A global report said on Tuesday that increased use of contraceptives has pushed global abortion rates down, but unsafe abortions kill 70,000 women every year, while seriously harming millions more.
The report by the Guttmacher Institute said the number of abortions fell from an estimated 45.5 million in 1995 to 41.6 million in 2003.
However, the study, which surveyed 197 countries, showed almost 20 million unsafe abortions took place, mostly in poorer countries often carried out by women themselves using inappropriate drugs or herbal potions.
“It is significant and tragic that while the overall rate of abortion is on the decline, unsafe abortion has not declined,” said Sharon Camp, president of the Guttmacher Institute, a think-tank which studies sexual and reproductive health.
“Legal restrictions do not stop abortion from happening, they just make the procedure dangerous. Too many women are maimed or killed each year because they lack legal abortion access,” she told a news conference in London.
Nineteen of the studied countries had liberalized their abortion laws over the ten years studied, compared with tighter restrictions in just three.
But despite the general trend towards liberalization, about 40% of the world’s women live in countries prohibiting such acts.
Over 90% of women in South America and Africa live in areas with strict abortion laws.
The researchers said that in the developing world as a whole, healthcare for women harmed by unsafe abortions costs an estimated $500 million.
“Behind every abortion is an unwanted pregnancy,” said Akinrinola Bankole, the Guttmacher’s international research director.
Bankole said developing countries and donor nations should look at the figures, which demonstrate that “preventing unwanted pregnancy is cost-effective.”
A recent study showed that in Nigeria, the costs of treating women for complications caused by botched abortions were about $19 million, while it would only cost about $4.8 million to provide contraception for those who wanted it.
According to the researchers, preventing the need for abortion entirely was unrealistic, but eliminating unsafe abortions by improving access to contraception and increasing pressure to lift abortion restrictions was a worthwhile and achievable goal.
“Women will continue to seek abortion whether it is safe or not as long as the unmet need for contraception remains high,” Camp said. “With sufficient political will, we can ensure that no woman has to die in order to end a pregnancy she neither wanted nor planned for.”
Camp says Western Europe is an example of what access to contraceptive services can achieve. The Netherlands has just 10 abortions per 1,000 women, compared to the world’s 29 per 1,000.
Josephine Quintavalle of the pro-life Comment on Reproductive Ethics said stopping women falling pregnant in the first place was an area the debated issue could find common ground.
“Abortion – back street or front street – is not the answer. Ensuring women have the means to end their pregnancies is not liberating them – they should be able to make real choices before they fall pregnant in the first place,” she said.
“But that shouldn’t necessarily mean taking pills everyday. There will always be problems with access and cost, particularly in countries where people struggle just to buy food.
“What we need is to better understand our fertility – if there are just 24 fertile hours in a month, we need to work out a cheap, effective way for women to know when they can fall pregnant. That would be freedom, and that’s what we should aim for.”
Every year, about 70,000 women die as a result of an unsafe abortion, leaving nearly a quarter of a million children without a mother.
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