Fewer Women Dying From Unsafe Abortion Though African Women Still Most At Risk
A new report from the World Health Organization confirms a significant decline in the number of deaths from unsafe abortion worldwide. However, the data show that women in least-developed countries and sub-Saharan Africa bear a disproportionate burden.
Unsafe abortion continues to be one of the primary causes of maternal mortality, causing 13 percent of pregnancy-related deaths worldwide. WHO researchers estimate that the number of women who died from unsafe abortion decreased by 16 percent — from 56,000 to 47,000 — between 2003 and 2008. The total number of unsafe abortions increased, however, from 19.7 million to 21.6 million during the same period, reflecting growth in the number of women of reproductive age (15-44).
“These new data show that efforts to address unsafe abortion are working,” says Janie Benson, Ipas vice president for research and evaluation. “When women have access to trained health-care providers and safe abortion technologies, within a supportive legal environment, fewer women die.”
Data presented in the report underscore that in countries with liberal abortion laws, and greater access to contraception, unsafe abortion is low to nonexistent. By contrast, in countries where abortion laws are most restrictive and women have low rates of contraceptive use, induced abortion rates are higher overall, and unsafe abortion poses a particular health risk for women.
Countries in middle and east Africa demonstrate this phenomenon: overall the contraceptive prevalence rates are low (19 and 26 percent, respectively), abortion laws are highly restrictive (usually only to protect a woman’s life or health) and the unsafe abortion rates are 36 abortions per 1000 women aged 15-44. As a result, more than one-third of all deaths from unsafe abortion worldwide take place in these two sub-regions.
Young women are also particularly affected by unsafe abortion, especially in Africa where nearly half of all women of reproductive age are between the ages of 15 and 24. Cultural attitudes that disapprove of adolescent sexual activity contribute to a severe lack of access to reproductive health information and services. Young women are therefore less likely to be able to prevent pregnancy, putting them at the greatest risk for unsafe abortion.
The new report indicates some bright spots in Africa, as well, however. The proportion of maternal mortality caused by unsafe abortion in southern Africa is lower than in any other part of that region. South Africa legalized abortion in 1994; as a result of its efforts to make contraception and safe abortion care more widely available, the rate of maternal mortality caused by unsafe abortion has declined by roughly 90 percent. In Tunisia, in North Africa, abortion has long been legal and accessible, and rates of unsafe abortion are also significantly lower.
Globally, the rate at which women seek unsafe abortions (the number of unsafe abortions per 1,000 women of reproductive age) remained relatively unchanged. “Women around the world continue to seek abortions at the same rate they did five years ago; however, many are able to access safe abortion care now. Though without continuing access to safe abortion and contraception, the numbers of unsafe abortions will likely increase. The work isn’t done yet and won’t be until no woman dies from complications of unsafe abortion,” adds Benson.