By Sola Ogundipe
EVERY year, newer, and more  effective and  widely available contraceptive methods are being introduced in Nigeria, yet more and more pregnancies that occur are considered unplanned and unwanted.  In Nigeria, pregnancy termination is legally restricted, being permitted only to save the life of a pregnant woman. So what does a woman do when she is has an unplanned or unwanted pregnancy?

Thousands of Nigerian women who have unintended pregnancies are being compelled to take a decision either to keep the pregnancy or terminate it. Regardless of the restriction of pregnancy termination, the practice remains common. Although a woman cannot just walk into a medical health facility, she can easily seek such services through clandestine means.

Of these unwanted pregnancies, a significant number end in elective terminations that occur  under unsafe conditions, contributing to maternal morbidity and mortality. Physicians and hospitals regularly tell tales of  women (married and unmarried) being treated for complications of unsafe voluntary pregnancy terminations that occur each year, and experts believe that unsafe elective pregnancy terminations account for as much as half of all maternal deaths in the country.

Estimates show that more than 40 percent of all women will end a pregnancy by termination at some time in their reproductive lives. Among practicing obstetricians and gynecologists, more than half say they regularly encounter patients seeking pregnancy terminations, although less than a quarter actually go on to perform the procedure. Hence, most terminations are carried out by quacks.

Years back, a study by the Alan Guttmacher Institute entitled “Severity and Cost of Unsafe Abortion Complications Treated in Nigerian Hospitals” noted that urgent policy and programme interventions are needed to improve access to contraceptive services and post-abortion care in order to reduce abortion-related morbidity and mortality in the country.

Induced abortion

In one particular study, among women admitted for pregnancy termination-related reasons, about 36 percent had attempted to end the pregnancy before coming to the hospital, 33 per cent obtained an induced abortion at the facility without having made a prior abortion attempt and 32 percent were treated for complications from a miscarriage.

Women with serious complications were poorer and later in gestation than those who sought abortions directly from hospitals. They paid more for treatment than those who went directly to the hospital for an abortion or those treated for miscarriage.

It was in response to the need to create awareness among women at the grassroots, the Young Women Christian Association, YWCA, in collaboration with Ipas, last week, held a sensitisation workshop for women traders at the Abibat Mogaji Market, Iponri, Lagos.

The aim was to sensitise and educate them on the need for awareness about their sexual reproductive health policy. The women clamoured for their rights, their voices strident and emphatic. They appreciated the fact that if one woman cannot stand, other women would fall, and so they strived to know what they needed to stand for and how it affects them.

In the view of Mrs. Hwongchun Majak, President of the YWCA, a woman deserves to choose whether or not to terminate her pregnancy.  “Is she given the chance to make a choice in the matter? We want women to have a right of choice in such issues which concern them directly. Others should not take decision for them.”

Majak opined that as Christian organisation, the YWCA was preaching that women should ensure they do not get pregnant when they know they are not ready, by taking preventive measures for themselves. “We are also preaching abstinence form sex for women until they get married as a way of avoiding unplanned pregnancies and unwanted children.”

In her argument, Majak said: “If a woman has an unwanted pregnancy as a result of armed robbery, she should have a right to decide whether to keep that child or not. The individual who is involved should have the right of decision about what to do.”

Preaching of abstinence

Majak opined that as Christian organisation, the YWCA was preaching that women should ensure they do not get pregnant when they know they are not ready, by taking preventive measures for themselves. “We are also preaching abstinence from sex for women until they get married as a way of avoiding unplanned pregnancies and unwanted children.”

In her argument, Majak said: “If a woman has an unwanted pregnancy as a result of armed robbery, she should have a right to decide whether to keep that child or not. The individual who is involved should have the right of decision about what to do.”

She said presently, laws of the land do not permit such termination, hence the YWCA was advocating for a law that would enable women terminate unwanted pregnancies. “We are joining voices with Ipas to urge the National Assembly to pass a law that if women so desire, they should be able to have access to adequate health services that would permit them to terminate unwanted pregnancies.

We should make laws to legally permit women to seek pregnancy termination from competent medical practitioners, especially those who get pregnant through rape,” she stated.

While accepting that pregnancy termination is often more of a moral other than a medical issue, Majak said it was an issue that deserved proper deliberation in the interest of maternal health. “The Church believes in the Holy book where it is said that life should not be taken.

Of course, life should not be taken, and the Church is not openly seeking for  legalisation of abortion. But as an enlightened society, the YWCA feels there should be a law giving women right to terminate a pregnancy they do not want because it arises from rape or robbery, or has a compromising health issue.

Dr. Olatokunbo Oseni,

also a member of the YWCA team, said the most crucial issue is that there are more women today seeking information about contraception, family planning and abortion.” In a presentation entitled “Sexual and Reproductive Health Rights Awareness Building Campaign” Oseni highlighted the burden of maternal mortality in Nigeria.

“Every six minutes, a woman dies needlessly as a result of an unsafe illegal abortion, obstructed labour, or hemorrhage. For every woman that dies, 20 others are maimed for life. When a mother dies the mortality rate of the under fives rise very sharply,” she noted.

We are taking the campaign to the market, because we are quite aware that many people at the grassroots do not have the benefit of access to TV, radio, or internet, due to the prohibitive cost. The YWCA is bringing this information to the doorstep of the people, as the only way to reach them, powered by Ipas, so they can get this information, so they can know how they impact on society.

We cannot deny the common people. It is for mothers, daughters, sisters and aunts. The idea is that they will go back and step down what they have learned to other women, friends, mothers and others. They will discuss these issues.”

Lamenting that there are women who are having more children than they can cope with and who are having to stretch their personal economy to take care of these children they cannot afford to have in the first place, she said such women are unable to achieve their full potential, economically, socially and in all spheres of life because they have no idea what is theirs by right.

Arguing that the law/policy in Nigeria should change, Oseni observed: “Majority of our people in Nigeria are petty traders. They form the majority, and we must seek them out, because a collective voice is needed towards changing policy in this direction.

Health reforms in Nigeria that will increase access to sexual reproductive health rights for all should be promoted. Each girl, woman, sister, mother, aunt must first stand to ensure that she knows,  decides and  acts for her own and her future generations’ rights.”