Though permitted only when necessary to save a woman’s life, induced abortion is common in Nigeria. A new study, "The incidence of abortion in Nigeria," conducted by researchers at the Guttmacher Institute and the University of Ibadan, finds that 1.25 million abortions were performed in the country in 2012, compared with the 610,000 abortions estimated to have occurred in Nigeria in 1996. This increase is due not only to greater population size, but also to an apparent rise in the abortion rate. The estimated abortion rate was 33 abortions per 1,000 women aged 15–49 in 2012. Although this rate is greater than the 1996 rate (23 per 1,000) estimated in a previous study, the most prudent conclusion may be that the abortion rate has increased slightly, as the two rates were calculated using different approaches.
Most of these abortions were clandestine and many were unsafe. Unsafe abortion is a major contributor to Nigeria’s maternal mortality rate, which remains among the highest in the world. Clandestine procedures are often carried out under unsanitary conditions by providers who are not appropriately trained. The resulting complications range from unchecked bleeding to serious infections and even death.
Another recent study by many of the same authors, "Maternal near-miss due to unsafe abortion and associated short term health and socioeconomic consequences in Nigeria," examined cases in 2012 where women with pregnancy-related complications would have died if they had not received treatment. The researchers found that almost 10% of these near-miss events in Nigerian hospitals were due to unsafe abortion.
"These findings make clear not only that abortion is common in Nigeria, but that unsafe services are putting women’s health and lives at risk," said Dr. Akinrinola Bankole, director of international research at the Guttmacher Institute and the study’s lead author. "Unwanted pregnancy is the root cause of most abortions. Nigerian women need access to high-quality family planning services to reduce rates of unintended pregnancy and the unsafe abortions that often follow."
Nigeria has low levels of contraceptive use. As a result, about one-quarter of the 9.2 million pregnancies that occurred in the country in 2012 were unintended. More than half (56%) of these unplanned pregnancies ended in abortion.
"When contraception is not used or fails, the evidence suggests that women with unwanted pregnancies often have unsafe abortions that put them at risk for adverse consequences," added Professor Isaac Adewole of the University of Ibadan, who also authored the study. "We hope these findings inform discussions on the public health benefits of allowing expanded access to comprehensive abortion care for Nigerian women."
Rates of abortion vary within Nigeria. The study found the highest rates in the North East (41 per 1,000 women) and South South (44 per 1,000) women) zones. The researchers believe the high rate in the North East zone—which includes the states of Adamawa, Bauchi, Borno, Gombe, Taraba and Yobe—is linked to particularly high levels of contraceptive nonuse, as more than 96% of women in those regions do not use a contraceptive method and thus face a high risk for unintended pregnancy. In the South South zone—which includes Akwa Ibom, Bayelsa, Cross River, Delta, Edo and Rivers— the high rate of abortion may be related to the combination of women having a strong desire to control family size and a relatively high level of unmet need for contraception. Women in the South South zone report wanting fewer children (3.9 on average) than the national average (5.2).
The researchers recommend that the Nigerian government and its local and international partners reduce unintended pregnancies (and, in turn, unsafe abortion) by promoting family planning programs and sexuality and family life education throughout the country. The researchers also urge that postabortion care services be expanded to ensure all women experiencing complications receive the care they need to avoid disability and death. The researchers anticipate that their findings will also contribute to a better informed debate on legal reforms so that Nigerian women can obtain comprehensive and safe abortion care.
"The Incidence of Abortion in Nigeria" is available online in International Perspectives on Sexual and Reproductive Health.
This study was made possible by grants from the Dutch Ministry of Foreign Affairs, the UK Government and the John D. and Catherine T. MacArthur Foundation. The findings and conclusions contained within do not necessarily reflect positions and policies of the donors.