Hi,

Abortion has remained a controversial subject in Nigeria, especially between the moralists and religious groups and the Pro Choice groups, with emphasis on the protection of the life of mothers and the sanctity of life. The recent move by the Lagos State government to leverage on the 2011 amendment of the criminal law on abortion as allowed by the Nigerian constitution, to spell out in details, under which lawful abortion can be performed was strongly condemned by Pro Life and religious organisation, forcing a retrieval of the documents.

The truth is that while we may choose to play the ostrich on this delicate subject bothering on life, safety and death, illegal and unsafe abortions are being carried out on a daily basis with the numbers and casualties increasing yearly. Many factors contribute to this rise, including the dire economic situation the country has sunk itself into. I have listed below, some of the major risks women are faced with when they undergo unsafe abortions. 

Risks of Unsafe Abortion

1.  Uterine Perforation: This is the accidental puncturing of the uterus or womb. In severe cases, it might involve the small intestines and/or the big intestines as well as the abdominal cavity or bladder. This accident usually occurs in abortion procedure such as the Dilation and Curettage (D&C- commonly used in Nigeria) which involves the scraping of the uterine wall with a surgical spoon shaped instrument called the Curette. Victims may present with lower abdominal pain, fever, and heavy vagina bleeding.

2.Pelvic Infection: This is very possible where the procedure is performed in unhygienic condition and/or using unsterilised instruments. This situation is common where abortion is illegal such as in Nigeria. Infection may be introduced through the vagina cavity and the uterus, and may travel to other reproductive organs. Pelvic Infection left untreated may prove very dangerous to the woman and her reproductive system and ultimately, lifestyle. 

3.Incomplete Abortion:  Retained products of conception resulting in a second procedure to completely evacuate.  This is when pieces of the baby’s placenta or amniotic sac are left in a woman’s body after the abortion. It may develop into pain, fever and infection which will need antibiotic treatment and possible hospitalization.

4. Mental Health: Though little medical or psychological organization has supported or recognized this concept, it is believed that there are groups of women who are likely to suffer some form of ill or poor mental health as a result of abortion. This is possible among women who suffer higher risk of coping with problems and emotional distress, women with emotional attachment to the pregnancy, women with pre–existing psychiatric illness, women with conservative or religions views on abortion and women with lack of social support.

The gestation age of pregnancy may also be a contributing factor as aborting a less than 49-62 days old pregnancy, may have a less emotional attachment than a pregnancy of 21 weeks or more. Recurrent dreams of the abortion experience are also possible after effects of abortion. Sleep disturbances, guilt about surviving, memory impairment, hostile outbursts, suicidal thoughts and actions, depression and substance abuse may occur days to years after the abortion. These conditions are known as Post Abortion Syndrome.

5. Bladder/Uterine Injuries: This can happen if the uterus is perforated. If the urinary bladder is perforated it can cause peritonitis (an inflamed, infected lining of the abdomen causing pain and a possible reparatory surgery.

6. Bowel Injuries: The intestines may be perforated too and this can lead to nausea, vomiting, fever, blood in stool and eventually death, if not promptly treated. Surgery must be done while a temporary or permanent colostomy might be put in a woman’s abdomen.

7. Ectopic (Tubal pregnancy): An ectopic pregnancy is pregnancy that occurs outside the uterus. If not detected early enough, the pregnancy will rupture, causing bleeding, loss of the tube and death. It is believed that once a woman has had an abortion, she is 8-20 times more likely to have an ectopic pregnancy. The chances of ectopic pregnancy even increases with the number of abortions a woman has performed.

(8) Failed Abortion: This is very common in abortion of less than 6 weeks gestation age. This happens when a failure to evacuate the placenta from the uterus occurs. This means the pregnancy continues to progress even though the woman has endured the agonizing pains and danger of an abortion.

(9) Haemorrhage: Excessive bleeding may sometimes occur. About one to fourteen percent of women require blood transfusion due to bleeding after an abortion.

(10) Infection: A mild fever which may lead to death may occur should an infection occur and is not promptly treated.

(11) Laceration of the Cervix: This is a cut which produces a wound with irregular edges on the cervical walls. About one out of every 20 women suffers this during an abortion. This causes a woman to have nearly a 50-50 percent chance of miscarrying in the next pregnancy if it is not treated.

(12) RH Incompatibility: It is important that every woman knows her Rhesus status. A negative rhesus status may cause incompatibilities between a woman and her baby. It is important that this status is detected and treated as soon as a woman is pregnant with her first baby. When not treated, future babies will need transfusions soon after birth. The incompatibility will also cause future babies to be born dead, or die soon after birth. Before abortion, your baby’s blood type must be ascertained so you will not be affected with future pregnancies.

(13) Sterility: After an abortion, a woman can become sterile. Sterility occurs in 1 out of 20 to 50 women after abortion. It is also believed that women who have had at least one abortion are three to four times at risk of secondary infertility than women who have not aborted.