THE INCIDENCE OF INDUCED-ABORTION IN NIGERIA

Context: Although abortion is illegal in Nigeria except to save the li fe of the woman, thousands of women resort to if each year. Informatio n on the incidence of abortion and on the consequences of abortion out side the health care system is needed to develop policies and programs that will address the problem. Methods: Experienced physicians conduc ted interviews at a nationally representative sample of 672 health fac ilities in Nigeria that were considered potential providers of abortio ns or of treatment for abortion complications. The data were used to e stimate the annual number of abortions and to describe the provision o f abortion-related services. Results: Each year, Nigerian women obtain approximately 610,000 abortions, a rate of 25 abortions per 1,000 wom en aged 15-44. The rate is much lower in the pear, rural regions of no rthern Nigeria than in the more economically developed southern region s. An estimated 40% of abortions are performed by physicians in establ ished health facilities, while the rest are performed by nonphysician providers. Of the abortions performed by physicians, 87% take place in privately owned facilities and 73% are performed by nonspecialist gen eral practitioners. Three-quarters of physician providers use manual v acuum aspiration to perform abortions, and 51% of providers who treat abortion complications use this method Physician respondents believe t hat the main methods used by nurses, midwives and other nonphysicians to induce abortions are dilation and curettage, hormonal or synthetic drugs and insertion of solid or sharp objects. Conclusions: Although h ighly restricted, abortions fake place in large numbers in Nigeria, un der both safe and unsafe conditions. Policies to improve access to con traceptive services would reduce unplanned pregnancy and abortion and, along with greater access to safe abortion would help preserve the he alth and lives of Nigerian women.