By Isaac senabulya

Confusing abortion laws and reproductive health policies in Uganda have forced women to turn to unsafe abortions and increased the number of unplanned pregnancies in the country, according to a new report from the Center for Reproductive Rights (Center), the International Women’s Human Rights Clinic and the O’Neill Institute for National and Global Health Law at Georgetown Law.
The report, released today, documents personal stories of women impacted by the widespread and false impression that abortion is illegal in all circumstances in Uganda. In fact the country’s laws permit abortion for women not only to save a woman’s life but also on mental and physical health grounds.

“The perceived illegality of abortion services in Uganda has led to stigma, fear and secrecy—driving far too many women to desperate measures to end a pregnancy,” said Evelyne Opondo, regional director for Africa at the Center for Reproductive Rights.

“Leaders in Uganda must not only clarify the abortion laws, but also broaden access to information among health care professionals and the public at large about reproductive health care, including access to family planning and safe abortion services.”

Each year an estimated 297,000 induced abortions occur in Uganda, with nearly 85,000 women receiving treatment for complications from unsafe abortion. About 65,000 women experience complications resulting from unsafe abortion but do not receive any treatment. Unsafe abortion is one of the most easily preventable causes of maternal mortality, yet more than a quarter of maternal deaths in the country occur because of unsafe abortion, according to an estimate by the Ministry of Health in Uganda. Many of these deaths are in large part because of confusion and ignorance of reproductive health laws, as women are often discouraged from accessing legal reproductive health services.

“Studies have shown that women’s ability to exercise reproductive autonomy, including access to effective contraception and safe abortion services, leads to better health for women,” said Dr. Charles Kiggundu, Vice President, Association of Obstetrics and Gynecologists of Uganda. “It is tragic that women in Uganda continue to lose their lives as a consequence of their ability to become pregnant.”

Personal interviews in the report highlight how women are discriminated against when seeking modern contraception or legal abortion services. Even though it’s not required under any law or policy in Uganda, modern contraceptives are usually only given to married women, and spousal authorization is often required by health providers.

Women are commonly viewed as subordinate to men and are perceived as having no right to control their own bodies—leading to deeply seated discrimination against women. These sociocultural norms are barriers to access for women to the essential health care they need, married or not.

“All women have a right to access essential health care. Indeed, the Constitution creates an obligation on the government to protect women and their rights. As such, we must put an end to the discrimination against women in order to empower women and improve their reproductive health,” said Moses Mulumba, executive director of the Centre for Health, Human Rights and Development.

The testimonials in The Stakes Are High were compiled from information obtained during interviews that took place in March 2012 in Uganda, within Kampala and Mubende District. Interviews were conducted by students from Georgetown Law, accompanied by supervisors from Leadership and Advocacy for Women in Africa, the Center and the Law Clinic.

In addition to women, stakeholders were interviewed, including medical practitioners, nurses, law enforcement officers, lawyers, government officials, and representatives of NGOs and international development agencies. More than 80 interviews were conducted and recorded, and ultimately 31 testimonials have been documented in this report.

In 2012, report by the Center for Reproductive Rights on Uganda’s laws and policies on termination of pregnancy found that the laws and policies are more expansive than most believe, and Uganda has ample opportunity to increase access to safe abortion services.