Shifting Demographics: New Study Reveals Married, Educated Women Lead in Abortion Rates

A comprehensive new study has challenged longstanding perceptions about abortion in Kenya, revealing that married, educated women who already have children now represent the majority of those seeking abortion services.

The report, “Incidence of Induced Abortions and the Severity of Abortion-related Complications in Kenya,” released on May 2, 2025, found that nearly 800,000 Kenyan women obtained an abortion in 2023, with 58% of them being married women.

Key Findings

The research, conducted by the African Population and Health Research Center (APHRC) and Guttmacher Institute between April 2023 and May 2024, surveyed 2,022 women and revealed several surprising trends:

– 58% of women who had abortions were married, with 32% having already given birth to two or three children
– Women aged 25-34 represented the largest demographic group, contradicting assumptions that abortion primarily affects younger, unmarried women
– Regional disparities were significant, with Nairobi and Central regions showing the highest abortion rates (78.3 per 1,000 women of reproductive age)
– 61.8% of women used medication abortion methods, while 27% employed traditional methods
– 66% of women were not using contraceptives when they became pregnant, with 42% citing fear of side effects as their reason for non-use

Unintended Pregnancies Driving Numbers

The study identified unintended pregnancies as a major factor, with an estimated 1.43 million unintended pregnancies in Kenya during 2023 – a rate of 103.8 per 1,000 women of reproductive age. Over half of these unintended pregnancies ended in abortion.

“Many women said they aborted as they were not ready to get a child at the time they got pregnant,” explained Margaret Giorgio, Research Scientist at Guttmacher.

Healthcare System Challenges

The findings highlight significant gaps in Kenya’s healthcare infrastructure for post-abortion care. Kenneth Juma, Senior Research Officer at APHRC and Project Lead, noted that only 18% of level two and three facilities can provide post-abortion care services.

“Health centres and dispensaries need to be well equipped to be able to take care of post-abortion cases. We also need to improve the capacity of the referral hospitals,” Juma stated.

While 92% of post-abortion care patients received family planning counseling, over half (56%) left healthcare facilities without adopting a contraceptive method.

Dr. Patrick Amoth, Director General of Health, acknowledged that unsafe abortion remains a significant public health challenge in Kenya. He highlighted government efforts to address the issue through improved contraceptive access, clinical guidelines, and healthcare provider training.

“The government has invested in multiple interventions to prevent unsafe abortions and their health consequences,” Dr. Amoth said, while noting that more comprehensive data is still needed.

Progress and Remaining Challenges

Compared to a similar study conducted in 2012, the abortion incidence ratio has increased from 30 to 48 per 100 live births. However, researchers noted a positive trend in the reduction of severe complications related to abortion procedures.

“The proportion of women with more severe complications has reduced significantly,” said Yohannes Wado, Research Scientist at APHRC. “One possible explanation is that access to post-abortion care services in Kenya has increased over the past decade.”

Researchers emphasized the need for community education on contraception and reduction of stigma, particularly for young women seeking reproductive healthcare services.

As Kenya continues to address these challenges, the study’s findings underscore the complexity of abortion decisions and the importance of comprehensive reproductive healthcare that addresses the needs of all women, regardless of age, marital status, or education level.​​​​​​​​​​​​​​​​