Akanni Ibukun Akinyemi, Obafemi Awolowo University

Nigeria classifies abortion as illegal except under certain medical circumstances. A recent investigation by Reuters news agency has alleged that, since 2013, the Nigerian military has run a secret mass abortion programme in the north-east of the country, where it is at war with the militant Islamic organisation Boko Haram. Ten thousand women were allegedly affected – the report claims the women had been raped and impregnated by Boko Haram insurgents. The military has denied the allegations. Reproductive health specialist Akanni Akinyemi sheds further light on abortions in Nigeria.

How common is forced abortion in Nigeria?

There is some evidence that the decision to terminate a pregnancy may be imposed on a woman by either her male partner or some significant others, such as parents and care givers. However, the systemic large scale forced abortions in the north-eastern part of Nigeria as reported in the media are a new development. I don’t think we have recorded anything like this before.

What factors encourage forced abortions?

At an individual level, differing views among partners on the status of the pregnancy may result in coercive or forced abortion. When there is doubt on the paternity of the pregnancy, this may create some tension between partners and lead to the enforcement of abortion. The status of pregnancy to some family, particularly when an adolescent girl or unmarried woman is pregnant, is another reason. The families may resort to forced abortion because of the cultural implication of keeping the pregnancy. However, the reason alleged by the women in the Reuters report for this new systemic large scale forced abortion is to prevent these children growing up to become Boko Haram members. The terrorists often abduct girls and impregnate them. This forced abortion, if confirmed, is against the law and a crime against humanity.

When is abortion legal in Nigeria?

The legal context of abortion in Nigeria is captured under the Criminal Code Act, Chapter 77 of the Laws of the Federation of Nigeria (Revised ed. 1990), Articles 228-230, 297, 309, 328; and the Penal Code (Northern States) Federal Provisions Act, Chapter 345 of the Laws of the Federation of Nigeria (Revised ed. 1990), Articles 232-236. By the provision of these two legal frameworks, induced abortion is illegal, except with evidence that it is to save the life of the woman. Abortion is, however, possible in any facility where and when the life of the woman is threatened by the pregnancy.

Given the conservative and largely religious nature of Nigerian society, Nigeria’s law is restrictive, and abortions are only permitted to save a woman’s life. There must be professional documentation of the pregnancy risk to the woman before this is possible.

Despite the law, abortion is common, with a rate estimated at between 41.1 and 59.4 per 1,000 women of reproductive age in 2017. However, the stigma associated with abortion, the largely incorrect understanding of the laws, and lack of access to trained providers can result in unsafe abortion practices. This has led to loss of lives of women and accounts for a high percentage of maternal mortality and morbidity in Nigeria. About 20,000 maternal deaths per year are due to unsafe abortion in Nigeria. It also has one of the highest maternal mortality rates in the world – 917 women per 100,000 births. This is very high compared to Ghana (308) and Kenya (342), both also in sub-Saharan Africa.

The legal status of abortion varies across sub-Saharan Africa. Evidence shows that while some countries (like Nigeria) still operate restrictive abortion laws, others (including Zambia) allow abortion on any health or socioeconomic grounds. Cabo Verde, Guinea-Bissau, São Tomé and Principe and South Africa have decriminalised abortion. They allow it without restriction.

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How accessible and safe is post-abortion care?

Post-abortion care is accessible, particularly for women who had a safe abortion in a suitable medical facility with qualified professional. However, most unsafe abortions are reported in health facilities after they have suffered serious complications or life threatening experiences due to unsafe abortion.

Medical abortion is available through the use of misoprostol. It is an abortion drug that is safe, and self-administered, with no or mild consequences. The prescription and likely complications of misoprostol are usually on the label, and clients can visit health professionals for any warning signs. Misoprostol is usually referred to as a harm reduction practice in the abortion context in Nigeria.

Why is post-abortion care so important?

Post-abortion care is important in ensuring that the abortion episode is successful without retaining any product of the process. It offers treatment for complications induced by having an abortion.

It also involves provision of contraception, counselling about preventing sexually transmitted infections and unwanted pregnancy, and counselling about adverse complications from the procedure. All post-abortion care models include two essential services: treatment of emergency complications, and voluntary family planning counselling, including provision of contraception.

Akanni Ibukun Akinyemi, Professor of Demography and Social Statistics., Obafemi Awolowo University

This article is republished from The Conversation under a Creative Commons license. Read the original article.