A teenage girl sat hunched on a chair in a small, sterile consulting room at Umaru Shehu Specialist Hospital in Maiduguri, Nigeria. Her hands trembled as tears streamed down her face. Her eyes were red and swollen. Words tumbled out as she pleaded with the doctor, explaining her fears of an unplanned pregnancy and a future she felt unprepared for.
During the first three years of gynecologist Dr. Shiktira Kwari’s practice, several other women approached her with the same request: Please perform an abortion.
“I always use that opportunity to talk to them about God’s plan for our lives and what the implication of their action [aborting the baby] is going to be,” Kwari said. “I always let them know that I have a moral and a personal belief against termination of pregnancy. I cannot offer them [an abortion], and I cannot also refer them to where they can get one.”
Kwari’s Christian faith influences not only her personal life but also how she conducts her medical practice. In addition to refusing to offer abortions, she counsels the teens and married women she cares for at Asokoro District Hospital Abuja.
“The number of women approaching me now has reduced drastically because they already know my stance,” she said.
But Kwari said she’s concerned about the efforts of pro-choice organizations to create more cultural acceptance and access to abortion in Nigeria. She believes pro-choice efforts have intensified with the rise of social media. Both Nigerian and international feminists have become more assertive with claims that Nigeria’s laws restricting abortion are against women’s rights.
In Nigeria, abortion is illegal except in cases when it may save the woman’s life, such as an ectopic pregnancy or eclampsia. Morally, though, Kwari doesn’t count those situations as abortions.
“Ectopic pregnancy is also life-threatening. … If you don’t do the surgery and remove the baby wherever it has implanted, that woman is going to die,” Kwari said. “So I cannot say, ‘Oh, I’m a Christian, I cannot do this,’ and then I’ll watch the woman die. So in situations like that, of course, we intervene. And that is acceptable by law.”
The law allows sentences of up to 14 years in prison for performing an illegal abortion and up to seven years for seeking one. Still, abortions are common, and the law is enforced inconsistently. Between 1.8 and 2.7 million women and girls seek abortions every year, often through unregistered abortion clinics. While cases of women charged with procuring an abortion are hard to find, authorities did recently charge a doctor and family member for giving a 10-year-old girl an abortion to cover up her sexual assault.
For years, International Planned Parenthood Federation affiliates and other pro-choice organizations have tried to influence changes to Nigeria’s abortion policies. Their efforts include influencing the nation’s health ministers to favor abortion rights.
In December 2024, Catholic activists with CitizenGO Africa protested efforts by Nigerian health ministers Mukhtar Yawale Muhammad and Osagie Ehanire to revise the penal code to allow more abortions. The activists criticized foreign nonprofits such as Ipas Nigeria Health Foundation for pressuring the Nigerian government to relax abortion laws. They also started a petition to expel International Planned Parenthood from Nigeria.
International nonprofits provide most of the financial support for efforts to legalize abortion in Nigeria. Last week, the Gates Foundation committed to spending most of $200 billion over 20 years on “Africa’s future,” including international family planning efforts. Marie Stopes International—an organization known for promoting abortion rights in Africa—received $30 million per year from USAID before a Mexico City Policy–based funding cut in 2017. International Planned Parenthood also lost funding during the cuts.
“These NGOS come with something that we need—like drugs, vaccines, family planning methods—but then underneath, of course, they have another motive,” Kwari said.
Efforts to legalize abortion have gained more traction after Women at Risk International launched the first “March for No Tolerance” in Lagos State in 2019 to campaign against sexual violence and support legal abortions.
In June 2022, the Lagos State government bowed to pressure and released a 40-page policy guidance document to “to provide safe and lawful abortion services within the ambit of the law.” Opposition from Protestant and Catholic leaders and laypeople resulted in the policy’s suspension within a few days. Pro-choice activists have continued to call for Governor Babajide Sanwo-Olu to reverse the suspension. They argue for “safe termination of pregnancy,” seeing themselves as opposing “powerful religious beliefs.”
Nigeria doesn’t have a cohesive pro-life movement—the Catholic church and individual Christians drive most efforts to keep abortion illegal.
“Nigerians, we are very religious people. We won’t want to be seen as outrightly in support of abortion,” Kwari said.
Pro-choice advocates use deaths from back-alley abortion and childbearing complications as reasons to legalize abortion. But one 2018 study concluded that abortion laws in Nigeria do not impact where women choose to go for abortions. Most maternal deaths result from treatable complications such as severe bleeding, infections, or eclampsia. And while complications from illegal abortions account for an estimated 6,000 women’s deaths each year—about 10 percent of Nigeria’s high maternal death rate—this number is down from 20,000 deaths in 2002.
Legalizing abortion also wouldn’t solve the country’s poor doctor-to-patient ratio. Nigeria has about one doctor for every 4,000–5,000 patients—well below the World Health Organization’s recommended one doctor for every 600 patients.
Kwari, like other Christians in Nigeria, has argued that liberalizing abortion laws would open the door to moral decay and worsen rather than reduce teen pregnancies, sexually transmitted infections, and drug abuse. Though Nigerian Christians tend to oppose abortion in cases of rape, church-run organizations advocate for stopping rape in the country and helping victims heal after assault.
“Abortion always leaves a scar,” she said. “It often leads to deeper vices until one is completely destroyed.”
To address issues such as teen pregnancy and STIs, Kwari uses the Health Week—a program common in Nigerian churches to educate members about topics such as disease prevention and maternal health—to present biblical teaching about abstinence and premarital sex.
Kwari told CT that a culture of life must begin in the church and family. She encourages Christian families to talk openly about premarital sex. These conversations can help counter peer pressure and social media influences that drive early sexual activity and abortion, she said.
“Children must be able to talk to their parents about everything and confide in them,” she said. “It is very dangerous for children to be left to discover this on their own.”
Once, a woman in church confided in Kwari that she had missed her period and was having marital difficulties. When a pregnancy test confirmed that she was pregnant, the woman cried and pled Kwari for an abortion. Kwari encouraged her to keep the baby and rely on God. While not everyone takes Kwari’s advice, this woman did—she moved to her parents’ house, gave birth, and later reunited with her husband. When Kwari met her again few months later, “She was joyful and committed to her child.”
Kwari attributed this to divine intervention.
“God’s Word is the most powerful truth we have,” she said, “so I’m really grateful to God that we still have that opportunity to use his Word.”
