabilities can find themselves unable to make decisions about their own bodies.  

During one of the sexuality conversations that we held as Women Spaces Africa, (supported by SAAF) girls and women with disabilities shared some of the harrowing experiences that they have been through.  

“I found myself pregnant after I was raped at the age of 15 years. I was raped by a man who was very well-known to me in my village. I told my mother what had happened to me, but fearing embarrassment she told me to keep quiet about my rape accusations. I kept the pregnancy and had to drop out of school to raise the child. It really pained me to see the man who did this to me and my mother forcing me to keep the pregnancy. It was only after recently going through counseling that I accepted the child. I think it is fair for girls and women with disabilities to decide for themselves whether to keep a pregnancy or not. I also feel that justice should be given to rape survivors instead of the perpetrator being given a free pass just because the community stigmatizes young women who have been raped or have had an early or unplanned pregnancy.”

‘Rose’

Even when girls with disabilities decide to have an abortion, they face negative attitudes from reproductive healthcare providers: 

“Once I made the decision to have an abortion, it was difficult to find a health provider who agreed to deliver abortion services. Several claimed it was a crime and the ones that agreed were reluctant to serve me because of my disability saying that they fear complications may arise and that I should consider keeping the pregnancy as I may not be lucky to get pregnant again.”

‘Belinda’
Healthcare services are also often inaccessible due to physical and communication barriers.  

Whenever I refer Deaf girls to abortion providers, they often need to request a sign language interpreter to accompany them because the service providers do not know sign language and communication becomes strained. Though the girls finally get the services they need, they often report frustrations, humiliation, and lack of privacy due to the inaccessibility of the healthcare facilities.  

As we celebrate the International Day of People with Disabilities, I call upon all reproductive health actors to be intentional about the inclusion of girls and women with disabilities. I acknowledge a lot is being done both locally and globally to support women to make their own reproductive health choices. However, more needs to be done to make sure that women with disabilities are not left behind.   


By Phylis Mbeke Ndolo, Director of Women Spaces Africa – a SAAF grantee partner in Kenya 

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