Reproductive health experts have warned that unsafe abortions continue to drive Nigeria’s high maternal mortality burden due to restrictive laws, stigma, poor access to safe services, and persistent misinformation.
The experts made this known during a three-day media training on women’s sexual and reproductive health and rights, held in Keffi, Nasarawa State between 2-4 December.
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Talemoh Dah, CEO of the Soteria-Afrique Rural Healthcare Initiative, explained the medical mechanisms through which unsafe procedures lead to preventable deaths.
Mr Dah noted that the uterus and surrounding organs contain major blood vessels, meaning that “if an untrained person introduces an instrument wrongly, heavy bleeding can occur and the woman may die before getting help.”
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He added that infections are another major cause of death.
“The vagina and bowel contain billions of bacteria. If an instrument pushes these organisms into the bloodstream, infection can set in, and when it progresses to sepsis, we may not be able to reverse it,” he said.
Mr Dah further highlighted other fatal pathways, including embolism, where amniotic fluid or fat enters the bloodstream and obstructs blood vessels, and organ damage such as kidney or liver failure arising from untreated complications.
The training, organised by the Ipas Nigeria Health Foundation, brought together journalists, reproductive health advocates, and content creators to strengthen reporting on reproductive rights, unsafe abortion, and maternal health.
Maternal mortality in Nigeria
According to Ipas Nigeria, the country’s maternal mortality ratio has risen sharply, from 576 deaths per 100,000 live births in 2015 to 1,047 per 100,000 live births, placing Nigeria as the source of 20 per cent of all maternal deaths worldwide.
The organisation also estimates that 1.8 million abortions occur annually in Nigeria, with nearly 60 per cent classified as unsafe because they are performed by unskilled providers, in unhygienic conditions, or using harmful methods.
These unsafe procedures account for between 13 and 40 per cent of all maternal deaths.
The rising scale of maternal deaths is closely linked to Nigeria’s extremely low use of modern contraception.
Only 12 per cent of women of reproductive age use modern family-planning methods, resulting in high rates of unintended pregnancies that often end in unsafe abortion.
According to the 2023 Maternal Mortality Estimates released by the World Health Organisation (WHO), one in every five women who die from pregnancy-related causes globally is Nigerian.
VAPP Act not enough to protect women’s reproductive health
Emannuella Azu, a development legal practitioner, warned that despite its popularity, Nigeria’s Violence Against Persons (Prohibition) Act (VAPP Act) remains insufficient in protecting women’s sexual and reproductive health and rights, particularly in the areas of consent, access to care, and justice for survivors of sexual violence.
Ms Azu noted that many Nigerians wrongly assume the Act addresses all GBV-related issues, but several areas, including marital rape recognition, access to post-abortion care, and referral pathways for survivors, remain inconsistently implemented across states.
“The VAPP Act does not fully protect women’s reproductive health. It addresses violence but does not holistically cover the scope of sexual and reproductive health rights,” she said.
Restrictive laws
Mr Dah argued that Nigeria’s legal and policy framework on abortion is restrictive, a situation that forces many women to resort to clandestine and unsafe procedures.
He explained that Nigeria is among countries where abortion is permitted only to save a woman’s life.
Although the law is restrictive, the federal government in recent years developed a policy document outlining medical conditions under which abortion may be provided to save the woman’s life.
These include severe hypertension in pregnancy, certain cancers that cannot be treated while pregnant, life-threatening kidney or heart diseases, and situations where continuation of pregnancy could worsen a woman’s health.
Nigeria’s legal framework on abortion is derived from two main statutes, the Criminal Code Act, applicable in the southern states, and the Penal Code, used in the northern states.
Under both laws, abortion is largely illegal except when performed to save the life of the pregnant woman.
Despite these strict provisions, unsafe abortions remain common nationwide.
Ipas Nigeria estimates that 1.2 million induced abortions occurred in 2012 alone, driven by unintended pregnancies, rape, incest, and serious health complications.
Many of these procedures were unsafe, significantly contributing to maternal mortality and morbidity.
Mr Dah added that while health workers are allowed to object on moral or religious grounds, they are professionally obligated to refer the patient to another provider.
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He stressed that the shortage of trained providers remains a major barrier to safe procedures, even in cases where the law allows them.
Social stigma, gender-based violence, trauma
Mr Dah also linked reproductive coercion, intimate partner violence, and societal stigma to the high number of unsafe abortions and maternal deaths in Nigeria.
He argued that Nigerian society often treats unintended pregnancy, whether arising from consensual sex or rape, with judgement, shame and punishment, adding that these attitudes fuel silence, misinformation, and dangerous delays in seeking care.
“Our laws, culture, religion and discrimination trap women like a spider web. That is why they die,” he said.
“Also, diversity is the norm in nature. Once you cancel diversity, you invite chaos.”
He stressed that differences in beliefs or values should not prevent women from accessing evidence-based healthcare services that can save their lives.
The training also emphasised the essential role of the media in combating widespread misinformation about sexual and reproductive health and rights, a key barrier to reducing unsafe abortion.
In addition, participants discussed ethical reporting, legal frameworks, and the importance of avoiding sensationalism while highlighting the preventable nature of many maternal deaths.
