Godwin Haruna
11 September 2007
Lagos — She was 18 year-old, and had just passed out of secondary school and was seriously seeking admission into a higher school. As part of the risky lifestyles adolescents like her engage, she was going out with a young boy in town. Unknown to their parents, the young lovebirds were seeing each other at odd hours as a result of which the girl became pregnant. What to do? They decided to get rid of the pregnancy before their parents could detect. Off, they headed to a quack to procure the abortion and the man's concoction swallowed by the girl proved fatal. The girl lost her life.
Days later, the boy and the quack were arraigned to answer charges of murder. Whatever the legal gymnastics that may rage in the courts, the girl of promise was gone forever. This true-life story happened in Bauchi last year and probably would have been replicated in several communities in Nigeria.
The Society of Gynaecologists and Obstetricians of Nigeria estimates that about 20,000 Nigerian women die from unsafe abortions each year. About 760,000 induced abortions occur annually in Nigeria. 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 Prof. 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. 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.
The World Health Organisation (WHO) describes maternal death as death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of pregnancy, from any cause related to, or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
Speaking on the issue to THISDAY last week, Dr. Boniface Oye-Adeniran, consultant gynaecologist and obstetrician at the University of Lagos College of Medicine, who is also executive director of Campaign Against Unwanted Pregnancies (CAUP), said no woman should die because she is pregnant. Oye-Adeniran stated that it was immaterial whether the pregnancy was wanted or not.
"Until we start seeing the woman's reproductive health as part of her human rights, these deaths will continue to occur. Every decision on the reproductive health of a woman should be entirely hers to make. The high rate of mortality associated with unsafe abortion is due to the prevailing restrictive abortion laws in the country, which encourages women to use unqualified personnel for the procurement of abortion", he stated.
He added that unsafe abortion is the termination of pregnancy carried out by someone without the skills or training to perform the procedure safely; or in a place that does not meet minimal medical standards, or both.
He described induced abortion as the termination of pregnancy by a deliberate intervention. "It is an extremely safe medical procedure when carried out by qualified personnel according to health policy guidelines", Oye-Adeniran stated.
According to him, while spontaneous abortion or miscarriage can result in complications, morbidity is usually very low in such rare situations. Nigeria, he said, has one of the highest maternal mortalities in the world-1500 women per 100 000 births.
Quoting a document from the Internal Conference on Population and Development (ICPD) held in Cairo in 1994, he said: "Reproductive rights embrace certain human rights that are already recognised in national laws, international human rights documents and other relevant United Nations consensus documents. These rights rest on the recognition of the basic rights of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes the right of all to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents".
According to Oye-Adeniran, at the core of reproductive rights is the principle that a woman has the right to decide whether and when to have a child. "When faced with an unwanted pregnancy, only she can decide whether she will carry the pregnancy to term.
According to him, as in many countries worldwide where abortion is highly restricted, safe care is often a matter of resources. Those with money, he added, can find a doctor to perform a safe procedure. "In Nigeria, access is denied to those on the lowest rungs of the socio-economic ladder," he explained.
"Governments are bound to respect this basic human right by ensuring that women have access to the full range of quality reproductive health services, including abortion. Not only should governments remove legal barriers to abortion services, they should ensure that safe and high-quality abortion services are accessible to all women to the full extent of the law", he added.
He said until this moment, there is no body of law known as the Abortion Law in Nigeria. Whatever is available now, he said, are 19th century English legislations on the subject, which Nigeria inherited from her colonial administrators. The sad fact, he added, is that the UK has reformed the laws severally, which Nigeria has continued to retain many years after she gained independence.
Oye-Adeniran contended that in drafting legislation or regulations regarding abortion, governments should make women's human rights - including their rights to reproductive autonomy, equality, and health - their primary consideration.
Also speaking on the issue, Prof. Isaac Adewole of the College of Medicine, University of Ibadan, stated that reproductive health is not about abortion alone. Also an executive director with CAUP, Adewole stressed that reproductive health implies that people have the ability to reproduce, to regulate their fertility, and to practice and enjoy sexual relationships.
He stressed further that it implies that reproduction is carried to a successful outcome through infant and child survival, growth and healthy development; that women can go safely through pregnancy and childbirth and that fertility regulation could be achieved without health hazards.
He said the reproductive rights entails the right to attain the highest standard of sexual and reproductive health and the right to services and information that make this possible. He stated that it was not normal to have killed the National Reproductive Health bill, which was all-embracing with a multitude of important issues on the subject matter.
He identified the components of reproductive health as including gender equality, sexual behaviour, adolescent reproductive health and sexuality, harmful traditional practices and violence against women. Others are reproductive health of older women and men, fertility regulation, infertility, safe motherhood, infant and child survival, growth and development, sexually transmitted diseases including HIV/AIDS and unsafe abortion.
Adewole stated that all the aforementioned are crucial aspects of general health and central to human development. He therefore expressed surprise that sexual and reproductive health is conspicuously missing from the Millennium Development Goals (MDGs).
Professor Adewole counsels antagonists of reproductive health: "You can't possibly say no to everything; you have to say yes to something. Every Nigerian should be able to buy into at least one of these programmes-sexuality education, family planning, adoption and fostering, or legal abortion-to prevent unwanted pregnancy and unsafe abortion."
Speaking on how the media could report issues pertaining to reproductive health issues without attracting stigma, Mr. Femi Adesina, Editor, Daily Sun, advised journalists to be creative in their reports. "What are news if not fresh information? As at two years ago, the statistics we had was 6 maternal deaths per hour in Nigeria, 140 per day, 4,200 per month, 800 in every 100,000 live birth. Of 550,000 annual global deaths, Nigeria accounts for 50,000. Has this changed upward or downward? It is news. It is something to monitor", Adesina challenged journalists.
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