About 25 million unsafe abortions, accounting for 45 per cent of all abortions, occurred every year from 2010 to 2014 worldwide, with 97 per cent of those unsafe procedures occurring in developing countries in Africa, Asia and Latin America, a new United Nations study has found.
“Increased efforts report are needed, especially in developing regions, to ensure access to contraception and safe abortion,” says Bela Ganatra, a scientist and the lead author of the study, The Lancet, released today by the World Health Organization (WHO) and the Guttmacher Institute.
“Despite recent advances in technology and evidence, too many unsafe abortions still occur, and too many women continue to suffer and die,” added Ms. Ganatra of WHO's Department of Reproductive Health and Research.
For the first time, the study includes sub-classifications within the unsafe abortion category as less safe or least safe. The distinction allows for a more nuanced understanding of the different circumstances of abortions among women who are unable to access safe abortions from a trained provider.
The risk of severe complications or death is negligible if procedures follow WHO guidelines and standards. About 55 per cent of all abortions from 2010 to 2014 were conducted safely.
Some 31 per cent of abortions were “less safe,” meaning they were either performed by a trained provider using an unsafe or outdated method such as “sharp curettage,” or by an untrained person using a safe method like misoprostol, a drug that can induce an abortion.
About 14 per cent were “least safe” abortions provided by untrained persons using dangerous methods, such as introduction of foreign objects and use of herbal concoctions. Complications from “least-safe” abortions can include a failure to remove all of the pregnancy tissue from the uterus, haemorrhage, vaginal, cervical and uterine injury, and infections.
The study also found that in countries where abortion is completely banned or permitted only to save the woman's life or preserve her physical health, only one in four abortions were safe; whereas, in countries where abortion is legal on broader grounds, nearly 9 in 10 abortions were done safely. Restricting access to abortions does not reduce the number of abortions.
Most abortions that take place in Western and Northern Europe and North America are safe. These regions also have some of the lowest abortion rates.
The proportion of abortions that were safe in Eastern Asia, including China, was similar to developed regions. In South-Central Asia, however, less than one in two abortions were safe. In Latin America, only one in four abortions were safe. Less than one in four abortions in Africa, excluding Southern Africa, were safe.