Restrictive laws and a lack of access to contraception are implicated.
An international team of researchers have found that nearly half (49%) of all abortions performed worldwide in 2008 were unsafe, compared with 44% in 1995, despite a slight overall decline in the worldwide abortion rate.
|Figure. The girl in the framed photo, Lidia Esperanza Carpio, died from an unsafe abortion in a village near Puerto Barrios, Guatemala. Her death left her mother, a poor bread vendor, to look after Lidia's four children. Unsafe abortions are a leading killer of poor women in Latin America, where access to family planning is severely limited. Photo by filmmaker Greg Brosnan.|
The researchers used a wide range of global and regional information sources-including data from the ongoing World Health Organization Special Programme in Human Reproduction-to estimate the rates of safe and unsafe abortion in all major regions of the world in 2008 and also compared them with estimated rates in 2003 and 1995. They also evaluated the association between the incidence of abortion and the legal status of abortion in these regions. Findings showed that abortion rates were lower in subregions with more liberal abortion laws.
In developing countries, the rate of abortions that were unsafe in 2008 was 56%. The authors suggest that restrictive laws may drive women to seek less safe options, such as waiting longer to seek an abortion and using abortifacients without supervision. In addition, they noted that modern contraception is more available in regions that have liberal abortion laws and less available in areas with restrictive laws. But the authors point out that even when liberal laws apply, providers and women need to be knowledgeable about them, and guidelines, training, and resources promoting safe abortion must be available, especially in remote areas.
Such findings suggest that it may prove difficult to meet the global maternal mortality target set forth in the United Nations Millennium Development Goals, which call for a 75% reduction in maternal deaths by 2015. Maternal deaths resulting from unsafe abortion remain "an important and avoidable occurrence," the authors conclude.-Gail Pfeifer, MA, RN, news director
Sedgh G, et al. Lancet. 2012;379(9816):625-32