Safe Abortion is Women’s Health Right

Her story was pathetic! Joyce (not real name) was 27, when she became victim of an unforgettable rape by the leader of a hooded robbery gang that forcefully had sex with her; right in her home, in the presence of the other hooded robbers, few months after moving to her new apartment. She was still waging in battle for about a month and half whether or not to discuss and confide in someone, when she realized she had been pregnant from the sex episode.

The shame, the trauma and other psychological tortures will be too much and punishing for her to carry the pregnancy to term. She concluded she had to terminate the pregnancy. A first timer, like many first timers, became victim of unsafe abortion. Even though she didn’t lose her life, she literally lost her motherhood as the clandestinely abortion ruptured her womb. Joyce at 49 remains single and mummy of adopted two kids. Still, she is a lucky victim, as many women and girls have lost their lives to unsafe abortion.

In a publication in African Journal of Legal Studies(2014) ‘ Justification for Women’s Right of Access to Safe and Legal abortion in Nigeria, Olaide & Aderibigbe  made a succinct case for liberalization of abortion in Nigeria to save the lives of women and girls, whose reproductive health rights are being hampered by Nigeria abortion laws.

According to the duo, abortion remains one of the most controversial, emotional and burning political issues of our time. Unsafe abortion is a serious public health problem and human rights issue. The pervasive criminalization of abortion in Nigeria is a serious obstacle to improving access to safe and legal abortion. Women’s lack of access to safe legal abortion is a major cause of high rates of maternal mortality. They asserted that the Nigerian government’s failure to fulfill its human rights obligations under national, regional and international law is largely responsible for this situation. Adding that, “overcoming these considerable barriers requires governments to sustain a firm commitment to women’s human rights and to ensure access to safe and legal abortion services. Women’s restrictive legal access to safe abortion services violates their human rights and is perhaps one of the pervasive manifestations of unjustified discrimination against women”.

Criminalization of abortion leads women to obtain unsafe abortions which threaten their lives and health. While the denial of free access to abortion service is a denial of woman fundamental human right, advancing access to safe abortion by the Nigerian government is a necessary requirement to save women’s lives, protect their rights to health, equality and human dignity.

Abortion, legally, denotes the intentional interruption of pregnancy by the removal of the embryo from the womb, through administration of drug, and other substance on a pregnant female or use of any instrument or any other means on a pregnant female

Safe abortion according to experts, is the termination of a pregnancy by trained health care providers using correct, sanitary technique and equipment, while unsafe abortion is the termination of pregnancy by individuals without the necessary skills, or in an environment that does not conform to the minimum medical standards, or both.

Abortion facts

With a population of roughly over 200million, and a growth rate of 2.58%, Nigeria is the most populous country in Sub-Saharan Africa. The Nigerian government has jeopardized the health rights of Nigerian women and girls, long enough, by her insistence to hold on to the status-quo to criminalize induced abortion. Induced abortion according to FIGO(International Federation of Gynecology & Obstetrics) Ethics Committee, is the termination of pregnancy using drugs or surgical intervention after implantation and before the embryo or fetus has become independently viable

In a 2015 Guttmacher Institute report on the incidence of abortion in Nigeria, frightening and damning abortion facts were reported by the authors who were mainly Nigerians in Guttmacher Institute & University of Ibadan. According to the report, an estimated 1.25 million induced abortions occurred in Nigeria in 2012, equivalent to a rate of 33 abortions per 1,000 women aged 15–49.

The estimated unintended pregnancy rate according to the report, 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

The report concluded that levels of unintended pregnancy and unsafe abortion is on high in Nigeria. Improvements in access to contraceptive services and in the provision of safe abortion and post abortion care services are required to help reduce maternal morbidity and mortality.

As far as religion is concerned, abortion is a highly emotional subject that elicites deeply held opinions.   The Christian doctrine and traditional tenets of Islam forbid abortion after animation of foetus, particularly if the life of the pregnant mother is not threatened. Religious leaders in Nigeria do not regard abortion as a health right to women and girls but as a “moral evil” that must not be legalized. Little wonder they spearheaded the fight against the attempt to liberalize abortion during the time of Late Prof. Olikoye Ramson Kuti as the health minister.

Woman’s fundamental human rights to control her body, to self-determination, and to health, depends in part, on her right to determine whether to carry a pregnancy to term. Women and girls who face punishment for having an abortion are not less likely to attempt abortion, but are more likely to have medically unsafe services. When law restricts abortion, as in Nigeria, trained service providers may even be reluctant to perform abortions In situations where abortion is allowed to save the woman’s life.

Nigeria is a developing country, and the lessons to be learned is that countries with permissive abortion laws, primarily developed countries, do not have increased rates of abortion whereas countries with highly restrictive abortion laws – primarily developing countries – do have high unsafe abortion rates. . In the 21st century, no woman should die or suffer the traumas of an unsafe or illegal abortion. Providing medical abortion services that women and young people need is not only the right thing to do, it’s the smart thing to do.

Moreover, equitable access to safe abortion services is first and foremost a human right. Where abortion is safe and legal, no one is forced to have one. Where abortion is illegal and unsafe, women are forced to carry unwanted pregnancies to term or suffer serious health consequences and even death.

Human Right Watch states further that “the denial of a pregnant woman’s right to make an independent decision regarding abortion violates or poses a threat to a wide range of human rights.” It is widely acknowledged that in countries in which abortion is legally restricted, women seek abortions clandestinely, under conditions that are medically unsafe and therefore life threatening.

The World Health Organization has identified unsafe abortion as a serious public health problem in many countries including Nigeria. The number of declarations and resolutions signed by various countries, including Nigeria, over the past two decades indicate a growing consensus that unsafe abortion is an important cause of maternal death. This can, and should, be prevented through the promotion of sexuality education, family planning, and safe abortion services within the law. The critical thing here is that Nigeria has refused to domesticate declarations, treaties and resolutions freely signed to in the committee of nations.

Abortion Controversies.

Abortion attracting criminal penalties, even when pregnancy is the result of rape or incest has resulted in a raging controversy between anti-abortion and pro-abortion groups on the justification of women’s right to abortion in Nigeria.

Opposition to women’s access to safe abortion comes from many sources: religious groups, opponents of women’s equality and of abortion as Western feminist concepts, health professionals who believe abortion is unethical, and community leaders who worry that liberalizing the abortion law will lead to unrestrained sexual activity among young people.

Liberalizing abortion laws is a burning political and emotional issue, especially in Nigeria where the legislators have consistently refused to amend the law to meet with the extant needs of contemporary woman. Some of the reasons advanced by those opposing abortion are as follows:

abortion constitutes a danger to women’s life and health;

legalizing abortion condones promiscuity; and

abortion amounts to killing of the foetus.

The pro-abortion groups on the other hand describe Restrictive abortion laws as an infringement on women’s human rights and on medical ethics. According to the pro groups, restrictive criminalization of abortion does not stop women from obtaining unsafe abortions to end unwanted pregnancies. Therefore, a restrictive legal framework regulating abortion directly affects the safety of the abortion procedure. It also means the quality of the services is not regulated and cannot be provided openly. In countries like Nigeria, where abortion is illegal, the risk of death and injury to women seeking abortion is higher than countries where abortion is legally permitted. Where abortion is permitted, it is possible for the legislature to regulate the access and quality of the abortion service based on the age of the pregnancy. In effect, there is some measure of protection for women dying from unqualified abortion providers who do not have the skills to provide the service.

The pro-abortion group further argued that Unsafe abortion from the public health point of view, accentuate maternal mortality. Adding that, limited access to abortion and lack of respect for reproductive rights amount to social injustice.

According to the pros, those opposed to abortion’s availability and legality have actively peddled misinformation in order to curtail women’s access to a full range of reproductive choices. They aim to stigmatize the procedure, the providers and the women who get abortions. The anti-abortion movement has created and propagated many myths, intended to cast abortion as a dangerous procedure that should be prohibited. These distortions of science and good health practices have a detrimental effect on women’s health, rights, and lives. Unfortunately, these myths have gained traction in some circles. The pro-choice community’s support for a woman’s right to have an abortion is based on science, history and human rights.

Since the International Conference on Population and Development held in Cairo in 1994, during which many countries made commitments to respect women’s reproductive rights, many of them have not recorded significant improvements to enact and implement the legal frameworks for abortion. There is still fierce contention between the anti-abortion and pro-abortion groups.

However, it is widely recognized that restrictive laws on abortion have little effect on reducing the rate of abortion. They commonly lead to the performance of abortions in unsafe conditions, and to increased maternal mortality and morbidity by denying women access to safe services.

The Undomesticated treaties/Agreements

-Right to life enshrined in the International Covenant on Civil and Political Rights (iccpr). UN Human Rights Committee called upon States to inform it of “any measures taken by the State to help women prevent unwanted pregnancies, and to ensure that they do not have to undergo life-threatening clandestine abortions.”

Several United Nations human rights bodies have framed maternal deaths due to unsafe abortion as a violation of women’s right to life. As a result, they have called on States to review restrictive laws that criminalize abortion and increase access to family planning, and sexual and reproductive health information in order to reduce the number of unsafe abortions.

-The Programme of Action adopted at the International Conference on Population and Development (icpd) in 1994 called upon governments to consider the consequences of unsafe abortion on women’s health. It states that governments should “deal with the health impact of unsafe abortion as a major public health concern.”

-At the 1995 Fourth World Conference on Women, the international community urged governments to “consider reviewing laws containing punitive measures against women who have undergone illegal abortions”

-In 1999, at the five-year review of the icpd, governments recognized the need for greater safety and availability of abortion services. They affirmed that “in circumstances where abortion is not against the law, health systems should train and equip health-service providers and should take other measures to ensure that such abortion is safe and accessible. Additional measures should be taken to safeguard women’s health.”

-In 1999, the Committee on the Elimination of Discrimination against Women (cedaw Committee) recognized “laws that criminalize medical procedures only needed by women and that punish women who undergo those procedures” as a barrier to women’s access to appropriate health care.

Furthermore, the Human Rights Committee has recognized criminalizing abortion, even in cases of rape, as being incompatible with the States’ obligation to ensure the equal right of men and women to the civil and political rights set forth in the International Covenant on Civil and Political matters(iccpr).

The African Protocol on the Rights of Women (2003) provides that member states must take all appropriate measures to “protect the reproductive rights of women by authorizing medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus”.

These are just few of the treaties relating to liberalization of abortion that Nigeria signed but never domesticated

The Campaign Against Unwanted Pregnancy

A multi -disciplinary initiative spearheaded by three O&G; The Nigerian Campaign Against Unwanted Pregnancy (CAUP) was launched on 17 August 1991. Its mission was to focus attention on the health problems of women caused by unsafe abortion in Nigeria. CAUP quietly garnered support for safe abortion through the medical community.

On 16—17 August 1991, CAUP convened a consultative group of 27 people committed to the promotion of women’s sexual and reproductive health and rights. CAUP’s vision, agreed at the founding meeting, was a Nigeria free of unsafe abortion. Its mission was to create a prominent organisation committed to reducing the burden of unsafe abortion among women in Nigeria.

In 2004, CAUP examined and analysed its work. The evaluation report noted that, though the initiative’s efforts to change the legal status-quo concerning abortion in Nigeria were met with brick walls, CAUP took a taboo topic and made it a legitimate subject for public discussion and debate.

Nigeria has over the years signed international treaties to support liberalization of abortion. Its therefore preposterous to still have abortion criminalized in our statutes book.