Increased contraceptive use has led to fewer abortions worldwide, but deaths from unsafe abortion remain a severe problem, killing 70,000 women a year, a research institute reported late yesterday in a major global survey.
More than half the deaths, about 38,000, are in sub-Saharan Africa, which was singled out as the region with by far the lowest rates of contraceptive use and the highest rates of unintended pregnancies.
The report, three years in the making, was compiled by the New York-based Guttmacher Institute, which supports abortion rights and is a leading source of data on abortion-related trends. Researchers examined data from individual countries and multinational organisations.
The institute's president, Sharon Camp, said she was heartened by the overall trends since Guttmacher conducted a similar survey in 1999, yet expressed concern about the gap revealed in the new report.
"In almost all developed countries, abortion is safe and legal," she said. "But in much of the developing world, abortion remains highly restricted, and unsafe abortion is common and continues to damage women's health and threaten their survival."
Guttmacher estimated previously that the number of abortions worldwide fell from 45.5 million in 1995 to 41.6 million in 2003 — the latest year for which global figures were available.
A key reason for that drop, the new report said, was that the portion of married women using contraception increased from 54 per cent in 1990 to 63 per cent in 2003 as availability increased and social mores changed. Guttmacher's researchers said contraceptive use had increased in every major region, but still lagged badly in Africa — used by only 28 percent of married women there, compared with at least 68 per cent in other major regions.
The report notes that abortions worldwide are declining even as more countries liberalise their abortion laws. Since 1997, it said, only three countries — Poland, Nicaragua and El Salvador — substantially increased restrictions on abortion, while laws were eased significantly in 19 countries and regions, including Cambodia, Nepal and Mexico City.
Despite this trend, the report said 40 per cent of the world's women live in countries with highly restrictive abortion laws, virtually all of them in the developing world. This category includes 92 per cent of the women in Africa and 97 per cent in Latin America, it said.
The survey concluded that abortion occurs at roughly equal rates in countries where it is legal and where it is highly restricted. The key difference, according to the report, is the high rate of deaths and medical complications from unsafe clandestine abortions in the restrictive countries.
"Legal restrictions do not stop abortion from happening. They just make the procedure dangerous," Ms Camp said. "Too many women are maimed or killed each year because they lack legal abortion access."
The report estimated that 19.7 million of the 41.6 million abortions in 2003 were unsafe — either self-induced, performed by unskilled practitioners or carried out in unhygienic surroundings.
"Almost all of them occurred in less developed countries with restrictive abortion laws," said the report, which estimated that — beyond the tens of thousands of women killed annually from unsafe abortions — another 8 million women suffer complications because of them.
Overall, the report is "a good news/bad news story," said Susan Cohen, the Guttmacher Institute's director of government affairs, who hailed the decline in abortions and unintended pregnancies.
"The bad news is that where most of the poor women live, throughout the developing world, unsafe abortion remains high, and women are dying as a result of it," she said. "It's so preventable, and that's the tragedy."
AP