A Landmark Ruling on Abortion in Kenya: What it means for women, girls, and self-care

As Executive Director of the Reproductive Health Network Kenya (RHNK)—the newest SCTG National Self-Care Network—Nelly Munyasia is well versed in the global fight for reproductive justice. On March 24th, 2022, the High Court of Kenya in Malindi reaffirmed Kenyan women’s right to abortion and provided extra protections for women seeking abortion care. Ms. Munyasia joined White Ribbon Alliance—SCTG Advocacy and Learning Lead—for a brief conversation to discuss the implications of this ruling for women and girls, including what it may eventually mean for self-managed abortion.

What is the RHNK, and what has your role been throughout this landmark case?

In 2010, a group of passionate healthcare providers and reproductive rights champions came together to form the RHNK. Though we began as a strict service delivery organization, we have expanded our work beyond abortion care to include advocacy on broader sexual and reproductive rights, including initiatives on LGBTQ+ rights, contraception access, and self-care. We’ve learned the power of coalition building, recognizing that the issues we face are too great to tackle as a single entity.  We work with key stakeholders, youth champions, and advocates at the local and national level to effect progressive policy change and implementation.

RHNK has been involved in this case from the very beginning. When an 18-year-old adolescent (identified only by her initials, “PAK”) experienced a spontaneous abortion (miscarriage), she sought emergency medical treatment from one of our service providers. She received the proper treatment and was recuperating in the maternity ward when plain clothed police officers stormed the clinic, confiscated PAK’s medical records, and arrested both her and the clinician who treated her. PAK was later forced to undergo a medical examination and was charged with procuring an illegal abortion, while the clinician was charged with providing the abortion service illegally. When a lower court refused to drop the charges, RHNK, in conjunction with the Center for Reproductive Rights, brought the case to the Malindi High Court, where we’ve been following its progress closely. We are thrilled with this ruling and very happy that PAK and our colleague have been exonerated.

The Malindi Court ruling is a powerful step in the fight for reproductive justice. What does this ruling mean, practically, for women and girls seeking reproductive healthcare?

Kenya’s 2010 Constitutional Referendum legalized abortion when the life and health of the mother is at risk. However, political opposition, community reporting, and police harassment at clinics are still pervasive issues, creating a culture of fear and distrust and deterring women and girls from accessing the safe abortion care they need. As a result, 50,000 women and girls die every year because of unsafe abortions. This ruling reaffirmed that abortion care is a fundamental right, enshrined in the constitution, and determined that the arbitrary arrest and persecution of women seeking abortion care is illegal. Practically, we hope the criminalization of harassment and arbitrary arrests will lead to a safer and more comforting environment for women and girls seeking abortion care. 

What are the implications for the use of medication abortion and, more generally, what is the path for self-managed abortion moving forward?

When choosing how to access health services, it’s clear that women and girls will prioritize their comfort, safety, respect, and dignity. We hope that this ruling will make the process much more comfortable for women and that they will feel safe coming to the clinic. But we also know that, for a variety of reasons including cost, privacy, and confidentiality, women often prefer to self-manage their abortion in the comfort of their own home. During COVID-19, health systems heavily invested in telemedicine as an easy method to access care. This really opened the door for self-managed abortion, and we’ve seen a significant increase in the use of medication abortion in the past two years. RHNK hopes the topic of self-managed abortion will provide a launching point for a larger national dialogue on Self-Care, especially as Kenya is looking to domesticate the World Health Organization’s (WHO) self-care guidelines.

What is next for RHNK in the fight for reproductive justice?

This ruling is incredibly significant, and we need to ensure that communities understand the practical implications. In the coming months, RHNK will utilize community dialogues, media, and radio to help get information about this ruling directly to women, health providers, policy makers, and especially law enforcement. While there is still political opposition to reproductive rights, we have a strong network of reproductive justice advocates who continue to fight for women’s rights, and we look forward to ensuring that every woman and girl has access to the quality health services she deserves. 


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