Unwanted pregnancies put women in Kenya at risk of morbidity and mortality associated with childbearing; induced abortion is an option some women seek as a response to that situation. Qualitative research was carried out to document the case histories of 30 Kenyan women who underwent induced abortion. In-depth interviews were conducted among an urban group of low-income women to identify sources of information about induced abortion and the decision-making process, and to describe the abortion experience among this group. Being unmarried and unemployed contributed to the decision to abort. Two main types of induced abortion, one provided in private facilities by medical personnel, and the other performed by a variety of untrained practitioners, are described.
PIP: In October 1989, researchers conducted in-depth interviews with 20 men and women knowledgeable about induced abortion in Kenya and with 30 mostly urban, single, and low income women from Nairobi who had an abortion. They intended to examine induced abortion in Kenya, which is illegal except to save the mother's life, since prior research is limited to hospital data. The key informants revealed that induced abortion is relatively common, especially among single women. Further they said abortion related deaths occur often and that friends usually provide the abortion seeker with information. They recognized that abortion is a woman's issue. Abortion costs and services varied. For example, trained health practitioners in top rate health facilities charged the most money (KSh.10,000). The informants noted that nonhealth workers also induce abortions. Among the women who had an abortion, almost all had used contraceptives in the past and many stopped due to complications or side effects. In fact, some were using contraceptives when they became pregnant. Economic reasons tended to explain why these women underwent an abortion. 6 of the 30 had at least 1 previous abortion. Further, except for 8 cases, they decided alone to have an abortion. They tended to seek information about abortion services from a friend. The most common abortion procedure in a health facility was dilation and curettage and the most common procedure performed by an untrained practitioner, usually a male, was inserting a hollow tube into the cervix for several hours. 15 of the women reported complications, 3 of whom went to Kenyatta National Hospital. This study showed that contraceptive failure and discontinuation contributed greatly to induced abortion. It also revealed that contraceptive practices did not effectively reach young, single, urban women.