t is no news that many women around the world today are still being denied key sexual and reproductive rights i.e. their right to enjoy control over and make decisions on their sexual and reproductive health without discrimination, coercion, detention, or violence. But perhaps nowhere is this more apparent than in Nigeria, where a woman cannot autonomously decide the number and timing of children she wishes to have.
Although governed by two separate anti-abortion laws—the penal code for the Northern states and the criminal code for the Southern states. Northern and Southern jurisprudence are aligned in their stance on prohibiting abortions. For example, the criminal code stipulates:
"S228- Any person who, with intent to procure miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, is guilty of a felony, and is liable to imprisonment for fourteen years.
S229- Any woman who, with intent to procure her own miscarriage, whether she is or is not with child, unlawfully administers to herself any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, or permits any such thing or means to be administered or used to her, is guilty of a felony, and is liable to imprisonment for seven years."
The only caveat to these laws comes from the authority of the case, Rex v. Bourne (1938), which states that a woman is allowed to have an abortion to save her life or to preserve her mental and physical health.
To be certain, Nigeria is not the only, or even the most prohibitive of African countries in this regard. As at 2015, 93 per cent of African women at child-bearing age, lived in countries that have restrictive abortion laws. In Gabon, Egypt and 9 other African countries, abortion is not permitted under any circumstance, and there are no legal provisions allowing abortion to save the life of the mother or in cases where the pregnancy was conceived from rape.
Of the 54 countries that make up the continent, only 3 countries have completely liberal laws on abortion. In South Africa, Cape Verde and Tunisia, women are allowed to terminate their pregnancies at will, with limits solely on the gestational age of the foetus at which this can be done.
There are many reasons why women, young women being in the majority, opt to have abortions—such as wanting to complete their education, having conceived the child through rape, or lacking socioeconomic resources to raise a child. Near the top of their list of considerations is also the social stigma attached to being pregnant outside wedlock. In Nigeria and many other countries around the world, popular sentiments around pre-marital pregnancy seem to rest on the unstated assumption that it is the woman who impregnates herself. While this is biologically impossible, the attitude of society to pregnant unmarried women would make one think otherwise.
In many cases, the burden of caring for children born out of wedlock falls squarely on the shoulders of women, in addition to public ridicule and the loss of social standing in a community that now sees them—but not their sexual partners—as people of questionable character. Therefore, thousands of women in Nigeria procure abortions to avoid being shamed and shunned as ‘loose women’ in the community simply because they are pregnant and unmarried.
Unfortunately, the stigma doesn’t end there. Society frowns heavily, and even more so on women who upon becoming pregnant, decide to have abortions.
The lack of proper family planning initiatives and education programmes in Nigeria further exacerbates the harsh effects of these anti-abortion laws. Most women who get abortions do so because they did not intend to get pregnant when they did and would thus have grateful benefitted from pregnancy-prevention measures. “If all the people who need contraception get it, [and] if the need for contraception is met, we will be left with a small number of women who get pregnant without wanting to,” explained Dr. Talemoh Wycliffe Dah, OB/GYN and Director of Soteria-Afrique Rural Initiative, during a recent interview. By extension, therefore, there will be much less abortions when contraceptive usage increases and the rate of unwanted pregnancies decreases.
It is estimated that 81 per cent of unwanted pregnancies in developing countries are as a result of an unmet need for modern contraception. In effect, many affected women do not have access to proper contraceptive options nor do they know that what options exist and where. In Nigeria, for example, only 11 per cent of women in reproductive ages (15-49) are using any modern contraceptive method.
It is no surprise therefore that countries that have good family planning structures and high contraceptive prevalence figures have very reduced rates of abortions when compared to those who do not. However, in the words of Dr. Dah, “Nigeria’s [low] contraceptive prevalence rate [remains] an enigma.” This is particularly so because when one considers that “other African, European and Middle Eastern countries with similar religions and cultures have very high rates.” Furthermore, despite the efforts that have been made within the Nigerian civil society to increase access to contraceptives, very little progress has been observed in this regard.
One explanation might be that for all the similarities Nigeria shares with other cultures, the sacrosanctity of our cultural values is distinctly pervasive in our society. To most Nigerians, it is an abomination to even broach the topic of abortion, and the few times the topic rears its head in popular discourse, it is almost always seen negatively through the tinted eyes of ‘culture’ and ‘morals’. It is therefore almost impossible to find people interested in critically engaging with the law or positively developing the law beyond its current anti-abortion stance.
Undeterred by this fact, several groups in history have ventured through the stormy waters of legal and legislatively reform. In 1972 and 1975, the Nigerian Medical Association (NMA) and the National Population Council (NPC) respectively tried to reform the laws but were faced with opposition and a glaring lack of support. Most notably, in 1981 the SOGON (Society of Obstetricians and Gynaecologists in Nigeria) initiated and tabled before the House of Representatives, a progressive bill on the termination of pregnancy. The bill faded out after the first reading because it was met with a high level of hostility and resistance from religious groups and the National Council of Women’s Societies. These opposing groups “feared that the passage of the bill would promote moral laxity” but failed to produce any evidence to support their position. All the same, citizens and organizations who were against the bill sent thousands of petitions to the National Assembly to prevent the bill from passing.
Things seemed to take a turn for the better in the 1990s. In 1991, the Campaign Against Unwanted Pregnancy (CUAP) was formed, with a primary mission to defend women’s sexual and reproductive rights and eliminate unsafe abortion. With a view to reviewing abortion legislation, it organized a reform meeting involving the minister of health and the NMA in 1992. Not surprisingly, this reform movement was also met with strong opposition and thus, never saw the light of day. From then onwards, CUAP, while receiving a lot of international support (mainly through grants from non-profits) and consequently organizing workshops, seminars and lectures on sexual health and women’s rights was never fully able to sway a critical mass of Nigerians. Sadly, it seems CUAP is now defunct.
While the correlation between anti-abortion legislation and unsafe abortions is readily apparent, the trends in abortion-friendly countries reveal a more puzzling fact. In South Africa, for example, where abortions were legalized since 1997 and public health centres are available for this procedure, women still patronise quacks and purchase unsafe pills and herbs to terminate their pregnancies. Revealing the underlying reason for this, Professor Jane Harries, director of the Women’s Health Research Unit at the University of Cape Town, that “many women do not feel comfortable accessing public sector facilities due to stigma and the attitudes of health care providers.” It is thus evident that even legal reform has its limits, especially in societies with deeply-rooted cultural values.
In light of the foregoing, the question remains: how can our societies cut through the high fences of law and culture to safeguard the health and reproductive rights of our women? One solution, advanced by many community health workers and eternal optimists like Dr. Dah, is to keep educating communities and in fact “to educate people more.” According to him, “people who stigmatize others are limited in their understanding.” To bring home to them the scale of this issue and move the reform discussion from an abortion debate to a more wholesale women’s health discourse, what is needed is not just “enlightenment on the vastly different and justified factors that may lead one to get an abortion, but [also enlightenment on] more general [matters].”
In the realm of women’s health, one statistic is particularly telling. Contrary to the opinions advanced by religious and other groups in the 1970s, highly restrictive abortion laws do not lead to lower pregnancy or abortion rates. According to the Guttmacher Institute, “when countries are grouped according to the grounds under which the procedure is legal, the rate is 37 abortions per 1,000 women of childbearing age where it is prohibited altogether or allowed only to save a woman’s life, compared with 34 per 1,000 where it is available on request.”1
Given the high rate of abortions (13% of all pregnancies in Africa), the consequences of disallowing abortions are not insignificant. By making abortion illegal, the government is directly hurting and contributing to the death of its young and vulnerable female citizens who choose not to go through childbirth. Of the yearly 6 million plus abortions in Africa, which already has the highest number of abortion-related deaths in the world, only 3% of them are performed under safe conditions. Unsafe abortions—defined by the Guttmacher Institute as abortions “performed by individuals lacking the requisite skills or in environments below minimum medical standards”—abound solely because women are scared, ashamed, and consequently have to hide to get abortions. To this end, they patronise unqualified medical personnel to carry out the procedure for them, or they sometimes desperately resort to cruder means like consuming bleach. These processes are often times life-threatening, leading to the deaths of women, who ordinarily would not have died had they been afforded legal and affordable access to proper medical services.
Furthermore, death is not the only consequence of unsafe abortions. Health problems like infertility, haemorrhage and sepsis are common consequences. Because health centres spend scarce resources providing expensive post-abortion care and treatment, unsafe abortion also places an economic burden on the nation’s health system.
Considering the socioeconomic and health-related effects of abortion in our societies, the arguments that abortions are not/should not be legally and socially accepted because of our cultural and religious values thus reveal a complete blindness towards the suffering and lived experiences of many of society’s women. More so, the number of women in Nigeria having abortions says otherwise about these supposed values, and whether they are truly shared by all or imposed on society by only a fraction of its inhabitants. Between 1996 and 2006, the number of yearly abortions in Nigeria rose from 610,000 to 760,000. The figure is currently estimated at more than 1 million annually.
It has never been more imperative that Nigeria move beyond doctrinal debates and become a society that cares about the health, safety, and welfare of all women—including women who for whatever possible reasons opt out of childbirth. The sooner the government—and indeed the citizens—accepts that the laws and social constructs we currently have in place are not just failing to stop women from getting abortions, but are actually directly putting women in harm’s way, and simultaneously draining our health and economic sectors, the better for us all.
Notes1 Emphasis of the author.
Three graphs have been omitted from this feature, and can be found in the original piece here.
Permission to republish this article was obtained from The Republic: A Journal Of Nigerian Affairs. No part of this article may be used, republished or modified without prior written approval from the publisher, The Republic. All rights reserved.