Pressure, peer influence driving unsafe abortions – Experts

Every day, Rasheedat, 34 years, is reminded of the path she chose 10-years ago when she decided to have an unsafe abortion.
Filled with guilt and agony, the Business Administration graduate from the Moshood Abiola Polytechnic Abeokuta, Ogun State, wonders if she will ever be able to bear children.
Recounting her experience to TVN, Rasheedat disclosed how fear of being mocked, rejected and abandoned by her family drove her to seek an unsafe abortion.
“When I became pregnant in my ND days, I was scared, confused and ashamed of myself. I come from a strong and religious Muslim family, my parents would kill me, and my friends, neighbours and even Alfa would laugh at me. So I told myself, ‘No you can’t keep this’.
“ A friend of mine introduced me to a woman who removes pregnancy for young girls in Ijebu Ode.
“When I got to her house, she pressed my tummy and asked if I could feel any pain, I answered, yes, then she asked me to follow her, we went inside one of the rooms then, she pointed at a wooden table placed in the center of the room and told me to lie down on it.
“I yelled out in anguish and shouted as she used one iron to open my vagina with another going inside. It felt like she was digging and sucking something out,” she said.
She told our correspondent that she was only instructed to take paracetamol if the pain persisted.
Eight years later, Rasheedat, who is now married, is yet to conceive.
“Every time I think back on the decision I made I feel regret, I can’t even tell my husband what I did. I just wished I had kept the pregnancy,” she added.
Like Rasheedat, a large number of women, adolescents, and young adults in Ogun State are entangled in the state’s unsafe abortion network. While some have escaped unharmed, others are living in regret.
What is Unsafe Abortion
An unsafe abortion is when a pregnancy is ended by someone who lacks the required training or in an atmosphere with inadequate medical standards.
The World Health Organisation (WHO), says every year, about 73 million abortions take place worldwide, an estimated 45% are unsafe and about 97% of unsafe abortions take place in developing countries and are higher in countries where abortion is illegal.
In Nigeria, 4.6% of reproductive-aged women undergo an abortion each year, equaling nearly 2 million abortions annually, says the October 2022 Performance Monitoring for Action (PMA) abortion survey.
Abortion is prohibited by the Nigerian law under the Criminal Code, Sections 228, 229, 230, and 297 of the Constitution.
Section 228 says “Attempts to procure abortion – Any person who, with intent to procure the miscarriage of a woman, whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind, or uses any other means whatever, is guilty of a felony and is liable to imprisonment for fourteen years.”
However, termination of pregnancy for legal indication sets out the different conditions that meet the requirements for a medical abortion.
Ogun Adopts the STOP Guideline
In May 2023, the Ogun State government launched the Safe Termination Of Pregnancy (STOP) guideline.
Commissioner for Health, Dr Tomi Coker in her statement, said that according to the NDHS 2023 report, Ogun State situation appears to be slightly better with a maternal death ratio of 179 per 100,000 live births, with outstanding returns on investment and notable advancements in mother and child health services.
She said the document was put together in order to reduce preventable deaths among women of childbearing age and victims of domestic violence.
Yet, unsafe abortions are still carried out in the state.
TVN, while speaking to some female residents, gathered that they feel ashamed to seek safe abortion services, due to fear of judgment from health practitioners, parents, and society, hence, they opt for unsafe abortion.
“I had my first abortion in Igbesa when I was 19-years-old, so far I’ve had 4 abortions and it was done by different people in this state.
“I never went to a hospital because I didn’t want any insult from those nurses,” an anonymous source said.
80% of abortions occur in private sector – OGUN Agency
Responding, the Executive Secretary of the State’s Primary Healthcare Development Board (OGUNPHCDB) Dr. Elijah Ogunsola, noted that the adolescents do not come to the public facility to seek services.
Dr. Ogunsola explained that due to stigma and fear of being underaged, they turn to patent medicine vendors.
He assured that the ministry was working nonstop to combat quack medical professionals in the state.
“These adolescents do not come to the public facility to seek services.
“No matter how we open all the public health facilities, they will not come, some of them are less than 18 and they are pregnant. They know they are minors so they will go to patent medicine vendors that can provide medical abortion at the early stage,” he said.
According to him, the state has trained medical personnel in adolescent health, to enable youth to communicate freely with healthcare providers.
“They have been trained on how to relate with these adolescents when they come.
“Recently we trained 60 of our health workers on adolescent health, so for us in Ogun State, we have also incorporated adolescent health into our health system,” he further stated.
He added that the state has also trained private practitioners, stressing that 80% of abortions occur in the private sector.
While law enforcement officials have typically stood between the procedure and the health practitioners, Dr. Ogunsola stated that the state will also train them in order to ensure that health workers perform their statutory duty without being molested or arrested.
“Even the legal officers need to know the position of the health sector regarding the termination of pregnancy.
“There is a training by one of the partners for legal officers for magistrates so that they can also be aware in case there is a breakdown in law,” he added.
We are working on curbing maternal mortality from abortion – Ogun NMA
The Ogun State chairman of the Nigeria Medical Association, NMA, Dr Kunle Ashimi, said the association is collaborating with the State’s Ministry of Health and other relevant organizations to educate its members on safe abortion practices.
Ashimi asserted that a large number of abortions were carried out in the state on a daily basis, for a variety of reasons but were kept silent unless complications arose.
While admitting that abortion had a significant impact on maternal mortality, he assured that the menace can be curbed.
Dr Ashimi said, “We had a conference a few days ago in collaboration with some organisations and the Ogun State Ministry of Health on ways to sensitise our members on safe abortion.
“We can ensure that maternal mortality and mortality of young women of reproductive age from abortion can be curbed and that is something we have really been working on.
“Let me be clear about abortions. I cannot tell you there’s any woman who is happy to abort. There is always something after them or something they’re running after but the decision to abort is not always a happy one.
“When it happens, she would not come to report to anybody that she did it so, it is difficult, except when an untoward event happens, that’s when we get to know but many abortions are committed daily in this country and in this state for various reasons.”
Abortion Laws Should Be reviewed – FIDA
Tomilayo Oduyebo, the Public Relations Officer of the International Federation of Women Lawyers, FIDA, Ogun State chapter, called for a review in the laws guiding abortion.
Oduyebo explained that the law should recognise additional factors that contribute to the procurement of illegal abortions, such as the mother’s mental health and sociological concerns.
“There has been a lot of conversations and advocacy on safe abortion.
“Safe abortion doesn’t mean when the life or health of the mother is at stake alone it should also include if the mother has mental or sociological issues that may affect either her life or the ability to even take care of her child.
“So because our law doesn’t really recognize some other components that make abortion safe, people tend to procure illegal abortion and that is where the issue of unsafe abortion comes in.
“FIDA, WARDC and so many other NGOs are now advocating that these laws should be reviewed.
“Abortion should not only be when the health or life is actually at stake, it should be allowed in cases of rape and incest.
“If the woman or girl is raped and such doesn’t want to keep the baby she should be allowed; we also have several cases of incest.
“So, if a sister is put in the family way by her brother or father, she should be allowed to have an abortion and then we’ve had instances of people with underlying mental health issues.
“We have seen cases of women getting pregnant and then the mental issue becomes pronounced in that case, even if the life is not actually at stake the mental health is at stake, if such a woman wants an abortion, she should be allowed.
“If a married woman has had 4-5 children and decides that she doesn’t want another because she doesn’t have the means to take care of the child, such should not be taken as an offender,” she added.
The legal practitioner, who also serves as the HR manager for the Women Advocates Research and Documentation Centre (WARDC), clarified that the advocacy does not imply that it should be free for all; rather, it should be regulated and subject to medical changes and guidance.
“We are not saying it should be free for all, of course we expect that it should be regulated and subject to medical change and advice, so people don’t take it for granted,” she further stated.
She, however, stressed the need for family planning awareness and policies to educate the public and lessen the issues associated with unwanted pregnancies.
Oduyebo also urged parents, religious authorities, and the general public to cease stigmatising young girls who become pregnant, arguing that doing so pushes them towards their peers and, ultimately, quacks.
Pressure, peer influence driving unsafe abortions – Experts