According to a new report from a sexual health organization, worldwide rates of abortion and unintended pregnancy are falling in both the developed and the developing world, primarily due to increased use of contraceptives, but significant disparities remain in that in the developed world abortions are mainly carried out safely and legally, whereas in the developing world they are not: worldwide 70,000 women a year die as a result of unsafe, illegal abortions.

Released in London on Tuesday, the report Abortion Worldwide: A Decade of Uneven Progress comes from the US-based Guttmacher Institute, which carries out social science research, policy analysis and public education to raise public awareness and encourage informed debate on matters related to sexual and reproductive health.

Worldwide, the number of abortions fell from an estimated 45.5 million in 1995 to 41.6 million in 2003. While both developed and developing countries show the same falling trend, the decline is faster in the developed world. Rates of decline vary more widely in the developing world, with Africa lagging behind the rest, said the report authors.

The report shows that the fall in numbers of abortions worldwide is in line with a global trend toward more liberal abortion laws. 19 countries have significantly relaxed laws restricting abortions since 1997, compared to three countries that have substantially tightened legal restrictions.

The report also highlights that:

  * 40 per cent of the women in the world live in countries with highly restrictive abortion laws, nearly all in the developing world.

  * For example 97 per cent of women of child-bearing age in Latin America, and 92 per cent in Africa, live in countries with highly restrictive abortion laws.

  * These proportions have not changed much in the last 10 years.

  * While the incidence of abortion closely follows that of unintended pregnancy, it does not coincide with the legal status of abortion.

  * Instead, abortion rates appear to be about the same in regions where it is broadly legal and regions where it is highly restricted.

  * But what is different is safety: illegal abortions carried out secretly cause significant harm to women, especially in developing countries, said the authors.

Sharon Camp, president and CEO of the Guttmacher Institute told the press that:

“The progress made during the past decade in increasing contraceptive use and reducing the need for abortion is fundamentally good news.”

“The world is moving in the right direction,” she added. However, she also pointed out that “we still have two widely disparate realities. In almost all developed countries, abortion is safe and legal.”

“But in much of the developing world, abortion remains highly restricted, and unsafe abortion is common and continues to damage women’s health and threaten their survival,” said Camp.

About 5 million women are treated every year for complications arising from unsafe abortions, while 3 million who need it don’t get any treatment, said the report, which also gives figures and trends about unintended pregnancy rates and contraception:

  * Worldwide the rate of unintended pregnancy fell from 69 per 1,000 women aged 15 to 44 in 1995 to 55 per 1,000 in 2008.

  * The proportions of married women and sexually active single women using contraception have both gone up.

  * The proportion of married women using contraception in 1990 was 54 per cent: in 2003 this was 63 per cent.

  * However, these figures varied widely region by region: while it estimated that 71 per cent of married women in Latin America and the Caribbean were using contraceptives in 2003, only 28 per cent of married African women were doing so.

  * In 2002 to 2007, nearly 25 per cent of married women in Africa who needed contraception were not able to get it, compared with 10 to 13 per cent in Asia, Latin America and the Caribbean.

Camp said there was strong and growing evidence that giving women the power to decide when to become pregnant and how many children to have significantly reduced unintended pregnancy and the need for abortion.

“Addressing the unmet need for contraception, which remains very high in many parts of world, is critical in promoting the well-being of women and their families,” she urged.

“This is especially true in those parts of the developing world where modern contraceptive use is still low and mortality related to clandestine and unsafe abortion is high,” she added.

The report recommends expanding access to modern contraceptives, family planning, legal and safe abortions to women who need them, and that caring for women after they have had an abortion should also be more extensive as this would reduce maternal deaths and complications from unsafe abortions.

“Too many women are maimed or killed each year because they lack legal abortion access,” said Camp.

“Abortion Worldwide: A Decade of Uneven Progress.”
Susheela Singh, Deirdre Wulf, Rubina Hussain, Akinrinola Bankole and Gilda Sedgh.
Guttmacher Institute, 13 October 2009.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today