New data show progress in addressing unsafe abortion – but too many women still die

Thursday, December 2, 2010

The WHO estimates underscore that far too many preventable deaths and injuries of women from unsafe abortion still occur.

New estimates from the World Health Organization indicate a substantial drop in the number of women dying from unsafe abortion. The estimates confirm that global efforts to make contraception, safe abortion and postabortion care more accessible to women are working. But they also underscore that far too many preventable deaths and injuries of women from unsafe abortion still occur and that women in developing countries remain especially susceptible.

In the current issue of Reproductive Health Matters, Iqbal Shah and Elisabeth Ahman estimate that the number of women who died from unsafe abortion decreased by about one-third -- from 67,000 to 47,000 – between 2003 and 2008. The global number of unsafe abortions increased from 19.7 million to 21.6 million during the same period, primarily reflecting growth in the number of women of reproductive age (15-44) worldwide. The global unsafe abortion rate (the number of unsafe abortions per 1,000 women of reproductive age) remained relatively unchanged.

“These new data show that efforts to address unsafe abortion are working,” said Janie Benson, Ipas Vice President and Director of Research and Evaluation. “More widespread availability of trained health care providers and WHO-endorsed safe abortion technologies, including manual vacuum aspiration and medical abortion, certainly have contributed to this encouraging trend.”  

Derived from review of thousands of hospital records, surveys and studies, the new figures highlight substantial declines in unsafe abortion rates in both Southern and Northern Africa – both of which include countries where contraceptive use is high and abortion is legally available on broad grounds. In addition, modest reductions in unsafe abortion rates were found in several sub-regions, including South-eastern and South-central Asia, with large populations.

The new estimates also reveal a continuing dramatic contrast between developed and developing countries in terms of access to comprehensive reproductive health care, including safe abortion. In 2008, nearly all the world’s unsafe abortions – 21.2 million out of 21.6 million – took place in poor countries. The unsafe abortion rate was highest in sub-Saharan Africa, where most countries have very restrictive abortion laws. In that region, the researchers estimated, 31 unsafe abortions occurred per 1,000 women of reproductive age, compared to only two in Europe and a negligible number in North America.

“The continuing disparity between rich and poor nations in women’s access to safe abortion is unconscionable, and its results are tragic,” Benson said. “In addition to those who die, millions of women suffer serious complications from unsafe abortion every year. All those deaths and injuries are preventable, and far too many still occur, especially in poor countries.

“As Shah and Ahman note, modern abortion techniques are among the safest clinical interventions in health care today. By ensuring that women everywhere can benefit from them, we can save even more lives.”