Medical abortion and matters arising

AS soon as she discovered she was pregnant, Comfort, a young Nigerian woman immediately made up her mind she was not keeping it. As events later showed, the unnamed housewife had given birth thrice in the past but for reasons best known to her, she put her foot down and insisted the fourth pregnancy had to go.

“I was a full-time housewife and my husband had just lost his job,” she narrated. “We were literarily struggling to put food on the table and pay all the bills. Survival was difficult. I wasn’t on any family planning method and we already had three children spaced less than two years apart and the eldest was barely 6, so another pregnancy was simply out of the question.”

“I did not even tell my husband I was pregnant. I knew if I did, he would try to convince me to keep it. For me though, the decision was made as soon as I heard that I was pregnant and I just went all out and terminated it on my own.”

But Comfort did not immediately makeup her mind how the unwanted pregnancy as to be terminated. Over the next few weeks, she pondered over the issue and finally settled for an unsafe abortion through the use of certain "pills" and "tablets" to initiate a crude medical abortion of the growing fetus.

“I bought the pills and some other recommended medicines that I was told were efficient in inducing abortion. I took them at home early one morning and started bleeding soon afterward.

“The bleeding became so much and I felt a bit of pain, but by the evening of the next day, everything had subsided. My husband did not even suspect anything but I later told him everything a few months afterward.

“He was very surprised and rather angry with me but appealed that I should never to try such a thing again. I promised and I am now on a reliable contraceptive.”

The home is important in the reproductive health story of women in Nigeria. Women get pregnant at home, give birth at home and often induce abortion at home.

Medical abortion actually brings access to safe abortion closer home. All over the country, all classes, women with unwanted pregnancies seek access to safe termination processes across the city women can easily purchase a wide range of drugs without a prescription to bring on their wayward periods.

Like Comfort, millions of Nigerian women experience unwanted pregnancies and resort to unsafe termination with the associated health. Experts say one of the reasons Nigerian women often turn to abortion is to avoid unwanted births.

“The provision of family planning counseling and information could substantially reduce the incidence of unwanted pregnancy and induced abortion in Nigeria,” said Prof Adetokunbo Fabamwo, a Consultant Gynaecologist and the Chief Medical Director, Lagos State University Teaching Hospital, Ikeja, Lagos.

Among  other factors are the fear of isolation and rejection, employment policies, ignorance, completed family, too young or too old.

 In the views of Ms. Sybil Nmezi of the Generation Initiative for Women and Youth Network (GIWYN) millions of women and girls finding themselves with an unintended pregnancy becomes a moment of decision.

Nmezi, who spoke about how barriers to reproductive health care and services affect women’s lives, said the law on abortion in Nigeria was too restrictive and should be reviewed.
  “For some, it is simple and straight forward, for others, it is difficult and complex,” she asserted.

In a study conducted by the Guttmacher Institute, almost a third of the women said they had undergone at least one unwanted pregnancy. About half of them admitted having attempted to end their last unwanted pregnancy.

Speakers at the forum agreed that at least every other woman who seeks an abortion does so because they are not married, are too young or are still in school. Of the women not practicing contraception when they had the unwanted pregnancy, a number are unaware of family planning, and about 1 in 5 either have no access to contraceptive services, or the services are too expensive or they’re afraid of side effects.

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