Unsafe Abortion in Nigeria: New Concerns, Old Problems

Tatiana Mckinney

Parable: A renowned "man of God" abhorred abortion, until his own wife was raped and, out of pride, he chose a back-alley abortion over a safe procedure, permanently harming his wife. In Nigeria, this scenario is all too common.

AllAfrica.com tells a story of a renowned man of God who abhorred abortion. He preached to his congregation that the termination of a pregnancy, whether wanted or not, was a mortal sin. During one of his messages, a 16- year old girl became pregnant due to “sexual misadventure.” Her parents went to the pastor for advice, and he insisted that there would be no termination of the pregnancy, and she had the baby.

As fate would have it, a few months later a gang of robbers broke into the pastor’s house and raped all the women, including his wife. Anger, frustration, and pain inflicted both Edward and his wife, but fate was not done with them yet. Soon after, Edward’s wife found out she was pregnant as a result of the rape, and Edward soon had a change of heart about abortion. He said he could not imagine his wife baring the child of a rapist, so abortion looked attractive to him. Instead of suggesting this to a qualified doctor, Edward let his pride get the best of him, and he took his wife to have a back-alley abortion, leading to permanent damage to her womb.

This story is important because many people deem abortion a sin. But, it’s always interesting to see how people react once the shoe is on the other foot. The young girl was religiously pressured into keeping her baby because she feared “eternal damnation,” but the pastor did not think twice about an abortion for his wife “due to his pride and self-pity,” which due to his own pride inevitably ended up hurting his wife in the end.

Due to religious backlash and fear of ruined reputations, Nigerian women turn to back-alley abortions when they receive news of unwanted pregnancy. According to AllAfrica.com, “From statistics, an estimated 46 million pregnancies [worldwide] end in induced abortions each year and 20 million of these are unsafe. About 13 per cent of pregnancy related deaths have been attributed to unsafe abortions and 80,000 deaths annually.”

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Nigeria has an 1861 abortion law that allows the procedure when the life of the woman is threatened. With this law in place many health watchers are beginning to ask questions about the fate of women who are raped or are victims of incest.

What makes the Nigerian government think they know a women’s body better than she does? It always frustrates me that the only way a women can have an abortion is if “rape,” “incest” or “medical condition” is the cause. What if the woman is financially unstable and cannot provide for the child, wouldn’t that be a hardship? What if the women is in an abusive relationship and she fears for the life of her and the child? Wouldn’t that be a hardship? What if the women just knows that having a baby is just not the right decision for her? Is that not her decision? Is it not her body?

According to AllAfrica.com:

Speaking at a three-day training workshop organized by Ipas Nigeria for journalists in Reproductive Health and Rights Development, Consultant Gynaecologist, Dr Emily Nzeribe lamented that Nigerian women may continue to die due to ignorance of the Nigerian society. She said every six minutes, a woman dies needlessly as a result of an unsafe illegal abortion and obstructed labour. (Emphasis mine).

To deny women access to abortion abortion is to take a life. Forcing a woman to receive a back-alley abortion because the government does not want to provide adequate healthcare is killing her without ever laying a finger on her body. You are causing her to damage her body or to die in the process, so either way you take a life.  But taking the life of the woman not only affects her, it affects her children, her family and her community.

According to Dr. Emily Nzeribe, “Unsafe abortion mortality ratio in Africa is 110 deaths per 100,000 live births. On the average each African woman will experience seven unsafe abortions in her reproductive lifetime.” These statistics scare me. African women are dying because they want to make their own decisions about their lives and bodies, and their government is preventing them from doing so. How does this promote the women’s human rights? How is this equal?

The abortion law fails to protect women from unsafe abortions. Rather it forces women to go an unsafe route, which is killing more women daily. There needs to be a reform on the Nigeria abortion law, to where women can receive proper post abortion care and receive reproductive health services. Women should not have to suffer and die because they want to make their own decisions or because someone decided to make decisions for them. When will the death toll start to matter to the Nigerian government? When will women be allowed to make their own decisions? When will human rights matter? AllAfrica.com quotes Nzeribe further:

The legal indications for abortion in Nigeria are quite restrictive, thus making unsafe abortion a silent and persistent pandemic. Access to abortion services is particularly important for women and girls who are victims of sexual violence, rape and incest. There is a need for a review of our restrictive abortion laws due to the Human Rights implications of unsafe abortion.

The lack of political will and the disregard for human life will continue to send women to their early graves in increased numbers. When does a woman’s life begin, and politics end?

Commentary Politics

Pennsylvania Lawmakers Square Off Over Abortion Law, New Bill

Tara Murtha

Anti-choice legislators in Pennsylvania recently pulled out all the stops when debating a bill that would be one of the nation's harshest abortion laws if passed. But in the wake of a recent Supreme Court ruling, other state lawmakers are trying to stop that bill and change existing policy.

With the new U.S. Supreme Court abortion ruling, some Pennsylvania lawmakers want to roll back provisions similar to those struck down in Texas—and to head off any new restrictions in a bill debated on the house floor in late June.

Several legislators have called for repeal of Act 122, which was enacted in 2012 and mandates that Pennsylvania abortion clinics meet the standards of ambulatory surgical centers.

The U.S. Supreme Court struck down Texas’ ambulatory surgical center provision in the 5-3 Whole Woman’s Health v. Hellerstedt decision. Justice Stephen Breyer concluded in the opinion that the provision represented a “substantial obstacle in the path of women seeking a previability abortion” and was unconstitutional.

Soon after the decision, Sen. Daylin Leach (D-Montgomery/Delaware), a member of the bipartisan Women’s Health Caucus of the Pennsylvania legislature, wrote a memo recommending repeal of Act 122. And at a June 30 press conference organized by the caucus, Rep. Steven Santarsiero (D-Bucks) introduced legislation to do just that. He weighed in on another bill, HB 1948, discussed in the house on June 21.

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During that debate, “[anti-choice lawmakers] were exposed, they were unmasked,” Rep. Santarsiero said. “They stood one person after another after another in support of [HB 1948], and they came right out and said this is all about the anti-choice movement. They were exposed. They tried 20 years ago to claim it was not about that, but they’re not making any pretense at this point.”

Like Act 122, HB 1948 is an urgent matter. Anti-choice lawmaker Rep. Kathy Rapp (R-Warren) introduced the latter legislation in April, which would be one of the most severe laws in the country if enacted. HB 1948 would ban abortion beginning at 20 weeksIt also includes a “method ban” provision, which would criminalize dilation and evacuation (D and E), often used after miscarriages and for abortions earlier than 20 weeks.

Currently, HB 1948 is still on the schedule of the Pennsylvania Senate Judiciary committee. Though the senate may reconvene this summer, it’s unclear when or whether HB 1948 will move forward.

But advocates must not lose sight of this bill. 

A ‘Dangerous Precedent’

HB 1948 inserts the legislature into the doctor-patient relationship, forcing medical professionals, ordinary Pennsylvanians, and even some legislators out of the process. In April, lawmakers twice rejected requests for input on HB 1948 from both medical professionals and the public. When Rep. Dan Frankel (D-Allegheny) spoke out against the bill, his microphone was reportedly cut off.

Struggling to be heard, doctors and relevant medical associations sent open letters and wrote op-eds against the bill. “We are highly concerned that the bill sets a dangerous precedent by legislating specific treatment protocols,” wrote Scott E. Shapiro, president of the Pennsylvania Medical Society, in an April letter sent to legislators.

They are right to be concerned. Around the country, lawmakers with no medical training frequently propose method bans to criminalize the safest, medically proven procedures. They then threaten to imprison doctors if they don’t provide less-than-optimal care for their patients. This kind of legislative coercion brings to mind Donald Trump’s March statement that women who seek abortion should suffer “some form of punishment” for having an abortion.

Punishment, indeed. Under HB 1948, the punishment can go one of two ways: Either women receive less-than-optimal care, or doctors must be incarcerated. While considering the potential fiscal impact of HB 1948, lawmakers discussed how much it would cost to imprison doctors: $35,000 a year, the annual expense to care for an inmate in Pennsylvania.

My colleagues here at the Women’s Law Project, who co-authored a brief cited by Justice Ruth Bader Ginsburg in her Whole Woman’s Health v. Hellerstedt concurrence, have sent an open letter to senate leadership asking them to remove HB 1948 from further consideration.

The letter said:

If enacted, HB 1948 would inflict even greater harm on the health of Pennsylvania women than House Bill 2 would have inflicted on Texas women. Relevant medical experts such as the Pennsylvania section of the American Congress of Obstetricians and Gynecologists (ACOG) and the Pennsylvania Medical Society strongly oppose this bill.

Under well-established constitutional standards, HB 1948 is quite clearly unconstitutional.

The Strange Debate About HB 1948

For a while, HB 1948 seemed to have stalled—like much business in the legislature. It took more than 270 days to finalize the 2015 budget—an impasse that forced dozens of nonprofit organizations serving rape survivors, domestic violence victims, hungry children, and the elderly to lay off workers and turn away clients.

But in April, Pennsylvania lawmakers whisked HB 1948 to the floor within 24 hours. Then, on June 21, the bill suddenly sailed through the appropriations committee and was rushed to the house floor for third consideration.

HB 1948 passed the house after the kind of bizarre, cringe-worthy debate that makes “Pennsylvania House of Representatives” feel like an insult to the good people of the state. Surely, Pennsylvanians can represent themselves better than elected officials who want to punish abortion providers, liken abortions to leeches, ignore science, and compare abortion regulations to laws restricting pigeon shooting. Surely, they can do better than the legislators who hosted the June 21 farce of a debate about a bill designed to force women to carry unviable pregnancies to term.

At that debate, primary sponsor Rep. Rapp stood for questions about HB 1948. But when Rep. Leanne Krueger-Braneky (D-Delaware County) began the debate by asking Rapp about what doctors, if any, were consulted during the drafting of the bill, Speaker of the House Mike Turzai (R-Allegheny) halted proceedings to consider if such a question is permissible. Also a co-sponsor of the bill, he concluded it was not, offering the explanation that legislators can inquire about the content of the bill, but not its source or development.

Rapp eventually stated she had many meetings while drafting the bill, but refused to answer with whom. She invoked “legislator’s privilege” and insisted the meetings were “private.” Legislator’s privilege is an esoteric provision in the state constitution intended to protect the process from undue influence of lobbyists, not shield lobbyists from public inquiry.

The bill’s language—referring to D and E by the nonmedical term “dismemberment abortion”—echoes legislation promoted by the National Right to Life Committee (NRLC). The NRLC has also drafted boilerplate 20-week bans, along with Americans United for Life, an anti-choice organization and a leading architect of the incremental strategy for building barriers to access safe and legal reproductive health care.

Next, Rep. Madeleine Dean (D-Montgomery) asked Rapp if similar bills have been deemed unconstitutional in other states.

Indeed, they have. According to Elizabeth Nash, senior state issues advocate at the Guttmacher Institute, similar D and E bans have been blocked in Oklahoma and Kansas, and 20-week bans have been struck down in Arizona and Idaho. HB 1948 is one of the first pieces of legislation to combine both provisions into one bill; at the Women’s Law Project, we call it a “double abortion ban.”

But no one in the chambers would know that these anti-abortion restrictions have been obstructed because, once again, Speaker Turzai halted the proceedings over these questions. This time, he stopped the debate citing the house rule that lawmakers cannot ask a question if they already know, or the speaker suspects they know, the answer.

In any case, so it went. Pro-choice lawmakers of the Women’s Health Caucus of the Pennsylvania Legislature spoke out against the bill, reading letters from physicians and sharing tragic stories of family members who died after being denied abortion care during severe pregnancy complications.

When Rep. Rapp was asked if she knew that many severe fetal abnormalities were not diagnosed until or after the 20th week of pregnancy, she responded that many were not diagnosed until birth, which misses the point: HB 1948 is designed to deprive women who receive a diagnosis of a severe fetal anomaly, even unviable pregnancy, at 20 weeks or later of safe and legal abortion.

That’s alright with Rapp and others pushing HB 1948; the bill contains no exemptions for fetal anomalies or pregnancies that were a result of rape.

The bill’s supporters didn’t refute allegations that if passed into law, it would negatively affect health care. They argued their case by invoking metaphors instead. They compared abortion regulations to laws about pigeon shoots. They compared fetuses to bald eagles and abortion to leeches. A white male legislator, a description unfortunately almost synonymous with “Pennsylvania legislator,” compared abortion to slavery, drawing the ire of Rep. Jordan Harris (D-Philadelphia).

“We use slavery references when it benefits, but won’t do anything about the systems that negatively affect their descendants,” tweeted Rep. Harris.

Democratic Rep. Dan Frankel, co-chair of the Women’s Health Caucus, attempted to put the bill into context by noting the barrage of abortion restrictions passed in Pennsylvania already. In addition to the ambulatory surgical facility requirement, the state already has a ban prohibiting women from purchasing affordable health insurance that covers abortion through the exchange; an arbitrary 24-hour mandated waiting period; and a Medicaid ban that allows federal funding of abortions only in cases of rape, incest, or life endangerment.

The house voted 132-65 in favor of the bill, mostly among party lines, though 25 Democrats voted for it and nine Republicans voted against it. Gov. Wolf has promised he will veto it if passes, while HB 1948 proponents are working to gather enough votes for an override if necessary.

News Abortion

New Data Shows Drop in Texas Abortion Rates After HB 2

Teddy Wilson

The driving force behind the overall reduction appears to be a dramatic decrease in the number of medication abortions: The number dropped from 16,756 in 2013 to 5,044 in 2014.

The Texas Department of State Health Services (DSHS) released Thursday the state’s abortion statistics for 2014, which show a decrease in the number of abortions in the state compared to the previous year.

The data release comes after the American Civil Liberties Union (ACLU) of Texas claimed that DSHS deliberately delayed releasing the information to hide it from the public. It also follows on the heels of the U.S. Supreme Court’s historic decision striking down two provisions of the state’s omnibus anti-abortion law, HB 2.

The total number of abortions in the state decreased from 63,849 in 2013 to 54,902 in 2014a reduction of 8,947 abortions.

Reproductive rights advocates say the data, which offers a look at the effect of HB 2 in the first full year of its implementation, provides further evidence of the law’s negative impact on access to abortion care.

“We will leave it to statisticians to undertake deeper analyses of this data, but at first glance the numbers demonstrate the devastating effect House Bill 2 had on the women of Texas,” said Trisha Trigilio, staff attorney for ACLU of Texas, in a statement.

The driving force behind the reduction appears to be a substantial decrease in the number of medication abortions: The number decreased from 16,756 in 2013 to 5,044 in 2014.

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HB 2 prohibits anyone other than a physician from dispensing abortion medications. At the time that the bill was signed into law, it also required the physician follow then-outdated FDA protocols. The federal regulations have since changed, increasing the time a pregnant person has to receive a medication abortion, from 49 days to 70 days of gestation.

The statistics also show a slight increase in the number of pregnant persons who traveled out of state to obtain abortion care. The number of abortions that took place “out of state” was 754 in 2014, compared to 681 in 2013.

However, data from other states suggest a much larger increase during that time period. As Rewire previously reported, statistics from Arkansas, Kansas, Oklahoma, and Louisiana appear to indicate at least 1,086 patients traveled to those states from Texas to obtain an abortion in 2014.

The DSHS’ 2014 abortion statistics also show that HB 2 had a disproportionate effect on women of color and women in low-income communities. In 2013, there were 24,063 abortions obtained by Latinas, and in 2014 that number fell to 19,654a decrease of 18.3 percent. Additionally, Black Texans saw a decrease of 7.7 percent, while there was a decrease of 6.7 percent among white Texans.

Trigilio explained in a statement that the statistics reflect the actual intent of proponents of HB 2 and explain why the state agency kept the information “out of the public eye” prior to the Supreme Court decision. (For its part, DSHS said in response to the ACLU’s claims that it had not released the data because it wasn’t final yet.)

“Given the overall drop in abortions—especially in vulnerable communities along the border—as well as the precipitous 70 percent drop in medication abortions, these numbers show that this law never had anything do with women’s health,” said Trigilio.

Heather Busby, executive director of NARAL Pro-Choice Texas, told the Austin American-Statesman that she was not surprised by the data because she has been “hearing firsthand” from people how difficult it is to obtain abortion care in the state.

The statistics are “further validation that the Supreme Court ruled correctly,” Busby said.

Republican Lt. Gov. Dan Patrick said during an interview Thursday on KFYO that the Supreme Court is “corrupt.” Patrick, who was among HB 2’s most strident supporters, argued that the statistics are a positive outcome.

“Our true purpose was to make sure the environments were safe for women, but obviously if you have fewer of abortions that’s something to celebrate,” said Patrick

Lawmakers passed the omnibus abortion bill in 2013 under the pretenses of protecting women’s health and safety. Since the law took effect, there have been multiple reports documenting the detrimental effect it has had on patients’ reproductive health care.

The 2014 abortion statistics also reveal that it continues to be safer to have an abortion than to carry a pregnancy to term in Texas: Between 2008 to 2013, the most recent years for which data is available, there were 691 maternal deaths in Texas, compared to just one death due abortion complications from 2008 to 2014.