Inequities in the incidence and safety of abortion in Nigeria

Abstract

BackgroundWe know little about the frequency, correlates and conditions under which women induce abortions in Nigeria. This study seeks to estimate the 1-year induced abortion incidence and proportion of abortions that are unsafe overall and by women’s background characteristics using direct and indirect methodologies.MethodsData for this study come from a population-based, nationally representative survey of reproductive age women (15–49) in Nigeria. Interviewers asked women to report on the abortion experiences of their closest female confidante and themselves. We adjusted for potential biases in the confidante data. Analyses include estimation of 1-year induced abortion incidence and unsafe abortion, as well as bivariate and multivariate assessment of their correlates.ResultsA total of 11 106 women of reproductive age completed the female survey; they reported on 5772 confidantes. The 1-year abortion incidence for respondents was 29.0 (95% CI 23.3 to 34.8) per 1000 women aged 15–49 while the confidante incidence was 45.8 (95% CI 41.0-50.6). The respondent and confidante abortion incidences revealed similar correlates, with women in their 20s, women with secondary or higher education and women in urban areas being the most likely to have had an abortion in the prior year. The majority of respondent and confidante abortions were the most unsafe (63.4% and 68.6%, respectively). Women aged 15–19, women who had never attended school and the poorest women were significantly more likely to have had the most unsafe abortions.ConclusionResults indicate that abortion in Nigeria is a public health concern and an issue of social inequity. Efforts to expand the legal conditions for abortion in Nigeria are critical. Simultaneously, efforts to increase awareness of the availability of medication abortion drugs to more safely self-induce can help mitigate the toll of unsafe abortion-related morbidity and mortality.

Induced Abortion Incidence and Safety in Rajasthan, India: Evidence that Expansion of Services is Needed

“…Prior research has indicated that women in their peak reproductive years, urban residents, and more educated women tend to have more abortions, and we expect similar results in Rajasthan (Bell et al. 2020; International Institute for Population Sciences (IIPS) and ICF, 2017; Singh et al. 2017).…”

Factors associated with induced abortion among women of reproductive age attending selected health facilities in Addis Ababa, Ethiopia: a case control study

“…This could be due to better educated women may have improved access to health information [35] and thus, better knowledge of the abortion law [36]. Similarly, the evidence provided by other studies from Ghana [29,36,37], Nigeria [38], Kenya [39], Iran [40] have shown that better educated women had higher odds of having an induced abortion compared with less educated women. The other possible reasons for higher odds of induced abortion among more educated women may be attributed to their employment status and lack of time to care for children [41], wanting to postpone/space childbirth [27], and more tendency to plan their family size [42].…”

Sublingual Misoprostol Versus Manual Vacuum Aspiration for Treatment of Incomplete Abortion in Nigeria: A Randomized Control Study

“…It is recognized that about 10 -15% of all pregnancies end in spontaneous abortion, [15] and another proportion is willfully terminated due to unintended pregnancy; for instance, rates of 33 to 46 induced abortions per 1,000 women of reproductive age group were reported in Nigeria. [16,17] It is noteworthy that either of these categories can end in incomplete abortion with the attendant morbidities and mortality when not managed appropriately. Thus, the need for a more convenient, affordable, and nonsurgical treatment method in our environment cannot be over-emphasized.…”