Blogging for Nigeria! Post 2 Unsafe Abortions

Although the substance of this article is neither to deal with the propriety of abortion, nor as to whether it has any sanction in religion or morality, the aforesaid story is a necessary introduction to the reality that surrounds us. The fact that abortion is outlawed on certain grounds while permitted on certain others warrants that there must be some modality of regulation on the manner and the basis on which it is carried out. Owing to the fact that certain grounds do not fulfil the criteria of becoming the basis on which an abortion may be carried out. There are plenty of instances wherein women seek recourse to unsafe and illegal methods of abortion. The end result is hardly anything to appreciate.

In the words of a renowned member of the medical profession based out of Nigeria who wishes to remain anonymous, an abortion in medical speak is called a termination or “planned miscarriage”. “Abortion is understood to be the Healthcare Professional used to describe the premature conclusion of a pregnancy whether planned or of natural causes… before it can be called a miscarriage.” He says. An unsafe abortion, as the very same doctor puts it, refers to “An abortion done by unskilled persons including the lady herself, or done by Professionals with insufficient experience or skill, or done by persons with skill but poor after care, or done to people who have additional risks like very late twins or may be susceptible due to other medical conditions in which infection or blood loss would be poorly tolerated.” In the doctor’s opinion, usually young girls with little access to money or other means coupled with the ignorance of the avoidable dangers of the procedure fall victim to the unsafe abortions in order to cut costs.

The consequences are plenty:

·         Death

·         Infection

·         Anaemia from blood loss

·         Damage to Bowel Bladder  and reproductive organs           

·         Difficulty in getting pregnant or carrying pregnancy neck of womb called cervix may be damaged           

·         Chronic pain from botched procedures including incomplete termination in which half of the fetus is left behind

·         Psychological issues of regret, guilt and depression

In Nigeria, abortion, as the law stands, is permissible on limited grounds which are enumerated as below:

Basis	Status under Law
To save the life of the woman	Allowed
To preserve mental health	Allowed
In cases of conception being a consequence of rape	No
In cases of foetal ill-health, impairment or disability	No
Economic and Social considerations	No
On request by the woman herself	No
Familial pressure	No

Evaluating the statistical side, there is plenty of evidence that suggest that women rely on unsafe methods of abortion in a bid to side-step the law, and to avail a series of back-alley mechanisms to bring their pregnancies to an abrupt halt. From the statistical resource pool collected by  AllAfrica.com, “From statistics, an estimated 46 million pregnancies worldwide end in induced abortions each year and 20 million of these are unsafe. About 13 per cent of pregnancy related deaths have been attributed to unsafe abortions and 80,000 deaths annually.”

The legal system governing abortion in Nigeria predominantly comprises two different laws. In the generally Muslim states in the North, the Penal Code, Law No. 18 of 1959 is in force. In the south, which is largely Christian, the Criminal Code of 1916 is in effect. Although both codes prohibit abortion, the differences in the wording of the Codes, as well as in their  interpretation, that have resulted in two slightly different treatments of the offence of abortion.

In general under the Penal Code, an abortion may be legally performed only to save the life of the pregnant woman. Save for this one explicit permission, any person who voluntarily causes a woman with a child to miscarry, can be subjected to a penalty that could range up to fourteen years’ imprisonment with, or without the payment of a fine. This punishment holds good even for a woman who causes her own miscarriage, although harsher penalties are awarded if the woman dies owing to the miscarriage. Under the Criminal Code, abortions are legally permitted only in the event that the life of a woman is to be saved. At the same time, any person who, with intent to procure the miscarriage of a woman, unlawfully administers to her any noxious thing or uses any other means is subject to fourteen years’ imprisonment.  A woman who undertakes the same act with respect to herself or consents to it is subject to seven years’ imprisonment. Any person who supplies anything knowing that it is intended to be unlawfully used to procure a miscarriage is subject to three years’ imprisonment.

One slight deviation in the context of the Criminal Code is that by interpretation, abortions have been allowed in the wake of broader circumstances. The English decision in Rex v. Bourneushered in an era where the element of necessity was read into situations to determine whether it was ripe for a legal authorization of abortion or otherwise. Besides these developments, in 1982, there was an attempt made to liberalize abortion law, but the same was nipped in the bud before it attained fruition.

In Nigeria, induced abortion using unsafe methods is considered to be a rather major cause of maternal mortality, which is considerably high in Nigeria. Delta Women conducted a survey amongst women in Nigeria, and the resultant data suggested a considerably shocking trend. Out of a survey pool of 20 sample respondents between the ages 25 and 50, 22% had undergone an abortion. Of these respondents, one of them stated, “Yes, I had an abortion. It was done in a clinic by a Certified Doctor, I will say. I had to do it because my parents wouldn't hear that I am pregnant outside wedlock.”As for considering abortion as an option, 22% of the women answered that they would, while another 22% were unsure, and the remainder were vociferously expressive of their antagonism to choosing abortions. About 80% of our respondents expressed that they were aware of the consequences of an unsafe abortion on their bodies, and also 90% of the respondents are aware of the legal standpoints on abortion in Nigeria. While as many as 80% of the respondents did not know of others who had undergone unsafe abortions, one of the remaining 20% explained, “A school mate of mine underwent an unsafe abortion, and she died. However, when one other friend of mine did the same, she didn’t face any such bad luck.”

20% of the respondents did not know what unsafe abortions were, while the predominant answers in the survey so far as their knowledge was concerned, most perceived unsafe abortions to be:

1.      a significant cause of maternal mortality

2.      the termination of an unwanted pregnancy by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both

3.      the absence of proper and clean/safe facilities and equipment

4.      an abortion at a late stage of pregnancy

5.      an abortion in a non sterile environment, with unsterilized tools and performed by unqualified personnel

6.      an abortion by self-medication

A Nigerian doctor (who wishes to remain anonymous) feels that rates of unsafe abortions can be reduced by making contraception easily accessible, along with offering awareness as to its usage. “Unfortunately some ladies use termination as “contraceptive” with disastrous consequences. The government should see a termination as a woman right, the deep religious, cultural and social stigmatisation of a terminationwill need to be addressed.
Opposing it forces it underground. It doesn’t stop it and “No sex” is practically impossible to advocate. Safe protected sex and condoms help with STDs, and will also cut down the need for termination but combined with the pill even more effective as it is unlikely that both methods would fail simultaneously         .” He further adds that there should be laws to protect qualified practitioners of safe abortions, should contraception fail. The procedure should be subsidised in order to make them affordable. “Unfortunately it has been a non-issue and unless there are statistics to make the people and government agencies aware that it is a major source of loss of women’s life and future fertility, unsafe abortions will continue as there is a market for it.”

There is evidently a cause for practical implementation of the legal system that exists on paper. Although in principle, abortions are banned except for certain grounds, there are plenty of clinics that thrive on the business of quick, unsafe and illegal abortions. At best, the solution does not lie in legalizing abortions, but rather, in legally regulating abortion. Simple means of doing this would be mandating the registration of medical practitioners under the law. There should be a compulsory rule that without a license, a practitioner cannot conduct any means of abortion. Furthermore, it would be wise to mandate that every case of abortion be a registered case, with the patient’s right to privacy being retained by allowing them to be unnamed.

By Kirthi and Shadrack Egbonimali