Dr. Pebolo the GRRH gynecology expert during a media engagement.
By Simon Wokorach
GULU: Gulu Regional Referral Hospital (GRRH) is facing increasing pressure from a surge in women seeking post-abortion care, raising concerns about access to reproductive health services, legal restrictions, and social stigma.
Dr. Francis Pebolo, a gynecologist at the hospital’s maternity ward and lecturer at Gulu University, revealed during a recent media engagement that daily admissions for post-abortion care have doubled from about five cases to at least ten.
He noted that the majority of patients are teenage mothers and women from economically disadvantaged backgrounds, many of whom resort to unsafe methods to terminate pregnancies.
“Most of these cases are preventable, but the restrictions and stigma push women to unsafe alternatives,” Dr. Pebolo said.
Uganda’s abortion laws remain restrictive, permitting the procedure only under specific medical and legal conditions. As a result, some women turn to traditional herbs, including a plant locally known as Lutoto (wandering jew), to induce abortion methods that often result in severe complications.
Hospital records indicate that 362 women sought post-abortion care over the past year. However, many of them did not receive follow-up psychosocial support due to a shortage of trained counselors.
Dr. Pebolo cited a severe case involving a young girl who attempted an abortion using a stick. Although her life was saved, she underwent a hysterectomy, permanently losing her ability to bear children.
“She came to the hospital for treatment but left without a uterus. Cases like this have pushed me to advocate for improved access to safe abortion and post-abortion care,” he said.
Nationally, Uganda records approximately 2.2 million pregnancies annually, with 44 percent classified as unintended. These figures contribute significantly to unsafe abortion practices.
In the Acholi sub-region, complications arising from abortions accounted for 9.4 percent of maternal deaths between 2021 and 2022, one of the highest proportions in the country.
Dr. Pebolo also raised concerns about unregulated practices in some private health facilities, which he said conduct abortion procedures without proper documentation, making oversight difficult.
Uganda’s legal framework, including Article 22(2) of the 1995 Constitution and the Penal Code Act, prohibits abortion except under limited circumstances such as rape, non-viable pregnancies, HIV-related risks, or when the mother’s life is in danger.
Despite these provisions, access to safe and legal services remains limited.
Margaret Atim (not her real name), a resident of Gulu District, shared her experience of an unintended pregnancy following a gang rape incident. Fearing stigma and disbelief, she opted for a herbal method to terminate the pregnancy.
“I feared telling my parents. I thought no one would believe me,” she said.
Although she survived after receiving treatment at a government facility, Atim continues to struggle with trauma due to lack of counseling services.
“I have to deal with my pain alone. I don’t know who my perpetrators are, and I cannot seek justice,” she added.
Atim also expressed concern about rising incidents of sexual violence during market days, noting that at least three women in her community have been raped this year.
Cinderella Alimuchan, a lawyer and sexual and reproductive health rights advocate, warned that restrictive abortion laws continue to endanger women and girls.
She noted that Uganda is a signatory to several international frameworks, including provisions under Article 14(2) of the African Women’s Charter, which support access to reproductive health services under specific conditions.
Alimuchan called for the decentralisation of post-abortion care services to lower-level health facilities to improve accessibility and reduce maternal deaths.
She also urged communities to support women with unintended pregnancies, including adoption options, to reduce the prevalence of unsafe abortions.
According to the Ministry of Health, Uganda records an estimated 800 abortion cases daily. However, many cases occurring at the community level remain undocumented, limiting the availability of comprehensive data for policy response.
