TUNDE OGUNTOLA writes on the need to expand access to effective contraceptive services as statistics from WHO and Guttmacher reveal that at least 22,800 women die annually as a result of complications of unsafe abortion.
The high rates of abortion, clearly underscore the need to improve and expand access to effective contraceptive services. Ensuring that women and couples have access to a wide range of effective contraceptive methods to choose from and that they receive comprehensive information about how to use their chosen method consistently and correctly is sound public health policy.
Investing in modern contraceptive methods would be far less costly to women and society than the costs of managing the outcomes of unintended pregnancies.
This is even as advocates of abortion often insist that it needs to be legal and readily available so as to reduce health risks for women. Some recent studies show, however, that abortion brings with it considerable risks.
A study, undertaken by the Guttmacher Institute and World Health Organisation (WHO), has estimated that, worldwide, during the period 2010-2014, there were 35 abortions per 1000 women aged 15-44. This translates to over 56 million abortions per year.
The study shows marked differences between the regions that are classified by the UNPD as developed (Europe, North America, Australia, New Zealand Japan) and those that are classified as developing regions.
However, as the World marks Safe Abortion Day 2019, a non- governmental organization, Women Friendly Initiative (WFI), has called for action to prevent abortion-related deaths as Nigeria accounts for 10 per cent deaths globally.
The chief executive officer, WFI, Dr. Francis Eremutha stated that most of the deaths occur due to restrictive abortion laws and therefore called for a review to save lives.
He said research by the Guttmacher Institute, revealed that an estimated 760,000 unsafe abortions are done in Nigeria every year. He revealed further that a surprising 55 per cent occurs amongst girls aged 15-19 years which calls for concern.
He said women and girls in Nigeria need the support of all in the quest for a healthy population.
“No woman must die from pregnancy-related complication no matter what. Nigeria accounts for 10 per cent of global maternal deaths, 13 per cent of which are attributable to unsafe abortion owing to restrictive abortion laws; many women resort to unsafe abortion methods, leading to abortion-related complications and increasing morbidity and mortality rates in the country,” he said.
Dr. Eremutha stated that without planning to, people can become pregnant for a number of reasons, including not having access to contraception, using contraception which fails, using unreliable methods of contraception and being raped, or restricted from using contraceptives.
He said “According to a research done by the Guttmacher Institute, an estimated 760,000 unsafe abortions are done in Nigeria every year. Most disconcerting is that 55 per cent occurs amongst girls aged 15-19 years.
He said “in order to prevent unplanned pregnancies, women and girls need a range of contraceptive methods made available to them.
“Where unprotected sex has occurred, emergency contraception should be available to persons involved to prevent unplanned pregnancies.”
He explained that there are two main types of abortion: medical abortion – taking medication to end the pregnancy; and surgical abortion – a minor procedure to end the pregnancy.
“Abortion can be safe if it is carried out by a trained health provider; it is carried out in a clean, hygienic setting and if sterilized instruments are used,” he added.
He noted further that the earlier in pregnancy an abortion is performed, the less chance there is of any complications and a woman who has an abortion is likely to have a better experience if she is provided with accurate information and stigma-free support.
“The most unsafe type of abortions are those which involve ingesting harsh substances or those performed by untrained persons inserting objects into the womb. Almost all complications and deaths from unsafe abortion could be prevented if comprehensive sexual reproductive health services were accessible, affordable and available in all healthcare facilities in Nigeria. Societies are as healthy as their womenfolk,” he stressed.
While in the more developed regions the abortion rate has declined by 41% since 1990-94 to a current rate of 27 abortions per 1000 women, the abortion rate in developing regions has remained virtually unchanged for the past 25 years at a rate of 37 abortions per 1000 women. Nearly 88% of all abortions take place in developing regions.
However, unintended pregnancies also occur among women using contraceptive methods who experience method failure or those who become pregnant as a result of rape.
Women may also seek abortion for other reasons related to their health or other circumstances. In such situations, they should have access to safe abortion services to the full extent of the law.
Where safe abortion services are not available, women may resort to an unsafe procedure and be at risk of severe complications and possibly death. Access to post-abortion care is critical to address such complications, counsel the woman on appropriate care, and ensure she has access to contraceptive services.