BMJ Essay, Open access
23 July 2026
Amos M Makelele, Baraka Marthe Kalyoko, Agness Shimilimo, Million Teklay Solomon, Simon Binezero Mambo, Iacane Bampoque, Gbolahan O Obajimi

Abortion policies in DRC and Nigeria: public health impacts
The Democratic Republic of Congo (DRC) and Nigeria, two of Africa’s largest and most populous nations, present unique yet interconnected narratives on abortion law and women’s reproductive rights. Both countries grapple with alarmingly high maternal mortality rates, a significant proportion of which is driven by complications from unsafe abortions.1 These challenges, rooted in restrictive legal frameworks, inadequate healthcare infrastructure and sociocultural barriers, highlight the critical need for reform in reproductive health policies and practices.

In the DRC, maternal mortality stands at an estimated 427 deaths per 100 000 live births.2 In Nigeria, the case is even worse, with maternal mortality rates reaching 993 deaths per 100 000 live births.3 One of the significant factors for these figures is unsafe abortion, especially in rural and underserved areas where access to quality reproductive healthcare remains restricted. According to the WHO, unsafe abortion contributes to 13% of global maternal deaths,4 but in Sub-Saharan Africa, it accounts for over 30%.5 These numbers highlight the significance of unsafe abortion as a public health crisis in the region, which demands urgent attention and action.

Continued: https://gh.bmj.com/content/11/7/e020673