14th October 2009

When it comes to the issues of contraceptive use and abortion ‘all too often emotion triumphs science,’ says Dr Sharon L. Camp, President of the Guttmacher Institute, speaking in London.

The new report launched by the institute uses reliable resources to highlight the global trend of safe and clandestine abortions.

Between 1995 and 2003, the number of abortions fell from approximately 46 million per year to 42 million.

This is a remarkable feat as the change is substantial, despite a large global population increase.

The use of contraception worldwide has increased and is thought to have greatly contributed to this decline.
Unsafe abortion

Laws against abortion are being liberalized around the world. Abortions have become safer and easier to access for many women. However, Dr Camp believes that in spite of these positive developments it is ‘significant and tragic’ that the number of unsafe abortions has not yet declined.

In many developing countries in Africa and Latin America, where restrictive abortion laws remain in place, women have no alternative but to have clandestine or self-induced unsafe abortions.

Statistics show that for every one safe abortion, 2 unsafe abortions occur.

Dr Kelly Culwell, Senior Abortion Advisor from IPPF, agrees that although the report highlights many ‘encouraging’ changes, ‘the law [in banning abortion] is not enough’ if unsafe abortions are to be reduced.

Global contrasts

Even though the issue of unsafe abortion affects many women in the developed world, with 20 million unsafe abortions occurring annually, it is ‘poor, adolescent, rural women who suffer the most,’ says Dr Culwell.

Dr Akinrinola Bankole, Director of International Research for Guttmacher, agrees that ‘poor women are worst affected due to lack of information as well as lack of means.’

In Uganda, while 83% of urban women obtain treatment after an unsafe abortion, only 51% of rural women do so.

Developing countries, which lack the means to provide services or qualified personnel to perform abortions, are also likely to have restrictive laws which make it likely for women to choose unsafe abortions.

Countries such as India and South Africa have liberal laws towards abortion but have uneven access to services.

After the abortion law was liberalized in South Africa in 1996, there was a 50% decline in deaths due to unsafe abortions, demonstrating the change that can occur if more countries followed this example.

Contraception and preventing unsafe abortions

Dr Camp says that meeting the ‘need for contraceptives’ and investing in ‘contraceptive research’ would help prevent unsafe abortions. ‘Funding for family planning has dropped or remained static, despite a growing population that needs these services.’

Unsafe abortions pose a host of ‘severe long-term complications’ faced by ‘4 in 10 women in developing countries,’ reports Dr Bankole.

‘Every year 70,000 women die due to complications from unsafe abortions and 220,000 children are left motherless.’

The health problems women face after unsafe abortions are expensive to treat, especially for developing countries with fragile economies. In Nigeria, the cost of providing contraceptives is USD $4.8 million compared to USD $19 million to treat women suffering from complications after clandestine abortions.

The report highlights three main goals that need to be achieved to reduce unsafe abortions:

• expanding access to contraceptives and family planning
• expanding access to legal abortions
• improving post-abortion care to reduce death or complications

Dr Culwell insists that though ‘you can never eliminate the need for abortion, you can reduce it to a relatively low level’ and ensure that no one has to resort to unsafe abortions.