Health

Safe abortions or letting women die? The Midwives’ perspective

The authors are; Namakula Ritah (L) and Lilian Nuwabaine (R)

Abortion in Uganda just like in any other African countries is legal only when performed to save a woman’s life. As of now, the Ugandan law doesn’t mean that abortion is legal but is rather restrictive, unclear, and not conclusive.
Every woman has the recognized human right to decide freely and responsibly without coercion and violence on the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. Access to legal and safe abortion, as a pillar of safe motherhood, is critical for the realization of these rights. 

According to the Uganda Demographic and Health Survey (UDHS 2016), Uganda has one of the high total fertility rates of 5.4. Additionally, 38% of women aged 15-49yrs do not want any more children or are sterilized while Uganda’s Contraceptive prevalence rate stands at 41.8% according to the 2018 World Bank report.
Moreover, with the teenagers and the least privileged of the society less likely to access family planning services. It is important to note that, despite the progress in alleviating Uganda’s maternal mortality ratio from 524 deaths to 336 deaths per 100,000 live births for the 7-year period preceding the 2001 and 2016 Uganda demographic health survey (UDHS) respectively, this falls short of the Sustainable Development Goal 3.1 target of less than 70 per 100,000 live births by 2030.

More than half of pregnancies in Uganda are unintended and nearly a third of these end up in abortion, with the poor and rural women whose access to skilled services providers is constrained by infrastructural and financial limitations more often than not, hence undergoing unsafe abortions. Unsafe abortion and its complications account for 5% of maternal deaths in Uganda.
Research by the Center for Health, Human Rights & Development (CEHURD) found that the unclear abortion laws cause distress to both abortion seekers and health care workers and continue to lead to maternal morbidity and mortality. Moreover, there is evidence from developed countries that liberalized policies on abortion improve maternal health.

We, therefore, recommend the Ministry of Health Uganda in conjunction with the health and law associations, Non-Government Organisations, and all stakeholders to quickly review the laws on abortion and update them. 

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The authors are; Lilian Nuwabaine; BSc Nurse and MSN-Midwife and Women’s’ Health Specialist and
Namakula Ritah; Registered Midwife and BSc trained midwife working with Mulago Specialised Women and Neonatal Hospital 



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