Abortion Reality Talk

By Dr. Goke Akinrogunde

This piece heralds a serial discussion on elective abortion and the effect, or otherwise, of criminalising the act of choosing to terminate a pregnancy earlier post-conception. In this, and subsequent editions, I will narrate real life experiences of fatalities and morbidities associated with the present status quo of criminalising elective abortion in our setting and beyond.

First, a peep into the world statistics on pregnancies and abortion:380 women become pregnant per minute. 180 – 200 million pregnancies occur globally per year. 75 million of these are noted as unwanted pregnancies. 50 million ended up with induced abortions. 20 million of these are tagged as unsafe abortions. 600,000 maternal deaths ( 1 per minute ).190 women face unplanned or unwanted pregnancy per minute. 110 women experience a pregnancy related complications per minute. 40 women have an unsafe abortion per minute. 1 woman dies from a pregnancy related complications per minute

The above highlights are indeed very appalling and taking control of the situation definitely go beyond mere rhetoric and hypocritical talks on morality under whatever guise.

My narration below brings home real life issues associated with criminalisation abortion. In came this patient for an ultrasound scan examination, a young lady in her early-twenties; she came to ascertain the state of her womb. According to her, she last saw her menses two months ago, a pregnancy blood test she did two days ago came positive – it confirmed that she was pregnant; she became worried and naturally scared for her future having recently got an admission into one of the federal universities in south west Nigeria. It is not difficult to come to the conclusion that this development will lead to a great disappointment from her parents and expectedly put a break to her academic pursuit; hence, she made her enquiries as to where she can procure an abortion.

In her investigations, to get it done in a decent ‘hospital’ would cost N50,000 minimum; she didn’t have this, ditto for her university undergraduate boy friend. However, there was an offer by a quark ‘doctor’ to get the evacuation done at a cost of N2,500. She consented and the procedure was carried out in the house of the quark. All seemed well for some days after the evacuation until she started feeling some tell-tale symptoms of pregnancy; she was advised to repeat the pregnancy test, which came out positive again; then she started bleeding. After this discovery she went back to the nurse who did the evacuation; without any ancillary investigation, she repeated the evacuation on the last day of the December 2010. In spite of this repeat evacuation, she did not feel better; hence her referral from the family hospital for a scan investigation, again she tested positive for pregnancy.

The ultrasound scan report revealed that in spite of the repeated evacuations the pregnancy still persist in her body but not in the womb but in one of her uterine tubes! She had an ectopic pregnancy of eight week maturation in one of her fallopian tubes and it is now slowly leaking blood. This is a medical emergency that requires an immediate surgical operation. She later had the surgery but did not leave to tell her story – She died.

The above story simply showed that the question of unsafe abortion is real in Nigeria and it is not just a question of concocted statistics as some people usually resonate, it is a very serious matter.

Check these deductions: there are a number of centers where concerned women can get abortion on demand in Nigeria but most of these centers are mostly unsafe for such high profile surgical procedure, which abortion is. The concerned practitioners cared less about making the procedure a sterile one or getting it done in a hygienic environment. Unfortunately, the more unsafe the procedure’s environment is and the lesser the practitioner’s skill the cheaper it comes. Invariably, poverty drives many to such places where death is so cheap to come by.

Talking about skill, the aforementioned example shows how important this is when it comes to medically attending to abortion cases. For one, as a rule, it is not advisable these days to enter the womb ‘blindly’ when an ultrasound scan can be obtained before the procedure is carried out; this is the rule in all places in developed countries where this procedure is procured without legal complications. If an ultrasound has been done in the case at hand, it would have revealed that there is no pregnancy in the womb but in the tube! Hence a potential danger would have been handled in a more professionalised setting, where appropriate surgical intervention that will avert the complications of a tubal ectopic pregnancy can be done, instead of the senseless and inappropriate repeated blind evacuations.

The funny thing in Nigeria is that it is hypocrisy galore when it comes to defending the criminal codes per abortion. Here, abortion is said to be illegal, nevertheless Nigeria has one of the highest rate of abortion cases in the world, in fact the highest in Africa, and much more than in those countries where abortion is legalised. The reason for this is obvious; even though people may frown generally against unwanted pregnancy, there are enough and countless reasons why it is socially permissible for abortion to occur in the face of certain social realities.

Moreover, notwithstanding the religious and other moral colorations, the underlying philosophy for criminalisation of abortion is the societal subjugation of the woman’s right to solely determine what happened to her body; it flows from the fact in the male-dominated society, it is impermissible for this right to be ceded to the women, the perpetually oppressed gender. As a matter of fact, it amounts to double oppression for the working class women among whom poverty reigns supreme.

The call for legalisation of abortion is however not the same as a campaign for abortion; hence, for those in league with the campaign to assert the right of a woman to determine what happen to her body, this comes as an empty and irresponsible phrase-mongering if the campaign for non-criminalisation of abortion is not linked to the rights to provide apt sexual education, free access to contraception options under experts’ guide and ultimately the need to have a just system in place where universal access to public health to those in need is obtained at no cost whatsoever.