Unsafe Abortions Increasingly Recorded among Adult Women, New Data Shows

Health experts caution, however, that these figures may only reflect a fraction of the true burden. Many abortions are illegally procured in unregulated settings where deaths and complications go undocumented.

A pregnant lady (courtesy photo)

Unsafe abortion is no longer predominantly a problem among teenage girls, as previously reported. New health surveillance data indicate that adult women, many of them married and in their prime reproductive years, now account for a growing proportion of abortion-related deaths in Uganda.

According to the Maternal and Perinatal Death Surveillance and Response (MPDSR) report for the Financial Year 2024/2025, abortion-related complications account for 4 per cent of all maternal deaths, translating to 189 deaths per 100,000 live births nationwide. The situation is particularly alarming in the Busoga sub-region, where abortion-related deaths stand at 7 per cent, with most cases occurring among women aged 25 years and above.

Health experts caution, however, that these figures may only reflect a fraction of the true burden. Many abortions are illegally procured in unregulated settings where deaths and complications go undocumented. In addition, some women who lose pregnancies in the first trimester may be unaware they were pregnant and often mistake the loss for a delayed or heavy menstrual period, meaning such cases never enter official records.

This trend is a significant shift from earlier reports that largely associated unsafe abortion with school-going teenage girls, many of whom sought abortions out of fear of stigma, expulsion from school, or rejection by their families and communities.

Medically, abortion refers to the termination of a pregnancy before 26 weeks of gestation, a period before the fetus can survive outside the uterus. In Uganda, the law permits abortion only under restrictive circumstances, such as when the pregnancy poses a direct threat to the mother’s life or when the fetus is not viable outside the womb. Despite this, unsafe abortions persist, driven by social pressures, misinformation, and limited access to reproductive health services.

Aggrey Bameka, an associate consultant in obstetrics and gynaecology at Buwenge General Hospital, notes that many women seeking abortions today are adults, some accompanied by their spouses, and that a number resort to unlicensed herbalists. He adds that the herbs given to the women often have high chemical concentrations with no clear dosage, resulting in severe bleeding, infections, and, in some cases, death if medical care is not sought early.

He adds that women who lose pregnancies due to medical complications, rather than intentional termination, face additional challenges during post-abortion care.

“For women in middle age who struggle to conceive, losing a pregnancy unintentionally is emotionally devastating, he says, adding that post abortion care must include extensive counselling.

A case in point is a 41-year-old woman who shared the emotional toll of losing a long-awaited pregnancy. After five years of marriage, medical examinations revealed that she could only conceive through assisted reproductive technology. Together with her husband, she saved over 30 million Shillings, with 25 million Shillings allocated for an in-vitro fertilisation (IVF) procedure and the remainder set aside for postnatal care.

Bameka says he receives at least two women every week seeking abortion services, citing reasons ranging from medical complications to unwanted pregnancies. He notes that myths surrounding childbirth, particularly among women who have delivered by caesarean section, are contributing to the problem.

“Some women believe that a caesarean section delays future conception,” he says. “When they become pregnant again within a short period, many opt for unsafe abortions as a way of enforcing child spacing.”

To reduce unsafe abortions and related deaths, Bameka advises women to adopt appropriate family planning methods immediately after delivery, stressing that informed reproductive choices can significantly lower the demand for unsafe procedures.

Health advocates argue that addressing unsafe abortion among adult women requires not only better access to family planning services, but also accurate information, stronger post-abortion care systems, and open conversations that move beyond outdated assumptions about who is most at risk.