In much of the world—the UK included—access to a safe, legal abortion is no guarantee. And in absence of legal abortions, women often put their lives at risk by seeking out abortions from those that are not trained to provide them. Sometimes those women wind up dead.
A new report from the WHO and the Guttmacher Institute now quantifies just how big of a problem unsafe abortions really are. Of the 55.7 million abortions performed each year, the new report found, more than 25 million of those are considered “unsafe.”
The report defines two separate categories of unsafe abortions. “Less-safe” abortions, it said, are those performed by a trained provider but with an outdated method, or a safe method performed by an untrained provider. “Least-safe” abortions are performed by untrained individuals using dangerous methods.
In the developed world overall, 88 per cent of abortions are considered safe. In developing nations, however, the picture is much grimmer. In most parts of Africa and Latin America, less than 25 per cent of abortions are safe. In countries where abortion is either completely banned or legal only when it is to protect a woman’s health, only 1 in 4 abortions were safe.
The WHO regularly conducts estimates of abortion safety around the world, but until this report relied on a different, less nuanced technique to arrive at those numbers. The most recent previous estimates, published in 2012, found that 21.6 of 43.8 million abortions in 2008 were unsafe.
For the new analysis, researchers looked at data from 182 countries and regions, then searched resources like PubMed in different nations and languages to pull data from population-based surveys on abortion care-seeking, surveys of health professionals and other national and regional data on abortion. From that literature review and expert group discussions, they then built a statistical model to calculate global abortion safety estimates. They concluded that both the number of abortions and the number of unsafe abortions have gone up.
The report, which looked at abortions that occurred from 2010 to 2014, broke out unsafe abortions into two categories for the first time— “less safe” and “least safe”—an effort to provide a more nuanced picture of the problems facing women who cannot access abortion services. About 14% fell into the “least safe” category. Deaths from complications related to an unsafe abortion were high in parts of the world where abortions occurred in least safe circumstances, which include things like reliance on herbal remedies as part of an abortion procedure. Those complications included incomplete abortions, haemorrhaging and infections.
If it wasn’t clear already, the report highlights just how important it is to preserve existing abortion accessin countries where it is legal. Without legal access to abortions, women are too often left without the option of safety.