The word “abortion” is used to describe two types of pregnancies that end before 20 weeks, which is now considered the age of viability for a pregnancy.
Spontaneous abortion takes place without the woman’s intention to stop the pregnancy, it is pregnancy loss before 20 weeks of gestation. Induced abortion is an intentional termination of a pregnancy because it is undesirable.
About 10% to 20% of all pregnancies in Nigeria end in miscarriage. This is in line with prices elsewhere in the world. It is 12% in Ghana.
However, induced abortion is believed to be more common in Nigeria compared to other countries. But it is difficult to measure the incidence of dismissals because abortions are restricted by law.
2015, Guttmacher Institute calculated The incidence of abortion in Nigeria was 50.6 per 1,000 per women of reproductive age. If correct, this is one of the highest abortion rates in the world. Guttmacher Institute is a research and policy organization committed to promoting sexual and reproductive health and rights worldwide.
In Ghana, there are between 30 and 61 abortions per 1,000 women aged 15-49. This gives an average value of 44.
In Europe, abortion rates are much lower. The Netherlands, for example abortion occurrence of 8.6 abortions per 1000 women, while in Sweden it is 18.3 per 1000 women.
IN a study I conducted in Benin City, Edo State in 2015, I asked women who went to the gynecology clinic at the University of Benin Teaching Hospital if they had ever had an abortion. About 72% answered yes, and many reported several episodes of abortion.
Based on my experience, I think these high levels continue. The pattern of abortions may have changed in the last seven years due to evidence that many more women are now self-induced to use drugs.
In addition, women continue to use hazardous substances to terminate pregnancies while uneducated professionals and quacks without clinical training continue to perform many procedures. This makes abortion extremely dangerous and fraught with complications.
Restrictive laws contribute to the abortion rate
The current abortion law in Nigeria was enacted by the British colonial government In the 1800s. It has never changed. It is mainly based on section 58 of the Offenses Against the Person Act, 1861 in England.
Abortion Law in Nigeria states that abortion is illegal if it is not done to save the mother’s life. It criminalizes abortion with severe punishment for both the woman and the staff who perform the abortion procedure. If arrested, those who break the law risk 7 years in prison (the patient) or 14 years (the practitioner).
Conditions for performing abortions are prescribed by the Federal Ministry of Health in a publication entitled National guidelines for safe termination of pregnancy for legal indications. These state the conditions under which induced abortion can be performed in a safe manner by health care professionals.
The guideline is intended to build up the healthcare staff’s capacity to identify pregnancies for which the abortion law is intended so that ethical and safe handling can be initiated. It provides information on the existing Nigerian law on termination of pregnancy, a compendium of medical conditions and circumstances in which the continuation of pregnancy endangers women’s lives and a description of the step-by-step options for ethical and safe medical management.
This document is available at the Federal Department of Health and has been well-publicized throughout the country. If used properly and understood by healthcare professionals, it will help identify pregnancies that pose a threat to women, which can be properly managed by safe abortion care at healthcare facilities.
In my experience, restrictive laws do not prevent women with unwanted pregnancies from having abortions anywhere. This also applies in developed countries. It only makes the procedure dangerous and unsafe. It causes women to secretly seek abortion at the hands of unqualified providers who can then lead to death or disability.
The World Health Organization (WHO) defines unsafe abortion as “termination of pregnancy by persons who lack the necessary skills or in an environment which does not comply with the minimum medical requirements”.
US abortion policy
I believe that US abortion policy should not affect Nigerian women because the United States is governed by different laws and processes.
Abortion in the United States has always been a controversial issue, and related policies have varied due to the changing political circumstances in the country. It is sad that an issue such as unwanted pregnancy and abortion that is the result of personal encounters can be turned into a public and political discourse that takes place in the United States.
I find it reprehensible that such public interference in family and private affairs can be allowed to continue to harden in the political space, despite the lack of evidence to suggest that abortion has a negative effect on the country in any particular way.
The long-term solution is for countries like Nigeria to develop their population, reproductive health and development policies without external influence.
Abortion as a women’s right
Several international organizations such as the WHO, the International Federation of Gynecologists and Obstetricians, Amnesty International, the Royal College of Obstetricians and Gynecologists and the United Nations have repeatedly issued guidelines to indicate that women have the right to decide whether or not to have an abortion.
In addition, it is recognized that women have the right to access to family planning, safe abortion and post-abortion care.
I agree with these recommendations. They form part of the benchmarks for measuring global development and social equality, as they e.g. Sustainable development goals.
Nigeria has signed these documents including Maputo Protocol which protects women’s rights in decision-making on safe abortion care and has an obligation to protect those rights.
I fully support women’s rights to safe abortion and post-abortion care. They are necessary to build women’s drive and social empowerment in other ways.
Author: Friday Okonofua – Professor of Obstetrics and Gynecology, University of Benin