Challenges in accessing abortion care for women

By Okon Taye – Abuja

Accessing abortion care is one of the problems women in Nigeria are facing which has led to maternal deaths.

The Performance Monitoring for Action, PMA research has revealed that 10 per cent of women had no direct interaction with the abortion provider.

This forces them to rely on partners, friends, or relatives to obtain abortion medication instead.

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According to the report from the research work, 9 per cent of women reportedly were refused care at some point in the process of seeking an abortion.

About 35 per cent of women stated that it was very difficult to pay for the cost of abortion, with the poorest women (52 pe4 cent) and women living in rural areas (44 per cent) giving cost as the reason for not being able to access clinical abortion care.

One out of four women reported they would have preferred to use a different abortion method or source.

Cost takes a whole (40 per cent) while distance took about (18 per cent) of the main reasons women could not access their preferred method or choice of abortion care.

Unsafe Abortion is Common Among Disadvantaged Women

Two out of three abortions were unsafe with women in rural areas, women with no education, the poorest women and girls aged 15-19 being the most likely to experience unsafe abortions.

About 63 per cent of abortions are considered unsafe i.e. involving a non-recommended method from a non-clinical source.

These include other pills like antibiotics, antimalarial pills, and pills of unknown type; injections, herbs, and home remedies.

The PMA factsheet spells out that younger women are prone to unsafe abortion as 88 per cent of women aged 15-19 are likely to be involved, 82 per cent aged 20-24, 63 per cent aged 25-29, 60 per cent aged 30-34, 59 per cent aged 35-39, 53 per cent aged 40-44 and 56 per cent for women aged 45-49.

About 79 per cent of women with no education, 70 per cent who had primary education, 62 per cent with secondary education, and 58 per cent who attended higher institutions are likely to experience unsafe abortions.

About 71 per cent of women who live in rural areas were likely to have unsafe abortions with 60 per cent in rural areas.

Quality of Clinical and non-clinical Abortion Care Needs Improvement Women who were well treated via a clinical method and disadvantaged women who took non-clinical methods both seek improvement in abortion care which include geographic accessibility, cost, and lack of privacy.

About 11 per cent of women reported that their abortion provider made judgmental comments and 8 per cent felt disrespected.

Meanwhile, 31 per cent of women with no education had more than three times the likelihood of feeling judged than women with at least some education (10 per cent).

In the same vein, 37 per cent of women would not recommend their termination source to a friend or family member in need of this service. 45 per cent of them would not also recommend the pharmacies or chemists they used while 75 per cent of the women would not advise another person to make use of the public facilities where they had their abortion done.

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About 16 per cent of the women who go for abortion with no education are the least likely to recommend their source.

About 68 per cent of women reported that aspects of their abortion process could have been improved if they had access to adequate health care services.

Women with no education up to 92 per cent, women residing in rural areas which are not less than 84 per cent, and 94 per cent of the poorest women were significantly more likely to report elements of their abortion experience that could have been improved compared to 61 per cent of the women with higher education, 60 per cent of urban residents, and 52 per cent of the wealthiest.

This study shows that women most often reported their abortion care could have been improved if it was less expensive (31 per cent), more private (21 per cent), and closer to home (15 per cent).

While the PMA research results have revealed the experiences of women who go for abortion, it is then the responsibility of governments at all levels and health organisations to use them to call for required solutions.

Recommendations
The following actions can be taken to reduce the burden of unsafe abortion-related maternal deaths and injuries;
1. Improve the availability of information on sexual and reproductive health services
2. Ensure that safe abortion and PAC (Post Abortion Care) services are available
3. Expand legal indications for safe abortion beyond situations in which the woman’s life is at risk.
4. Increase the availability of quality, voluntary contraceptive.

Vanguard News Nigeria 

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