Nigeria: Let the Debate on Reproductive Health Continue

In the past couple of years, there has been increased media attention in concerning reproductive health and rights in general and abortion in particular. Prior to this development, media reports on issues concerning reproductive health, especially, abortion were mainly sensational which contributed to the stigmatization of women who terminated pregnancies.

At this point in time, religious and cultural organizations enjoyed enormous amount of publicity which made the Nigerian woman look bad on issues that concerned her reproductive health and rights. It was easy to find and read stories and articles that were both biased or a little objective on abortion.

While many of such stories bordered on religious dogma, others were tainted with a lot of misinformation, half-truths and name calling. Very few articles made spirited efforts to explain what the whole issue of abortion is all about.

Over time, reproductive health experts noticed that these publications which were supported by a restrictive abortion law had caused the death of many Nigerian women. Women who got pregnant courtesy of rape, incest or women whose health condition could not withstand nine months of pregnancy were dying in their droves in the bid to terminate a pregnancy.

To seek a solution to the high death toll, the experts started engaging women groups, lawyers and other stakeholders, including journalists for sake of enlightening them on issues of reproductive health and rights, as well as abortion. The enlightenment which exposed the stakeholders to scientific proofs, realities and facts about abortion and reproductive health and rights, caused shifts in position on the subject matter.

A lot of Journalists who were there saw issues of abortion and reproductive health and rights from the lens of religion, culture and myths, discovered that most information they have been brainwashed with were neither scientific or factual.

The result of the latest information at their disposal was a collapse of the romance they had with the anti-choice groups and individuals.

In their bid to fight back, some of these individuals and groups opposed to abortion either publish misleading articles in the media or attack reports published by journalists who are aware of the issues and can contextualize matters related to abortion. Such journalists are convinced that the issues and the new information at their disposal should be in the public domain.

The outcome of this development is that there is now a healthy debate on whether abortion is desirable or not, whether there is need to reform abortion law in Nigeria and whether a woman deserves the right to make a choice or take a decision on what to do with her body as well as how she can manage her reproductive health and right.

As the debate rages, two key individuals, Sonnie Ekwowusi and Jerry Okwuosa stand out as arrow heads of the vanguard of individuals and groups who have sworn that abortion will remain topic that should not be discussed, meaning that the thousands of women who die from unsafe abortion should continue. Both men are Catholics and members of a Catholic organization known as the World Congress of Families.

For them, abortion should not be contemplated, no matter the circumstance under which a woman got pregnant and no matter her health condition. For them, once there is antennal care and access to services for pregnant women, abortion should not be condoned. They also believe that there is no link between reduction in maternal mortality and reduction in deaths caused by unsafe abortion. They believe that abortion should not be contemplated even when a pregnancy is capable of leading to the death of a woman.

It appears that they have forgotten about the law of double effect of the Catholic Church which allows abortion under certain conditions, the Italian law on abortion which has been in existence for over 30 years, the high contraceptive prevalent rate among Catholic women in Italy which stands at 60 per cent and the recent pronouncement of the Pope that discordant couples should use condom.

After reading Okwuosa article published by the Guardian Newspaper of 27th April 2011 where he condemned another feature story on "unsafe abortion and its implications to maternal mortality", the Director of International Research at Guttmacher Institute in the United States, Akinrinola Bankole responded thus: " To deny that unsafe abortion is directly linked to maternal mortality is not only misleading, but dangerous. Letting unsafe abortion persist amounts to a death sentence for tens of thousands of women every year."

In the article, Okwuosa observed that maternal deaths increased in countries where abortion law has been liberalized. He gave unverified figures and cited countries where he claimed that the liberalization of abortion law had not caused a reduction in maternal mortality. According to Bankola, the opposite is the case in the same countries that Okwuosa mentioned.

A misleading information in Okwuosa's article is that he isolated death from unsafe abortion as if itwas the only cause of maternal deaths, when it is common knowledge that hemorrhage accounts for a majority of maternal deaths, while hypertensive diseases, prolonged obstructed labour as well as infection are known to have contributed to Nigeria's high maternal mortality rate. In South Africa where he claimed that maternal mortality had not reduced since its abortion law was reformed, it is evident that deaths from unsafe abortion in South Africa reduced by 50 per cent since the procedure was legalized in 1997 and that the increase in the maternal mortality rate of that country is due to HIV/AIDS.

Okwuosa also gave the impression that maternal mortality rate will drop immediately abortion law is liberalized in a country, saying it was not the experience in Nepal and Ethiopia where abortion laws have been reformed. Meanwhile, the two countries liberalized their abortion laws in 2004 and 2005 respectively and according to Akintola, "it takes more time and research to establish the impact on maternal mortality".

Furthermore, the graph on the sharp drop in deaths arising from unsafe abortion and how it translated into reduced maternal mortality rate in Romania (one of the countries he listed) since its abortion law was liberalized in 1990 has been circulating around the globe for several years. The graph shows that maternal deaths reduced from 170 per 100,000 live births to 20 per 100,000 live births between 1990 and 2002.

Furthermore, it will not be proper to bath in the euphoria that there is no data on unsafe abortion deaths in Nigeria when the outcome of research conducted by Centre for Reproductive Rights and Women Advocates Research and Documentation Centre and published in 2008, shows that 34,000 women die from complications of unsafe abortion every year.

It will be total misinformation and mischievous to believe that abortion accounts for 2.7 per cent of maternal deaths in Nigeria because that is what applies to other African countries or that it is "the tenth on the list and accounts for five percent" going by a quotation by Okwuosa. The Society of Gynecology and Obstetricians of Nigeria has also conducted a research on unsafe abortion in Nigeria and the outcome has shown that its prevalence rate in Nigeria is still high. Okwuosa is of the view that since few women die from unsafe abortion, the victims should be ignored. It is like the number is not high enough to attract any attention.

He also tried to join issues with Dr. Ejike Oji, the Country Director of Ipas-Nigeria, a development that is worrisome based on the premise that the gynecologist is a women's right advocate whose organization has done so much for Nigerian women. At least seven women groups have been partnering with Ipas Nigeria to ensure that women do not die needlessly while trying to replenish the earth.

Through the activities of Ipas, the lives of at least 130,000 women, who would have died from complications of unsafe abortion or pregnancy, have been saved in the past few years. If there are doubts about the performance of Ipas in Nigeria, the National Planning Commission would not have given the organization a letter of commendation two years ago, neither will be organization have received over 24 awards in the past 10 years. Women groups would not have ben given testimonies on the benefits of Ipas presence in Nigeria at several fora.

With 34,000 Nigerian women dying from unsafe abortion every year, there is no doubt that the unsafe procedure has killed more women than many ailments annually. Okwuosa also doubts this fact.

Also reading through Sonnie Ekwowusi article in the Guardian of January 11th, 2011, where he tried in about 23 paragraphs to dismiss a publication by another Journalist, Lemmy Ughegbe who held a view that Nigeria's abortion law was due for review, one wonders what is going on..

Ekwowusi does not accept that the restrictive abortion law that is in Nigeria's statute books is derived from the Offences Against Persons Act of England of 1861. He said that "the law prohibiting abortion was not invented in far corner of the Church. It is a natural law written in every one's heart. It is natural law which every rational person, be he Christian, Muslim, Buddhist, atheist, Marxist, internet free-thinker, juju worshipper, agnostic, animist, among others, applying his/her natural intellectual comes to grasp and appreciated by his/her own effort".

The piece made efforts to dig into the history of some towns in Nigeria in a futile attempt to prove that a revised abortion law is not necessary. The historical rehearse are not relevant to the subject matter, just as statistics quoted are not verifiable and as such have no bearing to unsafe abortion and its consequences. The assumptions contained in the article are for the uninformed and quite a huge number of Nigerians belong to this group as far as reproductive health issues are concerned. They are unscientific and mainly belong to the class of what philosophers refer to transcendental truth. They fall within religious and belief systems in which case, adherents do not bother to verify claims.

Be that as it may, one thing stands out clear, there should be room for exchange of ideas. The only constant thing in life is change. Many Nigerians, including the very religious are beginning to see abortion and issues of reproductive health and rights from a different perspective. They are becoming bold enough to talk about it. It is a healthy debate. It is only those that resist change that will be consumed by their ignorance and resistance. Resisting change has been part of human nature but by the end the superior argument always carries the day. So, let the debate continue.

By Emmanuel Ekwueme, an Abuja-based social commentator. Copyright © 2012 Daily Independent. All rights reserved. This article was originally published in the Daily Independent on May 11, 2011.