Nigeria

Motherhood still entails serious risks in Nigeria, due to religious beliefs, poverty, gender discrimination, and limited access to health care. It is estimated that two-thirds of all births are high risk because of the mother's age, the number of times a mother has given birth to a child, or the spacing of births. The country has one of the highest maternal mortality rates in the world, second only to India. It is estimated that 60,000 Nigerian women die each year because of pregnancy-related complications. This figure amounts to 10 percent of the world's pregnancy-related deaths. The country's maternal mortality ratio is estimated at 800 deaths per 100,000 live births.

Because Nigerian cultures and religious beliefs continue to favor large families and early marriages, women have very limited access to services for family planning and reproductive health. The total fertility rate in 2003 was of 5.7 children per woman. Although this represents a slight decrease compared to 1990 (6 children per woman), the country is the most populous in sub-Saharan Africa; its population of 140 million is growing at a rate of 3.2 percent a year. Such growth effectively hinders any effort to raise standards of living and health for the Nigerian population, and nine out of 10 Nigerians live on less than $2 per day.

The use of contraception among married women aged 15–49 has doubled between 1990 and 2003, from 6 percent to 12 percent. However, this number is still quite low and is made up mainly of traditional methods. The use of contraception among sexually active unmarried women of the same age [Page 921]has risen from 38 percent in 1990 to 47 percent in 2003. Within this group, the use of modern methods of contraception has almost tripled over the 13-year period, from 12 percent to 33 percent. Yet, while the use of contraception has increased, so has the percentage of births that were either mistimed or unwanted, from 12 percent to 16 percent.

Large families and high maternal mortality contribute to Nigeria's poverty. These women boost their income producing cowpeas.

One of the major causes for maternal deaths is unsafe abortion. Because many women undergoing an unsafe abortion die before reaching a hospital, it is difficult to quantify the number of deaths due to this practice. However, official statistics show that at least 3,000 women who receive medical treatment for unsafe abortion die every year. As in other developing countries, maternal deaths are due to both direct causes such as hemorrhages, infections, eclampsia, and obstructed labor, and indirect causes such as diseases that are not the result of pregnancy, but are high risk for death (malaria, hepatitis, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and heart diseases).

Although the proportion of women receiving health care from a trained provider at delivery has increased from 30 percent in 1990 to 37 percent in 2003, the percentage is still low, even when compared to other west African countries. In addition, the proportion of women who do not receive prenatal care from a trained provider has disappointingly not improved between 1990 and 2003, remaining at more than 40 percent. These data show that, in spite of the commitment of the Nigerian government to reduce maternal mortality by 75 percent by 2015, policies to reach such a goal lack implementation and have not been adequately funded. The majority of programs on safe motherhood have actually been funded by nongovernmental organizations though international donations.

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