Unsafe abortion is a different layer of pain.
An investigative reporter and bandwidth journalist, Saheed Ibrahim shares this story.
Rape, Incest and Doubt of Motherhood
Lara Adekunle (not real name) was a teenager betrayed by her blood relative uncle – who was living with her family.
She was 13 years of age and in junior secondary school. While Laras parents were securing a better future for the young man, he was planning a sexual heist on the young girl.
He started by buying gifts for me. I thought it was a normal uncle-niece treatment. He was always around me. I did not know he was planning anything of the sort.
I used to be home alone with him whenever I was back from school.
So, on this particular day, I was home and he was in his room. He called me to see him in his room, which I did. Before I knew anything, he forcefully had carnal knowledge of me.
After the whole saga, he begged me not to tell my mother and promised to get me anything I wanted. It was such a scary thing. I did not know how to tell my mother or my dad.
I cried every day in my room.
After contemplation for a few days,
I had to open up to my mummy because I was not myself anymore,” she revealed.
Laras mother must not tell her husband because that would be the end of her and her brother in the house. Laras father is not only a principled person but also a no nonsense man as his daughter described him. What he would do could be unimaginable.
Laras mother questioned her brother, who confessed and apologized. But what would the poor woman do? Tell her husband or send her brother, whom the husband was sponsoring in school, away. What offence would she tell her husband her brother had committed?
It became oku oru as the Yorubas will say. Oku oru is used to describe a situation that cannot be revealed to anyone.
However, luck was not on the side of the poor little girl: her trauma became compounded when she started adding weight and her skin glowing she became pregnant.I was noticing some changes in my body. My mother was also monitoring me. I was supposed to see my monthly flow on the 28th of the same month, nothing happened until fourteenth day of the following month and my mother decided to carry out pregnancy test on me. She got me a test strip and it confirmed I was pregnant, she revealed.
The revelation did unsettle the mother. It was another trauma to deal with. Will she now tell the husband or handle the new development as oku oru? Yes! She had to save her daughter, her brother and her marriage. She consulted her friend, who told her what to do.
Mummy got some drugs for me to use. I took them that day and the following day. I noticed I was having some rumbling in my tummy and later started having some pains.
I started bleeding. It was a terrible situation. My mother was praying nothing should happen to me. In the evening, when my dad came back from work and asked about me, my mother told him I was feeling sick due to menstrual cramps.
Lara was taken to a nurse the following day, who injected her and also recommended some drugs to use. A few days later, she became well. But all was not well -unknown to her.
Its been over ten years after the ugly experience. I dont know if I will be able to conceive or ever have a baby. My menstruation stopped like eight months ago without any sign of pregnancy. I was at the hospital, and the doctor told me my chance of getting pregnant was very slim, which might be unconnected from the unsafe abortion she had to go through when she was 13.
Asked why the mother did not take her to the hospital to remove the pregnancy, she replied:
I don’t know but I think maybe because abortion is illegal in Nigeria.
Perhaps the stigma attached and dad must not know anything.
Lara finished university top of her class. She is currently doing well for herself as a communicator. For childbearing, she is only hoping on God.
Couples unspeakable loss
In the quiet corners of Ondo city, a couple battled life challenges just like countless other Nigerians striving to put food on their table amidst the harsh economic realities brought about by fuel subsidy removal, soaring inflation rates, and the escalating prices of goods and services.
With two little ones to care for, the thought of expanding their family further seemed like an overwhelming burden, given the economic strain they were already enduring. Yet, fate had other plans – the wife became pregnant. Faced with this bleak reality, they contemplated the unthinkable abortion.
In a desperate bid to resolve their predicament, the husband sought the assistance of a doctor, whose qualifications remained unverified till this report was filed.
Tragically, the abortion was performed within the confines of their home. But what was anticipated to bring relief only ushered in an era of unimaginable suffering, pain, and ultimately, the demise of their marriage.
Afterwards, the wife began to bleed profusely, writhing in agony. The pain became unbearable, forcing her to be rushed to the nearest hospital. Recognizing the gravity of her condition, the hospital referred her to Ife.
There, the horrifying truth was discovered: the so-called doctor had punctured the womans womb during the botched abortion attempt. Her womb was said to be decaying, necessitating its removal.
Tragically, the woman succumbed to this nightmare, her life extinguished by the tragic consequences of an unsafe abortion.
Further investigation showed the husband was arrested by the police in Ondo. A close source in the Nigerian police confirmed the case to The Hope. A prosecutor also confirmed knowledge of the ugly development.
The doctor was on the run as of when this report was filed. In the neighbourhood, whispers of the tragedy echoed through the air. One of the neighbours claimed the husband sold his late wifes phone to pay for the abortion that ended her life.
This heartbreaking tale serves as a stark reminder of the debilitating effects of unsafe abortion and the need for contraceptive use by couples to prevent unintended pregnancy that could lead to abortion.
Statistics show that Nigeria has a 61% unmet need for and use of modern contraception among women of reproductive age.
Six-month-old pregnancy in the toilet
Taibat dreamt of being one of the best journalists in Nigeria and probably beyond. Her lofty dreams drove her crazy always. While she was so concerned about her dreams, she thought all work and no play makes Jack a dull boy.
A little bit of fun one fateful night almost ruined her career and her young life. She had a one night stand with a young man without any form of protection shortly after her secondary school education.
That was the genesis of her travails.
As she narrated, she was well aware that abortion is illegal in Nigeria, and she could not confide in her mother, who happens to be her best friend. That was not the type of news I should give it to my mother. She would either faint or be heartbroken forever.
She believed so much in me and it was not what I intended. I never knew such experience would lead to something that would almost claim my life. My friends did it and I thought it was a normal thing.
After the one-night stand, Taibat never knew she was pregnant until the foetus was 4months old. As she was going about her normal life, another life was developing in her tummy.
Just as in rare cases, her menstrual circle never ceased. After discovering she was pregnant, the young man did not take responsibility.
Rather than seeking medical help at a registered hospital, Taibat opted for abortion pills.
I was 20 years old then. I opted for abortion because the guy responsible denied the pregnancy and was not ready to be a father. Secondly, I was scared of what people would actually say about me.
I didnt go to normal hospital not actually because of money but because they will need a guarantor to sign a document, and as a young girl, I was scared of telling my parents and people about it.
Well, I used abortion pills – Mifepristone and Misoprostol tablets. Thats the names of the abortion pills.
I got the abortion pills from a chemist. I went to the instructions and checked how its been used because I was asked to use three pills out of five and make sure I use it as prescribed but because I wanted it really out as fast as possible so I overdosed, she narrated.
My friend was involved because we both went to get the drugs, so once I used the pills. It was really bad and a sad moment for me. I felt a sharp pain in my stomach. It was really painful. I started bleeding and it was so much.
I regretted everything immediately because I didnt consult any doctor and I was in so much pain. I went through hell. When the blood didnt stop and I almost died, I had no other choice than to voice out.
I was rushed to the hospital to save my life: the hospital I couldnt go to. I was given some injections and drugs and those made me deliver the dead baby disturbing my stomach. I felt relieved when I gave birth to the dead foetus in the toilet. I went through hell, she explained.
It took Taibat many days to recover from the experience after she was discharged from the hospital. She fed on light food and drugs for many days cum a constant check-up at the hospital before she could regain her life fully.
Reflecting on the experience, Taibat believed that the best legacy for a teenager or young girl is to be chaste and focused on having a brighter future. Even though she gained admission into a tertiary institution in the state and emerged as one of the most beautiful girls on campus, she believed the trauma from the experience still hunted her.
If it (unintended pregnancy) eventually happens, engaging in self medication and unsafe methods of terminating pregnancy will do nothing than to damage the body system. I learnt my lesson in a very hard way. I hope others do learn from me, she concluded.
Taibat’s journey through darkness serves as a stark warning – a cautionary tale of the devastating consequences of unsafe abortion.
These stories and the unsafe abortion burden in Nigeria highlight the importance of investments in comprehensive sexual and reproductive health services, including contraception and abortion care.
Global Perspective
According to World Health Organisation (WHO), a woman dies of pregnancy-related causes every two minutes globally; most of these deaths are preventable with the right care at the right time.
Maternal Mortality estimates by the WHO, UNICEF, UNFPA, World Bank Group and United Nations Population Division (2000 to 2017) showed that Nigeria and India had the highest estimated numbers of maternal deaths, accounting for approximately one-third (35%) of estimated global maternal deaths in 2017, with approximately 67 000 and 35 000 maternal deaths (23% and 12% of global maternal deaths), respectively.
This translates to Nigeria having the highest burden of maternal mortality in the world.
One of the contributory factors to maternal mortality and morbidity is unsafe abortion. WHO states that unsafe abortion is a leading but preventable cause of maternal deaths and morbidities. It can lead to physical and mental health complications and social and financial burdens for women, communities and health systems.
If abortion is associated with 11% of maternal deaths, as indicated by the Federal Ministry of Health: about 7,370 maternal deaths are due to unsafe abortion in Nigeria yearly:
approximately 20 maternal deaths from unsafe abortion daily.
A 2022 report by the Guttmacher Institute shows that unintended pregnancy rate stayed about the same between 19901994 and 20152019 in Nigeria. During the same period, abortion rate increased by 39%.
The share of unintended pregnancies ending in abortion rose from 35% to 48%. In 20152019, there were a total of 10,500,000 pregnancies annually. Of these, 2,990,000 pregnancies were unintended and 1,430,000 ended in abortion.
Despite its huge contribution to maternal mortality and morbidity, unsafe abortion is one of the underreported issues in Nigeria.
The Hope tracks some unsafe abortion incidences in Ondo State. From the use of local methods to self-medication and patronizing quacks by teenagers and women of reproductive age, most of these stories remain untold.
Legal Framework for Abortion in Nigeria
Abortion in Nigeria is legal only to save a pregnant persons life. Section 228 of the Nigerian Criminal Code Act permits abortion to preserve the life of the pregnant woman.
Laws on abortion in Nigeria are covered by the Criminal Code Act (sections 228-230) and the Penal Code Act (sections 232-235). The two Acts specify punishments for anyone who seeks to procure a miscarriage by whatever means, assists another to intentionally procure a miscarriage, or supplies anything intended to be used to procure a miscarriage.
According to the National Guidelines on Safe Termination of Pregnancy for Legal Indications, conditions under which a medical practitioner can lawfully terminate pregnancies include obstetric and gynaecological conditions, maternal heart and vascular diseases; kidney diseases; cancer; blood diseases; psychiatric and mental disorders; auto-immune diseases;
thyroid-cardiac diseases; advanced diabetic mellitus with organ failure; other maternal pathology situations that put the mother at risk.
Taming the ugly tide
It is believed that if all needs were met for contraceptive, maternal and newborn and abortion care in Nigeria, unintended pregnancies, abortions and unsafe abortion would drop by 80%, maternal deaths would drop by 61%, while newborn deaths would drop by 76%.
The President of Academy for Health Development (AHEAD) Prof. Adesgun Fatusis said the unsafe abortion stories underscored the sad realities of many women and teenagers as situations leading to abortion are diverse.
While saying statistics shows that married women seek abortion more than the unmarried ones because the former are more exposed to sexual intercourse, the Public Health Expert said women would do anything possible to abort if they choose to and can use whether approved or unsafe methods, irrespective of the law.
The Vice Chancellor of the University of Medical Sciences, Ondo city in Ondo state stressed the need to tackle abortion in a strategic and holistic approach.
He said people must avoid by every means pathways that lead to abortion such as preventing unwanted and unplanned pregnancy through practicing safe sex, use of approved contraceptive and effective family planning. He stressed that the key to preventing abortion is to increase our drive to prevent unwanted pregnancy.
Anyone that finds themselves in a situation where they did not plan to have pregnancy but have sex should take the effective contraceptive to ensure they do not get pregnant, the public health expert recommended.
As the Executive Director of UNFPA, Dr. Natalia Kanem stated,
We know the steep costs associated with unintended pregnancy costs to an individuals health, education and future, costs to whole health systems, workforces and societies.
The question is: why has this not inspired more action.
– Saheed Ibrahim is a fellow of the Academic for Health Development ( AHEAD) and author of this special report.
