Women's health * Healthy living

Global increase in unsafe abortions

Global increase in unsafe abortions Women in developing world most at risk

The global abortion rate has levelled after a long period of decline, while the number of women having unsafe abortions has risen, a study found.

Between 1995 and 2003, the overall number of abortions worldwide fell from 35 to 29 per 1,000 women aged between 15 and 45, according to the research.

But in 2008, the rate remained virtually unchanged at 28 abortions per 1,000 women, the researchers reported in The Lancet journal.

Despite the decline in the abortion rate, the actual number of abortions worldwide increased from 41.6 million in 2003 to 43.8 million in 2008, due to the growing global population.

Since 2003, the overall number of abortions fell by 0.6 million in the developed world, but increased by 2.8 million in the developing world.

The research, conducted by the Guttmacher Institute in New York City, also found that half of all abortions worldwide are unsafe, and nearly all take place in the developing world.

Unsafe abortion is defined by the WHO as "a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both".

Some 49 per cent of procedures carried out in 2008 were deemed to be unsafe compared with 44 per cent in 2003.

Nearly all (97 per cent) abortions in Africa in 2008 were classed as unsafe compared with 65 per cent in south central Asia and 13 per cent in Eastern Europe. Almost all (more than 99 per cent) of abortions in North America and the rest of Europe were deemed to be safe.

Each year approximately 8.5 million women in developing countries experience abortion complications serious enough to require medical attention, and three million of them do not receive the needed care, the researchers said.

The researchers noted that abortion rates were higher in regions where "restrictive abortion laws" prevailed. In Latin America, where abortion is illegal in most countries under most circumstances, the abortion rate was 32 per 1000 women of childbearing age compared with 12 per 1,000 in Western Europe.

They also pointed out that the levelling off in the abortion rate has also coincided with a stall in the uptake of contraception.

Dr Gilda Sedgh, who led the study, said: "The declining abortion trend we had seen globally has stalled, and we are also seeing a growing proportion of abortions occurring in developing countries, where the procedure is often clandestine and unsafe. This is cause for concern.

"This plateau coincides with a slowdown in contraceptive uptake. Without greater investment in quality family planning services, we can expect this trend to persist."

Dr Richard Horton, editor of The Lancet, said: "These latest figures are deeply disturbing. The progress made in the 1990s is now in reverse. Promoting and implementing policies to reduce the number of abortions is now an urgent priority for all countries and for global health agencies, such as WHO.

"Condemning, stigmatizing, and criminalizing abortion are cruel and failed strategies. It's time for a public health approach that emphasizes reducing harm - and that means more liberal abortion laws."

This article was published on Thu 19 January 2012

Image © catherina holder - Fotolia.com

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