By Adeyinka Adeniran
In this piece, Adeniran Adeyinka takes a look at the need for reforms in the health sector, especially as it relates to unsafe abortion. the effort is based on finding by researchers at Guttmacher Institute, USA.
In Nigeria, a nation grappling with a staggering maternal mortality rate, the issue of abortion remains shrouded in legal restrictions and societal stigma. While the law permits abortion only to save a woman’s life, the reality is starkly different. Unsafe abortions are prevalent, often conducted in clandestine settings by unskilled providers, leading to devastating health outcomes for women.
The Hidden Toll of Unsafe Abortions
Abortion in Nigeria is not just a legal matter; it’s a public health crisis. Unsafe abortions are a leading cause of maternal death, contributing significantly to the country’s high maternal mortality ratio—estimated at 512 deaths per 100,000 live births as of 2021, one of the highest in the world. In 2012 alone, an estimated 1.25 million induced abortions occurred, reflecting a troubling trend that has continued into recent years. A recent study indicates that the number of abortions may have risen to around 1.6 million annually, exacerbated by increasing population pressures and limited access to reproductive health services.
Complications from unsafe abortions can range from severe pain and bleeding to life-threatening infections. A study in 2012 revealed that nearly 40% of women undergoing abortions experienced complications serious enough to require medical attention. Tragically, about 10% of women treated for pregnancy-related complications in hospitals were victims of unsafe abortion practices. This burden on Nigeria’s healthcare system is compounded by the financial strain on families, with post-abortion care costs soaring as high as $132 per patient, a significant amount in a country where many live on less than $2 a day.
Unintended Pregnancies: A Call for Change
The statistics surrounding unintended pregnancies are equally alarming. Approximately one in four pregnancies in Nigeria is unintended, with more than half of these ending in induced abortions. The unmet need for family planning is particularly pronounced among women aged 15–49, with recent figures indicating that about 19% express a desire to avoid or space births but lack access to contraceptives. This gap is most acute among sexually active unmarried women, where the unmet need rises to 27%.
Despite the desire for smaller families—Nigerian women want an average of 5.2 children yet are having 5.5—contraceptive use remains critically low. As of 2021, only 17% of women of reproductive age utilized any contraceptive method, with merely 12% using modern methods. This highlights a substantial barrier to achieving reproductive autonomy and underscores the urgent need for accessible family planning services.
Regional Disparities and Their Implications
The landscape of abortion varies across Nigeria’s diverse regions. In the North East and South South, abortion rates soar, driven by minimal contraceptive use and a strong desire for smaller families. Studies have shown that in 2021, the abortion rate was estimated at 44 per 1,000 women in the North East, compared to just 27 per 1,000 in the South West. The stark contrast highlights the critical role that access to family planning services plays in shaping reproductive health outcomes.
In the North East, where contraceptive use is a mere 3%, the average desired family size is only 3.9 children, leading to a significant gap between aspiration and reality. Conversely, the South West region, with a higher rate of contraceptive use (about 25%), reports the lowest rates of induced abortions, showcasing a direct correlation between family planning access and abortion rates.
A Path Forward: Empowering Women Through Education and Access
Addressing this silent crisis requires urgent action. Expanding family planning programs and enhancing education around reproductive health are essential steps toward reducing unintended pregnancies and the subsequent reliance on unsafe abortions. Quality care must be made available, encompassing comprehensive counseling on contraceptive methods and facilitating easy transitions between options.
Investing in education is crucial. Studies have shown that educated women are more likely to use contraceptives effectively and seek proper reproductive health care. Increased awareness about family planning can lead to significant decreases in unintended pregnancies—research suggests that improving access to contraceptive methods could reduce unintended pregnancy rates by as much as 70%.
Moreover, while the current legal framework restricts access to abortion, it is vital to establish efficient processes that allow women eligible for legal procedures to access safe services early in their pregnancies. By doing so, we can reduce the health risks associated with unsafe abortions and empower women to make informed choices about their bodies.
The Call for Comprehensive Reform
As Nigeria navigates the complexities of reproductive health, it is clear that the time for change is now. The dual challenges of unintended pregnancies and unsafe abortions are not insurmountable; with concerted efforts from the government, healthcare providers, and communities, it can pave the way for a healthier future for women across the nation.
Experts believe that the failure to modernize Nigeria’s abortion laws not only keeps women vulnerable but also contributes to one of the highest maternal mortality rates globally, stalling efforts for progress and equality.
Countries with progressive abortion policies have seen drastic improvements in maternal health. For instance, Ethiopia revised its abortion laws in 2005, allowing for safe terminations in cases of rape, incest, or risk to the mother’s life, and consequently reduced abortion-related deaths significantly.
Greater access to family planning and abortion care, as permitted by current laws, is critical. However, the realities on the ground point to an additional need. By taking these steps, experts said Nigeria can reduce maternal mortality, empower women to make informed decisions about their bodies, and uphold human dignity.
