By Gabriel Ewepu

ABUJA- Nigeria is ranked second highest in global maternal and infant mortality rate, which in 2023, she accounted for 12 per cent of global maternal deaths. This is over 50,000 women dying annually across the country.

The World Health Organisation, WHO, also ranked Nigeria as the second country with the highest number of maternal, neonatal and child deaths globally.

Also, WHO estimated that unsafe abortion contributes significantly to maternal mortality in Nigeria; Legal restrictions, socio-cultural barriers and inadequate healthcare infrastructure exacerbate the issues leaving many women with no safe options.

According to the Communication and Advocacy Officer, Youth Network for Community and Sustainable Development, YNCSD, Joan Obeta, it is imperative to examine Sexual and Reproductive Health Rights, SRHR, on the context of human rights as it concerns reproductive health and a healthy society.

Obeta said abortion, a deeply complex and contentious issue in Nigeria, is shaped by a multifaceted blend of cultural, religious and legal factors, creating a challenging landscape for women seeking reproductive health services. The rich cultural tapestry, interwoven with diverse traditions and beliefs, significantly influences perspectives on abortion, presenting a complex dilemma that urgently calls for reform.

Meanwhile, in Nigeria, the use of contraceptives and family planning is not pronounced and abortion is illegal carrying a heavy jail term of up to 14 years imprisonment, according Consultant Gynaecologist and Obstetrician, Lagos State University Hospital, Dr Modupe Adedeji, said it can only be carried out to save the life of a pregnant woman.

Dr Adedeji said, despite the criminalisation of abortion, more than half of all unintended pregnancies in Nigeria are resolved using abortion. In most cases such abortion practices are unsafe and often require treatment for complications.

To exacerbate the situation, cultural attitudes toward abortion are often reinforced by the teachings of the country’s major religions. Both Christianity and Islam, the predominant faiths, generally, oppose abortion on the grounds of the sanctity of life, profoundly shaping public opinion and reproductive health policies.

On Religious context in Nigeria

In Islam for example, the topic of abortion is approached with considerable nuance, reflecting the religion’s deep respect for the sanctity of life. Central to Islamic thought is the belief that human life is sacred and must be protected. This principle underpins the general stance on abortion, which varies depending on the stage of pregnancy and the circumstances surrounding it.

The Quran and Hadith place significant emphasis on the protection of life, establishing a strong foundation for the prohibition against taking life unjustly. Abortion is typically viewed as a serious matter due to the belief that human life begins at conception, though the specific timing of ensoulment—the moment when the soul is believed to enter the foetus—plays a crucial role in determining the permissibility of abortion.

According to many Islamic scholars, ensoulment is thought to occur around 120 days into the pregnancy, or roughly four months. This belief is based on Hadiths that suggest the soul enters the fetus at this stage. Consequently, abortion is generally considered impermissible after this period unless there are compelling reasons. Before this point, there is more flexibility, but opinions vary among different scholars and schools of thought.

Exceptions to the prohibition on abortion include situations where continuing the pregnancy poses a serious risk to the mother’s life or health. In such cases, clerics say preserving the life of the mother is prioritised, and abortion may be permitted. Additionally, some scholars allow abortion if severe foetal abnormalities are detected, particularly if these abnormalities are so severe that the child would face immense suffering or would not survive long after birth.

However, abortion for social or economic reasons is typically not permitted in Islam. The religion emphasises the responsibility of providing for a child and the sanctity of life, suggesting that decisions around abortion should be approached with this in mind. The interpretation of these principles can differ based on the Islamic jurisprudence school one follows—Hanafi, Maliki, Shafi’i, or Hanbali—each offering its own perspective on the issue. Additionally, as clerics explained, local cultural and legal contexts can influence how these principles are applied in different Muslim-majority countries.

In Christianity, abortion is also approached through a variety of interpretations, reflecting the diverse beliefs within the world’s most followed religion. Also, central to most Christian views on abortion is the belief in the sanctity of human life. Christian perspectives on abortion often emphasize that life is sacred from conception or an early stage of pregnancy.

This belief is supported by passages in the Bible such as Psalm 139:13-16, which speaks of God’s involvement in the formation of life in the womb, and Jeremiah 1:5, which suggests that God knows individuals even before they are born. These scriptures contribute to the view that human life begins at conception and should be protected.

According to Rev. Fr. Clement Laha, a Roman Catholic Priest, the stance on abortion is notably strict, the Catholic Church teaches that life begins at conception and that abortion is morally unacceptable in all circumstances except perhaps to save the life of the mother.

“This position is grounded in the belief that every human life is sacred from the moment of conception until natural death. The Church’s teaching is clear in its opposition to abortion, reflecting its deep commitment to the sanctity of life,” Fr. Laha said.

Sexual education; a need for women and girls

Reports from health professionals have disclosed that, too many young persons, women and girls receive confusing and conflicting information on sexual education as they make the transition to adulthood. A growing number of studies show that young people are turning to the digital environment as a key source of information about sexuality.

Dr. Adedeji also stated that information on contraceptives and safe abortion are almost not available to young girls and women who need them before and during the age of child bearing.

This is as the Nigerian society tends to preach abstinence but do not really educate young persons at instances when abstinence is not possible or practiced.

Methods of Family Planning

While speaking on the various forms of family planning, Dr Adedeji noted as number one preventive measures, stating if this is difficult, the barrier method should be used as it is another simple method. One of the partners make use of a condom, either a female or male condom. It then starts getting technical with ingesting medications.

“This could be orally, intramuscularly, intra-uterine, implants. These are all the types of family planning methods that we have. This will need more intervention from a health personnel.

“You then need to be actually checked to find out, the method that suits you. And the reason for all of these other ones is because they give a more surety of pregnancy not happening. The failure rate is actually slimmer than going through the ones that you cannot do yourself.

“That is the calendar method, the withdrawal method. Those ones can fail, despite you even being very careful. So these ones offer a less form of failure rate. It is not that the contraceptives do not fail, but when you’re talking about failure rates as less than 1%, that means that it’s safer.

“Then we even have the permanent method, of tube tying when you are sure that you are not having kids anymore, instead of using abortion as a means of contraception. Even the whole process of abortion itself, is also detrimental to life. Most especially when it’s unsafe. But people continue to explore the unsafe method because of the law of the land, the law has brought about discrimination, it has brought about segregation.

“There are several stories that I have heard, and several patients I have managed to the point of death. And even the ones that we have tried our best to avoid them dying, that they still die. And those that don’t even get to the hospital, that they eventually bring their bodies to the hospital, it’s so pathetic. Very, very pathetic.

She stated that, it is very important that we need to take all these into consideration and then look at it from the angle of number of avoidable deaths.

We cannot de-relegate morals, yes, but then how can we create a balance?

Challenges

Stating challenges in advocating for Sexual and Reproductive Health Rights, Dr. Adedeji decried obstacles breaking the chain of information is the health insurance system, in other climes, the system is properly taken care of, this helps the environment to be friendlier.

The Senior Gynaecologist and Obstetrician also lamented the ‘Japa’ syndrome which have created a gap of trained personnel. As trained health workers are expected to become trainers themselves but before such opportunity is created, they have sought greener pastures abroad, creating a vacuum that takes time to be filled.

Solution base

Health practitioners have noted that, It is important we take our health sector as equal as education, economy, although they are all intertwined, it is very important that we sit up and stop taking positions. And when we take a position, it is because we indeed want to make a change.

Start from the family, what training are parents giving to their children, again what does the parents know to pass down to their children, when does sex education starts in the family.

It is time to review the law on abortion, let’s stop looking at the moral aspect but also look at the consequences that we are facing.