Author's details
- Blessing Ime Eshiet
- MBBS
- Resident doctor Obstetrics & Gynaecology, Maitama District Hospital, Nigeria | Medical/Health Writer.
Reviewer's details
- Dr Austin Okoro Chigozie
- MBBS, MWACS, MPH, FWACS
- Consultant Obstetrician and Gynaecologist. Evercare Hospital. Lekki. Nigeria
- Date Published: 2025-11-29
- Date Updated: 2025-11-29
Understanding Abortion: A Simple Guide to Safe Care in Sub-Saharan Africa
Abortion means ending a pregnancy before the baby can survive outside the womb.
There are two main types:
- Spontaneous abortion (miscarriage): when the pregnancy ends naturally.
- Induced abortion: when the pregnancy is ended on purpose, either for health reasons or personal choice.
Knowing how to get safe abortion care is very important. Unsafe abortions cause many preventable deaths and illnesses among women in Sub-Saharan Africa. This guide explains safe methods, what to expect, and how to protect your health and rights.
📖 What Is Abortion?
According to the World Health Organization (WHO), abortion means ending a pregnancy 20 weeks (about 5 months).
Women may seek an abortion for many reasons — such as:
- A failed contraceptive (family planning) method
- Health risks to the mother
- Serious problems with the baby
- Pregnancy that is unwanted or not planned
👉 Key point: Understanding the types of abortion helps you make safe, informed decisions about your health.
💊 Safe Abortion Methods
- Medical Abortion (Using Medicines)
This method uses medicines to end a pregnancy. It works best in the first 12 weeks. You may take them at home or in a clinic, depending on the laws and services in your area.
You will likely have cramping, bleeding, and passing of pregnancy tissue, which are normal parts of the process.
Because access to medicines and trained providers differs across African countries, it’s important to use quality-approved drugs and seek help from a qualified healthcare worker.
- Surgical Abortion
This is done by a trained health worker in a clinic or hospital. The method depends on how far the pregnancy has gone:
- Vacuum aspiration: often used for early pregnancies (up to about 12 weeks).
- Dilation and Evacuation (D&E): used for later pregnancies. The doctor gently opens the cervix and removes the pregnancy tissue.
These procedures are safe when done by trained professionals in clean, equipped facilities.
👉 Key point: Either medical or surgical, abortion is safest when done by qualified health professionals.
📋 Preparing for Safe Abortion Care
Before having an abortion, you should have:
- Counseling: to discuss your options, risks, and what to expect.
- Pregnancy test or ultrasound: to confirm how many weeks pregnant you are.
- Health check: to review your medical history (e.g., heart problems, bleeding issues).
- Lab tests: such as blood tests and screening for infections.
✅ Tip: Always confirm that your provider is licensed and the clinic follows medical safety standards.
🧾 What to Expect During and After Abortion
- Where it happens:
- Medical abortion may partly happen at home (with follow-up).
- Surgical abortion is done in a clinic or hospital.
- Common side effects:
- Bleeding and cramping
- Nausea or mild fever
- Warning signs – seek medical help immediately if you have:
- Heavy bleeding (soaking more than two pads per hour)
- High fever or chills
- Severe abdominal pain
- Foul-smelling discharge
- Feeling very weak or faint
- Follow-up:
A check-up after 1–2 weeks ensures the abortion is complete and you’re recovering well.
⚠️ Unsafe Abortion: A Serious Health Problem
- In Sub-Saharan Africa, unsafe abortions cause thousands of preventable deaths every year.
- According to WHO and the Guttmacher Institute:
- Around 77% of abortions in the region are unsafe.
- 15,000 women die each year from unsafe procedures.
Unsafe abortions are those done:
- By untrained people
- With unapproved medicines or objects
- In unclean environments
These can cause:
- Heavy bleeding or infection
- Infertility (difficulty having children later)
- Long-term illness or emotional trauma
👉Key points: Restrictive laws, stigma, and lack of access to proper care make unsafe abortion a major public health issue.
⚖️ Abortion Laws and Ethics in Sub-Saharan Africa
Laws differ from country to country:
- Some, like South Africa, Cabo Verde, Angola, and São Tomé & Príncipe, allow abortion by choice within certain limits.
- In most countries, abortion is allowed only in special cases — for example, if the pregnancy threatens the mother’s life, or results from rape or incest, or if the baby has serious abnormalities.
All women deserve:
- Clear information
- Respectful, confidential counseling
- Safe, legal care where permitted
👉 Key point: Ethical abortion care means respecting women’s rights, privacy, and dignity.
💬 Why Safe Abortion Care Matters
Safe abortion saves lives. It prevents serious illness, infertility, and death caused by unsafe procedures.
It also supports women’s physical, emotional, and social well-being.
Abortion is part of comprehensive reproductive healthcare.
When it is safe, legal, and supported, women can make informed choices about their health and future.
If you or someone you know is considering an abortion:
- Always seek advice from a qualified healthcare provider.
- Never use unapproved medicines or go to untrained people.
- Ask about counseling and follow-up care.
Every woman deserves safe, respectful, and compassionate care.
- SRHR.org. Abortion Care Guideline: Chapter 3—Abortion Methods and Management. Accessed October 2025. https://srhr.org/abortioncare/chapter-3/abortion-3-4/
- SRHR.org. Medical Management of Induced Abortion: Recommendations 27–30. Accessed October 2025. https://srhr.org/abortioncare/chapter-3/abortion-3-4/medical-management-of-induced-abortion-recommendations-27-30-3-4-2/
- Guttmacher Institute. Abortion in Sub-Saharan Africa: Fact Sheet. Updated December 2020. Accessed October 2025. https://www.guttmacher.org/fact-sheet/abortion-subsaharan-africa
- Guttmacher Institute. From Unsafe to Safe Abortion in Sub-Saharan Africa. Published 2020. Accessed October 2025. https://www.guttmacher.org/report/from-unsafe-to-safe-abortion-in-subsaharan-africa
- World Health Organization. Abortion: Fact Sheet. Updated May 17, 2024. Accessed October 2025. https://www.who.int/news-room/fact-sheets/detail/abortion
- World Health Organization. Abortion Care Guideline: Methods and Regimens. Geneva: World Health Organization; 2022. Accessed October 2025. https://www.who.int/publications/i/item/9789240039483
- WHO Regional Office for Africa. Sexual and Reproductive Health: Preventing Unsafe Abortion. Updated 2023. Accessed October 2025. https://www.afro.who.int/health-topics/sexual-and-reproductive-health
- Thomas HL, Alzouma S, Oumarou S, et al. Postabortion care availability, readiness, and accessibility in Niger in 2022: results from linked facility-female cross-sectional data. BMC Health Serv Res. 2023;23:1171. doi:10.1186/s12913-023-10107-4