CONTEXT-Because of Nigeria's low contraceptive prevalence, a substantial number of women have unintended pregnancies, many of which are resolved through clandestine abortion, despite the country's restrictive abortion law. Up-to-date estimates of abortion incidence are needed.METHODS-A widely used indirect methodology was used to estimate the incidence of abortion and unintended pregnancy in Nigeria in 2012. Data on provision of abortion and postabortion care were collected from a nationally representative sample of 772 health facilities, and estimates of the likelihood that women who have unsafe abortions experience complications and obtain treatment were collected from 194 health care professionals with a broad understanding of the abortion context in Nigeria.RESULTS-An estimated 1.25 million induced abortions occurred in Nigeria in 2012, equivalent to a rate of 33 abortions per 1,000 women aged 15-49. The estimated unintended pregnancy rate was 59 per 1,000 women aged 15-49. Fifty-six percent of unintended pregnancies were resolved by abortion. About 212,000 women were treated for complications of unsafe abortion, representing a treatment rate of 5.6 per 1,000 women of reproductive age, and an additional 285,000 experienced serious health consequences but did not receive the treatment they needed.CONCLUSION-Levels of unintended pregnancy and unsafe abortion continue to be high in Nigeria. Improvements in access to contraceptive services and in the provision of safe abortion and postabortion care services (as permitted by law) may help reduce maternal morbidity and mortality.Induced abortion is illegal in Nigeria except when performed to save a woman's life. Both the penal code, which is generally applied in the country's northern states, and the criminal code, which generally applies in the southern states, allow this exception, and both regions specify similar criminal penalties for noncompliance. 1 Yet pregnancy terminations are quite common, and because they are often performed clandestinely or by unskilled providers, most are unsafe. 2 The first national study to examine the incidence of abortion estimated that in 1996, about 610,000 abortions, or 25 per 1,000 women aged occurred in Nigeria. 3 Author contact: abankole@guttmacher.org.
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Author ManuscriptA decade later, another study noted that if the abortion rate had not changed since 1996, then 760,000 abortions would have occurred in 2006, given the increase in Nigeria's population during this period. 4 Since the release of the 1996 estimates, the Nigerian government and other stakeholders have initiated a number of policies and programs to improve the reproductive health of women in the country. Notable among them are the government's efforts to achieve the United Nations Millennium Development Goals, including Goal 5, to improve maternal health. This goal has two targets: to reduce the maternal mortality ratio by 75% between 1990 and 2015, and to provide universal access...
