Abstracted from Guttmacher Institute’s Induced Abortion Worldwide 2018 Fact Sheet
GLOBAL ABORTION DATA
- Approximately 1 in 4 pregnancies globally end in abortion (Sedgh 2016).
- Estimated global abortion rates are higher among married than unmarried women (35 vs. 26 per 1000, respectively).
- Legal restrictions do not decrease abortion rates (rates are similar in countries where it is legal vs. highly restricted), but make them much less safe.
- Many patients globally are denied abortion even where legal. Many later seek care outside the formal health system, which can increase risks of complications and mistreatment (ANSIRH Global Turnaway Study).
- Globally, about half of all women want to avoid a pregnancy; of these, about 75% are using modern contraceptives (defined as sterilization, hormonal methods, IUDs, condoms, fertility awareness, lactational amenorrhea, and emergency contraception).
- Compared to those in industrialized countries, a greater proportion of people in developing countries have an unmet need for contraception, and these account for 84% of unintended pregnancies in developing regions.
- Reducing unmet need for modern contraception globally can decrease rates of maternal and infant mortality (Guttmacher 2017).
SAFETY OF ABORTION
- Abortions are safer where laws are less restrictive and also in countries with higher gross national incomes (Singh 2018).
- An estimated 45% of the abortions performed globally are unsafe (Singh 2018).
- In many regions of the world, stigma is a recognized contributor to maternal morbidity and mortality from unsafe abortion, even where abortion is legal.
- At least 8% of pregnancy related deaths worldwide are from unsafe abortion (although this is likely an underestimate).
WORLD’S ABORTION LAWS
- In 1994, 179 countries signaled their commitment to prevent unsafe abortions and reduce pregnancy-related mortality by signing the first international consensus document recognizing reproductive rights as human rights (CRR ICPD).
- The 25 years since ICPD have seen an overwhelming global trend toward the liberalization of abortion laws, with nearly 50 countries worldwide enacting laws expanding the grounds under which abortion is legal.
- Abortion laws vary widely from country to country. Laws by country are in map below and available from the Center for Reproductive Rights: https://reproductiverights.org/worldabortionlaws
- Many global efforts focus on providing accesible, affordable, and high-quality reproductive health care in ways that recognize autonomy.
- Of the world’s women of reproductive age, 6% live where abortion is banned outright, and 37% live where it is allowed without restriction as to reason. Most people capable of pregnancy live in countries with laws that fall between these two extremes.
World’s Abortion Laws
- Abortion Modifiers:
- We use the terms “medication abortion” or “abortion pill” instead of the previously common term “medical abortion” as it more accurately represents the use of effective medication-based methods to terminate unwanted pregnancies. The term “medical abortion” can be associated with medical necessity (Weitz 2004).
- We have adopted the terms “in clinic” or “aspiration abortion” instead of “surgical abortion” or “dilation and curettage”, as this avoids the connotation of abortion as a surgical procedure that requires an operating room, incisions and / or sharp curettage. However, access to specific procedures including aspiration abortion may vary by practice location.
- Abortion Indications:
- We avoid the terms “elective” or “therapeutic” abortion. In abortion care, the term “elective” is often used as a moral judgment that determines which patients are entitled to care (Watson 2018). Unless required by an insurer, these terms should be avoided. Regardless of reason, the proper term for abortion is health care.
- Pregnancy loss:
- We have chosen to use “early pregnancy loss” and “miscarriage” interchangeably, and have purposefully avoided terms like “pregnancy failure” that can leave patients with a sense of responsibility for the pregnancy loss.
- Gender-neutral language:
- In recognition of a non-binary gender spectrum, we have incorporated gender-neutral language where appropriate including using the term “patient” and the singular “they” instead of “he” or “she” (Moseson 2020).
- We continue to use gender-specific language to report some research, legal decisions, and some exercises. Also see Chapter 2 and 7: Gender Spectrum and Pregnancy and Contraceptive Care Across the Gender Spectrum.