Sedgh, G., Henshaw, S., Singh, S., Ahman, E., & Shah, I. H. (2007). The Lancet, 370, 1338-1345.
Abortion is a such a "hot topic" that we sometimes forget that information on incidence of safe and unsafe abortion rates is crucial for public health programs aimed at reducing unintended pregnancy and monitoring progress on the health of women and children. This report documents the rate and number of abortions globally from 1995 to 2003. The absolute number and rate of abortions have slightly declined since 1995, but nearly one-half of abortions are still performed illegally in potentially dangerous conditions. The procedure seems to be no less prevalent where it is prohibited, according to this study-it is just more dangerous. "The legal status of abortion seems to predict not the number of abortions that occur, but the safety," according to this report.
About one-half (48%) of the 42 million abortions performed worldwide in 2003 were performed illegally by unskilled individuals or in unhygienic conditions (labeled "unsafe" in this article). More than 97% of all of these "unsafe" abortions were in developing countries. Hence, although abortion rates are similar in the developing and developed world, unsafe abortion is concentrated in developing countries, resulting in the death of about 70,000 women annually (13% of maternal mortality).
The conclusion seems to be that the legal status of abortion does not dissuade women and couples who seek to end their pregnancies. Whatever your political or religious persuasion, prevention of unsafe abortion seems an imperative public health goal. The way to prevent unsafe abortion, according to this article, is not to make it illegal but to work to prevent it and respond to its causes. The root cause of abortion is unintended pregnancy. It is there that our efforts should be focused. "Meeting the need for contraception and improving the effectiveness of use among women and couples who are already using contraception are crucial steps toward reducing the incidence of unintended pregnancy" (p.1345).
Linda Beth Tiedje