How Do We Enhance Access to Safe Abortions in Nigeria?
Every year, nearly half of all pregnancies (121 million) are unwanted; 6 out of 10 undesired pregnancies and 3 out of 10 all pregnancies result in induced abortion.
Abortion is safe when performed according to WHO guidelines, at the appropriate stage of pregnancy, and by a skilled practitioner. When women with unwanted pregnancies confront hurdles to obtaining a quality abortion, they frequently resort to risky procedures.
Ensuring that women and girls have access to evidence-based abortion care that is safe, respectful, and non-discriminatory is critical to reaching the Sustainable Development Goals (SDGs) for good health and well-being (SDG3) and gender equality (SDG 5).
Over the last 30 years, more than 60 countries and territories have liberalized abortion legislation. Abortion rights are becoming recognised as fundamental human rights by millions of people all across the world, from Ireland to Nepal.
The Green Wave is also ushering in a new era of liberalization in Colombia, Mexico, Argentina, and other Latin American countries. Only four countries have repealed abortion laws: the United States, El Salvador, Nicaragua, and Poland. The terrible decline in abortion rights in the United States makes the country a striking outlier in the global trend towards liberalization.
Like the rest of the world, the African continent is home to several organizations trying to increase access to abortion information and support. However, legal limitations remain. Lawmakers and policymakers in Africa and around the world have implemented a variety of legislative limits on abortion, including self-managed abortion.
Most countries' criminal laws explicitly prohibit self-induced abortion and create vulnerability and risk for individuals who engage in it by limiting access to information and overregulating access to critical drugs, violating people's human rights. The Malawian and Ugandan Criminal Codes, as well as Togo's Public Health Law, all criminalize those who self-manage abortions and those who advise, support, provide, or obtain abortion.
Abortion is a grey area in the law in Nigeria. While the legislation allows for pregnancy abortion solely to save the woman's life or, in Lagos state, to preserve physical health, the reality is significantly more nuanced.
To understand the accessibility of abortion care in the country, we conducted a qualitative survey where we asked respondents who were anonymous about their experience with abortion care in Nigeria. From their responses, we derived some themes;
The Women Were Teenagers and Young Adults
The study respondents were between the ages of 16 and 29 when they sought abortion care. Women who sought care in their teens were more likely to resort to unsafe means than women who were young adults.
Resorting to Unsafe Practices Due to Fear
Many women are forced to engage in unsafe practices due to legal limits on abortion. This drives them to seek assistance from inexperienced healthcare professionals, which frequently results in traumatic experiences. These procedures can cause infections, haemorrhaging, and even death.
Inaccessibility and High Cost of Care
Most of the respondents (41.2%) reported that it was challenging for them to access abortion care, and 31.3 per cent reported that it was costly. The cost of safe abortion services can be a significant hurdle, especially for young women.
Stigma and Sexual Assault
41.2 per cent of the respondents reported facing stigma when receiving care. They mentioned reports of slutshaming in the hands of medical professionals. One of the respondents detailed the sexual assault she faced at the hands of the doctor who performed the procedure, which was done under the guise that the drug would only work if he penetrated her.
Importance of Support
The value of having a confidante during this challenging period is evident. The stories narrated by the respondents emphasize the value of having a trusted friend or family member who can provide emotional support and help navigate the complexity of abortion care.
There is an urgent need for transformation in abortion care. Increased access to safe and legal abortion services, together with comprehensive sexual education and readily available contraception, are essential steps to be considered. Also, removing the stigma surrounding abortion and encouraging open discussions are vital in ensuring women's health and well-being, especially for women in Nigeria.