Perspectives of Male Youth on Induced Abortion in Kiambaa Division, Kiambu District - Kenya

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Most of the respondents knew that abortion was illegal (86.2%). 6.9% thought that they were legal 
and 6.9% did not know the legal status of abortion. On asking them if they preferred abortion to be 
legalized only 16.6% said that abortion should be legalized while 82.9% were against it. 
 
In the bivariate analysis, the respondents’ perspectives towards abortion were significantly 
influenced by their use of FP methods (P<0.05) and their previous involvement in abortion 
(P<0.05). 
The study concluded that while the male youth were aware of the high prevalence of abortion, they 
still held a strong pro-life perspective. The negative attitude towards abortion was as a result of the 
associated morbidity and mortality. 
 
Some of the recommendations of this study include the need to strategize on Information 
Education and communication (IEC) targeting the male youth, on ways of preventing unwanted 
pregnancies. This should focus particularly on the post coital contraception, sex education and 
advocacy for safe and legal abortion.  
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CHAPTER ONE 
 
INTRODUCTION AND BACKGROUND 
1.1 Introduction 
Abortion is the expulsion of the conceptus before 24 weeks of pregnancy. This prevents the foetus 
from developing and being born with a viable life.
1
 Induced abortion refers to the termination of 
pregnancy  for medical reasons or otherwise after fertilisation has taken place.
 
There are various 
reasons why a woman may procure an abortion. This occurs when the pregnancy is unwanted at that 
particular time. Reasons for this include adolescent pregnancy, when a woman may feel too young to 
become a mother, contraceptive failure, rape,  pressure from spouse, lack of support or financial 
difficulties. In other instances, the pregnancy may be wanted but may be injurious to the health of 
the mother if the pregnancy is carried to term. Investigations may also reveal foetal abnormalities. 
 
There are  wide varieties of techniques and abortifacients used to induce abortion. These include 
safe modern methods such as vacuum aspiration or dilation and curettage.  Others include 
(a)insertion of a probes or catheters, (b)  pouring of toxic fluids into the uterus, (c) insertion of metal 
objects into the uterus (d)  insertion of herbal suppositories into the vagina,  or (e)jumping falling, 
exercising violently or using injections. A study in Peru showed that 84% of rural women and 64% 
of urban women attempted to induce abortion themselves or to seek the aid of untrained midwives. 
Ninety-five percent of wealthier urban women were attended to by health professionals. 
2,3 
 
Every pregnancy carries potential health risks to women. This is even for those who appear healthy 
and at low risk. Millions of women have unwanted pregnancies each year. These are pregnancies that 
are unplanned for or mistimed at conception. Unwanted pregnancies are most likely to be fatal 
because they are more likely to end in unsafe abortion. Complications of unsafe abortion cause 
50,000 to 100,000 maternal deaths each year.
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The concept of safe motherhood consists of efforts that ensure good health for women and their 
babies during pregnancy, at the time of delivery and in the postpartum period.  Men play major roles 
in women’s pregnancy and delivery and in the care of babies after birth. They are the ones who 
mostly decide when a woman’s condition is serious enough to seek medical care. Their decisions and 
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actions often make the difference between illness and health. This has a direct bearing on the life 
and death for women resulting from pregnancy.
4 
 
Unsafe abortions are common in sub-Saharan Africa. The management of associated complications 
consume a large amount of resources. These complications include severe bleeding, shock, infection, 
lacerations of the cervix and vagina, perforations of the uterus and pelvic inflammatory disease.  
They may be fatal or lead to infertility or disability. These complications are among the five direct 
causes of maternal mortality, the others being haemorrhage, sepsis, pregnancy induced hypertension 
and obstructed labour. As defined by WHO, maternal deaths are deaths occurring during pregnancy 
up-to 42 days after pregnancy, irrespective of the duration or the site of pregnancy, from any cause 
related to or aggravated by the pregnancy or its management.  
4
 
 
Unsafe abortions are a consequence of unwanted pregnancies. They are characterized by the lack or 
inadequacy of skills of the provider, hazardous techniques and unsanitary facilities. This is one of the 
greatly neglected problems of health care in developing countries and a serious risk to women 
during their reproductive lives. Prevention of unwanted pregnancies remains the highest priority and 
every attempt must be made to eliminate the need for abortion. Unwanted pregnancies can be 
prevented by effective use of family planning (FP) methods.  Where contraception is not available or 
inaccessible, many women will seek to terminate unwanted pregnancies even in the face of 
restrictive laws and lack or inadequate abortion services. Women who resort to unauthorized 
providers put their health and lives at risk 
4,5 
 
Young people are more vulnerable to abortion than older people . This is because their social, 
emotional and psychological development is incomplete. They tend to experiment with irresponsible 
sexual behavior which may result in unwanted pregnancies .In general boys engage in more 
irresponsible sexual behavior than girls. Many cultures are more tolerant to male youth sexual 
activity and even encourage it. In addition these male youth tend to use alcohol and drugs more than 
girls, which increases their irresponsible sexual behavior. Encouraging young men to avoid 
irresponsible sexual behavior can result in better reproductive health for girls as well.
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In this study the male youth will comprise young men aged 18-25. This will include teenagers (18- 19 
years) and young adults (aged 20-25). These are legally adults and thus can consent independently for 
the study. At the turn of the 21
st
 century 1.7 billion people, that is, more than one-fourth of the 
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worlds population of six billion, were  aged between 10 and 24. Eighty six percent of the age group 
10 to 24 years  live in  less developed countries such as Kenya. Many of these young people are 
sexually active which exposes them to sexually transmitted infections (STIs) including human 
immune virus/ acquired immune deficiency syndrome (HIV/AIDS), unwanted  pregnancies and 
complications from pregnancy and child birth. Young people often have inadequate or misleading 
information on sexuality and reproductive health and lack access to reproductive health care
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. 
 
Men in Africa play an important role in most decisions pertaining to family life, including family size 
and family planning. A number of cultural factors favour men in matters related to marriage and 
family life. Men play an important role as heads of households, are viewed as custodians of their 
lineage and are protectors and providers for their families. The social and economic dependence of 
wives on their husbands give men a great influence in family decisions .
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In addition, the idea of involving men more into  reproductive health is rapidly gaining momentum 
and credibility. This is partly due to a shift in emphasis in the international donor community from  
family planning being used purely for demographic reasons to broader reproductive health issues for 
human and health reasons.
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Men have been neglected in the past in family planning and reproductive health issues. A growing 
number of  programs and providers are  realising these. Men deserve more attention for their own 
sake, for the women’s sake and for the health of their families and communities. From this new 
perspective, men are potential partners in  advocating for good reproductive health rather than being 
bystanders, barriers or adversaries.
4
 
 
In many countries, traditional male and female gender roles deter couples from discussing sexual 
matters. They condone risky sexual behaviour and this ultimately contribute to poor reproductive 
health among men and women. Programs can encourage men to adopt positive gender roles such as 
being supportive partners.
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1.2 Background 
Abortion is one of the oldest methods of preventing  an unwanted birth. Among the preliterate 
people, use of abortion and infanticide exceeded the measures to prevent conception. The earliest 
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written reference to any method of fertility control was a recipe for an oral abortifacient. This 
concoction, which may have included quicksilver, is found in the ancient Chinese medical text 
written by the Emperor Shen Nung in the period 2737-2696 BC
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Abortion was common in ancient Greece and Rome. A 1922 review of Greek practices included 12 
pages listing abortifacients, instruments, injections and medicated pessaries or tampons used. 
Hippocrates reportedly advised one woman to jump in the air and striking her heels against her hips 
to induce abortion. In ancient Rome, abortion was also a frequent practice. The methods used 
included oral agents(usually strong purgatives), douches, (often caustic agents) and curettage. 
Although there are no data to determine the hazards or the efficacy of these methods, clearly they 
were risky. Purgatives and caustic agents were often administered until either abortion or death 
resulted. As a result of curettage procedures perforation and sepsis were not uncommon.
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Religious criticism of abortion is noted in the Old Testament but became stronger in the Christian 
era. During the Middle Ages abortion was condemned and, as the procedure was performed in 
secret, medical information about methods and complications was not readily available. Drugs and 
herbs were widely used. For instance especially materials from trees that did not bear fruit such as 
the willow. The limited information available suggests that these abortifacients were usually not 
effective. If they were effective, they were widely toxic to the woman. 
 
In some African tribes, abortion was practised to terminate premarital or extramarital pregnancies. 
For example among the Meru in Central Kenya, illegitimate children were not accepted in the 
society and uncircumcised women were expected to refrain from sexual activity. If a mother 
discovered that her uncircumcised daughter was pregnant, she called the aruti ba mau  (people who 
terminate pregnancies)who applied pressure to the abdomen until the foetus was expelled.
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1.3 Magnitude of the problem 
Abortion is one of the greatest public health problems. This is because of its repercussions which 
cause maternal morbidity and mortality and because of its ethical, political, social, religious moral 
and legal implications. Complications of pregnancy, childbirth and unsafe abortion are the major 
causes of death among women aged 15-19.
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