Forty years ago today, in the district of Colombia, the American Supreme Court passed a law that guarantees the right of American women to legal medical abortion. Roe V. Wade made access to sexual reproductive health a right that cannot be denied for American women. Since then, the conservative faction of that government has been looking for ways of denying the American women their constitutional right. It has passed various restrictions; attacked clinics offering abortion services, and some of its more strident members have been guilty of murder. To them, the right of the unborn child supersedes the right of a woman to control her physical health, economic health and general quality of life. While the war on women goes on in America, women in Africa are still trying to gain access to contraceptives and their human right to prevent, not abort, pregnancies. The reality of sexual reproductive health in Africa is so archaic that it borders on crimes against these women’s humanity. As an African woman, on the anniversary of Roe V. Wade, I am newly outraged about the low access to reproductive health and the denial of our right to safe and legal terminations of unwanted pregnancies.
Brenda Adewale was in last year of secondary school when she got pregnant and had her first abortion. She really did not want to be a mother, she never thought about contraceptives, and she was sexually active with a senior at her school. She got pregnant and her mother and sister convinced her to have an abortion after being found douching her private part with alcohol, leaves and other foreign objects. Her school friends had told her that that was how to have an abortion. She might have died or been seriously injured but today she is a mother of three children whom she loves. Each year, hospitals around the country threat 142,000 women experiencing complications from abortions. The illegality of the procedure with a 14-year jail sentence for both the provider and the patient drives them into the hands of quarks and other unskilled health professionals.
All over the world, women experience unplanned pregnancies and after intense consideration of their health and finances, they often choose to legally terminate such unwanted pregnancies. Pregnancy is hard on a woman’s body and a 6th pregnancy carries 50% more risk of death than a 3rd pregnancy. Every time a woman has to have a child when her body is no longer keen, she carries a major burden and death is often the consequence. In Nigeria, given the high poverty rates and the high maternal mortality rates, thousands of women each year choose to terminate pregnancies they do not want and is not in their best interest. In 2010, the chairman of the Nigerian Senate Committee on health, Dr. Obasanjo-Bello reported that Nigerian women have about 500,000 abortions every year. The Guttmacher Institute claims that the number is even higher and conservatively pegs this at 610,000 abortions. For every 1000 women, there are 25 abortions. These women were all forced to make difficult choices in a country where poverty, senseless deaths and tradition drive their lives. The cost of having a child, or another child would be too high, and thus they take the risk of 14 years in jail. The health system, socio economic setup, and archaic gender reality all failed to help these women prevent a pregnancy and this rightly led them to choose to medically let go of an unwanted pregnancy. Considering that abortions are illegal in Nigeria, this means that many of these women actually die during the procedure. Illegal abortions often lead to a strain on the health system that could have been avoided if the system gave these women access to the methods that would have prevented unwanted abortions. I, of course, believe that access to abortion is a human right that Nigerian women deserve.
The moral responsibility to protect an innocent child is very important to many people, this writer included. But the responsibility to protect an adult who already faces difficult choices, who has very little agency in her relationships, is also very important. So then what can be done? How does a Nation concerned with morality and human freedom decide what to tell her constituents what they can do with their bodies? Physiologically, a fetus is viable at certain points in its development, the Roe V. Wade ruling pegs this time at 28 weeks. Meaning that a fetus can survive outside its mother’s uterus if it were removed. Before this point, this fetus is entirely dependent on its mother’s body and it cannot survive without her. In order to protect the freedom and human right of the mother, it is fair to allow such a mother to choose to terminate such a pregnancy. However, after this point of viability, the responsibility to protect a fetus from its mother’s freedom becomes imperative for some people. A fetus becomes a child when it can survive without its mother and for those concerned about morality and the responsibility to protect, they may pass restrictions that reflect this biological reality.
Alan Guttmacher, the famous warrior for women’s health, said in November 1973 “those who oppose and those who favor legalization of abortion share a common goal—the elimination of all abortion.” Medical abortion, while a human right, is simply the worst choice for a bad situation. Helping a woman prevent, not abort a pregnancy she does not want is frankly in the best interest of that woman, and that of her family. By the time a woman chooses to abort, the health system of her country has already failed her. In Nigeria’s case this health system fails 610,000 times every year. Access to contraceptives can lower Nigeria’s high rate of maternal mortality by 70%, prevent unintended pregnancies, unsafe abortions, and HIV/AIDs, and may result in 50% decrease in infant deaths. If there is one thing that could serve as a single silver bullet for prosperity and societal wellbeing, it is giving all women the right and access to the range of sexual reproductive health services there are.
Anita Idahosa, an undergraduate in university, has had many abortions. Her method of contraception is medical abortion. She is not a monster or a disgusting person. Her story is common in Nigeria. It is not that she does not know about contraceptives, or that she is uninterested in using contraceptives. She has absolutely no agency in her relationship. She is unable to choose contraceptives because of the economic and emotional cost of such a choice. When she was interviewed and asked about her choices she said this: “I remember when I had my fifth pregnancy and went for D & C, I still slept with my boyfriend that same night. He is responsible for my education and everything, so if he doesn’t want to use condom, will I force him?”
16 million Nigerian women, in rural and urban areas, want access to contraceptives but because of the inefficient Nigerian health system, they lack access and are forced to give birth to children they do not want and cannot afford. The unmet need for contraceptives measures the number of married women who do not want any more children, who want to space their children, or who want to postpone their next child and are not using any modern contraceptives. The last National Demographic and Health Surveys (NDHS) show that 20% of Nigerian women had an unmet need for contraceptives. Although this is still 6% lower than the regional average, it is still high enough to be a game changer in better health and a sustainable population growth. Recently a Marie Stopes worker wrote that during a trip to Nigeria she met 70 women who had travelled overnight just to get to the clinic where they can access family planning services. This is a common trend all over the country.
The real truth of Nigeria’s alarming population growth, maternal mortality and child death is the lack of access to life saving contraceptives. It seems that the Nigerian government is listening. The government months ago announced that it plans to invest US$33,400,000 on contraceptives over the next four years. It is important to follow this money so that it actually delivers these services to women who need it the most.
If there is anything close to a silver bullet against perpetual poverty, maternal deaths and high rate of abortions in Nigeria, I am inclined to believe that it is access to family planning methods that works. On this anniversary of Roe V. Wade, my greatest wish for Nigerian women is the right to do what is in the best interest of their health, wealth and life and this includes access to contraceptives, access to legal abortions up to the point of viability, and better agency in their lives.