Abortion in Nigeria

Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by The Penal Code and southern Nigeria is governed by The Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother’s life in danger.^[1]

Nigerian Law

Nigeria’s abortion laws make it one of the most restrictive countries regarding abortion.^[2] Nigeria’s criminal law system is divided between the northern and southern states of Nigeria.

The Criminal Code is currently enforced in southern Nigeria. The abortion laws of the Criminal Code are expressed within sections 228, 229, and 230. Section 228 states that any person providing a miscarriage to a woman is guilty of a felony and up to 14 years of imprisonment. Section 229 states that any woman obtaining a miscarriage is guilty of a felony and up to imprisonment for 7 years. Section 230 states that anyone supplying anything intended for a women’s miscarriage is also guilty of a felony and up to 3 years of imprisonment.^[3]

The Penal Code operates in northern Nigeria, with abortion laws contained in sections 232, 233, and 234. The sections of the Penal Code parallel the Criminal Code, besides the exception for abortion with the purpose of saving the life of the mother. The Penal Code’s punishments include imprisonment, fine, or both.^[2] The offenses of these codes are punishable regardless of whether the miscarriage was successful.^[4] No provisions have been made to the Criminal Code making exceptions for the preservations of the mother’s life. However, the cases of Rex vs Edgar and Rex vs Bourne have made it generally accepted that abortion performed to preserve the mother’s life is not an appropriate transgression of the Criminal Code.^[2]

Statistics

Since abortion is illegal in Nigeria, many women resort to unsafe abortion methods thereby leading to abortion-related complications and increasing mortality and morbidity rates in the country. In a further research made by the Guttmacher Institute, an estimated 456,000 unsafe abortions are done in Nigeria every year.^[5] In a joint research carried out by the Society of Gynaecologists and Obstetricians of Nigeria and Nigeria's Ministry of Health, estimates of women who engage in unsafe abortion were put at about 20,000 each year.^[6] According to a research made by the Guttmacher Institute in 1996, Nigerian women obtain approximately 610,000 abortions, a rate of 25 abortions per 1,000 women aged 15–44 each year.^[7] These figures are estimated to have increased to 760,000 in 2006.^[8] The research further revealed that only 40% of abortions are performed by physicians with improved health facilities while the remaining percentage are performed by non-physicians.^[7]

History

Throughout history, Nigeria’s abortion laws have mobilized several groups and movements with opposing missions regarding the liberalization of abortion laws and promotion of women’s rights. In the 1972 conference of the Nigerian Medical Association (NMA), the first attempts were made to reform abortion laws in Nigeria. However, a lack of support caused no revisions to result from this attempt. In 1975, the National Population Council further advocated for women’s access to safe and legal abortion on the basis of promoting health and well-being of the mother. Defended by the Nigerian Medical Association (NMA) and the Society of Gynecologists and Obstetricians of Nigeria (SOGON), this sparked a controversy in 1976. At the yearly SOGON convention, the Prime Minister of Health gave a speech noting the possibility for national reform of abortion laws.^[9]

In 1981, the National Council of Women's Societies countered the SOGON’s proposed bill regarding termination of pregnancy, preventing it from reaching the House of Representatives. The National Council of Women’s Societies expressed that more efforts should be put towards family planning education and prevention of pregnancy outside of marriage. They expected parents of the House to enforce strong moral values for the country.^[10] In 1998, the Women’s Health Research Network of Nigeria emerged with the purpose of promoting research and encouraging other groups to advocate and unite around women’s health issues.^[10]

The Campaign Against Unwanted Pregnancy (CAUP) was created in 1991 with the mission of defending women’s sexual and reproductive rights and eliminating unsafe abortion. In 1992, CAUP organized a reform meeting in which the Minister of Health and NMA president reviewed legislation regarding abortion. However, this reform was met with much opposition and was not successful. An important goal of the CAUP is public health education. In 1997, they established the Action Group for Adolescent Health (AGAH), in which they trained medical students to become public educators on sexual and reproductive health. From 1999 to 2004, CAUP organized many workshops and lectures on sexual health and women’s rights with the hope of empowering Nigerian citizens with the knowledge to lead a healthy lifestyle and advocate for change. The focus of CAUP since 2002 has been abortion bill reform. A group of experts collaborated to outline changes in 2003. As of 2004, the bill was in its eighth stage of revision.^[11]

In 2015 The Violence Against Persons Prohibition Act (VAPP) was passed into law. This act is meant to provide sexual assault and relationship violence survivors with aid. Thus it is helping women get the contraceptives they need to prevent unwanted pregnancy, the leading cause for abortions.^[12]

Despite the combined and continued efforts of various Nigerian and International advocacy groups, only a woman whose life is endangered can undergo a legally performed abortion today.^[13]

Practices and Consequences

Many regions in Africa are known for their unsafe practices in health care and disease, specifically when it comes to young pregnant women and abortion. The major problem in these regions is that rights to adequate health care are limited, meaning that people don’t have many outlets to safe health care practices and this forces them to turn to unsafe methods of handling their situations. In most Sub-Saharan African regions, unsafe abortion practices are very common and Nigeria is a victim of this. Abortion accounts for 40% of maternal deaths in Nigeria, making it the second leading cause of maternal mortality in the country ^[14]

There are several reasons why the health care systems in African countries have failed to make the proper changes to ensure a better future for their citizens. The government has either failed to make these issues a priority or they have attempted to introduce policies that had an opposite result of what was desired. It’s difficult to address abortion issues because of the intense emotions people have about the topic. It’s an awful reality for some women and sometimes they are forced to make a decision that works best for them and their situation. Specifically in Nigeria, religious and cultural factors are a major reason behind the failure to address certain abortion issues.

According to the article,^[14] many of these unsafe abortion issues focus on adolescents. Although these unsafe abortion practices do affect most of the sexually active women in the country, it is believed that adolescents may require special circumstances and could be a cause for change in this area. Adolescents are the most in need of these services and if they adopt the correct and safe practices to avoid unplanned pregnancy, this problem could start to decline. The problem with teens in Nigeria is that they are the most likely to not use any type of contraceptive to avoid pregnancy and they are also the most likely to turn to unsafe abortion practices.^[14]

Contraceptive use is a big issue for teens and the country must put in place a trustworthy plan to advertise the great health benefits of contraceptives. There are several pros and cons to using them, but for Nigerian women, this is definitely a critical piece of the puzzle that is missing in obtaining better health care and overall quality of life.

The need for increased access to safe abortion practices in Nigeria is very apparent. There are several different methods used to try and ensure a healthy and safe approach to abortions, but Nigeria hasn’t always been able to keep up with the costs of these medical advances. In Nigeria, there are three first-trimester safe practices that are utilized to compare costs and effectiveness. Hospital-based dilatation and curettage, hospital-and clinic-based manual vacuum aspiration, and medical abortion using misoprostol are all considered to be a huge cost savings and ultimately puts the mother in its best interest.

Prior to women practicing these medically safer and more cost-effective methods, the rate of self-induced abortions was extremely high relative to other countries and regions. The side effects of using other methods have proved to be damaging to the mothers, resulting in high fevers, urinary tract infections, and genital trauma.

There are also issues where the women who did induce their own abortions did so incorrectly and could have caused other complications by overdosing on misoprostol - a method that is most commonly used safely and cost effectively. The most important part of these three methods are that they take into consideration that Nigeria is a region where there are low health system requirements and where they strive to use non-surgical options.^[15]

Causes for Abortion

Unwanted pregnancies is the leading cause for abortion in Nigeria. Unwanted pregnancies have many causes. Nigeria’s growing economy and increasing urbanization is making the price of living higher. This is making it more necessary for women to be working, as well as the men, to help support the family. When there are more children it makes it harder for the women to focus on work because they are expected to take care of the family first thus women would rather be working than pregnant or taking care of a child.^[16]

Another reason for the high rates of unwanted pregnancy in Nigeria is that there is low contraceptive use and family planning. Much of this is a result of not being educated on the use of contraceptives but also there is a lack of access to health care and contraceptive products in Nigeria. They is trend of uneducated, young, childless women, and women with many children to get unwanted pregnancies because of the lack of contraceptives. This is believed to be because both of these groups of women live in rural areas where healthcare is spread out, hard to find, and government campaigns to help educate the public on family planning and contraceptives don’t get as much advertisement in rural areas.^[16]

Nigerian women want around 6.7 children. They have 25 years from the ages of 20-45 where they are mostly likely to get pregnant and they spend around 15 of those years pregnant, trying to get pregnant, and not having sex immediately after pregnancy as accustomed to Nigerian culture. This equates to them having around ten childbearing years where they don’t want to be pregnant and need to use contraceptives to make sure that doesn’t happen. Thus Nigerian women have a long span of their life where an unwanted pregnancy can take place.^[16]

Further reading

• Abortion Law in Nigeria: The Way Forward. Women's Health and Action Research Centre. 2000. ISBN 978-978-044-770-0. 
• Irehobhude O. Iyioha; Remigius N. Nwabueze (28 February 2015). Comparative Health Law and Policy: Critical Perspectives on Nigerian and Global Health Law. Ashgate Publishing, Ltd. ISBN 978-1-4724-3677-1. 

References