Why the American abortion debate is affecting access in Kenya

Abortion is a closely watched issue in this year’s election, and not just in the U.S. As president, Trump cut funding for international groups that offer and counsel on abortion services. With support from The Pulitzer Center, special correspondent Neha Wadekar reports from Kenya where advocates are watching for who wins. A warning, this story contains accounts of sexual and gender-based violence.
Amna Nawaz:
Abortion is a closely watched issue in this year’s election, and not just in the United States.
Former President Trump cut funding for international groups that offer or even counsel on abortion services. Advocates on both sides of the debate in Kenya are watching for who wins and what that may mean.
With the support of the Pulitzer Center, special correspondent Neha Wadekar reports from Nairobi. And a warning: This story contains accounts of sexual and gender-based violence.
Neha Wadekar:
Anne became an orphan when she was just 10 years old. With nowhere to turn, she moved to Dandora, Kenya’s largest dump site, and began sorting trash to earn some money.
Shortly after she arrived, Anne was raped by an older man. We have changed her name and concealed her identity. Anne soon started making a living as a sex worker. Many of her clients were abusive and some refused to wear condoms.
Anne, Sexual Violence and Back Alley Abortion Survivor (through translator): That’s because, when you meet a guy, if you ask him to use protection, he says: “I don’t eat a sweet while it’s still wrapped.”
Neha Wadekar:
At age 13, Anne became pregnant. Nearly one in five Kenyan girls becomes pregnant before they’re 18, in part due to poverty and lack of sex education and access to contraception. Back in 2004, abortion was completely illegal in Kenya.
Anne used black market pills for her first abortion. Her second pregnancy two years later was harder to terminate.
Anne (through interpreter):
So I used knitting needles. It got to the point where I bled for two months. I had to go to the public hospital, where I got help.
Neha Wadekar:
Anne’s story is far too common in Kenya, where an estimated seven women and girls die each day from unsafe abortions. Many who survive the procedures are left with severe complications, says Monica Oguttu, founding executive director of the nonprofit health care organization KMET.
Monica Oguttu, Founder and Executive Director, Kisumu Medical and Education Trust: They bleed a lot from these damaged organs. We have seen cases that that sharp object was through the uterus.
Neha Wadekar:
The country’s 2010 Constitution now permits abortion in a narrow handful of circumstances, like for emergency treatment or if the life and health of the mother is in danger.
But it’s still confusing, even for physicians, says Dr. Ernest Nyamato, an associate director at the nonprofit Ipas. Kenya is also a very religious country, and abortion is highly stigmatized.
Dr. Ernest Nyamato, Associate Director, Ipas:
When you see this ambiguity, and, as a medical provider, you take the safer road and say, let not provide these services, or let me allow other people to do it.
So, instead of accepting this thing of this is a backstreet service, let it stay there.
Neha Wadekar:
Some government facilities do perform abortions. Private clinics also do, but they can be expensive, so women look for other, cheaper options.
Pamela, Traditional Medicine Vendor:
For abortion, we have charged 3,500. If you have two months, it’s 3,500. If it’s five months, we take 4,000.
Neha Wadekar:
Pamela is a traditional medicine vendor who charges women and girls between $27 and $31 for help. Pamela claims she stopped selling abortion-inducing herbs long ago.
This type of denial is commonplace among black market actors offering illegal abortion-related services, both in person and on social media, where misinformation thrives. If the herbs don’t work, a woman might turn to a quack doctor for help.
This is a room in a back-alley abortion clinic in one of Nairobi’s informal settlements. Many of the people who work here claim to have medical training, but really have very little. They will often use unsterile instruments like this to perform unsafe abortion procedures on women and girls, which can leave them either infertile or even lead to death.
Samuel is a self-proclaimed doctor who offers surgical abortion to poor women with nowhere else to turn. We have changed his name because his work is illegal.
Samuel, Back-Alley Abortion Provider:
The challenge is, for example, when you want to interact with somebody who has just come for it, it has to be a secret, because the government doesn’t allow.
Neha Wadekar:
Many poor and indigent women who die from back-alley abortions end up at public morgues. Abandoned fetuses often end up there too.
Some of those fetuses are fished out of the river in Dandora, the slum where Anne lives. After her own two abortions, Anne helped other women and girls abort around 150 pregnancies using a rusty pair of knitting needles. She throws the fetuses in this river at night to avoid getting caught.
Do you — Anne, do you ever feel any guilt?
Anne (through interpreter):
Yes, I do. That’s because we’re taking the life of young babies, but we have to do that because we have no other choice.
Neha Wadekar:
Since Kenya adopted its 2010 Constitution, the country’s judges have expanded abortion access through several major court decisions.
But after Roe v. Wade was overturned in 2022 in the United States, abortion rights advocates became concerned that the same thing could happen in Kenya. One of the groups pushing for those decisions to be overturned is the Kenya Christian Professionals Forum, led by a constitutional lawyer named Charles Kanjama.
Charles Kanjama, Chair, Kenya Christian Professionals Forum:
We believe that abortion is not care. Abortion doesn’t save lives. Abortion takes lives.
Neha Wadekar:
Several cases are making their way through Kenyan courts, including one petitioning for unborn children’s right to life and for equal protection and benefit of the law, a familiar argument in the United States’ own abortion debate, says Martin Onyango, a lawyer at the Center for Reproductive Rights.
Martin Onyango, Center for Reproductive Rights: Those are not new tactics. Those are the same tactics being applied by the opposition group in the U.S. in various states and also at the Supreme Court.
Neha Wadekar:
That’s in part because the Kenyan anti-abortion movement is being bolstered by international groups, especially American groups, promoting conservative policies and ideology in Africa.
These groups travel to Africa as speakers for events and conduct anti-abortion training sessions. According to parliamentarian Esther Passaris, this type of campaigning is highly influential, because politicians fear losing the support of important conservative voting blocs.
Esther Passaris, Nairobi County Women’s Representative, Parliament:
I think the idea that you will offend the church, the idea that you will lose votes if the church doesn’t endorse you as a candidate.
Neha Wadekar:
There are huge sums of money flowing from American conservative groups into the continent of Africa. A 2020 investigation by openDemocracy revealed that $54 million flowed from U.S. Christian right groups to Africa between 2008 and 2018.
Many of these groups are led by prominent American evangelicals with close ties to former President Donald Trump and his administration.
Donald Trump Former President of the United States (R) and Current U.S. Presidential Candidate: To protect the unborn, I have reinstated a policy, first put in place by President Ronald Reagan.
Neha Wadekar:
Trump also reinstated and expanded the Mexico City policy, known as the global gag rule, which restricts U.S. funding to any international organization that performs or even counsels on abortion.
These policies emboldened anti-abortion advocates during his term.
Charles Kanjama:
They don’t use federal funds to support pro-abortion organizations. So the noise of pro-abortion in our countries goes down.
Neha Wadekar:
They also created a chilling effect for Kenyan reproductive health care providers like KMET, who chose to lose $3 million in U.S. funding rather than stopping abortion-related services.
Monica Oguttu:
We had 15 staff that we laid off. It was the most difficult moment for me as the CEO of the organization.
Neha Wadekar:
With an American election around the corner, Kenyans on both sides of the issue are waiting to see which way the chips fall.
Martin Onyango:
Depending on the government that is elected in the United States, we may have either continued progress in realizing reproductive rights or we can go back, we can lose the gains that we have made.
Neha Wadekar:
The stakes are highest for Kenyan women and girls, who will feel the greatest impact if abortion rights are rolled back once again.
For “PBS News Hour,” I’m Neha Wadekar in Nairobi, Kenya.