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Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by The Penal Code and Southern Nigeria is governed by The Criminal Code. [1] The only legal way to have an abortion in Nigeria is if having the child is going to put the mother's life in danger. [2] However, sex-selective abortion has long had acceptance in Nigeria. [3] [4]
Nigeria's abortion laws make it one of the most restrictive countries regarding abortion. [5] Nigeria's criminal law system is divided between the northern and southern states of Nigeria.
The Criminal Code is currently enforced in southern states. The abortion laws of the Criminal Code are expressed within sections 228, 229, and 230. [6] Section 228 states that any doctor providing a miscarriage to a woman is guilty of a felony and up to 14 years of imprisonment. Section 229 states that any woman obtaining a miscarriage is guilty of a felony and may be sentenced to imprisonment for up to 7 years. Section 230 states that anyone supplying anything intended for a woman's miscarriage is also guilty of a felony and may be sentenced to up to 3 years of imprisonment. [7]
The Penal Code operates in northern states, with abortion laws contained in sections 232, 233, and 234. The sections of the Penal Code parallel the Criminal Code, besides the exception for abortion with the purpose of saving the life of the mother. The Penal Code's punishments include imprisonment, fine, or both. [5] The offenses of these codes are punishable regardless of whether the miscarriage was successful. [8] No provisions have been made to the Criminal Code making exceptions for the preservations of the mother's life. However, the cases of Rex vs Edgar and Rex vs Bourne have made it generally accepted that abortion performed to preserve the mother's life is not an appropriate transgression of the Criminal Code. [5]
Many Nigerian women seek unsafe abortion methods to avoid criminal and social penalties, leading to abortion-related complications and increasing mortality and morbidity rates in the country. According to research done by the Guttmacher Institute, an estimated 456,000 unsafe abortions are done in Nigeria every year. [9] In a joint study carried out by the Society of Gynecologists and Obstetricians of Nigeria and Nigeria's Ministry of Health, the number of women who engage in unsafe abortion was estimated at 20,000 each year. [10] Research has revealed that only 40% of abortions are performed by physicians with improved health facilities while the remaining percentage are performed by non-physicians. [11] A 2020 study of Nigerian abortion experiences found that most respondents were non-Catholic Christians. [12]
Throughout history, Nigeria's abortion laws have mobilized several groups and movements with opposing missions regarding the liberalization of abortion laws and the promotion of women's rights. In the 1972 conference of the Nigerian Medical Association (NMA), the first attempts were made to reform abortion laws in Nigeria. However, a lack of support caused no revisions to result from this attempt. In 1975, the National Population Council further advocated for women's access to safe and legal abortion on the basis of promoting the health and well-being of the mother. Defended by the NMA and the Society of Gynecologists and Obstetricians of Nigeria (SOGON), this sparked a controversy in 1976. At the yearly SOGON convention, the Prime Minister of Health gave a speech noting the possibility of national reform of abortion laws. [13]
In 1981, the National Council of Women's Societies countered SOGON's proposed bill regarding the termination of pregnancy, preventing it from reaching the House of Representatives. The National Council of Women's Societies expressed that more efforts should be put towards family planning education and prevention of pregnancy outside of marriage. They expected the parents of the House to enforce strong moral values for the country. [14] In 1998, the Women's Health Research Network of Nigeria emerged with the purpose of promoting research and encouraging other groups to advocate and unite around women's health issues. [14]
The Campaign Against Unwanted Pregnancy (CAUP) was created in 1991 with the mission of defending women's sexual and reproductive rights and eliminating unsafe abortion. In 1992, CAUP organized a reform meeting in which the Minister of Health and NMA president reviewed legislation regarding abortion. However, this reform was met with much opposition and was not successful. An important goal of the CAUP is public health education. In 1997, they established the Action Group for Adolescent Health (AGAH), in which they trained medical students to become public educators on sexual and reproductive health. From 1999 to 2004, CAUP organized many workshops and lectures on sexual health and women's rights with the hope of empowering Nigerian citizens with the knowledge to lead a healthy lifestyle and advocate for change. The focus of CAUP since 2002 has been abortion bill reform. A group of experts collaborated to outline changes in 2003. As of 2004, the bill was in its eighth stage of revision. [15]
In 2015 The Violence Against Persons Prohibition Act (VAPP) was passed into law. This act is meant to provide sexual assault and relationship violence survivors with aid. This act is helping women get the contraceptives they need to prevent unwanted pregnancy, the leading cause of abortions. [16]
Despite the combined and continued efforts of various Nigerian and International advocacy groups, only a woman whose life is endangered can undergo a legally performed abortion today. [17]
Many regions in Africa are known for their unsafe practices in health care and disease, specifically when it comes to young pregnant women and abortion. A major problem in these regions is that access to adequate health care is limited, meaning that options for safe healthcare practices are not easily accessible, and some turn to unsafe methods of handling their pregnancies. Abortion accounts for 40% of maternal deaths in Nigeria, making it the second leading cause of maternal mortality in the country. [18]
Healthcare systems in African countries have failed to make the proper changes to ensure a better future for their citizens. The government has either failed to make these issues a priority or they have attempted to introduce policies that had the opposite result of what was desired. [19] Specifically in Nigeria, religious and cultural factors are major reasons behind the failure to address certain abortion issues.
Many of the issues surrounding unsafe abortion focus on adolescents. [18] Although unsafe abortion practices do affect most of the sexually active women in the country, it is believed that adolescents may require special circumstances and could be a reason for change in this area. Adolescents are the most in need of these services; if they adopt safe practices to avoid unplanned pregnancies, these problems could start to decline. In Nigeria, teens are the most likely not to use contraceptives to avoid pregnancy and the most likely to turn to unsafe abortion practices. [18]
Contraceptive use is a common issue for teens in Nigeria and there are no services to support this. Contraceptives are an important resource in a community where abortion and high fertility is an issue.
The need for increased access to safe abortion practices in Nigeria is very apparent. There are several different methods used to try and ensure a healthy and safe approach to abortions, but Nigeria has not always been able to keep up with the costs of these medical advances. In Nigeria, there are three first-trimester safe practices that are utilized to compare costs and effectiveness. Hospital-based dilatation and curettage, hospital-and clinic-based manual vacuum aspiration, and medical abortion using misoprostol are all considered to be huge cost savings and ultimately in the mother's best interest.
Prior to women practicing these medically safer and more cost-effective methods, the rate of self-induced abortions was extremely high relative to other countries and regions. The side effects of using other methods have proved to be damaging to the mothers, resulting in high fevers, urinary tract infections, and genital trauma.
There are also issues where the women who did induce their own abortions did so incorrectly and could have caused other complications by overdosing on misoprostol – a method that is most commonly used safely and cost effectively. An important aspect to take into consideration is that Nigeria is a region where there are low health system requirements and where they strive to use non-surgical options. [20]
In 2022, Reuters reported that the Nigerian military conducted a mass-abortion program at least since 2013 in Northeastern Nigeria, where women separated from Islamic insurgents who had impregnated them. Over 10,000 pregnancies have been terminated without the mothers' knowledge or consent. The women were forcibly administered abortion-inducing injections and pills without being told what the medications were for, and after the abortion was completed they were told not to tell anyone about it. Some women died in these forced abortions, despite the procedures being carried out by medical professionals. Some of the women stated they would not have chosen to have an abortion if given a choice. Forced abortions were illegal under both civilian and military laws in Nigeria. [21]
Unwanted pregnancy is the leading cause of abortion in Nigeria. Unwanted pregnancies have many causes. Nigeria's growing economy and increasing urbanization are making the price of living higher. This is making it more necessary for women to be working, as well as men, to help support the family. When there are more children it becomes harder for the women to focus on work because they are expected to take care of the family first, thus women would rather be working than pregnant or taking care of a child. [19]
Another reason for the high rates of unwanted pregnancy in Nigeria is low contraceptive use and lack of family planning. Much of this is a result of lack of education on the use of contraceptives, as well as a lack of access to health care and contraceptive products in Nigeria. Due to the lack of contraceptive use, there is a trend of uneducated, young, childless women, and women with many children, who end up with unwanted pregnancies. Both of these groups of women live in rural areas, where healthcare is spread out, hard to find, and government campaigns to help educate the public on family planning and contraceptives do not get as much advertisement. [19]
Nigerian women want around 6.7 children. They have 25 years from the ages of 20-45 where they are mostly likely to get pregnant. They spend around 15 of those years pregnant, trying to get pregnant, and not having sex immediately after pregnancy, as accustomed in Nigerian culture. This equates to them having around ten childbearing years where they do not want to be pregnant. Nigerian women have a long span of their life where an unwanted pregnancy can take place, thus these women need contraceptives to make sure an unwanted pregnancy will not occur. [19]
However, it has also been acknowledged that sex-selective abortion has long been a common practice in Nigeria but this practice of sex-selective abortion is gradually going extinct as education and civilization is playing a major role in public enlightenment and awareness. [3] [4]
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The most common reason women give for having an abortion is for birth-timing and limiting family size. Other reasons reported include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.
A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.
An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, abortions in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention. About 25 million unsafe abortions occur a year, of which most occur in the developing world.
Sexual and reproductive health (SRH) is a field of research, health care, and social activism that explores the health of an individual's reproductive system and sexual well-being during all stages of their life.
Abortion is illegal in the Philippines.
Abortion is illegal in El Salvador. The law formerly permitted an abortion to be performed under some limited circumstances, but in 1998 all exceptions were removed when a new abortion law went into effect.
Since 2021, abortion has no longer been a federal crime in Mexico. The criminal law in Mexico varies by state. On 7 September 2023, the Mexican Supreme Court unanimously ruled that penalising abortion is unconstitutional, setting an important precedent across the whole country. Before 2019, abortion had been severely restricted outside of Mexico City, where it was legalized on-request in 2007. As of August 2023, abortion is available on request to any woman during the first twelve weeks of a pregnancy in Mexico City and the states of Oaxaca, Hidalgo, Veracruz, Coahuila, Colima, Baja California, Sinaloa, Guerrero, Baja California Sur, Quintana Roo, and Aguascalientes. However, even in states where abortion is legal, there continue to be women in pre-trial detention for murder due to spontaneous miscarriage.
Abortion has been legal in India under various circumstances with the introduction of the Medical Termination of Pregnancy (MTP) Act, 1971. The Medical Termination of Pregnancy Regulations, 2003 were issued under the Act to enable women to access safe and legal abortion services.
Abortion in Venezuela is currently illegal except in some specific cases outlined in the Venezuelan Constitution, and the country has one of Latin America's most restrictive laws.
Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception.
The Dominican Republic is one of 24 countries in the world and one of six in Latin America that has a complete ban on abortion. This complete ban includes situations in which a pregnant person’s life is at risk.
Reproductive coercion is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and control related to reproductive health by a current, former, or hopeful intimate or romantic partner, but they can also be perpetrated by parents or in-laws. Coercive behaviors infringe on individuals' reproductive rights and reduce their reproductive autonomy.
Abortion is illegal in Bangladesh under most situations, but menstrual regulation is often used as a substitute. Bangladesh is still governed by the penal code from 1860, where induced abortion is illegal unless the woman is in danger.
Abortion in Uganda is illegal unless performed by a licensed medical doctor in a situation where the woman's life is deemed to be at risk.
Abortion in Kazakhstan is legal as an elective procedure up to 12 weeks, and special circumstances afterwards. The relevant legislation is based on the laws inherited from the country's Soviet past, when abortion was legally permitted as a contraceptive.
Abortion in Cambodia is legal upon request within the first twelve weeks of pregnancy.
In Yemen, abortions are only “permitted to save the life of a pregnant woman”, making it one of the strictest abortion laws in the Middle East and the world. Abortion is not widely accepted in Yemeni society. However, because of the recent conflict in Yemen, rape, honor killings, and unsafe abortions have increased in Yemen. According to a study conducted by Canadian Studies in Population, the number of unsafe and illegal abortions are high in Yemen, which can lead to fatal health risks for women.
Abortion in Ghana is legally permissible. The abortion should also be conducted only at a Government hospital; registered private hospital, clinics registered under the Private Hospitals and Maternity Homes Act, 1958 and a place approved by the Minister of Health by a Legislative Instrument. Illegal abortions are criminal offenses subject to at most five years in prison for the pregnant woman who induced said abortion, as well as for any doctor or other person who assisted this pregnant woman in accessing, or carrying out, an abortion. Attempts to cause abortions are also criminal, as are the purveyance, supply, or procurement of chemicals and instruments whose intent is to induce abortions.
Abortion in Kenya is prohibited with the exception of certain circumstances including danger to the life and health of the expectant mother, and rape. Unsafe abortions are a major cause of deaths and health complications for women in Kenya.
Abortion is illegal in Tanzania except to preserve the life of the mother. Under the Tanzanian penal code, health practitioners who perform illegal abortions may receive sentences of up to 14 years in prison, while those who procure abortions for themselves may be sentenced to up to seven years in prison.
