At just 19 years old, Resty (not her real name) from Namisindwa District faced a nightmare no girl should ever endure. One evening, while walking along a bushy path near her home, she was ambushed and raped by an unknown man.
When she later missed her period, she dismissed it as normal; her cycle had always been irregular. But as the days went by, morning vomiting and persistent illness set in.
Slowly, the reality she dreaded became clear.
She was pregnant. Caught between shame, fear, and the trauma of sexual assault, Nabulobe felt she had no safe options.
In the end, she chose to seek an abortion, joining hundreds of girls and women in Uganda who turn to unsafe methods every single day.
According to a study by the Guttmacher Institute and Makerere University, an estimated 840 abortions occur daily in Uganda.
Of these, about five women die each day from complications. Annually, unsafe abortions are responsible for more than 1,500 maternal deaths.
With no access to professional care, Nabulobe visited a traditional healer who prepared a concoction of crushed leaves, tree bark, and water. She was instructed to drink the bitter mixture. The outcome was devastating.
‘The next four days were a nightmare,’ a relative recounted.
‘She bled heavily, suffered unbearable pain, and grew too weak to move. She eventually lost both the pregnancy and her life.’
Her story reflects a widespread yet silent tragedy across Uganda, especially in rural communities where myths, poverty, and restrictive laws push girls into life-threatening situations.
While Ugandan law allows abortion only to save a woman’s life, national guidelines broaden this to cases such as rape, incest, severe foetal anomalies, or when the mother is HIV-positive.
However, accessing safe and legal abortion remains extremely difficult, particularly outside urban centres. Ms Olive Kawala, a social worker in Bududa District, said many women facing unwanted pregnancies resort to the same dangerous routes that killed Nabulobe.
‘Poor and rural women cannot afford skilled providers or travel long distances to hospitals,’ she said.
‘They rely on untrained individuals or attempt self-induced abortions. Some drink petrol. Others swallow unsafe mixtures of herbs or drugs. Many die quietly,’ she added.
Ms Kawala argued that inconsistent interpretation of the law leaves both women and health workers trapped in fear and confusion. Uganda’s Constitution states that no person has the right to terminate the life of an unborn child except as permitted by law.
The Penal Code, Sections 141 and 142, imposes harsh penalties: up to 14 years in prison for anyone assisting an abortion, and up to seven years for a woman who terminates her own pregnancy.
Although the 2006 National Policy Guidelines for Sexual and Reproductive Health allow abortion in specific circumstances, many health workers avoid providing these services because they fear arrest or public condemnation.
Ms Rhodine Kitandwe, the project advocacy officer at CEHURD, says the current legal environment forces women into risky alternatives.
‘As a country, we need to expand grounds for safe abortion and improve access to sexual and reproductive health services,’ she said.
‘The law should not trap healthcare workers in a criminal justice system that prevents them from offering essential care,’ she added. Medical professionals echo this concern.
Dr Lettica Tumusime, a gynaecologist in Mbale, said stigma and fear drive hundreds of young women to terminate pregnancies under unhygienic and dangerous conditions.
‘A lot of girls misuse misoprostol, an ulcer drug that causes uterine contractions. When used wrongly, it can cause excessive bleeding, sepsis, or death,’ he warned.
Retired midwife Roseline Nanbafu urged women to seek medical help, saying unsafe practices continue to claim young lives unnecessarily. For some, the problem runs deeper than legality, it is tied to culture and religion.
Mr William Okello, a medical officer in Mbale District, said abortion debates in Uganda rarely move forward because they collide with deeply rooted beliefs.
‘Medical evidence shows that access to safe abortion saves lives and empowers women; but because of religion and tradition, it remains one of the most divisive health issues,’ he said.
Mr Okello added that Uganda must confront the realities facing women and girls.
‘Teenage pregnancies don’t come from moral decay alone. They also come from sexual violence, poverty, lack of information, and gaps in reproductive health services. Ignoring these causes won’t solve anything,’ he said.
As long as the law remains unclear and access to safe abortion limited, health experts warn that more women will die from preventable complications.
Grim picture
A Guttmacher-Makerere study found that in 2013, at least 314,300 abortions occurred in Uganda, 57,000 of them among adolescents. More than 93,000 women were hospitalised due to complications.
Globally, the World Health Organisation estimates that 22 million unsafe abortions occur annually, accounting for between 4.7 percent and 13.2 percent of maternal deaths.
WHO notes that restrictive abortion laws are a major driver of unsafe procedures; countries with strict laws report unsafe abortion rates four times higher than countries with more liberal policies.