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Saving Nigerians from risky abortions

By Andrew Walker
BBC News website, Abuja

When she discovered she was pregnant, Faith stole a few thousand naira - about $40 - from her mother to pay for a secret abortion.

Women in nigeria
In Nigeria women can only get an abortion is their life is at risk

The 21-year-old wasn't ready to have a baby, she said.

She doesn't have enough money to look after a child as she earns only 300 naira per day, just over $2.5 (1.30).

"They put iron inside me, it pains a lot," she said in a written answer to questions from the BBC.

"I was vomiting, and felt sad."

The "doctor" was not trained to perform abortions, and may not have been qualified at all.

Faith is fortunate to be alive.

Figures show that 10,000 women die every year in Nigeria from unsafe abortions, carried out by untrained people in unsanitary conditions.

That is 27 deaths every day.

According to the US-based Guttmacher Institute, that is one sixth of the total number of women who die worldwide from such procedures.

Traditional 'doctors'

In Nigeria abortion is illegal unless the life of the woman would be at risk if she were to give birth.

But the Guttmacher Institute estimates that more than 456,000 unsafe abortions are done in Nigeria every year.

These women are very young. They are often not married or still in school
Doctor who provides safe - but illegal - abortions

Some women go to traditional healers to terminate their pregnancies.

Methods include trying to break the amniotic sack inside the womb with a sharp stick. This causes infection and in extreme cases the tissue inside the body can start to die.

"They're pulling out intestines," says gynaecologist Dr Ejike Oji, of Ipas, an international organisation working to secure reproductive rights for women.

Another method is to pump a toxic mixture of fiercely hot Alligator chilli peppers and chemicals like alum into their bodies.

"The women go into toxic shock and die," Dr Oji said.

Taboo

Abortion is a taboo subject in Nigeria. The BBC couldn't find any woman who had an abortion willing to speak about it openly.

But 12 women responded to questionnaires about their experiences.

ABORTION IN NIGERIA
Instruments used in illegal abortions
About 750,000 women have abortions every year
60% of those are "unsafe"
20% are done by a traditional healer or the woman herself
The average cost of an abortion is $15
The lowest reported cost was $4
20% of pregnancies in Nigeria are unplanned
50% of those end in abortion
Women in the mostly Christian south as likely to experience unwanted pregnancy as women in the Muslim north
Source: Guttmacher Institute

The women were contacted though a doctor who arranges abortions by trained doctors at a medical clinic in the capital Abuja.

"People know I am into women's issues," she says, "so when a woman comes to an organisation looking for help, they send them to me." The doctor did not want to be identified because she feared the authorities would prevent her from providing a service she says saves lives.

All but one of the 12 women are single, and all are below the age of 27. Two are still in secondary school.

All of them earn less than $60 (30) a week.

Two women said they had abortions before, and two other women said their boyfriends refused to let them use contraception.

Most of them did not tell their partners or their families they were pregnant, and had to borrow money from friends to pay for the abortion.

At the doctor's clinic it costs $169 (86) for the operation.

In unqualified hands, an abortion could cost as little as $4 (2).

"It's expensive, but they realise its better than spending 500 naira and then having permanent medical problems or dying," says the doctor.

She gives the women a pill normally used for treating stomach ulcers.

This causes the womb to contract and start bleeding.

The doctor, with the approval of another consultant, can then go ahead and perform the abortion, because they can say it appeared the woman's life was at risk.

"These women are very young," says the doctor.

"They are often not married, sometimes still in school. There are serious social consequences if they were to have the child. They might not be able to afford to raise them."

Even if it was possible to get a legal abortion, many women would not be able to get a safe one
Dr Francis Ohanyido
International Public Health Forum

Married women may seek abortions because they already have more children than they can afford.

Two attempts to change the law were stopped by conservative women's groups.

They say a change in the law would promote promiscuity, and weaken the moral fibre of Nigeria.

"Making more abortions available is not the answer," says Saudata Sani, a female member of the House of Representatives for Kaduna state, in northern Nigeria.

"Women need to be educated about their rights over their body and given opportunities to plan their families, but it must be done in a way that protects public morality."

Other medical specialists say that the law is just a part of the picture.

"Even if it was possible to get a legal abortion, many women would not be able to get a safe one," said Dr Francis Ohanyido, the president of the International Public Health Forum.

"Medical facilities vary widely and it is almost impossible to guarantee quality."

Cultural taboos mean even if there was a clinic in their town, it would be impossible for most women to go there, he said.

Among the 12 women the BBC questioned, five said they believed it would be wrong to make abortion more easily available.

Sharle, a 25-year-old university student, who had an abortion so she could continue her education, said she regretted what she did, saying it was against God's commandments.

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