|Finding Common Ground in the Debate over Unsafe Abortion: The Campaign Against Unwanted Pregnancy|
"If you saw what we see every day," says Dr. Boniface Oye-Adeniran, an obstetrician-gynecologist and one of the four coordinators of the Nigerian Campaign Against Unwanted Pregnancy, "You would be moved to action too." Dr. Oye-Adeniran is talking about young women who suffer the consequences of unsafe abortions—most commonly, teenage girls. As a practicing doctor in Nigeria, where abortion is legal only when the pregnancy threatens the woman's life, such young women cross his door—or are brought across—on a daily basis.
The death, disfigurement, and health complications experienced by women like these have compelled Dr. Oye-Adeniran to act. In August 1991, he and his longtime friend and colleague, fellow obstetrician-gynecologist, Isaac Adewole, together with activist Ngozi Iwere of the Lagos-based Community Life Project, founded the Campaign Against Unwanted Pregnancy (the CAUP), a group of doctors, lawyers, women's rights activists, nurses, journalists, social scientists, and other concerned citizens dedicated to ending unsafe abortion in Nigeria. Dr. Oye-Adeniran and Professor Adewole's wide-ranging affiliations and activities have helped build a strong base of support for the group: both men are practicing physicians and professors of medicine, and both have held leadership positions in Nigeria's most influential medical schools and physicians' associations. Their groundbreaking research has shed light on the largely undocumented nature and extent of unsafe abortion in Nigeria. And in hopes of raising awareness among the next generation of Nigerian medical providers, in 1997 they oversaw the formation of Action Group on Adolescent Health (AGAH), a students' association with chapters in eight Nigerian medical schools.
For Dr. Oye-Adeniran and Professor Adewole, unsafe abortion is a simple matter of individual and public health. "As obstetricians and gynecologists, we know that anybody who has made up her mind to discontinue a pregnancy will do so," says Dr. Oye-Adeniran. "She will go to any extent, any length, to get it done. So why not do it safely? As a provider, in spite of your religious inclinations or teachings or lineage—if your father was a priest or your grandfather was a priest and you cannot see yourself doing that—you must recognize that even if you think the patient has sinned, she must be alive to repent. That is our position. Maternal mortality is on the rise in Nigeria, and we know that one-third to 40 percent of it is attributable to complications from unsafe abortion. So this is the real issue."Nigeria's maternal mortality ratio is among the highest in the world—one in 14 mothers will die from pregnancy or childbirth—and many of them will seek the services of unskilled providers to terminate their pregnancies. Young women are at the greatest risk: Over half of the patients seen for complications from unsafe abortion in Nigerian hospitals are teenage girls. And the poorest young women are at the greatest risk of all. As in many countries worldwide where abortion is highly restricted, safe care is often a matter of resources. Those with money can find a doctor to perform a safe procedure. "In Nigeria, access is denied to those on the lowest rungs of the socioeconomic ladder," explains Dr. Oye-Adeniran. "The poor, the unsung, and the young persons."
The four co-coordinators of CAUP—Dr. Oye-Adeniran, Professor Adewole, Ngozi Iwere, and Justice Pat Mahmoud from the Northern Shari'ah State of Kano—are a microcosm of Nigerian regional, ethnic, and religious diversity, and a testament to the urgency of the tragedy of unsafe abortion. They have shown that although the debate over legalizing safe abortion may be heated, it is possible to carve out common ground. "We have different views at CAUP, but we accept each other's differences," says Professor Adewole. "You can't possibly say no to everything; you have to say yes to something. Every Nigerian should be able to buy into at least one of these programs—sexuality education, family planning, adoption and fostering, or legal abortion—to prevent unwanted pregnancy and unsafe abortion."
Dr. Oye-Adeniran agrees. "We want to be inclusive, so we try to avoid forcing people to clarify their beliefs, and ask them simply to tell us what they can support."
IWHC has supported the CAUP since its creation in 1991. We are currently supporting their efforts to raise awareness on unsafe abortion in Nigeria and to establish youth-friendly sexual and reproductive health services in tertiary health institutions throughout the country.>>Read more about IWHC's colleagues in Nigeria