NIGERIA – Blurring the lines: The stark reality of safe abortion access in Nigeria

In Nigeria, accessing safe abortion care is a contentious issue fraught with myths, misconceptions, and misinformation that often obscure the reality of sexual and reproductive healthcare.

According to the World Health Organization (WHO), about 73 million abortions take place worldwide every year. Worldwide, an estimated 22 million abortions continue to be performed unsafely each year, resulting in the death of an estimated 47,000 women and disabilities for an additional five million women with 29% of all pregnancies ending in an induced abortion. Almost every one of these deaths and disabilities could have been prevented through sexuality education, family planning, and the provision of safe, legal induced abortion and care for any complications of abortion.

According to a more recent nationally representative study of women of reproductive age, there were 29 abortions per 1,000 women aged 15–49 in Nigeria, which is believed to have been 1.25 million induced abortions in 2012, or 33 abortions per 1,000 women aged 15–49.

In Nigeria, it is unlawful to perform an induced abortion unless it is done expressly to preserve the woman’s life. Hence, unless the pregnancy is putting her life in jeopardy, it is difficult for any pregnant woman who does not want to have a child to obtain an abortion at a government hospital, regardless of how serious or legitimate her reasons may be.

Because the average Nigerian woman cannot afford to engage the services of a willing private clinic, she is compelled to resort to unsafe abortion by patronising inexperienced workers who use inappropriate and contaminated instruments under unhygienic conditions to perform it. The result is the staggering statistics of 1,000 out of every 100,000 maternal deaths arising from the estimated 1,000,000 abortions performed annually in Nigeria. Also, it has the consequence of endangering women’s reproductive health, particularly in adolescents.

Today’s harsh reality is something that no restrictive abortion legislation can suppress no matter how stringent; in fact, it is what restrictive abortion laws are to be held accountable for. The expediency of this situation motivated our approach to examine the necessity of reforming Nigeria’s abortion laws to provide access to safe abortion care and correct misinformation, regardless of one’s personal stance on the sanctity of human life.

Abortion is a historical practice that has been prevalent in human civilizations and is not a modern aberration. Despite the fact that abortion has always been lawful on a federal level, divisive political discourse has hindered practical access to abortion services. Misinformation and disinformation about abortion have been purposefully incorporated into political agendas and ideologies, creating a gulf between the general public’s view of abortion care and patients’ actual experiences receiving it.

Nigeria’s abortion laws are some of the most restrictive in the world. In the northern states, the Penal Code Act of 1861, which is based on Islamic law, criminalises abortion except when it is performed to save a woman’s life. This strict interpretation limits access to safe abortion care and contributes to the prevalence of unsafe abortion practices in the region. The stigma surrounding abortion in these states is also particularly strong, driven by cultural and religious beliefs that view abortion as morally wrong or as a sin.

In contrast, the southern states operate under the Criminal Code Act of 1960, which allows for broader grounds for abortion, including to preserve a woman’s physical and mental health. However, the interpretation and implementation of these laws vary, leading to inconsistencies in access to abortion services across the region. Additionally, bureaucratic bottlenecks and the lack of trained providers further limit access to safe abortion care in the southern states.

The legal ambiguity and restrictions surrounding abortion in Nigeria create barriers for women seeking reproductive healthcare. Many women are unaware of their rights under the law or are unable to navigate the complex legal and healthcare systems to access safe abortion services. As a result, they often resort to unsafe practices, putting their health and lives at risk. Efforts to improve access to safe abortion care in Nigeria must address the legal challenges through reform of the outdated and restrictive laws….

[Meanwhile] unsafe abortion continues to be a significant cause of maternal morbidity and mortality in Nigeria, a country with one of the highest maternal mortality ratios worldwide…. In addition, a recent study documented high levels of abortion stigma among close to half of Nigerian abortion seekers. Silence and secrecy shrouds abortion in Nigeria and women who have had an abortion limit disclosure for fear of exclusion, judgment, and shame in families and social circles. Such a culture of secrecy may be a product of, or exacerbated by, the legal status and perceived illegality of abortion in Nigeria.

[The article continues, talking about dispelling myths and misconceptions, reducing stigma, exposing false claims that abortion is unsafe, and much more. It ends by calling for safe, legal abortion across Nigeria.]

SOURCE + VISUAL: Premium Times Nigeria, Press release. 22 April 2024.


Federal Government plans annual safe maternity scheme for seven million pregnant women

The Federal Government on Monday launched guidelines on safe motherhood, targeting at least seven million pregnant women and at least six million newborn births annually.

Speaking at the launch of the guidelines – the Labour Care Guide, and the Guidelines for Community Use of Misoprostol – to commemorate the 2024 Safe Motherhood Day in Abuja, the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, noted that it is possible to achieve safe motherhood in the country. He said: “Nigeria has a large burden of preventable maternal deaths, and we also have a large burden of newborn mortality. We have made progress, but it is not enough. Every death of a mother is an unfortunate incident. No level of maternal mortality is acceptable. Despite the progress that we have seen, postpartum haemorrhage remains a very important cause of maternal mortality and newborn mortality, asphyxia, and complications of preterm. We have to ensure that all women in Nigeria have access to quality maternal care, irrespective of where you come from, so that we don’t leave any woman behind.”

The UNFPA Gender and Reproductive Health Specialist in Nigeria, Dr Musa Elisha, said: “It is important for all pregnant women to deliver at health facilities where there are skilled attendants and appropriate equipment. However, women and girls across Nigeria continue to face challenges in accessing quality maternal and newborn care, particularly amongst the underserved, marginalised, and vulnerable populations.” On her part, the Permanent Secretary at the Ministry of Health and Social Welfare, Daju Kachollom, noted that with the launch of the documents, postpartum haemorrhage, preeclampsia/eclampsia, and unsafe abortion affecting maternal health in Nigeria will be addressed.

SOURCE: Punch Nigeria, by Lara Adejoro, 22 April 2024