Trump’s Global Gag Rule denying Nigerian women access to family planning

In spite of Nigeria’s highly restrictive abortion law, complications of unsafe abortion remain high in the country and among the leading causes of maternal deaths.

Unsafe abortion, according to reports, continues to claim the lives of many adolescent girls and women in the country on a daily basis as they are carried out by unskilled practitioners or under unhygienic conditions.

Induced abortion is illegal in Nigeria except when performed to save a woman’s life and this has made many women to consult quacks.

Experts say unsafe abortion complications leave millions of women temporarily or permanently disabled.

They argued that unsafe abortion is a major consequence of unintended pregnancy which they attributed to high unmet need for contraception.

Studies have shown that preventing unintended pregnancies by promoting contraceptive use would significantly reduce the number of unsafe abortions and maternal deaths in the country.

This, according to experts, is beacuse it is when a pregnancy is not wanted that a woman will have the urge to want to terminate it.

Hence the need for family planning to prevent the pregnacy from taking place in the first place and post abortion services for the women who will go underground to get the termination done following the restrictive abortion laws in the country plus the stigma attached to it.

However, while Nigeria with major support from international Non-Governmental Organisations (NGOs), is making serious effort in removing barriers to accessing modern family planning serivices in a bid to reducing her high maternal mortality rate, the expanded Global Gag Rule (GGR) of the US President, Donald Trump, is beginning to reverse the gains the country has made so far.

The GGR also known as Mexico City Policy was expanded by Trump soon after his inauguration in January 2017.

The policy prohibits foreign NGOs that receive any United States global health assistance from performing or promoting abortion as a method of family planning.

The GGR was first introduced by President Ronald Reagan in 1984. The policy was repealed by Bill Clinton in 1993, reinstated by George W. Bush in 2001, repealed by Barack Obama in 2009, and again reinstated by President Trump when he took office.

Reproductive health experts, foreign NGOs and maternal and child health advocates have kicked against the policy, insisting it would have negative impact on women especially those in the developing countries like Nigeria that rely heavily on donors’ support for their healthcare needs.

Many have argued that GGR would be a major setback to Nigeria’s quest to achieving its set target of modern contraceptive prevalence rate of 27 per cent among all women by 2020.

Bill and Melinda Gates​ Foundation had seriously warned that Trump’s GGR could endanger lives of millions of women and children.

For Ipas, a Non-Governmental Organisation that works globally to improve access to safe abortion and contraception, Trump’s decision on GGR remains a big blow to women worldwide.

Another NGO,Marie Stopes International (MSI) that is also providing contraception and safe abortion services is equally not happy with Trump over GGR.

MSI in Nigeria says it is bracing for a dramatic drop in funding following the policy as it declined to sign onto the policy, which would require them to cut all services and information relating to abortion, and will therefore forfeit all funding from the US Agency for International Development (USAID).

Already, the United Nations Population Fund (UNFPA), the UN agency responsible for family planning and one of the largest providers of contraceptives worldwid is also feeling the heat of the financial cut. Reports show that the UNFPA is facing a funding gap of more than $700m until 2020.

MSI Nigeria Country Director, Effiom Effiom, in a release, said that the loss of US support stands to jeopardize recent progress in reducing Nigeria’s maternal death rate.
Currently, Nigeria account for 10 percent of global maternal deaths.

He therefore, warned that maternal and child welfare could suffer in Nigeria if women lose access to contraceptives and other health services.

“We know a good way to protect maternal and child health is the timely spacing of births,” Effiom said.

Speaking in an exclusive interview with The Daily Times, a Senior Nursing Officer with Taiwo Convalescent & Nursing Home, Bariga, Lagos, Mr. Taiwo Bamgboye,said with the number of cases of unsafe abortions recorded in his clinic annually, the GGR if not reversed, would worsen the situation on ground.

Bamgboye who is the Zonal Chairman, Association of General Private Nursing Practitioners (AGPNP),Bariga Zone, said family planning prevents unsafe abortion and reduces maternal deaths by more than 35 per cent.

He explained, “We are carrying out a lot of programmes on family planning in this community to educate women on the importance of the use of contraceptives in preventing abortion and spacing their children. Now, if after this effort, the NGOs providing us with family planning commodities are nowhere to be found, it means that our women and girls are in trouble.

“In Bariga here for instance, we have a lot of cases of unsafe abortions and unwanted pregnancies. Every year, I see over 72 cases of unsafe abortion. They go to quacks and when the situation is out of hand, they rush in here bleeding. The ones we could not handle ,we refer them to Island Maternity,Lagos.”

He further added: “Apart from those who rushed in here bleeding, we also have a lot of single ladies in their 20s and 30s who walk in here requesting for abortion and we counsel them.”

According to a research conducted in 2012 by a United States-based Guttmacher Institute and Ipas, over 1.25 million abortions are carried out in Nigeria every year, 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.

A recent study published by The Lancet publication revealed that restricting access to abortion by law does not reduce the number of abortions but only increases the risks to lives of women and girls.

According to the study, 25.5 million unsafe abortions were carried out yearly between 2010 and 2014 worldwide, with 97 per cent occurring in developing countries in Africa, Asia and Latin America.

The World Health Organisation (WHO) defines unsafe abortion as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both .

Maternal health experts believe that improved access to comprehensive abortion care, including counselling and effective contraceptive access and use, will both save women’s lives and reduce poverty and child labour.

Recently, the National Bureau of Statistics (NBS) 2017 Multiple Indicator Cluster Survey (MICS), said about 50.8 per cent of Nigerian children mostly young girls, aged between five and 17, are involved in child labour,which experts attributed to uncontrolled familiy size.

Further investigation by The Daily Times showed that GGR poses a major threat to the future of adolescents girls in the country if denied access to contraceptives and sex education.

According to Director-General, National Agency for the Control of AIDS (NACA), Dr. Sani Aliy,15 per cent of Nigerian youth lose virginity before age 15.

“More young Nigerians are engaging in sex much earlier and are increasingly engaging in unprotected sex and having multiple sexual partners”, he said.

Aliyu noted that the situation calls for concern in order to secure the lives of these youths.

On her part, Ipas Nigeria Country Director, Barrister Hauwa Shekarau, identified stigma,myths and misconception as factors fuelling unsafe abortion.

“Unfortunately, myths on abortion are many and prevent people from taking informed and correct decisions. Since they do not know the reality, they assume the myths are true. This is a barrier fuelling quackery and creating barriers to safe services for women. Myths on abortion include: Abortion can lead to breast cancer; women that do abortion are four times more likely to die”, she explained.

While calling for the review of abortion law in Nigeria,Shekarau, pointed out that legally restricting reproductive health services such as safe abortion does not only affect the number of abortions that happen but also fails to achieve the purpose for which it was established.

Some women who spoke with our correspondent on the benefits of family planning, said access to contraception had enabled them to take better care of themselves and their families, support themselves financially, complete their education, and to also keep their job.