Despite government efforts to provide safe abortion services and post-abortion care in health centres across the country, the number of deaths resulting from complications related to unsafe abortions continues to rise each year.
This is largely due to a widespread lack of public awareness about safe abortion both spontaneous and induced. Many people are unaware of the legal provisions regarding abortion in Uganda, where it is largely illegal, highly restricted, and only permitted when necessary to save a woman’s life.
It is important to note that an estimated 297,000 abortions occur annually in Uganda. According to the latest data, women aged 20 to 24 years experience the highest rate of abortion-related complications, although all age groups are affected.
Because abortion is widely perceived as illegal, many women seek unsafe procedures outside health facilities in an effort to avoid criminalization.
This exposes them to unskilled providers and dangerous practices, often resulting in life-threatening complications such as excessive bleeding, fistula, uterine perforation, infertility due to removal of the uterus, and, in some cases, death.
In response to this public health crisis, the Association of Obstetricians and Gynaecologists of Uganda (AOGU), under the project “Leveraging Progress in the Reproductive Health Environment to Enhance the Agency of Women and Girls Towards the Realization of Reproductive Justice in Uganda,” has trained journalists on how to effectively report on issues related to safe abortion and post-abortion care.
The training focused on helping journalists communicate the legal circumstances under which safe abortion can be accessed, without victimizing patients. By raising awareness and promoting accurate information, this initiative aims to reduce the high rates of morbidity and mortality associated with unsafe abortion.
According to Dr. Simon Peter Kayondo, a gynaecologist, when patients approach him for abortion consultations, he takes them through a process known as Abortion harm reduction counselling. This approach helps the patient understand the circumstances under which abortion may be legally and safely performed, while also offering emotional and psychological support to help them reflect on whether they are able or willing to continue with the pregnancy. Ultimately, he gives them the space to make their own informed decision.
Dr. Kayondo noted that patients without serious health complications that would medically justify an abortion such as uterine abnormalities, preeclampsia, or severe infections often reconsider their decision after going through harm reduction counselling. Many of them choose not to proceed with the abortion, which he attributes to the effectiveness of the counselling process.
He emphasized that if such counselling is made widely available to women seeking abortion services, it could significantly reduce the number of deaths and complications resulting from unsafe abortions.
Furthermore, Dr. Kayondo highlighted the importance of providing accurate information on self-care. He stressed that individuals, families, and communities should be educated on essential components of self-care, including antenatal care, family planning, screening and treatment of sexually transmitted infections (STIs), and post-abortion care. These are services that people can often initiate or manage themselves, making them more accessible and less dependent on formal health systems.
Empowering people with this knowledge, he said, would enable self-testing, self-management, and more informed engagement with healthcare providers when needed ultimately improving reproductive health outcomes across the country.
According to the law, attempting to obtain an abortion, procuring a miscarriage, or supplying any drugs intended to induce an abortion are all criminal offenses that can result in imprisonment.
John Paul Nsanja, also from the Association of Obstetricians and Gynaecologists of Uganda (AOGU), emphasized that unsafe abortion is a national concern that requires the involvement of various stakeholders including religious leaders, medical professionals, media houses, and other community influencers. He urged these groups to collaborate in disseminating accurate information about safe abortion practices, the legal circumstances under which it is permitted, and where such services can be safely accessed.
Nsanja explained that the goal is to prevent the occurrence of unintended pregnancies that may lead to unsafe abortions and, ultimately, maternal deaths.
He also highlighted a significant barrier to access, the negative attitudes of some health workers, who are often judgmental toward women seeking abortion-related care. This stigma, he noted, discourages many from visiting health centres, pushing them instead toward unsafe alternative
