By Elizabeth Osayande

Nigeria is facing a reproductive health crisis that remains largely invisible in national conversations, yet its toll is deadly and escalating. An estimated 610,000 unsafe abortions occur annually in Nigeria, according to recent national surveys. Of the roughly 20,000 women who die from abortion-related complications each year, nearly half are adolescents. These numbers, though staggering, only hint at the deeper systemic failures that expose Nigerian girls to life-threatening risks for seeking autonomy over their bodies.

At the intersection of public health research, demographic insight, and social justice is Dr. Bosede O. Adejugbe, a US-based Nigerian demographer whose work amplifies this hidden epidemic. Her scholarship brings rare visibility to the lived realities of young girls navigating fertility decisions within a web of restrictive abortion laws, entrenched gender norms, and poor access to adolescent-friendly healthcare services.

Behind the Numbers: A Reproductive Rights Emergency

For many Nigerian adolescents, pregnancy is neither planned nor desired. Lacking access to accurate sexual health education or modern contraception, they are left vulnerable to unplanned pregnancies. When pregnancy does occur, especially out of wedlock, stigma, fear of parental rejection, and legal obstacles often force these girls to seek unsafe abortions from unqualified providers.

The consequences are grim: sepsis, uterine perforation, severe bleeding, infertility, and death. “The tragedy,” Dr. Adejugbe notes, “is not simply that unsafe abortion is happening-it’s that girls are dying silently in communities where even speaking about reproductive health is taboo.”

Her 2023 study, Abortion Practices Among Adolescent Girls in North-West Nigeria, offers a rare glimpse into the social and household pressures that drive adolescents toward clandestine procedures. From economic dependence to fear of expulsion from school, the motivations are deeply embedded in Nigeria’s patriarchal and moralistic frameworks. Moreover, Dr. Adejugbe’s recent study titled “Availability, Readiness, and Barriers of Post-Abortion Care in Public and Private Healthcare Facilities in Ile-Ife, Osun State, Nigeria,” which has been accepted for publication in the African Journal of Reproductive Health, revealed significant gaps in the availability of post-abortion care services, especially within public health facilities. The study was supported by a grant from a consortium that includes the Centre for Research, Evaluation Resources and Development (CRERD), the Academy for Health Development (AHEAD), and the Guttmacher Institute, USA. A key finding in her study revealed that many women, especially those who had undergone clandestine abortions, often resorted to seeking post-abortion care from unqualified providers or traditional practitioners due to the lack of accessibility and shortage of safe post-abortion care services in some of the health facilities. This situation significantly heightens the risk of maternal mortality, especially among young girls, underscoring the urgent need for better-equipped health facilities and a greater number of trained healthcare professionals.

Research Rooted in Social Demography and Health Inequity

With over a decade of experience in population research across Nigeria and the United States, Dr. Adejugbe is shaping a new understanding of adolescent fertility that moves beyond behaviour to context, highlighting how family structure, partner attitudes, and socio-economic status mediate girls’ reproductive outcomes.

Her findings have revealed how young women in marginalised settings often lack decision-making power, access to care, or knowledge of safer reproductive options. These dynamics are not isolated; they echo across West Africa, where Dr. Adejugbe has also studied fertility trends and the gendered politics of household decision-making.

“In the absence of accurate data and grounded research,” she emphasises, “we continue to create policies that fail to reflect the lived experiences of the most vulnerable, especially adolescent girls in rural and urban slums.”

From Data to Policy: The Path to Safer Futures

Dr. Adejugbe believes that breaking this cycle requires a bold, evidence-informed approach. Her advocacy calls for:

Comprehensive sexuality education that is age-appropriate, culturally adapted, and school-based;

Decriminalisation of abortion, or at minimum, expanded legal exceptions for adolescents;
Investing in post-abortion care services to ensure that more women can safely access the help they need
The adoption of the 2022 WHO abortion care guidelines, that “post-abortion care should always be provided regardless of whether abortion is restricted and without the threat of criminal prosecution or punitive measures”.
Youth-friendly reproductive health centres that offer confidential care, counselling, and post-abortion services;

Community engagement initiatives to dismantle stigma and raise awareness among parents, religious leaders, and traditional authorities.

Her work has already shaped dialogues at international conferences, academic publications, and local community training sessions. But she insists that research alone isn’t enough, policy must catch up to evidence.

Empowering Girls, Restoring Dignity

In Nigeria, where public discourse often silences adolescent sexual health and shames reproductive autonomy, Dr. Adejugbe is among a new generation of scholars pushing for a more humane approach. “We must stop framing adolescent fertility as moral failure and start addressing it as a public health and human rights issue,” she asserts.

At Utah State University, where she is completing her Ph.D. in Sociology with a specialisation in demography and health inequality, she continues to study the intersection of race, disability, and reproductive access, building parallels between marginalised Black communities in the U.S. and young Nigerian women fighting similar battles.

Toward a Just Reproductive Health Strategy

Dr. Adejugbe envisions a Nigeria where no girl dies because she couldn’t afford, access, or speak about safe reproductive care. She urges the Federal Ministry of Health and policymakers to move beyond donor-driven short-term programs and invest in a national adolescent reproductive health strategy rooted in equity, compassion, and community ownership.

“This is not just about reducing maternal mortality,” she concludes. “It’s about restoring dignity, giving girls a future, and recognising that safe reproductive health is not a privilege-it’s a right.”