The Morning After: Ugonma’s Decision
By Nneka Ukachukwu
Ugonma woke up late as usual but this time, too lazy to get out of bed. The school had closed for the semester break and she was enjoying the holidays at home with her parents and siblings.
Feeling happy that her parents had gone to work and will not hound her to do the house chores, she settled cosily under the sheets and got lost in thoughts.
For some reason, her countenance changed to worry as it occurred to her that a month had gone by since her last monthly cycle.
She immediately jumped off the bed and ran to the calendar hung on the wall to check the dates and confirm her worst fears.
“I have missed my period and it’s always pretty regular; I am pregnant,” she mused.
Low use of contraceptives
Contraceptive prevalence rate in Nigeria among women aged 15 to 49 was reported at 16.6% in 2018. This is according to the World Bank collection of development indicators, complied from official recognised sources.
Professor of Obstetrics and Gynaecology, Oluwarotimi Ireti Akinola of the College of Medicine, Lagos State University Nigeria, says “contraceptive prevalence rate in Nigeria is very low. There is evidence that says you can reduce 33% maternal mortality rate by simply improving contraceptive prevalence rate.”
You will not die of pregnancy if you do not get pregnant. And contraception does that”.
“The target of Nigeria is to reach at least 22% contraceptive prevalence rate,” he added.
Major contributors to low usage of contraceptives remain lack of knowledge and misconceptions about the use of contraceptives.
Ugonma is smart and intelligent but she lacked knowledge of contraceptive use. She was also brought up in a society where discussions on sexual reproductive health are shrouded in secrecy.
There is need for sensitization and creation of awareness on the safe use of contraceptives among sexually active women.
There are many young and clueless girls like Ugonma who are not aware of contraception.
In the forefront of encouraging and changing the pattern of contraceptive use across Nigeria is Marie Stopes International Organisation Nigeria MSION, a result-oriented Non-Governmental Organisation.
An estimated 12,000 women in Nigeria used contraceptives provided by Marie Stopes in 2010. The number increased to more than 3,000,000 in 2018.
On creating awareness amongst girls, the Regional Manager South-West Nigeria, Alfred Olusegun, said “the first step is for information and education to get out there to all persons. And the best way to get information out there is to ensure there is unfettered access which is why we have an avenue for every person to call for free on 08000022252. Through the contact center you can call to get information and counselling you need to make informed decisions.”
“We have trained over 2,000 providers of information across the country. Marie Stopes has operational presence in basically all the states of Nigeria. This has greatly helped in ensuring that those who need the training get it,” he added.
The odds against her
Ugonma had only been 17 when she became sexually active and four years later she found herself in a dilemma of deciding what to do with the unwanted pregnancy.
The news terrified her and so many thoughts raced through her mind.
“I am 21 and still in school. I can’t tell my parents”, she thought.
One of the consequences of unprotected sex is unwanted pregnancy which ultimately leads to abortion. Most of these abortions are unsafe because the young girls cannot afford the cost or patronize quacks in a bid to hide the pregnancy from friends and family.
But Akinola feels that “it is not safe abortion that is the solution. It is preventing them from getting pregnant in the first place so that you can offer them contraceptive advice.”
He also listed increasing contraceptive prevalence rate, making contraceptive education and contraceptive commodities available, as part of measures to reduce deaths from unsafe abortion.
“I can boldly say Nigerian government are founders and supporters that are assisting us with contraceptive commodities. We are not spending money on contraceptives. It is more of gifts and donations.” Akinola added.
As a teenager, Ugonma wanted to be so many things; an actress, on-air personality, musician, teacher, in the limelight, on the red carpet, but most importantly, she wanted to be seen.
She had to stay in school and get a degree in order to achieve her dreams. Moreover, she came from a family of women who are driven, strong-minded, opinionated and are not lazy. So she had no other way than to go for her goals and things she wanted to achieve.
Having a baby at that age was therefore out of the equation. Something needed to be done urgently at that stage and she knew the only option at that time was to go for abortion.
Sexual Reproductive Health Rights
Access to quality sexual and reproductive health services and information is essential to protect adolescents’ and young women’s health and their ability to plan their lives.
But social norms, gender stereotypes, need to control female sexuality and other issues make accessing information and services challenging for young girls.
In developing countries, more than 20million girls and young women aged 15-19, have an unmet need for modern contraception. More than six out of 10 abortions in Nigeria are unsafe with disadvantaged women most likely to have unsafe abortion.
Every abortion death and disability could be prevented through sexuality education, use of effective contraception, provision of safe, legal induced abortion and timely care for complications.
Despite her ignorance, Ugonma happened to be one of the few who had safe abortion in a medically recommended clinical facility.
Abortions are safe when they are carried out by a person with the necessary skills, using a WHO recommended method appropriate to the pregnancy duration.
People need to change their attitude and make a paradigm shift from wrong beliefs, customs and practices.
Like Akinola said, “If you advocate for family planning and contraceptive use, Nigerians and women in particular will be in the forefront campaigning against it”.
However, this should not be the case. Contraceptive use should not lead to promiscuity rather it leads to better and balanced choices.
There is also the need to withdraw reservations and abolish laws which discriminate against women and girls.
“There is divergence between culture and religion. The law is on one side, culture and religion are on one side. The law purports to be neutral. Religion and culture are not neutral; they take sides. Depending on the muscle of the law, religion and culture most times have their way and law becomes irrelevant,” a lecturer at the University of Lagos, Barrister Asikia Karibi-Whyte said.
Some of these laws pose questions about who has more rights – the unborn child or the mother.
“The State has a stake on the right of the unborn child; that is the position of the State. The right of the child is not more important than that of the mother. But when they are put on a scale, the State will say they have a stake in the life of the unborn. And unless the coming to effect of that unborn child is going to adversely affect the life of the mother that is when the State backs down,” she added.
Government must ensure that sexuality education is accessible to young women and adolescents to acquire knowledge and skills needed to make healthy choices about relationships and sexuality.
It’s a win-win
For Ugonma, there was no law as to how her life turned out after the abortion. “My life just continued. I walked into the clinic, came out and continued my life. I was on holiday…then went back to school,” she said.
Her family values moulded her into the powerful woman she is today. “I come from a family of very strong and enterprising women, women who put their hands to the plough. I come from a family of women who are doing something; either working or business. I don’t know any other way than to be relevant to myself, to family and to humanity in general,” she added.
Ugonma has three beautiful daughters. She lives and works in Abuja, Nigeria where she’s fulfilling her dreams as a mentor, coach and public speaker.
(None of the photos in the story is Ugonma)
– Nneka Ukachukwu
First published by Voice of Nigeria