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RIGHTS: Unsafe Abortions Killing 70,000 a Year

Sanjay Suri

LONDON, Oct 13 2009 (IPS) - Unsafe abortions kill about 70,000 women a year, says a report by the U.S.- based Guttmacher Institute. An additional five million women are treated annually for complications arising from unsafe abortion, adds the report, based on a global survey.

The institute, which seeks to advance sexual and reproductive health through research and policy education, notes that the number of abortions worldwide fell from 45.5 million in 1995 to 41.6 million in 2003. But that has still not reduced the number of deaths.

“Unsafe abortions, including deaths from unsafe abortions, have not changed, even though overall rates of abortion are declining,” Sharon Camp, president of the Guttmacher Institute, told IPS in an interview.

“The explanation for this is that populations of women are growing faster in various parts of the world that are least likely to make safe abortion widely available, and so women in some of the poorest countries of the world with the most rapid rates of population growth are having unsafe abortions at the same rate as they have for the last decade,” she said.

Half of the deaths due to unsafe abortions are in Africa, Camp said. “The next largest number are in South Asia. Even though in India and Bangladesh abortion is legal, not all women in those countries have access to quality services.”

The most timely prevention inevitably is contraception, Camp said. “Behind every abortion is an unwanted pregnancy, and if women can avoid those unwanted pregnancies in the first place, then abortion, whether legal or illegal, will go down. But until women’s need for contraception is met, abortion rates are going to remain high.”

Governments need to expand high quality family planning services because that in itself will reduce the need for abortion, Camp said. “But it won’t reduce it to zero. And so I would hope that governments would liberalise abortion laws and make the investments that are needed in making safe abortion services available.”

Greater investment needs to be made also in medical services for women who suffer the effects of badly done abortions, Camp said. “Obviously if you do the first two things, that problem will largely go away. But until it does, governments are going to need to put out services so that women who suffer complications from unsafe abortions should have humane and good quality medical care.”

The report, titled ‘Abortion Worldwide: A Decade of Uneven Progress’, notes that 19 countries have significantly reduced restrictions in their abortion laws since 1997. But despite these trends, 40 percent of the world’s women live in countries with highly restrictive abortion laws, virtually all of them in the developing world.

In Africa, despite the progress in some countries, 92 percent of reproductive- age women live under highly restrictive abortion laws, and in Latin America, 97 percent do so, the report says. These proportions have not changed markedly over the past decade.

The report says three countries – Poland, El Salvador and Nicaragua – have increased legal restrictions on abortion. But it also makes note of considerable progress in many countries.

“Most of the countries that have liberalised abortion laws are in the developing world,” Camp said. “Eight African countries have modified their laws, including two of the largest – South Africa and Ethiopia.”

The new laws in South Africa have delivered dramatic results. “In South Africa early abortion in the first 12 weeks is available on request, at least in principle,” Camp said. “Obviously not all rural women have access to good services, but even with the investment that has been made so far, there has been a more than 90 percent reduction in hospitalisations from unsafe abortion, and a more than 50 percent decline in abortion- related deaths.”

Worldwide, the unintended pregnancy rate declined from 69 per 1,000 women aged 15-44 in 1995 to 55 per 1,000 in 2008, the report says. The proportion of married women using contraception increased from 54 percent in 1990 to 63 percent in 2003. Increases also occurred among sexually active single women.

However, regional levels of birth control use varied greatly. “While 71 percent of married women in Latin America and the Caribbean were using contraceptives in 2003, only 28 percent of married African women were doing so,” the report says. “Nearly one in four married women in Africa had an unmet need for contraception in 2002-2007, compared with 10-13 percent of their counterparts in Asia and in Latin America and the Caribbean.”

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