Lagos State assurance on how medical abortion protects women’s health is expected to close up lots of .gaps
Abortion from time immemorial is known as the ending of a pregnancy by removal or by expulsion of an embryo or fetus before it can survive outside the uterus. It can occur without intervention as a miscarriage or spontaneously -it can also be induced or assisted.
But arguably, moralists all over have continued to take a stand against assisted abortion saying it is anti-life.
However, Lagos State Government at the recent launch of its Safe Engage Advocacy Tool and a documentary titled: “Out of The Shadows: Saving Women’s Lives from Unsafe Abortions in Lagos State”, to drive home the reason behind the introduction of the Tool justified why it is imperative to offer women “who require care when it comes to unsafe abortion, have access to such assisted care in the form of medical abortion “.
According to former commissioner for Health, Dr. Jide Idris, “We are not trying to legalize abortion, what we are trying to do is to ensure that people who ordinarily would have died from unsafe abortion have access to the right treatment, medical abortion, in our public hospitals and from qualified professionals”.
Idris explained to Healthstyleplus: “We see it as pertinent to bring all stakeholders to terms with the magnitude of unsafe abortion on the economy of the state”.
Launching the Lagos State Maternal & Perinatal Death Surveillance & Response (MPDSR) Annual Report (2018) at the event, Idris noted: “Report of survey on the magnitude of unsafe abortion shows it constitutes almost 11.3% of total maternal mortality in our country, with about 3-4% among women of reproductive age in our State. This is a huge chunk of our population which we cannot ignore”.
Chairman, Lagos State Society of Obstetrics and Gynecology of Nigeria (SOGON), Dr. Joseph Akinde equally pointed out, “we are offering medical abortion within legal application; not liberalizing abortion, because it is essential as it affects the physical health of a woman.
“Sometimes, a woman could be pregnant and develop suicidal tendencies and would require assisted termination; but if denied, could go ahead to procure an unsafe abortion. No other word to be used to replace abortion”, said Akinde.
The State Safe Engage Advocacy Tool, shows that within the ambit of the State Criminal Law 2011, Chapter 21 Section 201 Titled: ‘Medical Abortion’, “A medical doctor is not criminally responsible for performing in good faith, with reasonable care and skill a surgical operation on any person for his benefit, or on an unborn child for the preservation of the mother’s life and physical health, if the performance of the operation is reasonable, having circumstances of the case.”
According to Chief Medical Director, Lagos State University Teaching Hospital (LASUTH), Professor Adetokunbo Fabamwo, also Chair, Safe Engage Project Technical Committee, “Medical abortion is not a contraceptive method or a substitute for family planning”.
Fabamwo during a 2-day Safe Journalist Training Workshop sponsored by the Population Reference Bureau (PRB), Washington DC, in collaboration with Network of Reproductive Health Journalists of Nigeria (NRHJN), explained that medical abortion is a procedure that uses medication to end a pregnancy; and can only be done by a medical doctor under the provisions of the State Criminal Law.
According to Fabamwo in his presentation: “Her Life in her hands: Medical Abortion and Allied Issues”, he noted that annually, about 610, 000 unsafe abortions are carried out in Nigeria out of which 50% about 305,000 women die from complications caused by unskilled persons most of who are adolescents.
He gave reasons why women regardless of age, would opt for unsafe abortion to include: lack of access to any Family Planning method (possibly due to out of reach), failure of contraceptive, rape, incest (pregnancy-which could lead to terrible hereditary disorders), wrong partners in marriage, fear of rejection and isolation, ignorance, completed family, too young or too old among other reasons.
Fabamwo listed complications from unsafe abortion to include: bleeding, injury to internal structures such as cervical lacerations, incomplete abortion, acute and renal failure, failed abortion, increased risk of ectopic pregnancy, pelvic inflammatory disease (PID), pain among others.
“Although it does not require surgery or anesthesia, a patient must be well prepared through counselling to go through the procedure which can only be most effective within first trimester under the legal provisions of Criminal Law 2011, Section 201 and can only be done by a Physician”, said Fabamwo.
He added that medical abortion protects the health of a woman and its often to complete an early miscarriage, to end an unwanted pregnancy associated with medical conditions that makes continuing a pregnancy life threatening.
Data from the State Maternal Death Surveillance and Response (MDSR) 2018 shows, “Pregnancy with abortive outcomes (11.3%), was the third most common cause of maternal mortality particularly among young women” with hypertensive disorders (31.1%) and obstetric hemorrhage (28.8%) as first and second leading causes respectively.
Chair of the Maternal Death Review Committee, Dr. Donald Imosemi also noted: “the economic implication of unsafe abortion on Post Abortion Care for the State is enormous saying, most of the resources to look after referrals could have been deployed to prevention of most of the complications seen which end up in mortality”