WUNRN
"Almost half of all abortions are categorized as “unsafe”by
Guttmacher Institute Study, and this figure is rising."
UNSAFE ABORTIONS ARE ON THE RISE -
STUDY
LONDON, 19 January 2012 (IRIN) - A new study by the New York
Guttmacher
Institute states that the number of women having induced abortions has stayed
stubbornly high since the last such report in 2003, and that the marked
reduction in the eight years before that has not been maintained.
Almost half of all abortions are categorized by the institute as “unsafe”, and
this figure is rising – it estimates 49 percent in this latest (2008) study
compared with 44 percent at the time of the baseline study in 1995. According
to the World Health Organization (WHO), 13 percent of maternal deaths, and a
vast amount of suffering and ill-health can be attributed to the consequences
of unsafe abortion.
Abortion is a worldwide phenomenon, and although variations exist between
regions, they are not huge. Developed countries have an estimated 24 abortions
for every 1,000 women aged 15 to 44; the rate in developing countries is 29 per
1,000. Around one in five pregnancies ends in abortion.
Dr Iqbal Shah of the WHO’s Department of Reproductive Health stressed the
universality of the predicament. “One should say that no woman actually wants
to become pregnant to have an abortion. It is the result of an accident. And at
the WHO we estimate that this amounts to 33 million accidental pregnancies a
year, which of course can lead to abortion. And where that is restricted by
law, they have no choice but to resort to unsafe procedures.”
The main author of the report, Gilda Sedgh, said: “Abortion laws tend to be
restrictive in developing countries. The majority of abortions are unsafe, and
some people are sure that those abortions are unsafe because they are happening
in very poor countries with very poor health systems. And that is true, and
that is important... but even within developing countries, illness and death
from abortion have declined where abortion laws have been liberalized. We have
evidence from South Africa where the abortion law was liberalized in 1997...
the annual number of abortion-related deaths, within three years of the
liberalization of the law, fell by about 90 percent.”
Burden of death
Commenting on the research, Beverly Winikoff, of Gynuity Health Projects in New
York, said: “Almost the entire burden of death due to abortion occurs in
Africa, Asia and Latin America. Somehow, we typically act as if this were
neither surprising nor troubling. But there are no regional biological
differences in women that could account for this discrepancy; there is no
procedure to prevent death that is unknown to practitioners where the toll is
high; there are no costly technologies needed to avoid these deaths. If a lack
exists, it is a lack of caring – a willingness to sacrifice lives to an
ideological moral high ground, to social acceptability or to the maintenance of
a political comfort zone.”
The abortion rate is actually lower in sub-regions characterized
by liberal laws, compared with [those] characterized by restrictive abortion
laws
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The figures show that a woman who feels she has to have an
abortion will go ahead regardless of the law. The only difference will be
whether she is able to terminate her pregnancy safely. The study gives no
support at all to the idea that making abortion illegal stops it happening. In
fact, it shows that the highest rates of abortion are in countries where
abortion is illegal.
Sedgh says: “The abortion rate is actually lower in sub-regions characterized
by liberal laws, compared with [those] characterized by restrictive abortion
laws.” But she adds, “That’s not to say that these laws lead to lower or higher
abortion rates; our findings add to the evidence that abortion rates are
especially correlated with trends in contraceptive use. Basically the higher
the contraceptive use, the lower the abortion rate.”
Contraception funding
Thus a stalling in the availability of contraception is the underlying reason
behind a stalling in the reduction in abortions. Sedgh told IRIN: “In some
countries this stalling has been attributed to the funding for family planning
not keeping pace with the demand, which has been constantly increasing both as
the size of the population has been growing and as women and couples
increasingly want to have small families. So the supply is not keeping up with
the demand.
“In some countries it also has to do with the limits of the family planning
programmes that are in place, which don’t offer a wide range of methods. So at
first you can see an increase, as the need which is most easily met is met. But
the quality of the family planning services needs to expand. They need to offer
a wider range of methods. They need to make sure that information and
counselling is there to match women to the methods that they need.”
Stigmatization
Sedgh and her colleagues confine themselves to medical statistics, avoiding the
politics of abortion. But Richard Horton, editor of the London-based medical
journal, The Lancet, which published the research, said: “We have found at The
Lancet that the mere mention of the word ‘abortion’... leads to a phenomenal
and visceral reaction against even discussing the issue. I was involved in a
commission on women’s and children’s health last year... and in our final
report we drew attention to the issue of abortion, and the American
representative on the commission explicitly came to me and asked me to remove
the word ‘abortion’ from our draft.
“Even under an Obama administration it is not possible to have an open
discussion about abortion in international agencies and commissions. And this
stigmatization, this censorship around the issue of abortion, is what is
causing the enormous distortion in priorities for women’s health today.”