GOOD HEALTH: NIGERIAN WOMEN NEED BETTER POST ABORTION CARE SERVICES
By Ibeneme Ebele, Vanguard (Lagos)

September 7, 2004 – In Nigeria where abortion is illegal and the criminal code strictly prohibits any form of procurement of abortion except in saving the life of a woman, there are indications that induced abortion is still widely practiced.

The absence of legal backing to willingly support any woman's desire to undergo abortion without being punished or victimized by society, has, to a great extent, contributed to the continuation of unsafe abortion with the resultant increase in maternal mortality.

That unsafe abortion is responsible for a significant proportion of matenal deaths, particularly in younger women while contributing to maternal morbidity by increasing exposure to infection and the risk of hemorrhage and mechanical injury, is no longer news.

Every year several millions of women lose their lives through procurement of clandestine abortions and according to the World Health Organization, 55, 000 unsafe abortions take place daily. About 13 per cent of pregnancy-related deaths, worldwide, are due to unsafe abortion. African women suffer the world's highest abortion-related deaths, estimated at 680 deaths per 100,000 abortions, compared to 330 deaths per 100,000 abortions in the rest of veloping world.

Simply put, unsafe abortion is a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills/training or in an environment lacking minimal medical standards or both.
Research shows that socio-economic factors ranging from lack of resources to raise and support a child, unstable relationship, sexual violation including rape, incest or coercion, psychological problems that put the women or the fetus at risk, her right to health are some of the reasons why women opt for abortions.
Others include social stigmatization as a result of fear of isolation and rejection, employment policies, lack of knowledge as well as religious views.

But it remains fact that these deaths can be prevented if women have access to family planning services. Presenting a paper on "Unsafe Abortion: An Issue of Right and Social Injustice" at a training workshop for the media on saving women lives organized by Ipas in collaboration with Devcoms Communications, a member of International Federation of Female Lawyers (FIDA).

Ms. Chinelo Aroh pointed out that there is no specific law on abortion in Nigeria. She said nation's criminal code provides for any issues on the practice of abortion and makes it illegal for abortion to be practiced as fashioned from 1861 English statute.

It was gathered that deaths arising from unsafe abortions could be prevented if information and access to better choices are available to women who either have spontaneous or induced abortion.

"The issues of illegal of abortion contributes to the increasing rate of maternal mortality, because abortion is criminalized, a lot of women go to unskilled people to procure abortion in unsafe environment".

She called for reformation of the country's abortion law while citing the international experience which indicates that de-criminalizing abortion leads to decrease in abortion-related complications and deaths.
Ipas Country Representative, Dr. Ejike Orji further revealed to Good Health Weekly that the highest cause of maternal morbidity in Nigeria is unsafe abortion. His words: "In Nigeria, 19 million unsafe abortions are performed daily, 95 percent of them occur in the developing world which includes Nigeria, and there are over 70,000 women dying from it"

Orji added that in Africa, the ratio of deaths from unsafe abortion is 110 per 100,000 live births -- a figure that is more than twice that of any region.

The only way to control unsafe abortion and reduce maternal morbidity in the country is to provide universal access to women for high quality post abortion care and other reproductive health services, safe services within the law limits of the law, ensure reform of the abortion law, increase deployment of funds to reproductive health, as well as getting community participation in reproductive health issues and services.

Reduction of maternal mortality is one of the millennium development goals.