Health'Contraceptives can help prevent Nigeria's annual 6,000 maternal deaths...

‘Contraceptives can help prevent Nigeria’s annual 6,000 maternal deaths from unsafe abortion’

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Angela Onwuzoo

Maternal health experts say if women have access to the contraceptive method of their choice, the 6,000 maternal deaths recorded in Nigeria annually from complications of unsafe abortion could be averted.

Citing an abortion study conducted between 2018 and 2020 on women in the country by the Performance Monitoring for Action Nigeria, the experts stated that every year, about 6000 Nigerian women die from unsafe abortion.

According to them, unsafe abortion is the consequence of unwanted pregnancy which they emphasised could be prevented through the use of contraceptives.

The experts disclosed this during a media training in Lagos, revealing that more than three in five abortions in Nigeria were unsafe.

Speaking at the training titled, ‘Amplify, Media Communication for Access to Safe Abortion’ organised by Media Development Collective and Population Reference Bureau, a Professor of Obstetrics and Gynaecology, College of Medicine, Lagos State University, Ikeja, Oluwarotimi Akinola said unwanted pregnancy leads to unsafe abortion and unsafe abortion leads to maternal morbidity and mortality.

Akinola who is the immediate past President, Society of Gynaecology and Obstetrics of Nigeria, said an estimated 45,000 women die annually from pregnancy-related causes in Nigeria representing 124 daily, citing the Nigeria Demographic Health Survey 2018.

The gynaecologist noted that the country’s mortality ratio of 512 maternal deaths per 100,000 live births far surpasses the global average of 254 maternal deaths per 100,000 live births, lamenting that Nigeria has one of the highest maternal mortality ratios in the world.

The professor in his presentation which centred on medical aspects of abortion in Nigeria noted that abortion deaths constitute about 10-14 per cent of these deaths.

Attributing maternal deaths from complications of unsafe abortion to lack of access to family planning services, Akinola said, “The legality of abortion in any jurisdiction is determined by the scope of the sexual and reproductive health rights of women.

“The drivers of the increasing rates of unsafe abortion in Nigeria are low contraceptive prevalence rates; poor appreciation of the sexual and reproductive health rights of women; social and cultural limitations with regards to women and restrictive laws.”

Giving insight into the scope of maternal health problems in Nigeria associated with unsafe abortion, the maternal health specialist revealed, “An estimated 1.25 million induced abortions occurred in Nigeria in 2012, – a rate of 33 abortions per 1,000 women aged 15-49.

“The estimated unintended pregnancy rate was 59 per 1,000 women aged 15-49. Fifty-six percent of unintended pregnancies were resolved by abortion. About 212,000 women were treated for complications of unsafe abortion, representing a treatment rate of 5.6 per 1,000 women of reproductive age, and an additional 285,000 experienced serious health consequences but did not receive the treatment they needed.”

He said unsafe abortion is a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards or both.

According to the World Health Organisation, women, including adolescents, with unwanted pregnancies often resort to unsafe abortion when they cannot access safe abortion.

The world health body listed barriers to accessing safe abortion to include: restrictive laws, poor availability of services, high cost, stigma, conscientious objection of healthcare providers and unnecessary requirements, such as mandatory waiting periods, mandatory counselling, provision of misleading information, third-party authorisation, and medically unnecessary tests that delay care.

To reduce the cases of unsafe abortion in Nigeria, Akinola said, “It is not safe abortion that is the solution; it is preventing women from getting pregnant in the first place by offering them family planning services. The contraceptive prevalence rate in Nigeria is very low. If we can improve that, certainly the number of maternal deaths from unsafe abortion will reduce.

“There is evidence that shows that we can reduce the maternal mortality rate by 33 per cent by just improving and increasing the contraceptive prevalence rate. You will not die of pregnancy if you don’t get pregnant and contraception does that.”

According to NDHS 2018, the total contraceptive prevalence rate in Nigeria for married women using both traditional and modern methods is 17 per cent.

Also speaking, a Representative of PRB in Nigeria, Dr. Moriam Jagun, citing the PMA Nigeria survey, said adolescents and women who are poor, have little schooling, or live in rural areas were most likely to have an unsafe abortion.

 Jagun who is a Public Health Physician said most of the maternal deaths from unsafe abortion could be prevented if safe abortions were made more accessible and more equal to women.

“More than three in five abortions in Nigeria are unsafe. Unsafe abortion can lead to a range of health complications and even death for women.

“Women with disadvantages are most likely to have unsafe abortions and least likely to receive treatment for complications because of inequities in access to safe care,” she noted.

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