Maternal and reproductive health experts have described unsafe abortion as a “silent killer” of women in the country, blaming poverty, ignorance, and Nigeria’s restrictive abortion laws for the growing number of preventable deaths.
The experts lamented that at least 40 per cent of maternal deaths in the country were linked to abortion-related complications, many of which occur outside proper medical facilities.
Speaking exclusively to PUNCH Healthwise, the gynaecologists called for urgent reforms, including the decriminalisation of abortion under specific conditions, expansion of access to family planning services, and the provision of free maternal healthcare.
They noted that criminalising abortion does not reduce its occurrence but only makes it more dangerous, especially for poor women who lack access to safe alternatives.
A Professor of Obstetrics and Gynaecology at Obafemi Awolowo University, Ile-Ife, Osun State, Ernest Orji, identified unsafe abortions as a major contributor to the country’s staggering maternal death figures.
The maternal health expert decried the worsening economic situation in Nigeria, which he said is driving more women to seek dangerous alternatives during unintended pregnancies.
He described poverty as the root cause of most maternal deaths, saying it fuels ignorance, limits access to proper healthcare, and pushes women into desperate and often fatal decisions.
According to him, unsafe abortion accounts for a significant portion of maternal deaths in Nigeria, with some studies suggesting that as much as 40 per cent of maternal mortality is linked to complications arising from abortions carried out in unsafe conditions.
“Abortion is illegal in Nigeria. So even if a woman comes to a public hospital seeking to terminate a pregnancy, no doctor wants to risk their career and life. The law prescribes up to 14 years in prison for any doctor who assists in abortion, so they avoid it. Unfortunately, this legal barrier doesn’t stop women from aborting pregnancies – it only drives them to unsafe environments,” he said.
The don explained that many of these women resort to local or unqualified individuals and facilities, where substandard procedures often lead to severe infections, uncontrolled bleeding, and death.
“People get pregnant, sometimes from rape, incest, or financial desperation, and because abortion is criminalised, they go to chemists or traditional homes. By the time complications develop, they arrive at hospitals too late. Some of them die before anything can be done,” he added.
Orji stressed that many of the women who seek unsafe abortions are young, poor, and uneducated.
He said Nigeria’s high fertility rate, lack of access to contraception, and low uptake of family planning services are worsening the crisis.
He described a vicious cycle where women get pregnant without intention, face rejection or economic hardship, and then choose unsafe abortions due to lack of legal, affordable, and safe options.
“This cycle continues because there is no system in place to stop it. We are not solving the real problem,” he said.
The gynaecologist called for urgent reforms, recommending a multi-pronged strategy to address maternal mortality and specifically reduce deaths from abortion-related complications.
Among his recommendations is the provision of free maternal healthcare services, including antenatal care, childbirth, caesarean sections, and postnatal services.
“Every pregnant woman in Nigeria should have free access to comprehensive maternal care. That way, they are encouraged to go to the hospital early and seek the right treatment,” he said.
He also advocated massive investment in family planning, calling for policy changes that would mandate family planning education and services for all women of reproductive age.
The physician said preventing unintended pregnancies is key to reducing the rate of abortions and their complications.
“It is not just enough to talk about pregnancy complications. We must also talk about preventing unwanted pregnancies in the first place. Family planning should be available, accessible, and strongly encouraged,” he added.
On her part, a reproductive health advocate and consultant at Lagos University Teaching Hospital, Dr. Kemi Oduyemi, warned that the lack of safe abortion services, combined with widespread stigma and moral judgment surrounding unplanned pregnancies, is driving many Nigerian women, especially young girls, into life-threatening situations.
According to her, Nigeria’s restrictive reproductive health policies have created a dangerous environment where desperation and silence often lead to death.
Oduyemi noted that despite the legal restrictions, women, especially adolescents, students, and unmarried young adults, are still getting pregnant and seeking ways to terminate those pregnancies.
“We are losing young lives every day because our system refuses to acknowledge the realities.
“Women will continue to seek abortions, whether we legalise it or not — the only difference is whether they live or die. It’s not a moral debate at this point; it’s a public health emergency,” she said.
The physician further explained that unsafe abortions contribute significantly to maternal mortality, often leading to complications such as sepsis, organ failure, infertility, and, in many cases, death.
She called for urgent reforms, including comprehensive sex education, expanded access to contraception, and safe, legal abortion under specific circumstances, particularly for rape victims and women whose lives are at risk.
“We must stop pretending that restricting abortion prevents it. It doesn’t. What it does is push it underground — and underground is where our daughters are dying,” she added.