By Oluwasola Samuel, Freelance Writer.
Medical reviewer: Dr. Azuka Ezeike, MBBS, FWACS (Obstetrics and Gynaecology), MSc (Public Health),
Did you know that many young girls and women in Africa resort to unsafe abortions because they lack a safe option?
Yes, that's a fact. Unsafe abortion is a major public health crisis that has put many lives at risk. But why is the safe abortion option limited? Why are young girls and women going for unsafe abortions, and what are the consequences?
In this article, we will delve into these important issues. We will also highlight the complications, lack of access to healthcare, and what to do to safeguard women's reproductive health.
What's unsafe Abortion?
Before we look at what unsafe abortion is, it will be fair to explain what abortion is. This will help give you a better understanding on this topic in general.
Abortion is medically defined as any form of pregnancy loss (spontaneous or induced) before the age of viability. The age of viability depends on the locality - 28 weeks in most African countries, and 20 weeks globally. [1]
“Abortion can be induced (voluntary termination of pregnancy) using different methods (safe or unsafe). It can also be spontaneous (happen on its own),” says Dr. Osom Onyeche, a consultant gynecologist and obstetrician with the Ministry of Health in Saudi Arabia.
According to the WHO, An “unsafe abortion” is defined as a procedure for terminating a pregnancy performed by persons lacking the necessary information or skills or in an environment not in conformity with minimal medical standards, or both. [2]
Simply put, therefore, abortion is unsafe when it is done by unskilled and uninformed persons. It is also unsafe if it is also done in an environment lacking minimal medical standards (unhygienic).
“Many young girls and women engage in unsafe abortions in Africa. They have procedures performed on them by unqualified or uninformed people in environments lacking the minimal medical standards, Dr. Osom Onyeuche explains
Unsafe abortion is a major public health issue, especially in countries with highly restrictive abortion laws. These restrictive laws often totally prohibit abortion, except where the pregnancy puts the physical and mental well-being of the woman at risk.
Unsafe abortion is a worldwide issue and a major cause of preventable deaths of girls and adult women. According to the WHO, 45% of induced abortions globally in 2010 - 014 are unsafe. In Africa nearly 3 out of every 4 abortions were unsafe and nearly half of these were performed in the least safe conditions. [2]
There is most probably considerable under-reporting of cases of unsafe abortion in several African countries because of stigma and legal consequences. So much of the statistics on the condition may not fully capture the true picture.
Abortion is highly prohibited in many sub-Saharan countries. Anyone caught engaging in abortion faces criminal charges and could end up in jail. This leads many young girls and women to seek other options (that are most often unsafe) to abort their unwanted pregnancies.
These unsafe abortions often lead to incomplete abortions or abortion complications. In Africa, between 2003 and 2012, about 77% of abortions were unsafe, and 4.7%—13% of these unsafe abortions led to death. [3]
According to Guttmacher, Sub-Saharan Africa had roughly 185 deaths per 100,000 abortions, which amounts to 150,000 preventable deaths each year, [4] the WHO estimates the death rate to be above 200/100,000 abortions. [2]
These statistics show the death toll and how widespread unsafe abortion is in Africa.
Unsafe abortions in Africa are a complex and growing concern in the region. Let's explore some reasons young girls and adult women in Africa resort to unsafe abortion procedures.
Basically, the majority of abortions (safe and unsafe) that occur globally are because they are unintended and/or unwanted for whatever reasons. African countries are no exception.
In most sub-Saharan African countries awareness and education about safe sex practices are poor and contraception uptake generally low among married and sexually active unmarried women between ages 15 to 49 years for various complex reasons.
One reason women may seek unsafe abortions is because it's cheaper when compared with the long-term financial and social responsibility of keeping an unintended and or unwanted pregnancy.
Not uncommonly, even married women who get pregnant soon after a prior delivery or have an unexpected pregnancy after completion of family size, have a pregnancy that poses a threat to their career or business, or get pregnant for another partner (not the husband) choose to have abortions that may not be safe.
In many parts of Africa, if you get pregnant before marriage, people look at you differently. They consider such an act taboo and unacceptable. As a result, when young girls, especially, get pregnant out of wedlock, they hide it and get rid of it.
Also, some women with unintended pregnancies seek abortion because they do not want to disappoint or lose their family's trust in them. Hence, they go to any length to abort the pregnancy, even in unsafe situations, without considering the complications that might arise afterwards.
Protection of career and education are two other reason why girls and adult married and unmarried women in Africa seek abortions.
With respect to education, most young girls and some adult women have high hopes and are aware that it is a gateway to their socioeconomic empowerment. As a result, they are open to seeking unsafe abortion options to abort their pregnancies if need be. A young pregnant girl who is still in school is likely to drop out of school.
To some adult women, pregnancy may constitute a reason why critical career advancement cannot be achieved. When faced with a situation, affected women may seek unsafe abortion options where safer opions are inaccesible for whatever reason.
Many young girls and adult women with unintended pregnancies have little to no knowledge of their safe abortion options. Hence, they sometimes out of ignorance, seek unsafe means to abort their pregnancy.
7. Restrictive abortion laws
Many African countries have highly restrictive abortion laws that prevent many girls and women from seeking safe abortions. [5] This lack of access forces them to seek care from unskilled providers to abort their pregnancy. As a result, they may be subject to the use of harmful instruments and herbs to abort their pregnancy.
It is noteworthy though that progress is being made, although very slowly, in easing restrictive abortion laws in many countries in sub-Saharan Africa. Indeed the countries of Sao Tome and Principe, as well as Benin, now have open-request abortion laws that permit abortion on request subject to a 12-week limit. [5]
8. Lack of access to safe abortion services
Even in countries where abortion is legal, there is limited access to safe abortion services. Shortage of trained service providers, limited facilities, and the high cost of safe abortion are also leading causes.
Unsafe abortion can lead to various complications if not properly managed.
The WHO estimates that about 4.7%–13% of maternal deaths are abortion-related. (4) Furthermore, in developing nations where unsafe abortion is common, an estimated 7 million women are treated annually in hospitals because of the complications of unsafe abortion.
Aside from death-related cases, there are other potential risks young girls and adult women (married and unmarried) face because of unsafe abortion.
Complications of unsafe abortions can be grouped under the following:
Early health-related complications include:
Late health-related complications include:
Socially related complications include:
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Published: July 7, 2024
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