I must have been 12 when I found out that I was three months pregnant.
At the time, I didn’t have a boyfriend I could turn to—and, worse still, I didn’t know whose pregnancy I carried. At the age of 11, I was forced to become my family’s breadwinner, caring for my four siblings and my mother who suffered from Schizophrenia. I began sex work when I could secure neither formal nor informal employment, and when I became pregnant, I knew that my only option was to procure an abortion.
I couldn’t let anyone know about the pregnancy, let alone my intention to terminate it. Abortion was illegal in Kenya, where I am now a doctor, unless deemed medically necessary by a trained health professional—and I grew up in a community that viewed abortion to be deviant and wrong, so I knew even then that I couldn’t share my plight with friends or relatives.
Instead, I secretly sought the services of Quinta*, a renowned illicit brewer in Gatwekera, a village on the outskirts of Nairobi. She charged only $10 USD for the procedure—but as I didn’t have that kind of money, I intensified the sex work until I earned enough, having unprotected sex with multiple partners in the meantime.
Between 2010 and 2014, a staggering 25 million unsafe abortions are estimated to have occurred in developing countries each year. But I did not die on Quinta’s couch. I was lucky to have lived. I went on to complete my education through scholarships and achieved my dream of becoming a medical doctor.
Now, 17 years later, I am saddened when I see patients like Esther*, a 17-year-old who, like me, opted to procure a clandestine abortion due to fear and stigma—feelings that commonly affect how, where and when young girls and women seek care. By the time she came to me, damage to her reproductive system from the illegal abortion was so bad that the surgery required a multidisciplinary team: a urologist to repair her urethra, a gynecologist to repair her uterus and an abdominal surgeon to repair her intestines. In the end, she lost her uterus.
What happened to Esther is not unusual. Desperate women and girls will turn to unsafe procedures if they can’t procure legal ones.
Today, my sadness originates not only with the experiences of women and girls like Esther, but with what’s happening on the other side of the globe. Today, I worry about the politicization of reproductive health and the appointment of justices like Brett Kavanaugh to the Supreme Court—because the negative rhetoric and associated funding cuts to family planning services are putting in jeopardy the slow wins happening across Africa.
In countries like Zambia, abortion is now allowed due to social-economic reasons. In South Africa, Cape-Verde and Tunisia, there are no limits on the reasons for demanding abortion services, nor based on the gestational age. I worry that the direction of lawmakers in the West on these issues could negatively influence the African leaders currently relaxing their abortion laws. I worry about the Trump administration’s dramatic expansion of the global gag rule, a policy that blocks U.S. federal funding for non-governmental organizations that provide abortion care, advocate to decriminalize abortion or even so much as mention abortion services.
And I worry that these threats could worsen in the wake of the confirmation of a new Supreme Court Justice who could to tip the balance on U.S. abortion laws, leading to a ripple effect on women’s access to abortion around the world. Whenever the Supreme Court is faced with the decision of whether to uphold abortion rights in the U.S., the Justices on its bench should consider the potential repercussions of their actions on women’s reproductive rights, health and lives in countries such as my own.
Just last month, Tanzania’s President Magfuli “advised” women not to use contraceptives just because they are “lazy” and “fear feeding the children.” What he forgot to mention is that in Tanzania, 556 out of every 100,000 women die during childbirth—making up 18 percent of all deaths of women age 15-49 in the nation. Unsafe abortions are among the top five causes of these deaths in Tanzania.
When developed countries politicize the female body, those of us in developing countries feel the effects—both through policies and culture. Three-quarters of the world’s unsafe abortions are still taking place in developing countries, and 93 percent of African women live in countries that criminalize abortion. Worldwide, up to 13 percent of maternal deaths are attributed to unsafe abortions and their complications.
Denying women sovereignty over their bodies drives stigma and discrimination. It creates obstacles to safe abortion access. It fuels the rates of unnecessary maternal deaths. And these ideologies tend to affect the poor the most, further perpetuating existing social-economic inequalities and disparities.
How many young girls and women will have to die before political leaders stop perpetuating patriarchal ideologies and policing the female body?