3-Day Capacity-Building Workshop: LIFE Enlightens Young Girls/Women on Preventable Maternal Deaths From Unsafe Abortions

By Naomisophyblog

The 3-day capacity-building workshop with the theme "Amplifying female voices in demanding accountability on preventable maternal deaths in Lagos State," specifically targeted at young girls and women, aims at creating widespread awareness of preventative procedures needed to curb maternal deaths from unsafe abortions, which remains a major public health challenge in Nigeria. The theme of the year 2025 program is 'Amplifying

LIFE program officer Oluwatoyin Mokwe enlightened the audience of young girls and women on building self-awareness, confidence, and positive self-image for empowered decision-making. She noted that self-indulgence in sexual acts without information on safe reproductive health choices to make informed decisions can lead to the unsafe abortion of unwanted pregnancies, causing bodily harm and possibly death.

She enumerated possible causes of maternal morbidity from unsafe abortions, which include lack of knowledge about their bodies and rights, low self-confidence in decision-making, societal pressure and stigma, and limited access to safe reproductive health services. Moreover, Toyin noted that every year, thousands suffer complications from unsafe abortions due to fear, stigma, and lack of access to good health care services; many also do not feel empowered to make informed choices about their reproductive health.

However, self-awareness, she says, is important in reproductive health; the ability to recognize personal values and beliefs helps individuals make productive choices aligned with their well-being. Meanwhile, understanding peer and societal pressures reduces the likelihood of being influenced into unsafe decisions, promotes awareness of reproductive rights and health, and empowers individuals to seek safe, legal healthcare services as well as build emotional intelligence, enabling individuals to handle relationships and reproductive decisions with confidence.

To put self-awareness in action, Toyin mentions that young girls and women should seek safe and legal reproductive health services, avoid risky sexual behaviors that may lead to unintended pregnancies, and stand firm against coercion or stigma when making reproductive choices even in the face of external pressures. This, she says, is why confidence is considered integral in reproductive health, as it encourages seeking reliable information on accurate sexual and reproductive health (SRH), which helps to empower women and girls to make safe choices (they are more likely to access contraception, safe healthcare, and support systems). It also reduces vulnerability to coercion and stigma, as confidence helps individuals resist pressure from peers, partners, or society, enhances communication skills, and enables assertiveness in discussing reproductive health with partners, family, and healthcare providers.

To put confidence in action, a young woman who is confident in her reproductive health choices will say no to unwanted sexual advances and seek contraception without fear or shame. Speak up and demand safe medical care if needed. Make informed decisions about pregnancy, including avoiding unsafe abortion and seeking legal, medical options where available.

More also, building positive self-image and making informed decisions on reproductive health choices is vital in curbing unsafe abortion; self-worth, body confidence, and belief in one's abilities help an individual develop a positive self-image as self-worth leads to self-care. Individuals who value themselves are more likely to prioritize their health; they seek safe reproductive health services rather than engaging in risky behaviors, Toyin noted.

She further stated that

The link between empowerment and prevention of unsafe abortion and understanding the root causes of unsafe abortion below is a lack of information about reproductive health and rights, stigma and societal pressure leading to secrecy and unsafe methods, limited access to contraception and safe abortion services, low self-esteem, and lack of confidence, causing poor decision-making.

Research has shown how empowerment reduces maternal morbidity from unsafe abortion, and this includes informed decision-making, increased confidence to seek help, breaking the cycle of shame & stigma, and economic and social empowerment (education and financial independence reduce vulnerability to unplanned pregnancies and unsafe abortion). Women with opportunities plan their futures and make informed reproductive choices.

However, strategies to build self-awareness, confidence, and positive self-image state that education and awareness, communication and assertiveness training, peer support and mentorship, addressing emotional and mental well-being, and access to reproductive health services are appropriate measures towards curbing unsafe abortions. Also, to advocate for lesser vulnerability to unsafe abortions and their complications entails that non-governmental bodies and individuals should seek policies that support reproductive rights through campaigns to draw the government's attention; empower youths through education and mentorship; strengthen access to safe reproductive health services; and break the stigma around reproductive health decisions.

To create knowledge for a positive effect leading to change, it is important that respective advocates educate (share knowledge with others and debunk myths about reproductive health); Advocate (Speak up for policies that support safe reproductive choices); Support (encourage women and girls to make empowered, informed decisions about their health).

In addition, navigating challenges in implementing safe abortion guidelines involves the interplay of policy, religion, and public health in Nigeria, promoting friendly family planning services.

Eliminating the contribution of unsafe abortion and lack of contraceptive use leading to maternal mortality in Nigeria, as presented by Dr. Adeboje Jimoh Fatimah, a consultant obstetrician and gynecologist at Lagos University Teaching Hospital, states that the family planning method is a low-cost yet effective way of preventing maternal deaths whereby risky pregnancies are avoided and unsafe abortions prevented. Unsafe abortions, she says, have great public health significance and are one of the leading causes of maternal mortality worldwide.

She noted that developing countries have 85% of cases of unsafe abortions and 98% of deaths. Care by skilled health professionals before, during, and after childbirth can save the lives of women and newborns. Maternal deaths can be caused by hemorrhage, sepsis, hypertensive disease of pregnancy (pre-eclampsia/eclampsia), labor complications/obstructed labor, and unsafe abortion. Together, this can account for about 2/3 of all maternal deaths.

However, the method of family planning with the use of contraception is advisable to serve as preventive measures and is divided into traditional and modern contraception. The traditional contraception involves rhythm (periodic abstinence) and the withdrawal method, while the modern contraception is the use of combined hormonal contraception, progesterone-only preparation, emergency contraception, intrauterine contraception, barrier methods, and sterilization.

Also, there is the 'Unmet Need for Contraception,' defined as the proportion of currently married women who do not want any more children but are not using any form of family planning (unmet need for contraception for limiting), while the 'Contraceptive Prevalence' is the percentage of women who are currently using, or whose sexual partner is currently using, at least one method of contraception, regardless of the method used.

Fatima stated that the use of contraceptives is low, leading to unsafe abortions. On central roles of contraception, she mentioned that awareness is low, low usage, 3% usage in women in union, unmet need for family planning 18.89%, low felt need, low contraceptive prevalence rate, and a large family is the norm, especially for poor homes. However, safe motherhood initiatives have benefits of an increased planned pregnancy, a reduction in the risk for STIs and HIV and other transmitted diseases, a decreased mother-to-child transmission of HIV, increased capacity of facilities to respond to obstetric emergencies, increasing referrals to gynecological care, increased girl child education, increasing women's status, poverty reduction, and sustainable economic development.

Prevention and the way forward to curbing maternal morbidity through unsafe abortions can be achieved by advocacy to increase awareness, public education, and reproductive health education in schools on contraception, abortion and its complications, abstinence when not ready for conception, and if otherwise, using effective contraception and SDGs universal basic education on gender equality, women empowerment, and eradicating poverty.

A secondary prevention will be the upgrading of the healthcare system to provide safe and affordable abortion services in terms of training, equipment, and infrastructure; the reformation of abortion laws to address other issues like physical and mental health, rape, incest, and congenital malformations, among others; political willingness; and social, cultural, and religious involvement, while tertiary prevention is the prompt and appropriate treatment of abortion complications, the concept and practice of comprehensive abortal care by community/provider partnerships, counseling and treatment of post-abortal patients, provision of contraceptive services and linkage to other reproductive health services, and provision of 'Emergency Obstetric Care (EmOC)' and post-abortion care (PAC).

In conclusion, it should be noted that maternal mortality is a global issue, unsafe abortion is a major contributor to maternal mortality, contraception has a major role in the reduction of maternal mortality, all levels of intervention have to work simultaneously to curb maternal morbidity, and Nigeria is lagging behind in the recent global trend. Appropriately directed political advocacy can serve as an essential factor in eliminating unsafe abortion in Nigeria. Access to quality reproductive health and family planning is essential, especially as we move into the 'Survive, Thrive, and Transform' agenda of sustainable development. We need to transform the way we visualize the problem of unsafe abortion and non-usage of contraceptive services.

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