The Incidence of Abortion in Nigeria

Abstract

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.

Facility‐based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries

“…The primary data source for this investigation is a series of published studies that provide national estimates of the number of women treated for complications of pregnancy termination in health facilities . To be included in our calculations, estimates needed to be nationally representative and provide data for 2000 or later.…”

Estimating Abortion Incidence: Assessment of a Widely Used Indirect Method

“…Sources Health Professional Surveys, in each country, based on opinions of key informants. See Bankole et al (2015), Basinga et al (2012), Keogh et al (2015), Mohamed et al (2015), Moore et al (2016), Polis et al (2017), Prada et al (2016), Puri et al (2016), Sathar et al (2014), Sedgh et al (2011Sedgh et al ( , 2015 and Singh et al (2017) Country treated for complications with official statistics or with results from other data collection approaches such as a Prospective Morbidity Survey (PMS); comparison of a multiplier based on the HPS with multipliers from population-based surveys; and AICM estimates of abortion incidence with estimates obtained through different methodologies, such as the secret ballot or sealed envelope approach.…”

“…Three main steps are needed to estimate the multiplier, and calculations are done for each population subgroup and then combined, weighting each subgroup by its proportion of all women of reproductive age, to yield a national multiplier. Where sample sizes are large enough to provide regional estimates, we make the calculations by region to yield a multiplier for each region (Bankole et al 2015). Data from the Uganda 2013 (Prada et al 2016) incidence study are used to illustrate these calculations (Tables 1 and 2).…”

A prospective study of severity of complications associated with use of misoprostol and other abortion methods in South West Nigeria

“…Despite Nigeria's restrictive abortion laws, a 2012 survey of health facilities that treat postabortion patients reported an estimated 1.25 million induced abortions; in 2012, the estimated abortion rate was 33 abortions per 1000 women aged 15–49 years . Henshaw et al .…”

“…Different methods are used in Nigeria for abortion, such as dilatation and curettage (D&C), manual vacuum aspiration (MVA), and ingestion of abortifacient pills such as misoprostol, herbs, local gin, and lime . Misoprostol is a prostaglandin E 1 analogue that is legally available in over 80 countries.…”