Nairobi, Kenya • Nowhere in the world is there a higher rate of unsafe abortions or unwanted pregnancies than in sub-Saharan Africa, where women are often scorned for conceiving before marriage.
Efforts to legalize and make abortion safer in Africa were shattered when the US Supreme Court overturned national abortion rights a year ago. Within days, Sierra Leonean President Julius Maada Bio declared that his government would decriminalize abortion “at a time when women’s rights to sexual and reproductive health are either being suspended or threatened.”
But some US-based organizations active in Africa have been encouraged, particularly in predominantly Christian countries. One is Family Watch International, a nonprofit Christian conservative organization whose anti-LGBTQ+ stance, anti-abortion activities, and “intense focus on Africa” led it to be classified as a hate group by the Southern Poverty Law Center.
In April, Family Watch International helped develop a meeting on “Family Values and Sovereignty” at Uganda’s presidential offices with lawmakers and other delegates from more than 20 African countries. The organization’s Africa director is also calling for his country, Ethiopia, to repeal a 2005 law that expanded access to abortion and drastically reduced maternal mortality.
“It’s like the gloves have come off,” said Sarah Shaw, head of advocacy at UK-based MSI Reproductive Choices, an international provider of reproductive health services, in an interview.
Speaking to the African Bar Association in September, Family Watch International founder and president Sharon Slater claimed that donor countries were attempting a “sexual social recolonization of Africa” by smuggling in legal abortion along with sex education and LGBTQ+ rights.
“Sexual rights activists know that if they can win the hearts and minds of African children and indoctrinate and sexualize them, they will win the future lawyers, teachers, judges, politicians, presidents, vice presidents and more, and in doing so they will win hearts of Africa,” Slater claimed.
Slater is a member of the Utah-based Church of Jesus Christ of Latter-day Saints. In June, she spoke about “immunizing children against modern pressures” at a church-sponsored Strengthening Families Conference in Nigeria, according to a church press release. Nigerian leaders chaired and attended the conference.
Her speech in Malawi was attended by the country’s president, a former leader of the Pentecostal Assemblies of God movement.
After urging lawmakers in the South African country not to consider a bill that would have allowed abortions in certain circumstances, US-based Catholic group Human Life International told supporters in March that “Malawi, thanks to you safe from legal abortion.”
The African Union two decades ago recognized the right to abortion when rape and incest are occurring, or when the life of the mother or fetus is at risk, or the mother’s mental or physical health is at risk.
A growing number of countries have relatively liberal abortion laws. Benin legalized abortion less than a year before the US Supreme Court ruled, even though Nigeria, Africa’s most populous country, only allows abortions to save the mother’s life.
African experts say events in the US could undo progress in making safe abortion procedures available, especially since the US government is the world’s largest donor of international reproductive health assistance.
Such changes could have a profound impact on the lives of women of childbearing age in sub-Saharan Africa, where an estimated 77% of abortions, or more than 6 million a year, are considered unsafe, according to the Guttmacher Institute, an international research and development agency Political organization headquartered in New York, said in 2020.
Unsafe abortions cause 16% of maternal deaths in the World Health Organization’s largely sub-Saharan Africa region, the UN agency said last year, “with variations from country to country depending on the level of abortion restrictions.”
Anti-abortion opponents are particularly vocal in East Africa, where countries have publicly addressed the issue of teenage pregnancy but offer little sex education and access to legal abortion in limited circumstances.
A sexual and reproductive health bill introduced in 2021 is still being debated by the East African Community, whose member states include Burundi, Congo, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Some Catholic and other conservative organizations have criticized a section that would allow a woman to terminate a pregnancy in the event of rape, incest or compromised health.
Earlier this year, the Protestant Council of Rwanda ordered all health facilities run by its member institutions to stop performing abortions, even though Rwandan law allows it in certain cases.
“We have a very strong anti-right-wing narrative,” Brenda Otieno, research coordinator at the Kisumu Medical and Education Trust in Kenya, said during a Tuesday webinar on the global implications of the US Supreme Court decision.
Abortion providers are often harassed, Otieno said, and a year ago Kenya passed a national reproductive health policy that pays little attention to safe abortion care.
In Uganda, a human rights official said the issue of access to abortion is taboo and advocates face discrimination, even when some women resort to self-mutilation.
“We have seen a number of people lose their lives,” said Twaibu Wamala, executive director of the Uganda Harm Reduction Network.
Abortions are illegal in Uganda but can be legally performed by a licensed health professional who determines that pregnancy endangers the mother’s life. But fearing medical complications, many doctors offer only post-abortion follow-up care, which may be too expensive or too late to save a woman’s life.
In Ethiopia, civil society workers have asked the government to investigate what they fear is a new trend: fewer public health facilities are offering abortions and more women are seeking help after unsafe abortions.
Anti-abortion groups in Africa’s second-most populous country are largely egged on by outsiders and “take the Supreme Court decision as fuel for them,” said Abebe Shibru, Ethiopian director of MSI Reproductive Choices.
Associated Press writer Rodney Muhumuza from Kampala, Uganda contributed.
Salt Lake Tribune reporter Emily Anderson Stern wrote from Salt Lake City, Utah.