Abiodun Raufu Lagos
The Society of Gynaecologists and Obstetricians of Nigeria estimates that about 20 000 Nigerian women die from unsafe abortions each year.
The figure comes from studies carried out by the society and Nigeria's Ministry of Health. The estimate also tallies with the result of a nationwide survey conducted by Friday Okonofua, dean of the School of Medicine at the University of Benin and executive director of the Women's Health and Action Research Centre in Nigeria. This survey showed that an estimated 610 000 unsafe abortions a year are carried out in Nigeria, and that about half of the 20 000 women who die from the complications of unsafe abortion are adolescents. The death rate from unsafe abortions is thought to be one of the highest in Africa.
Abortion is illegal in Nigeria, and most medical practitioners refuse to conduct abortions because of fear of the legal consequences. The result is that most women wanting an abortion tend to patronise unqualified practitioners who offer quick and cheap abortions.
"This high rate of mortality associated with unsafe abortion is due to the prevailing restrictive abortion law in the country, which encourages women to use unqualified backstreet abortionists for the procurement of abortion," says the society's president, Linus Ajabor.
Nigeria has one of the highest maternal mortalities in the world1500 women per 100 000 births.
"The abortion rate in Nigeria is 45 per 1000," says Professor Okonofua. "About 80% of the women we interviewed said they have had an abortion in their lifetime, and that is the highest rate ever in any country in the world."
About a million births a year in Nigeria are to teenage mothers, according to former minister of health Olikoye Ransome-Kuti, and abortion complications are responsible for 72% of all deaths among teenagers below the age of 19.
Professor Okonofua said that one major reason why the abortion rate in Nigeria was so high was that only about 6% of women of reproductive age practise birth control.
The lack of enthusiasm for birth control is thought to be due to ignorance, as well as cultural and religious inhibitions. "A lot of women believe that family planning methods can harm and thus regard it to be unsafe and dangerous," said Professor Okonofua.
BMJ November 2002