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Addressing the Barriers to Safe Abortion in Uncertain Times : The Role of Policymaking in Ensuring Access to Safe Abortion in Nigeria

One of today’s most divisive, sensitive, and important political issues is the topic of abortion. Unsafe abortion is a significant human right and public health concern that must be addressed and acknowledged. This year’s theme for International Safe Abortion Day focuses on Addressing the Barriers to Safe Abortion in Uncertain Times.

Access to safe abortion especially with so much uncertainty surrounding abortion laws across the globe is essential for women’s health as well as a fundamental human right. Where abortion is restricted or out rightly prohibited, women’s self-respect and dignity are undermined by a lack of access to safe abortion. Youth Network for Community & Sustainable Development (YNCSD) aims to tackle these issues via partnerships with relevant stakeholders to develop sustainable solutions and initiatives.

The commemoration of International Safe Abortion Day is an opportunity for sexual & reproductive rights activists and advocates around the world to speak out for access to safe abortion. The origins of this day can be traced back to the Campaña 28 Septiembre, which was originally observed as a day of activism for the decriminalization of abortion in Latin America and the Caribbean in 1990. The Women’s Global Network for Reproductive Rights (WGNRR) proclaimed September 28th to be a global holiday in 2011.  In 2015, the day’s name was changed to International Safe Abortion Day, and various events were held across 47 nations that year by activists, NGOs, and other relevant organizations to commemorate the day.

According to research, women, healthcare practitioners, and even policymakers around the world have incomplete or incorrect knowledge of national abortion laws and regulations.

When there is no accessible guideline or set of regulations, the law’s ambiguity can lead to uncertainty, disagreement, and other challenges which can hinder safe abortion policies. This can further be impeded by the inconsistency of national legislation and a crisis of accountability from policymakers. This creates several policy-based issues as it is difficult for those seeking care to understand their legal rights, for service providers to operate with legal protection, and for governments to be held accountable for the unfavourable and oftentimes harmful impact of their laws.

The restrictive nature of abortion laws in Nigeria is still influenced by religious, moral, and social factors. Abortion is only termed legal in Nigeria if it is to save a woman’s life.   Policymakers have not done enough to address these issues despite unsafe abortion being prevalent and being a significant contributor to maternal death.

Additionally, Nigeria’s abortion laws do not permit abortion in circumstances involving rape or incest, when the fetus’s development is compromised, or when other critical conditions arise. These shortcomings in Sexual & Reproductive Health Rights (SRHR) policy-making undermine the equality and human rights of Nigerian women, girls and other pregnant persons as provided by the constitution. These become more important because pregnant people especially women who lack the resources to have safe abortions frequently turn to providers who are not skilled or medically licensed and in most cases try to conduct the procedure themselves, both of which carry serious risks.

Lagos State is one of the most progressive states in Nigeria when it comes to matters surrounding Sexual & Reproductive Rights. The state government through its Ministry of Health released a guideline on safe abortion in June 2022. The 40-page policy document outlines guidelines to safely terminate pregnancies within the boundaries of Lagos State’s criminal code.

The Permanent Secretary of the Lagos State Ministry of Health presented and launched the document at a stakeholders’ meeting; acknowledging that the development of these guidelines was an important step in providing evidence-backed information for health professionals in both the public and private sectors who have the necessary knowledge and skills needed to conduct safe abortions order to greatly decrease the occurrence of preventable deaths.

However, on the 7th of July 2022, the Lagos state government suspended the guideline document in a press statement titled “Retraction of Guidelines Relating to Safe Termination of Pregnancy for Medical Reasons in Lagos State.’’ The reasons outlined for the suspension of the guidelines included the fact that the public required further sensitization and clarification on some of the objectives highlighted. The press release also stated that the Executive Council would continue to have discussions and deliberate on the matter.  It is also imperative to note that the Lagos State governor was targeted and faced serious backlash from religious and political bodies due to the release of this document.

The implementation of this policy document would have made an impactful change and most likely set the stage for other Nigerian states to develop similar guidelines on safe abortion. However, rescinding this policy document shows that there is still a gaping opportunity for activists, feminists and healthcare practitioners to speak with louder voices towards ensuring that abortion is seen as healthcare and human rights. Rescinding this policy has taken us back several years and shows a lack of commitment toward protecting the bodily rights and integrity of Nigerian, women and girls as well as other interested groups.  It is also important to note that there has not been any recent feedback given to the general public concerning the suspension of the policy document.

Various studies show that restricting access to abortion does not deter women from having unsafe abortions to end unplanned or unwanted pregnancies. As a result, access to safe abortion is directly impacted by a restrictive legislative environment. Additionally, it implies that the quality of medical services is unregulated and cannot be openly provided to the patient. These consequences showcase the important role policymaking plays in ensuring access to safe abortion not only in Nigeria but across the globe.

If Nigeria is to achieve the SDG target 3.1 labelled Maternal Mortality, which focuses on reducing the global maternal mortality ratio to less than 70 per 100 000 live births by 2030, unsafe abortion must be addressed and tackled swiftly.

Nonetheless, there is hope and there is still time to act.  September 28th is another day for stakeholders to remember commitments made to protect the rights and well-being of women and girls and a day like this set the stage for more favorable policy-making, dialogues, and actions surrounding abortion rights in Nigeria.

The Youth Network for Community & Sustainable Development (YNCSD) is one of the leading advocacy organizations in Nigeria that addresses the issues of safe abortion and sexual & reproductive health rights. As an organization, we have been unwavering in our commitment to comprehensive sexual and reproductive health and rights for all, including delivery of advocacy initiatives aimed at ensuring that women, girls, Female Sex Workers, and other pregnant persons have unhindered access to safe abortion services.   Some of our recent projects and initiatives made possible through the magnanimous support from our donors have seen the development of policy guideline documents on access to SRHR services, Quality of Care Training for multiple cadres of abortion service providers leading to improved service delivery to our beneficiaries, digital advocacy training, and robust narrative change activities needed for countering a growing anti-gender and anti-rights movement spring up not only in Nigeria but around the world.

YNCSD uses the opportunity of a day like this to advocate and call for global and national action toward ensuring accessible sexual and reproductive services in these uncertain times.

From all of us at YNCSD, Happy International Safe Abortion Day!