MEDIA TIP SHEET: UNDERSTANDING SAFE IN

Thousands of Nigerian Women WHAT MAKES ABORTION SAFE Die Needlessly Each Year. OR UNSAFE? Their Lives Can Be Saved With Equal Access to Safe Abortion.

Abortion is considered safe if the person providing or Every year Every year, about supporting the abortion is trained and uses one of the IN two methods approved by the 1 20 6,000 World Health Organization: Nigerian women in their Nigerian women die from ■ Medication abortion is childbearing years (ages 15 to 49) -related complications, induced by pills. It often has an abortion, adding up to representing 10% of the nation’s includes a combination about 2 million annually. - and childbirth-related deaths. of taken by mouth, followed by taken by mouth or inserted into the vagina. It can also include misoprostol only.

■ Abortion surgery is performed by a trained provider with a manual or electric aspirator, which Unsafe abortion as defined by Performance Monitoring for Action (PMA) is performed with a non- removes the contents of recommended method and in an environment that does not meet minimal medical standards. a woman’s uterus (womb) using suction.

Most of these deaths could be prevented if safe abortion were more accessible and more equal.

■ More than three in five ■ Women with disadvan- ■ Most Nigerian women abortions in Nigeria are tages are most likely to who have abortions are Abortion is unsafe unsafe. Unsafe abortion have unsafe abortions already mothers and when it is carried out by can lead to a range of and least likely to receive have husbands or live-in an unskilled provider, health complications— treatment for complica- partners. or in an environment that and even death—for tions because of inequities does not meet minimal women. in access to safe care. medical standards, or both. For example:

■ A health care worker uses a method that is no longer recommended, YOUR QUESTIONS ANSWERED such as inserting a sharp instrument into the Is abortion legal in Nigeria? If abortion is illegal in most circumstances, uterus. In most states, abortion is legal only does that mean it rarely happens? ■ A woman takes pills to save a woman’s life. No, women still have abortions, but the or traditional mixtures procedures are more likely to be unsafe. at home and does not know a trained person to What happens if an abortion is unsafe? Is any abortion safe? contact if she needs help. Women who have unsafe abortions risk Yes. When performed using a medically heavy bleeding, infection, and punctures approved method administered by a Source: World Health Organization, to their internal organs, which can lead skilled provider, abortion is among the “Preventing Unsafe Abortion,” Evidence to long-term health problems or death. safest medical procedures. Brief, Human Reproduction Programme (2019). MEDIA TIP SHEET: UNDERSTANDING SAFE ABORTION IN NIGERIA

Women who seek Adolescents and women who are poor, have little schooling, abortions are from all or live in rural areas are most likely to have unsafe abortions. different backgrounds, They are also more likely than other to experience complications ages, family types, and death because they cannot access postabortion care. These figures show the percent and places. of unsafe abortions, as defined by PMA, by population characteristics: They have abortions for diverse AGE GROUP LOCATION reasons, including when the pregnancy threatens their health, when they can’t afford 88% 82% 63% 60% 59% 53% 56% 71% 60% to feed or care for a child, and when adding another child 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Rural Urban will compromise the well-being of their existing children. EDUCATION LEVEL INCOME LEVEL (QUINTILES)

“I was so worried. I felt that way because I would have had 79% 70% 62% 58% 81% 76% 63% 60% 53% to stop school. It would have disturbed my education. If you are pregnant and in school, None Primary Secondary Higher Poorest Second Middle Second Wealthiest other students will mock you… poorest wealthiest If my parents had found out, I don’t know what would have Note: Wealth quintiles divide households into five roughly equal-sized groups based on household assets become of me.” and access to water and sanitation. —Age unknown, childless, unmarried Women’s abortion decisions are Most women in Nigeria have not heard about either of the “Myself and my husband were guided by proximity, privacy, knowledge, two safe abortion methods. not together anymore… This lack of knowledge puts The problems I would have and cost—not medical safety. faced would have been too their health at risk. much: I put my two children in school, then the house rent, % % % maintenance, and feeding IN allowance. There was nobody 1 4 69 1/3 91 75 to carry the burden with me.” women said privacy sought care of women said did not did not know was the primary at the closest cost and distance know about about abortion —Age 44, two children, separated reason for their available option. were barriers medication surgery. choice of abortion to their preferred abortion. method and source. abortion care options. “Because of the suffering and hardship in my family, I decided to abort the pregnancy. I could not afford to give birth to a child under such hardship.” —Age 38, HOW CAN JOURNALISTS REPORT ON THIS TOPIC? three children, married

Most recent abortions occurred among women who were: Break news. Combat Consider solutions Above all, don’t ■ Already mothers of one The data and misinformation. in the public interest. forget that or more children. conclusions Correct myths Increased access to abortion is ■ Married or living with presented in this and stereotypes safe abortion could about people. a partner. fact sheet are newly about who prevent women from Tell the stories ■ Residents of urban areas. released from has abortions dying. What are the of the women, ■ Current or former attendees the most recent and why they barriers to making families, and of secondary school or higher. nationwide study have them. abortion safer? communities ■ In their 20s. of abortion and its Could expanding affected. links to economic, access to family A woman’s income, location, health, and policy planning reduce age, and education level questions. unsafe abortion? influence whether she can access safe care.

Notes: These findings are based on surveys of Nigerian women conducted between 2018 and 2020 by Performance Monitoring for Action (PMA). Source: Suzanne O. Bell et al., “Inequities in the Incidence and Safety of Abortion in Nigeria,” BMJ Global Health 5 (2020): e001814, doi:10.1136/bmjgh-2019-001814.

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