Just like any other person, people with Disability have the right to post abortion care. Safe abortion data related explicitly to PWDs is limited, as research indicates challenges in accessing Sexual Reproductive Healthcare, including abortion and post abortion services, for this population.
Tina*, a 35-year-old mother of two, is a resident in Kibra, Nairobi. She has a physical disability. She was diagnosed with paraplegia, a condition that has affected her lower part of the body. Her legs are the most impacted by her condition, making it hard for her to locomote. At the age of 23, she discovered she was pregnant. As a young woman with disability, she faced the kind of decision many women handle in silence, whether or not to carry an unplanned pregnancy to term.“I wasn’t ready to carry the pregnancy,” she said. When Tina first visited a local health facility in Kibra slums to seek abortion care, the experience was traumatic.
“There were no ramps. I fell on my way in. I also struggled to get onto the bed since it was high,” she recalls. She added that no staff came to her assistance, despite seeing her struggle. “It was a painful reminder that even in health care settings, accessibility is still treated as an afterthought for people with disabilities,” said Tina.
“The cost of the abortion was beyond what I could afford,” she added. Tina explained that due to the challenges, she decided to seek a cheaper alternative to terminate the pregnancy. Tina described how she had lost her job and was struggling to meet her basic needs, making the idea of raising a child more challenging. She was referred to Marie Stopes Kenya, where she mentioned receiving affordable and respectful care that included post-abortion support.
“There is so much shame and stigma when you have a disability and you go to seek abortion and post -abortion services. People question your right to even make such choices,” said Tina.
Tabitha*, who lives with multiple disabilities, was turned away from a health facility when she sought safe abortion services. She was born with a condition of both partial sight and partial hearing loss. “I was asked why someone like me would get pregnant,” said Tabitha. With no medical option left, she resorted to pills, which, according to medical experts, are used for unsafe abortion. She noted that the pills caused harm as she bled profusely.
“Nilipelekwa hospitali nikaambiwa kilichonifanyikia ni kuwa sikuoshwa tumbo baada ya kumeza dawa kutoka kwa chemist,” she recounted.
Tabitha recalled how a good Samaritan took her to the hospital, where she received post abortion care and her life went back to normal. She reiterated that healthcare workers need proper training to provide inclusive abortion care for Persons With Disabilities. Tabitha called upon girls and women to seek safe abortion procedures when they feel not ready to carry a pregnancy.
Another group of persons with psychosocial disabilities, such as schizophrenia, bipolar disorder, and developmental disorders, live on the streets. Some are raped repeatedly, others give birth to multiple children, often without understanding how and why.
“They are easy targets for sexual predators . Most of them cannot consent to sex in the first place, and no one is held accountable for such actions,” said Maureen Moraa, clinical officer at CFK.
She added that even when pregnancies result, few of these women are taken to health facilities. The issue of informed consent becomes complex as they may act aggressively due to trauma and their conditions.
“These women are often excluded from health services because society doesn’t know how to support them ethically. Most never receive counseling, contraception, and follow-up care,” noted Moraa.
“For women who are deaf, communication remains a major barrier. Most hospitals in Kenya lack sign language interpreters, making basic health services difficult to access. Imagine needing post- abortion services and not being able to explain why or having a procedure done without proper consent because you couldn’t communicate,” noted Moraa.
Medical Perspectives on Disability Inclusion in Post Abortion Services
In Nairobi, Kenya, innovative approaches have been implemented to enhance access to safe abortion practices and post- abortion services. Organisations have developed self-care models where trained disability champions provide referrals to secure health facilities, ensuring services are accessible and judgment-free.
Maria*, a 25-year-old with physical disability, has undergone training through a local organisation on safe abortion practices. She was amputated of one of her legs after it developed an infection that threatened her life. She recounted how, through Women Spaces Africa, an organisation championing equal opportunities for girls and women with disability in society, she acquired knowledge on safe abortion. At a point in her life, she had abnormal, continuous stomach pains during her pregnancy. After consultations with a trained medical practitioner, the pregnancy was terminated for her safety.
“Nilikuwa nasikia uchungu kwa tumbo,vile nilienda hospitali nikaambiwa lazima nitolewe huo ujauzito, nilirudi kwa organisation penye tulifunzwa mambo na safe abortion nikakuwa reffered kwa daktari.Nilienda nikatolewa na ikakuwa sawa,” said Maria*.
Public Health Data
A report by the Ministry of Health in Kenya, released in collaboration with the African Population and Health Research Centre (APHRC) and the Guttmacher Institute, indicates that between April 2023 and May 2024, more than 792,000 cases of induced abortions occurred in the country, representing 57.3 abortions per 1,000 women between 15 – 49 years.
Policy Gaps Hindering Safe Abortion
Access to safe abortion is hindered by several significant policy gaps. Evelyn Odhiambo, a sexual health and reproductive advocate, shared that abortion services are poorly integrated into public health systems, which restricts access for low-income and even persons with disabilities due to a shortage of trained providers, equipment, and referral mechanisms.
“Weak legal protections for healthcare workers discourage the provision of services, as providers face the risk of prosecution if the services go astray,” added Evelyn.
She further said that misinterpretation of abortion laws by both law enforcement and health personnel contributes to the wrongful denial of services. The situation is worsened by inadequate data collection and reporting, limiting evidence-based policymaking.
Evelyn shared that the exclusion of abortion from national insurance schemes leaves many unable to afford safe and legal procedures, thus pushing them toward dangerous alternatives of abortion.
Government Interventions
According to Dr. Patrick Amoth, Director General of Health, “Unsafe abortion is still a significant public health challenge.
“The Kenyan government has made considerable progress in addressing the challenge of maternal morbidity and mortality in the country through a range of policies and actions that enhance access to maternal health services and remove barriers to these critical services. Nonetheless, unsafe abortion remains a public health challenge,” said Dr Patrick Amoth, Director General of Health in Kenya.
He further noted that the government has invested in multiple interventions to prevent unsafe abortions and their health consequences. These include availing modern contraceptives to prevent unintended pregnancies, developing appropriate clinical guidelines to support health providers in the delivery of health services, and training health providers on post-abortion care.
Including disability in national sexual and reproductive health policies, offering mental health and trauma-informed counseling services, post abortion care services, and training providers to deliver non-judgmental, inclusive care will go a step further to combat challenges facing the health sector.
Way Forward
Maria* urged Persons With Disability and any other woman in need of the service to acquire it from trained practitioners rather than the quacks. She emphasized that seeking help from unqualified individuals puts women’s health at risk of complications, including infections, injury, and even death. Maria added that every woman, regardless of her disability status, deserves access to dignified reproductive health services.
Maureen Moraa, clinical health officer, called upon facilities to ensure the safety of patients seeking various services,including counseling and follow-up care, which are critical for recovery and well-being.
