The cries from the modest home of Alhaja Kudirat Fasina in Idi-Mangoro, Agege, Lagos, pierced the afternoon silence. Neighbours gathered as family members rushed to help a 35-year-old mother of three who was writhing in pain, bleeding heavily and clutching her abdomen. She was rushed to a private health facility in the neighbourhood.
Within hours, she was dead, leaving behind three children and a grieving family struggling to understand how a desperate decision had ended in tragedy.
Her relative, Mrs Ola David, who shared the family’s account, described her cousin as an illiterate woman who survived by hawking cooked food. Following a prolonged marital dispute with her husband, she had moved into her aunt’s, Alhaja Fasina’s home in search of refuge.
Life, however, took another difficult turn when she reportedly became pregnant during an extramarital relationship, a development she feared would expose her to shame, family conflict, and social condemnation.
According to the family, she chose to conceal the pregnancy from everybody, except her boyfriend, and instead of seeking medical attention to resolve it, she settled for unsafe abortion. Believing she had no safe or acceptable option, she allegedly consumed a locally prepared concoction containing kaun (potash) mixed with ‘Blue’ mostly used on white garment, which some communities falsely believe can terminate a pregnancy. Soon afterwards, she developed severe abdominal pain and began bleeding profusely.
“When my mother saw her holding her stomach and bleeding, she demanded to know what had happened,” the relative recalled.” She admitted she was pregnant and had taken the mixture because the pregnancy was not for her husband. She said the man responsible had become aware of it, and she wanted to get rid of it quickly. Moreso, her third child was relatively young,” recalled Ms David.
Despite the family’s intervention, and the spirited effort of the private hospital, her condition deteriorated rapidly. She died; leaving behind three children whose care has since fallen largely on their mother’s aunt. For the family, the loss remains a painful reminder of how desperation, misinformation and fear can combine with devastating consequences.
According to the founder and executive director, Women Advocates Research and Documentation Centre (WARDC), Dr Abiola Akiode-Afolabi, and some other Public health experts the tragedy is far from isolated.
This is because Nigeria continues to record deaths and serious injuries linked to unsafe abortion, particularly among women who cannot access accurate reproductive health information or safe medical care. Many resort to dangerous herbs, chemicals or unqualified providers, often with fatal consequences.
The deceased added to the grim statistics of deaths from unsafe abortion. Nationally, and in Lagos state. Unsafe abortion remains a significant contributor to maternal deaths in Nigeria. A peer-reviewed national analysis published in BMJ Global Health estimated that unsafe abortion accounts for about 10 percent of maternal deaths in Nigeria, with as many as 6,000 abortion-related deaths annually. Earlier Guttmacher research estimated around 3,000 deaths per year, but noted that the figure was likely an underestimate because many women who die from complications never reach a health facility.
The burden is also reflected in the number of women experiencing complications. A nationally representative study estimated that about 1.25 million termination of pregnancy occurred in Nigeria in 2012; approximately 212,000 women were treated in health facilities for complications, while another 285,000 experienced serious complications without receiving the treatment they needed. More recent research also found that a substantial proportion of abortion in Nigeria falls into the most-unsafe category, highlighting the continuing public-health consequences of limited access to safe, timely reproductive healthcare.
In Lagos State, the latest population-based Lagos Verbal and Social Autopsy–Sample Registration System (LVASA-SRS) provides particularly important evidence. Its surveillance of pregnancies occurring between March 2023 and February 2025 identified abortion-related deaths as accounting for 10.2 percent of maternal deaths. The study estimated Lagos’s maternal mortality ratio at 833 deaths per 100,000 live births. These findings show that abortion-related mortality remains a substantial component of maternal deaths in Lagos, although the 10.2 percent figure represents the proportion of maternal deaths attributed to unsafe abortion, not the percentage of women undergoing unsafe abortion who die.
These figures will continue to rise, according to experts. This is because, under Nigeria’s Criminal Code, abortion is generally illegal except when performed to save the life of the pregnant woman. Medical and reproductive health advocates have long argued that these restrictions contribute to unsafe termination of pregnancy rather than preventing it.
According to Dr Akiode-Afolabi, “there is a need to review the laws on abortion in Nigeria. This is because criminalising abortion has not addressed the problem. So it is important to have law that allows for women to make a choice, a particularly law that allows for abortion in exceptional cases, like in the case of foetal abnormality, rape, incest, in line with the Maputo protocol.
Section 14, subsection (2) (c) that allows for safe termination of pregnancy in cases of rape. There are many people who have been affected by rape and incest, and because of stigma and discrimination in their society, committed suicide. So the law should be able to support the vulnerable. And not to criminalise their actions.”
Dr. Moriam Jagun of the Centre for Health, Bioethics and Gender Policy Studies (CBHGAPS) has repeatedly stated that restrictive unsafe termination of pregnancy laws drive many women to seek unsafe procedures, increasing the risk of preventable maternal deaths. She has called for reforms that expand access to comprehensive family planning, sexuality education and evidence-based reproductive healthcare while reviewing the country’s unsafe termination of pregnancy laws to better protect women’s health.
For this family in Agege, however, policy debates are deeply personal. They believe no woman should lose her life because she felt trapped by an unintended pregnancy or lacked access to safe, accurate reproductive health services. Reproductive experts are urging government authorities to intensify public education on modern family planning, ensure contraceptives are readily available and affordable, and review Nigeria’s abortion laws to reduce the number of women forced into dangerous, life-threatening choices. Behind every statistic, they say, is a family left to mourn—and children left to grow up without a mother.
Dr Akiode-Afolabi under pinned it that restrictive abortion laws in Nigeria should be reviewed.
Already, in Lagos there is a simple, uncomplicated guidelines developed to address that, “the Lagos State Guidelines on Safe Termination of Pregnancy (STOP) for Legal Indications were developed by the Lagos State Ministry of Health over about four years with input from obstetricians, gynaecologists, lawyers and public health experts,” according to Dr Moriam Jagun, of BTHGap, adding, “they were launched in June 2022 but were suspended less than two weeks later on the directive of Governor Babajide Sanwo-Olu. The guidelines have remained suspended.”
Advisor of the non governmental organization (NGO), the Network of Reproductive Health Journalists of Nigeria (NRHJN), Sola Ogundipe, said as an advocate for Sexual and Reproductive Health and Rights, along with his members, they are of the opinion that the suspension of the Lagos State Guidelines on Safe Termination of Pregnancy for Legal Indications is ill advised and should be reversed.
He clarified, “First, the guidelines didn’t create a new abortion law. What its creators did was to enable healthcare professionals with a clear clinical and operational framework for providing termination of pregnancy as permitted within existing Nigerian law, particularly where a woman’s life or physical health is at severe risk.
“So, suspending the guidelines will not reduce unsafe abortion, on the contrary it heightens the potential risks because are left uncertain about how to proceed. The result is a potential delay in care for women who need timely medical intervention, and such delays can turn a manageable complication into severe illness, disability or even death.”
He added, “Then there’s the concern of women seeking unsafe alternative care.
While wealthier women may be able to seek alternative specialist care, the poorer and more vulnerable women are less likely to have that option. When safe, regulated services become harder to access, women of lower means are more likely to face delays or resort to unsafe alternatives. The suspension of the Guidelines has only left healthcare professionals in uncertainty. Rather than indefinite suspension, legitimate concerns about the Guidelines should be openly reviewed and strengthened where necessary by appropriate legal, ethical and clinical safeguards.
“The call on Lagos state government to reinstate the STOP Guidelines remains. It will strengthen oversight and ensure that lawful reproductive healthcare is provided safely, professionally and without discrimination. The protection and safeguarding of women’s lives and health must remain at the heart of the conversation.”
What were the STOP Guidelines intended to do?
According to Ogundipe, the guidelines were not designed to legalise abortion on demand. Rather, they sought to provide a clear clinical framework for healthcare workers on when and how pregnancy could be safely terminated within the limits of existing Nigerian law. They aimed to: Standardise medical practice across Lagos health facilities. Clarify the legal circumstances under which doctors could intervene.
Reduce deaths and complications from unsafe abortion. Improve post-abortion care and referrals. And protect healthcare workers by providing clear professional guidance.
Benefits for doctors
Adding that, “if implemented, the guidelines would give doctors clear protocols for managing complicated pregnancies. Reduce uncertainty about legal and ethical responsibilities. Improve documentation and accountability. Encourage timely referrals and evidence-based care. Reduce the number of women arriving at hospitals with life-threatening complications from unsafe procedures.”
Benefits for Lagos residents
Ogundipe with other advocates said the guidelines could reduce maternal deaths linked to unsafe abortion. Improve access to emergency reproductive healthcare where legally permitted. Ensure women receive counseling and post-abortion care. Reduce reliance on unqualified providers and dangerous traditional methods. Provide clearer pathways for managing pregnancies that seriously threaten a woman’s life or health.
Why did Governor Sanwo-Olu suspend the guidelines?
The official reason given by the Lagos State Government was not that the governor rejected the policy permanently. According to the state’s Commissioner for Health, Prof. Akin Abayomi, the governor ordered the suspension because the guidelines had generated significant public interest and controversy, and he wanted more public sensitisation and stakeholder engagement so their objectives would be better understood.
From investigations, many observers also noted that the guidelines faced strong opposition from some religious organisations and pro-life groups, who believed they would expand access to abortion beyond what Nigerian law permits. While these groups publicly campaigned against the policy, the government itself did not officially state that religious pressure was the reason for the suspension.
Why are health advocates asking for the suspension to be lifted?
From investigations, groups such as the Women Advocates Research and Documentation Centre (WARDC), Centre for Bridging Health Gaps (CBHGAPS), and the Network of Reproductive Health Journalists of Nigeria argue that the guidelines would save lives rather than promote indiscriminate abortion.
Dr. Jagun said the STOP Guidelines were created to help doctors provide care within the existing law, not to encourage abortion on demand. According to her, suspending the guidelines has left doctors without clear guidance and has contributed to women seeking unsafe abortions, increasing preventable maternal deaths.
In summary, the STOP Guidelines remain one of the most debated reproductive health policies in Lagos. Supporters view them as a life-saving clinical guide that operates within Nigeria’s legal framework, while opponents fear they could widen access to abortion. The Lagos State Government’s stated position is that the suspension was to allow for broader public understanding and consultation before any further action is taken.
While the suspension lingers, there are indications that unsafe termination of pregnancy rages on, with its ripple effects. Just as it happened to Ms David’s relative, who departed to the great beyond leaving three children.
This report was facilitated by Women Advocate Research and Documentation Center (WARDC) as part of the Memorial Campaign on Ending Preventable Deaths from Unsafe Abortion in Lagos State. Series 1.
