Abortion is a loaded term in the United States, conjuring up many years of history and debate from political, medical and social contexts. However, in Kenya, there are even more challenges around perception of and access to abortion and post-abortion care services. In 2010, the new Kenyan Constitution legalized abortion when a provider deems that life or health of a woman are in danger. Although this is less restrictive than previous legislation, abortion is generally considered illegal throughout the country. While post-abortion care has always been legal in Kenya, it remains stigmatized, particularly because most often post-abortion care occurs after unsafe abortions that are occurring in the community due to the current restrictive policies. Indeed, post-abortion care guidelines were restricted from use for a number of years due to worry that the post-abortion care guidelines would help individuals perform these services illegally and were just re-released in February of this year back to health facilities throughout the country. Despite the complexities of the subject, post-abortion care is necessary in decreasing maternal mortality – abortion complications make up 8% of maternal deaths worldwide.


Through my research project, “Clinical Knowledge of Essential Maternal and Child Health Services in Kenya” I investigated the commodities and provider training and knowledge to perform post-abortion care versus other similar maternal and newborn interventions – management of pre-eclampsia/eclampsia, management of postpartum hemorrhage, and neonatal resuscitation. Given the stigma around the procedure, I found that approximately 30% less providers reported training in post-abortion care compared with other similar maternal and newborn interventions and approximately 30% less facilities report having up to date guidelines on post-abortion care. A few participants refused to answer questions on post-abortion care due to their own beliefs of the procedure. Further, in speaking with providers about how to improve their knowledge of post-abortion care, many highlighted increasing family planning services – that with less unintended pregnancies they hoped they would not have to have the knowledge to manage post-abortion care; despite the fact that these services are the same provided in the case of a spontaneous miscarriage or fetal demise. Others stressed a different aspect of community engagement – letting communities know they could receive safe post-abortion care services at these facilities as opposed to seeking unsafe options in the community, as many patients present with severe complications from the community that the facilities I visited did not always have the resources to care for.


There are many champions for post-abortion care in Kenya – individual providers at government facilities, non-profit organizations providing training and services, as well as reproductive health coordinators working through the county departments of health. However, focus on post-abortion care needs to be re-invigorated across Kenya, including focus on availability of training and guidelines for all clinical care providers, sensitization of providers, and expanded access to supplies and commodities to perform these services across multiple levels of the health care system. In order to decrease the maternal mortality rate in Kenya, post-abortion care is a vital piece of the puzzle.

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