The Sexual and Reproductive Health Challenges of Young Women in Northern Nigeria

Dr. Oluseyi Akinola is a physician from Nigeria who has worked in rural and urban health facilities and is passionate about the sexual and reproductive health of young women. She is presently completing a master’s degree in public health, majoring in maternal and child health at the Gillings School of Global Public Health, University of North Carolina, Chapel Hill.

Nearly one third of Nigeria’s total population is between the ages of 10 and 24 years. The Northern region of the country accounts for 42% of the nation’s 15- to 19-year-old girls, many of whom are among the least educated in the country. Sadly, these girls account for 71% of all births occurring in this age group and have a fertility rate a full two points higher than Nigeria’s average fertility rate of 5.2.

The events of April 14-15, 2014 brought global attention to some of the challenges young women face in the Northern region. On this night, approximately 274 teenage girls were kidnapped from their secondary school dormitories while sleeping. The majority of these girls were ages 16-18. They have not yet been found, and they face the potential of rape, subsequent pregnancies, sexually transmitted infections, and forced marriages. This horrific kidnapping shines a spotlight on the challenges faced by millions of voiceless, faceless adolescent girls in Northern Nigeria.

As a doctor working in several maternity centers in Nigeria, I have witnessed first-hand these young women’s struggles. For example, only married women have access to contraception in the general hospitals, which increases the chances of unmarried girls having unplanned, unwanted pregnancies and becoming infected with HIV and other STIs. When they do become pregnant, the choice of terminating the pregnancy safely is not theirs to decide; abortion is illegal and a crime punishable by up to 14 years imprisonment unless it is performed to save the life of a pregnant woman. 

The plight of the kidnapped Nigerian school girls has rightly engendered global outrage; however, millions more Nigerian women suffer and die out of the limelight every day, for lack of access to safe abortion, educational opportunities, contraception, and proper health care.

I will share the story of one 15-year-old girl, Aisha, who was brought unconscious into the emergency room of the hospital where I offered ob-gyn services. She had bled profusely as a result of unsafely terminating an unwanted pregnancy and being too afraid to let her relatives know what she had done. Despite our battle to save her life, she died about 30 minutes after arriving at the hospital. Many young women I came across in practice suffered similar dire consequences. Sometimes we were able to save their lives, other times we were not so fortunate.

I also worked with girls who did not make Aisha’s choice and did decide to carry their pregnancy to term. I watched as these girls had to drop out of school because of gross stigmatization and lack of a child care system that would allow them to continue their education.

Adolescent sexual and reproductive wellness can only be achieved when these youth have access to a safe education and are free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV, all forms of sexual violence and coercion, maternal morbidity (e.g., obstetric fistula), and maternal death.