“Increased access to Safe Abortions have led to increased safety of the procedure and reduced maternal death…”-Goal of the The goal of the “Out of the Shadows: Saving Women’s Lives From Unsafe Abortion in Lagos State”.
“It is no longer a hidden fact that unsafe abortion is as a result of unmet reproductive health needs” – Dr. Funmi OlaOlorun, Co-Principal Investigator, Performance Monitoring and Accountability 2020 (PMA2020)
Between 2014 and 2018, an investigation measuring safety levels of pregnancy removal or safe abortions, was carried out in 11 countries including Nigeria in a collaboration between the Johns Hopkins Bloomberg School of Public Health (JHSPH) and the Centre for Research, Evaluation and Resource Development (CRERD) in Nigeria.
The outcome according to Co-Principal Investigator, Dr. OlaOlorun “was amazing as it was quite revealing”.
OlaOlorun was a presenter at the recently held media safe engage workshop organised by Population Reference Bureau in collaboration with Network of Reproductive Health Journalists of Nigeria (NRHJN) in Lagos.
According to her, the pattern of safe abortions which was investigated in seven states of Lagos, Kaduna (with 5 annual rounds of data collection between 2014 and 2018); 3 annual rounds of data collection in Anambra, Kano, Nasarawa, Rivers, Taraba (2016-2018) and additional one round of data collection in Oyo state (2017) showed most of the abortions done were “least safe” thus ending in fatality.
She said, categorization was done along: ”Safe”: ie used only surgery or mifepristone/misoprostol accessed from an appropriate source (public and private hospitals, clinics, and mobile clinics, private doctors, and NGOs); “Less safe”: mifepristone/misoprostol accessed outside of the appropriate sources included in the safe category and “Least safe”: (use of everything else).
The survey instrument used across the states included Household questionnaire, Female respondent questionnaire (15-49 years) and Service delivery point questionnaire for a total of 11, 106 women and 5,7772 close confidantes in addition to Demographic and Health Survey question and an abortion module in the fifth round.
The result of the survey showed that unmet reproductive health needs was highest in Kano State (32.6%); followed by Kaduna (31.7%); Taraba (22.9%); Nassarawa (22.2%); Rivers (18.7%); Lagos (17.7%) and Anambra (13.4%).
The result of the survey showed also, that there were an estimated 1.8 million to 2.7 million abortions Nigeria in 2017 alone, referring to induced abortions and not including spontaneous abortion or miscarriage.
While the survey revealed that in Lagos for instance 25.5% women use modern contraception, in Kano, only 7.8% of the women surveyed used modern contraceptives, but overall, only about 40% of all the women survey used one method of contraception.
Consequently said OlaOlorun, “Incidence of abortion therefore has a likely annual rate of 1,773,067 with about 2,696,270 confiding in friends” they had attempted abortions.
Also said OlaOlorun, “Most young people who engage in unsafe abortions from the study are below 20 years and most often had surgery to remove pregnancy and pills for menstrual regulation. But, majority of the likely abortions* were least safe”, the result of the Survey also indicated.
She therefore observed, “we really should be talking about safe abortions in the context of access to modern contraceptives as a safe way to meet the reproductive health needs of young people who are mostly likely to engage in unsafe sex and then go for least safe method of abortion”.
By introducing the safe engage advocacy tool in Lagos State other experts at the workshop agreed, it is as a way to safeguard the lives of women who could become another round of statistics as a result of death from unsafe abortions.
According to the Dean of the Faculty of Law, University of Lagos, Professor Ayodele Atsenuwa, who spoke on the ‘Legal Framework for Termination of Pregnancy in Lagos State’, “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 a mother’s life and physical health, if the performance of the operation is reasonable having regard to the circumstance of the case”.
She noted though, “Any discussion of Abortion and the Law is largely a discussion of abortion as the subject of criminal prohibition”.
Citing various sections of the Law which contest the validity of the status of abortion in Law, Atsenuwa pointed out, “There is a historical context to the law on abortion which suggests that aim of the law on abortion was to protect women from unsafe abortion carried out by quacks (altruistic and regulatory) and to protect medical doctors who carry out abortion”.
Highlights of section 201(Criminal Law of Lagos State 2011) changes and adds to the qualification that “abortion may be carried out for preservation of a mother’s life, the preservation of the woman’s physical health”.
In the words of Associate Vice-President of Population Reference Bureau (PRB), Charlotte Feldman-Jacobs , “introducing the safe engage advocacy tool in seven countries including Nigeria and choosing Lagos State first is strategic .
She said,“Out of the Shadows: Saving Women’s Lives From Unsafe Abortion in Lagos State” is a multimedia advocacy tool developed by
Population Reference Bureau (PRB) to be used in a variety of settings or environments, especially as African nations implement the Sustainable Development Goals and continue to work towards full implementation of the Maputo Protocol and other regional commitments”.
The launch in Lagos was to ensure women who have health challenges have all the necessary information to make informed decisions about their reproductive health status within the ambit of the law.
“If things can change in Lagos the whole of Nigeria will follow and women’s health would be better for it “said Charlotte.