On October 23, 2025, two very different corners of the world found themselves at the center of the ongoing debate over abortion laws and the lives of women: Tennessee, USA, and Lagos, Nigeria. While their legal frameworks and cultural backdrops differ dramatically, both regions are grappling with the consequences of restrictive abortion policies, the confusion sown by vague legal exceptions, and the mounting toll on women’s health.
In Tennessee, a three-judge panel delivered a significant blow to Governor Bill Lee’s administration by ruling against the state’s attempt to end a lawsuit challenging the state’s near-total abortion ban. According to Tennessee Lookout, the lawsuit was initially brought in 2023 by a group of Tennessee OB-GYNs and women who had suffered serious medical complications during their pregnancies. The American Medical Association later joined the case, underscoring the gravity of the issues at stake for both patients and medical professionals.
The roots of the lawsuit trace back to Tennessee’s 2022 abortion ban, enacted in the aftermath of the Supreme Court’s decision to overturn Roe v Wade. The law, and its subsequent amendments in 2023 and 2024, allowed only extremely limited exceptions for abortion—mainly when necessary to prevent a pregnant woman’s death or to avoid “serious risk of substantial and irreversible impairment of a major bodily function.” Notably, the ban does not contain exceptions for victims of rape or incest, nor for pregnancies involving fetal abnormalities. In 2023, lawmakers added exceptions for molar and ectopic pregnancies, but the medical community remained deeply uneasy about the law’s vagueness.
As the legal battle unfolded, the court temporarily blocked Tennessee’s medical board from disciplining doctors who provided emergency abortions, but declined to halt criminal prosecution of physicians, citing its lack of authority to do so. The panel also clarified four specific pregnancy-related conditions that would qualify as “medical necessity” exceptions: previable preterm premature rupture of membranes, inevitable abortion prior to viability, fatal fetal diagnoses causing maternal health conditions such as severe preeclampsia and mirror syndrome, and fatal fetal diagnoses that could lead to infection risking uterine rupture or loss of fertility.
Lawmakers responded in 2025 by amending the abortion ban to explicitly incorporate these four conditions. However, they also made it clear that mental health diagnoses would not qualify as exceptions, a decision that the court’s ruling last week now allows plaintiffs to challenge. The judges—Chancellor Patricia Head Moskal, Judge Sandra Donaghy, and Chancellor Kasey Culbreath—wrote that the plaintiffs “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk in violation of their constitutional right to life.” They added, “The changes made by the 2025 Amendment do not significantly alter the status of this case,” allowing the lawsuit to proceed.
In a separate but related move, the panel granted the plaintiffs the right to subpoena internal documents from the Tennessee General Assembly, the governor, and legislative committees, as well as data from the Department of Health covering abortions, maternal mortality, and any unofficial guidance given to health providers since 2022. The state quickly filed an emergency motion to appeal this order, arguing that it raises a “momentous separation-of-powers question – pitting the state judiciary against the other two branches – that should be decided by the appellate courts.” The Center for Reproductive Rights, a New York-based law firm, represents the group challenging the law.
Meanwhile, thousands of miles away in Nigeria, the Leadership Initiative for Youth Empowerment (LIFE) is sounding the alarm about the dire public health consequences of abortion stigma and restrictive laws. LIFE has launched its “Advocacy and Training Guide for Health Workers,” urging Nigerians to view abortion not as a moral failing but as a public health emergency and a fundamental human rights issue. According to LIFE, more than 1.25 million abortions occur annually in Nigeria, with over half performed by untrained providers—making them unsafe and often deadly. The World Health Organisation estimates that unsafe abortions contribute to up to 13% of maternal deaths globally, with Nigeria carrying a disproportionate burden.
Under Nigerian law, abortion is permitted only to save the life of the pregnant woman—a provision that remains poorly understood by both the public and many healthcare professionals. According to the Guttmacher Institute and LIFE, this legal ambiguity, combined with cultural and religious stigma, leaves countless women in fear and isolation. During a community session in Oshodi-Isolo, a 22-year-old woman shared, “I didn’t know where to go. I feared being judged, even by nurses.” This sentiment is echoed by many Nigerian women, especially young and low-income individuals who are most affected by misinformation and limited access to safe care.
LIFE’s guide aims to tackle these challenges on several fronts: clarifying the law, challenging stigma through storytelling and dialogue, training health workers in empathy and reproductive rights, and advocating for policy change. A 2023 study by IPAS Nigeria found that 38% of health workers in Lagos felt uncomfortable providing post-abortion care—even when legally allowed—due to fear of community backlash and religious pressure. Dr. Chinwe Okafor, a public health specialist and LIFE member, emphasized that the attitudes of health workers often determine whether a woman receives safe care or is forced to turn to unsafe alternatives. “Compassion should be a clinical best practice, not just a moral choice,” she urged.
The guide also addresses the legal confusion that leaves both women and providers vulnerable. Funmi Adeyemi, a reproductive health lawyer, explained, “Nigeria’s abortion law, rooted in colonial-era penal codes, remains restrictive and ambiguous. Although termination is permitted to save a woman’s life, the law offers no clear definition of what constitutes a life-threatening condition. Fear of prosecution shouldn’t stand between a woman and her doctor.”
The need for education is acute: a 2022 report by the Nigerian Urban Reproductive Health Initiative revealed that 61% of women in Lagos had never received formal education on reproductive rights, and 47% believed abortion was always illegal. Dr. Ayoade Olatunji, a reproductive health researcher at the University of Ibadan, called for a new approach: “Abortion is a health issue, not a character judgment.” He recommended integrating reproductive rights education into secondary schools and medical training to normalize informed, compassionate care.
Both Tennessee and Nigeria are now at pivotal moments. In Tennessee, the courts are wrestling with the boundaries of the law and the realities facing pregnant women and their doctors—particularly when life and health hang in the balance. In Nigeria, advocates are pushing for a shift from moral panic to evidence-based public health policy, hoping to stem the tide of preventable deaths and suffering.
As debates rage on in legislatures, courtrooms, and communities, the lived experiences of women—often silenced by stigma, fear, or legal uncertainty—remain at the heart of the issue. The coming months will reveal whether either region can move toward laws and practices that protect women’s health and dignity, or whether the status quo will continue to put lives at risk.
