Socioeconomic determinants of access to safe abortion and experiences along the care trajectory: A survey of women with a five-year abortion history in Abuja and Lagos, Nigeria

Matthea Roemer, Marie Stopes International (MSI)
Boniface A. Ushie, African Population and Health Research Center (APHRC)
Akinsewa Akiode, APHRC
Ochanya Idoko, MSI Reproductive Choices - Nigeria
Ogechi Onuoha, MSI Reproductive Choices - Nigeria
Anne Taiwo, MSI Reproductive Choices - Nigeria
Matthew Wilson, /

Unsafe abortion remains a significant cause of maternal morbidity and mortality in Nigeria. This study provides new insights on the status of safe abortion access, who has access, as well as pregnant people’s experiences along the abortion care trajectory in Nigeria. Drawing on data from a survey of women of reproductive age with a 5-year history of induced abortion(s), analyses include frequencies of abortion safety and experiences along the abortion care trajectory and bivariate and multivariate assessments of sociodemographic and reproductive history correlates. Almost half (44.7%) of respondents reported the most unsafe abortions, with those living in rural areas and those living in severe poverty being significantly more likely to have had the most unsafe abortions. Those living in poverty were also at increased likelihood of being unable to access an abortion from their preferred source and of experiencing any complications. Abortion in Nigeria is a public health concern and an issue of social inequity. Efforts to improve equitable access to in-facility services, particularly surgical procedures and post-abortion care is critical for management of complications from unsafe abortion. Simultaneously, increasing awareness of the availability of quality-assured medication abortion products can mitigate the toll of unsafe abortion-related morbidity and mortality.

Keywords: Sexual and Reproductive Health and Rights, Comparative methods , Family Planning and Contraception

See extended abstract.