Sanwo-Olu remains silent two years after suspension of Lagos abortion guidelines

Two Years after Lagos State Governor Babajide Sanwo-Olu ordered the suspension of the implementation of the state’s new policy to ensure safe abortion, the governor has still not lifted the suspension despite appeals from stakeholders.

Some stakeholders who spoke exclusively with PUNCH Healthwise on the need for the governor to reinstate the policy without further delay disclosed that cases of unsafe abortions in the state had reached worrying levels due to economic difficulties.

The Society for Family Health announced last week that the number of abortions among married women is currently increasing, especially in light of nationwide inflation.

According to the SFH, married women terminate pregnancies because they want to minimize the negative economic impact of having additional children on their family.

Sanwo-Olu had on July 7, 2022, ordered the suspension of the directive titled “State Guidelines for Safe Termination of Pregnancy for Legal Indications” issued by the Directorate of Family Health and Nutrition in the Ministry of Health.

According to a statement by the state’s Health Commissioner, Prof. Akin Abayomi, the governor ordered the suspension of the guidelines to allow more time for public sensitization due to increased interest in the matter.

“The Governor of Lagos State, Babajide Sanwo-Olu, has ordered the suspension of the ‘State Guidelines on Safe Termination of Pregnancy on Legal Grounds’ issued by the Directorate of Family Health and Nutrition in the Ministry of Health.

“These guidelines have generated tremendous public interest, necessitating forwarding them to the Governor. He has advised further sensitization among the public and key stakeholders to ensure a clearer understanding of the objectives of the guidelines,” the statement said.

The Commissioner said the directive had been developed over four years through careful work by experts in the fields of law, obstetrics and gynecology, with a focus on creating the possibility of reducing maternal mortality and being in line with existing laws.

But two years later, the governor has still not lifted the suspension of the policy, despite numerous appeals from no fewer than 150 women’s rights and civil society organizations and other stakeholders.

Speaking to our correspondent, Dr. Benjamin Olowojebutu, maternal health expert and first vice president of the Nigerian Medical Association, said the number of abortions among married women in the state was increasing.

Olowojebutu said: “It is really true that the number of unsafe abortions is currently increasing. We see many women having septic abortion after going to quacks to perform abortions for them.

“They are now coming back to hospital with very serious complications. So it is important that we now have a very good model for policy guidelines.

“We have shown the Lagos State Government the importance of implementing the policy and we hope that it will be implemented soon.”

He assured that the policy would reduce maternal mortality associated with unsafe abortions in the state if the governor lifted the suspension.

The outgoing Chairman of the NMA in Lagos State noted: “If the suspension is lifted, it means that there will be safe abortions in Lagos State and women will be able to seek help in hospitals and not have to go to quacks. And there will be fewer complications due to unsafe abortions and maternal mortality.”

He disclosed that SOGON, NGOs, religious leaders and other relevant stakeholders are currently meeting with the Commissioner for Health to ensure the reinstatement of the guideline.

In Nigeria, according to maternal health experts, access to safe abortion care is a controversial issue, riddled with myths, misconceptions and misinformation that often obscure the reality of sexual and reproductive health care.

They point out that these falsehoods cloud public understanding and thereby hamper efforts to provide basic health services to women in need.

Consequently, unsafe abortion remains a major cause of maternal morbidity and mortality in Nigeria, a country with one of the highest maternal mortality rates in the world.

According to the non-governmental organization Women Advocates Research and Documentation Centre, unsafe abortions in Nigeria account for ten percent of the global maternal mortality rate and are the second leading cause of maternal deaths in the country.

WARDC also states that in 2017 alone, no fewer than 212,000 of the estimated two million women who had an abortion each year sought treatment due to complications, while 285,000 did not receive the necessary care given the serious health consequences they faced.

Speaking at a media training for selected journalists in Lagos on the dangers of unsafe abortion, Rumunse Obi, project director of the Campaign to End Unsafe Abortion, recently said the government could not deny that unsafe abortions were occurring.

“We want fewer women to die from unsafe abortions. We want to end the frequency and occurrence of unsafe abortions because we know it is possible,” she said.

The founding director of WARDC, Dr. Abiola Akiyode-Afolabi, stressed that women’s health, rights and lives must be the government’s top priority, regardless of the “feelings” that may surround the issue.

Akiyode-Afolabi said the guidelines were designed to protect women from preventable deaths and pointed out that the suspension undermines this crucial goal.

“We are aware that certain religious, cultural and philosophical beliefs are contrary to the document that has been developed over the course of four years,” she said.

She stressed that the guidelines are important to provide an opportunity for abortion in cases of incest, rape and sexual and gender-based violence.

The women’s advocate said there was an increase in cases of rape and incest resulting in pregnancies and that these victims, including children, were not legally granted access to safe abortion services.

According to a more recent nationally representative study of women of childbearing age in Nigeria, there were 29 abortions per 1,000 women aged 15-49 years. In 2012, this equates to an estimated 1.25 million induced abortions, or 33 abortions per 1,000 women aged 15-49 years.

According to the World Health Organization, approximately 73 million abortions take place worldwide each year.

Worldwide, an estimated 22 million abortions are still performed for safety reasons each year, resulting in the death of around 47,000 women and disabilities for another five million women. 29 percent of all pregnancies end in induced abortion.

The Permanent Secretary, Lagos State Ministry of Health, Dr. Olusegun Ogboye, told our correspondent that the purpose of suspending the guidelines was to give the public a full understanding of the intentions of these guidelines.

Ogboye said: “We have not lifted it yet. Discussions are going on in the background with very important stakeholders about it.”

“We will continue to talk to the public so that if we reintroduce it we do not encounter resistance from some parts of the public, as was the case.”