Out of the Shadows: Saving Women’s Lives From Unsafe Abortion in Lagos State is an ENGAGE multimedia production that outlines progress toward safe abortion in Lagos state, barriers to ensuring access to safe abortion, and steps that policymakers and decisionmakers can take to improve access to safe abortion within the full extent of the law.

Restrictive abortion laws, prohibitive costs, poor access to safe health services, and intense social stigma are barriers that prevent women from accessing safe and legal abortion. Estimates show that unsafe abortions account for roughly 5,000 maternal deaths every year in Nigeria, or on average, 14 maternal deaths each day. Unsafe abortions are also costly to women and the health care system. Poorer women, less educated women, and rural women are particularly affected by these challenges.

Recently, the Lagos Ministry of Health began disseminating the 2011 Criminal Code—which allows for legal abortion to protect the physical health and life of a woman—and required that safe abortion services be provided within the full extent of the law. Opportunities also exist to adopt the nationally approved clinical guidelines on safe abortion for legal indications and the 2015 Violence Against Persons Prohibition (VAPP) Act. The VAPP Act protects girls, women, and marginalized communities from abuse, and ensures comprehensive medical services for victims of rape and incest.

Developed with the input of advocates, medical and legal experts, and the Lagos State Ministry of Health, this resource makes the case for (1) public and private health facilities to operate within the full extent of the law, (2) adapting the VAPP act, and (3) pushing forward new legal and health system reforms. In taking these steps, Lagos can set an example for the rest of the country by improving access to safe abortion and averting preventable deaths.