Saturday, April 01, 2006

Global Unsafe Abortion Resources

An article from Reuters entitled "Desperate Kenyan women risk last-resort abortions" covers the women's health consequences of unsafe and illegal abortions in Kenya and other parts of Africa. According to the article, "Across sub-Saharan Africa, more than 30,000 women die each year from unsafe abortions and many more suffer lifelong consequences. In Africa, the rate of deaths from abortions is one per 150 procedures, compared with one in 3,700 in rich countries, according to the World Health Organization... Despite the dangers, a recent study estimated that more than 300,000 abortions are carried out in Kenya each year, and that the annual cost of treating the resulting complications exceeds 90 million Kenyan shillings ($1.2 million)."

Until reading this article, I was not aware of the World Health Organization's resources on this topic (such as this website), and hadn't thought much about the problem. When most people think of health problems in Africa, I'd wager they think of AIDS, vaccines, water-borne disease, and hunger. This 2000 report (PDF), "Unsafe Abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000, 4th edition," attempts to quantify the problem. In assessing unplanned pregnancy, it states:
It has been estimated that almost two in every five pregnancies worldwide are unplanned— the result of non-use of contraception or of ineffective contraceptive use or method failure. The 1994 ICPD Programme of Action emphasizes that expanding and improving family planning services can help reduce unintended pregnancy and induced abortion. However, family planning services are frequently unable to meet the demand, or may be inaccessible or unaffordable, or there may be a range of social barriers that prevent women and couples from using them. Studies show that many married women in developing countries do not have access to the contraceptive methods they would prefer to use in order to space pregnancies or limit family size. The situation is worse for unmarried women, particularly adolescents, who rarely have access to reproductive information and counselling, and are frequently excluded from contraceptive services."
It also addresses how legal restrictions affect safety, reporting, "In the case of Romania, for example, the number of abortion-related deaths increased sharply after November 1966, when the government tightened a previously liberal abortion law (Figure 2). The figure rose from 20 to 100,000 live births in 1965 to almost 100 in 1974 and 150 in 1983.14 Abortions were legalized again in December 1989 and, by the end of 1990, maternal deaths caused by abortion dropped to around 60 to 100,000 live births."

Table 2 of the report emphasizes the stark difference in mortality rates for obstetric procedures between the United States and developing countries. (Click to view a larger version)
The report goes on to analyze patterns of unsafe abortion and mortality by age and region, and concludes, "Although the evidence remains incomplete, there are increasing indications that both incidence of unsafe abortion and resulting mortality are rising among unmarried adolescent women in urban areas, particularly where abortion is illegal and fertility regulation services are inadequate or inappropriate. A variety of demographic and socioeconomic developments – earlier menarche, rising age at marriage, and the influence of the media – can contribute to increasing the likelihood of premarital sexual activity and early pregnancy. Where information about sexuality, safe sexual practices and contraception is either lacking or of insufficient quality to respond to the needs of the young, there are likely to be many unintended pregnancies, a proportion of which will be terminated by safe or unsafe abortion. Young women may undergo an unsafe abortion even when abortion is legally permitted, because of lack of information and skills to make informed decisions and seek assistance. Where abortion is strictly illegal, they have no other option than to seek an unsafe abortion or continue the pregnancy – with all the attendant social and educational consequences."

Related Resources: (from a pro-choice perspective, and addressing how U.S. policy impacts global women's health)
  • Breaking the Silence: The Global Gag Rule's Impact on Unsafe Abortion - Center for Reproductive Rights
  • Global Illegal Abortion and Preventing Unsafe Abortion - Planned Parenthood
  • Opinion piece - Against the Gran: U.S. Abortion Policy from a Global Perspective - Center for American Progress
  • Global Gag Rule - International Women's Health Coalition
  • Unsafe Abortion - Family Care International
  • Why the Global Gag Rule Undermines U.S. Foreign Policy and Harms Women's Health and Access Denied- Population Action International
  • Issue in Focuse: Global Gag Rule - Feminist Majority Foundation

    Technorati Tags: ; ; ; ;
    MeSH Tags: Abortion, Induced/adverse effects OR Abortion, Induced/mortality; Family Planning Policy; Family Planning Services; World Health; World Health Organization; "gag rule" (keyword search)
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