Abortion, the expulsion of a fetus from the uterus before it has reached the stage of viability (in human beings, usually about the 20th week of gestation). An abortion may occur spontaneously, in which case it is also called a miscarriage, or it may be brought on purposefully, in which case it is often called an induced abortion.
Abortion is a controversial topic in Nigeria. Abortion in Nigeria is governed by two laws that differ depending on geographical location. Northern Nigeria is governed by The Penal Code and southern Nigeria is governed by The Criminal Code. The only legal way to have an abortion in Nigeria is if having the child is going to put the mother’s life in danger. Unsafe abortion is a major contributor to the country’s high levels of maternal death, ill health and disability. Nigeria has one of the highest maternal mortality ratios in the world, and little improvement has occurred in recent years.
Contraceptive use remains low in Nigeria. In 2013, only 16% of all women of reproductive age (15–49) were using any contraceptive method, and only 11% were using a modern method levels that remain virtually unchanged since 2008. One of the major reason for legal abortions in Nigeria is Ectopic pregnancy also called extrauterine pregnancy, which is when a fertilized egg grows outside a woman’s uterus, somewhere else in her belly. It can cause life-threatening bleeding and needs medical care right away. In more than 90% of cases, the egg implants in a fallopian tube. This is called a tubal pregnancy
Types of Abortion carried out in Nigeria
Vacuum Aspiration (Suction Abortion): Vacuum or suction aspiration is a procedure that uses a vacuum source to remove an embryo or fetus through the cervix. The procedure is performed to induce abortion, as a treatment for incomplete miscarriage or retained pregnancy tissue, or to obtain a sample of uterine lining.
Dilation and Evacuation: Dilation and evacuation is the dilation of the cervix and surgical evacuation of the uterus after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.
Dilation and Extraction: Intact dilation and extraction is a surgical procedure that removes an intact fetus from the uterus. The procedure is used both after miscarriages and for abortions in the second and third trimesters of pregnancy.
An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, abortions in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention. About 25 million unsafe abortions occur a year, of which most occur in the developing world.
After Abortion Symptoms You Should Know
Symptoms of nausea, vomiting and tiredness usually stop within 3 days of an abortion. Sore breasts may take 7 to 10 days to disappear. Your breasts may feel firm and tender and leak milk after your procedure. You will feel more comfortable if you wear a supportive bra and apply cold ice packs to your breasts. Take ibuprofen or paracetamol, if necessary for the pain. Your next menstrual period will begin 4-6 weeks after your treatment. If you have not had a period 4 weeks after your treatment, you should do a pregnancy test. If it is positive, ring the clinic where you were treated to make a follow up appointment. It’s important to remember that any bleeding immediately after your treatment is not a period.
Most women can return to normal activities in 1 to 2 days after the uterus has cleared. Avoid strenuous exercise for 1 to 2 weeks.
Do not have sexual intercourse for 1 to 2 weeks or as advised by your doctor.
Be sure to use birth control when you start having sex again. And use condoms to prevent infection. For more information, see the topic Birth Control.
Do not rinse the vagina with fluids (douche). This could increase your risk of infections that can lead to pelvic inflammatory disease.
Normal symptoms that most women will experience after a medical abortion include:
Bleeding or spotting for up to 14 days. Bleeding may last longer for pregnancies of more than 7 weeks.
Cramping for the first 2 weeks. Some women may have cramping (like menstrual cramps) for as long as 6 weeks.
Call your doctor immediately if you have any of these symptoms after an abortion:
Severe bleeding. Both medical and surgical abortions usually cause bleeding that is different from a normal menstrual period. Severe bleeding can mean:
- Passing clots that are bigger than a golf ball, lasting 2 or more hours.
- Soaking more than 2 large sanitary pads in an hour, for 2 hours in a row.
- Bleeding heavily for 12 hours in a row.
- Signs of infection in your whole body, such as headache, muscle aches, dizziness, or a general feeling of illness. Severe infection is possible without fever.
- Severe pain in the belly that is not relieved by pain medicine, rest, or heat
- Hot flushes or a fever of 100.4°F (38°C) or higher that lasts longer than 4 hours
- Vomiting lasting more than 4 to 6 hours
- Sudden belly swelling or rapid heart rate
- Vaginal discharge that has increased in amount or smells bad
- Pain, swelling, or redness in the genital area
NOTE: Hormonal changes after a pregnancy can cause depression that requires treatment.
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Complications that can occur include:
Tissue remaining in the uterus (retained products of conception). Cramping belly pain and bleeding will occur again within a week of the procedure.
Infection. Symptoms of fever of 100.4°F (38°C) or higher, pain, and belly tenderness will usually start within 2 to 3 days of the procedure. But you can have a serious infection without fever.
Blood clots blocking the cervix (hematometra). If the uterus doesn’t contract to pass all of the tissue, the cervical opening can become blocked. This prevents blood from leaving the uterus. The uterus will become enlarged and tender. Belly pain, cramping, and nausea may be present.
Moderate to severe bleeding (hemorrhage). Bleeding may be more than normal if:
- Products of conception are retained in the uterus.
- The uterus has not contracted toward its prepregnancy size (atony).
Uterine muscle rupture has occurred. In rare cases, a uterine incision scar tears open when a medicine is used to induce contractions.
When a medical abortion fails, a surgical abortion must be done as follow-up to prevent complications or development of a fetus with abnormalities. Read : Alabukun Powder and Abortion: Everything You Should Know