Nearly 56 million abortions are performed annually throughout the world, with every fourth pregnancy ending in an abortion. According to a disturbing new study published in, the Lancet on May 11th , 2016, there has been no anti-abortion measure in recent years that has had a significant effect on abortion rates.
Such studies are desperately needed to monitor the trends of abortion, unintended pregnancy rates, their consequences and the rates of un-safe abortions performed. The resulting data helps policy strategists around the world develop new ideas or modify the ones already in use in order to provide better reproductive healthcare to women worldwide.
Reliable data on abortion is often rare due to the controversial nature of the subject. The controversy frequently manifests itself in the form of pressure on prohibition of abortion due to cultural and religious reasons. The data flow is also often inconsistent over the years due to rapidly changing policies regarding abortion in the US and worldwide.
The data for this study was requested from official government agencies, international healthcare organization databases and nationally performed representative scientific studies. The final data used for analysis consisted of the abortion rates from 1,069 country years over a period of 24 years. Abortion incidence trends were extensively observed both internationally and nationally from 1990-2014 with the rates being calculated per 1,000 women of reproductive ages from 15-44.
Under the supervision of lead author, Dr Gilda Sedgh, the team analyzed the data using a Bayesian hierarchical time series model, which considers the overall abortion rate as a function of the different rates in subgroups of women of reproductive age. The model was used to construct and analyze country-year-specific estimates for 184 countries in which the factors affecting the women involved in the study included contraceptive need, contraceptive use, marital status and the size of each subgroup.
Developed VS Developing Countries
The scientists at the US-based, Guttmacher Institute, observed that the annual number of abortions in developed countries dropped from 12 million in 1990-1994 to 7 million in 2010-2014. Because of this development, annual global abortion rates decreased from 40 per 1,000 women to 35 per thousand women.
Eastern Europe observed a massive decline in abortion rates from 88 per 1,000 women in the 1990s to 42 per 1,000 women, which was mostly due to better access to contraception. However, compared to the rest of the Western world, the new rate is still quite high as the current rates for Europe stand at 21 and for North America at 17.
Dr Gilda Sedgh, the principal research scientist from Guttmacher Institute’s New York office, explained that the downfall in abortion rates is mainly due to the increased control a woman has over her body along with an increased use of modern contraception.
The study, funded by the UK government, Norwegian Agency for Development Cooperation (NORAD), the Dutch Ministry of Foreign Affairs, The David and Lucile Packard Foundation, the United Nations Children’s Emergency Fund (UNICEF)/World Bank Special Program of Research, Development and Research Training in Human Reproduction, the World Health Organization (WHO), the United Nations Development Programme (UNDP), and the United Nations Population Fund (UNFPA), showed that abortion rates remained consistent.
She further explained that in developing countries, there is an unmet need of contraception which is not consistent with the increasing desire of smaller families. Nearly 80% of unintended pregnancies in such countries are a direct result of this unmet need for modern contraception, and often end in abortion.
Legality Of Abortion
A powerful observation of the data available in the study revealed that no matter the legal status of abortion worldwide, the abortion rate remains similar. In places where abortion was available on request, the rate was 34 women per 1,000 but in countries where abortion was prohibited or only aimed at saving the life of the pregnant women, the rate was much higher, at 37 women per 1,000.
Dr Diana Greene Foster, from Advancing New Standards in Reproductive Health (ANSIRH), of the University of California, wrote in a comment piece linked to the report in Lancet, that the obvious interpretation of this data says that criminalizing abortion does not prevent it from happening and only drives women to seek illegal services. However, the report overlooks the fact that women with unintended pregnancies than may have to carry an unwanted burden.
The reason for such high rates of abortion in countries with similar laws can include absence of contraception, sex education, and other family planning countries.
The math is simple – when there is more contraception available to people, lesser unintended pregnancies occur, which in turn results in fewer abortions. The reverse is true for developing countries, due to the lack of availability of contraceptives, resulting in an increased number of abortions which are usually illegal due to certain laws.
Bela Ganatra, of the WHO, co-author of the study, said that another study is currently underway with the objective of gathering more data and developing more information about the condition that results in safe and unsafe abortions.
Women who cannot receive safe or unsafe abortion service while carrying their babies, are at an increased risk of maternal mortality.
In Latin America, which has some of the world’s most punishing anti-abortion laws, the rate of abortion was at 32%, the highest in all the regions. A special mention is reserved for the fast-spreading Zika virus, because of which there is currently a greater need of realignment and strengthening of family planning services. The US has not been of much help in this matter as the Helms amendment has prevented the country’s government from providing foreign aid for abortion since 1973.
Republicans in the US believe that abortion is less preferable to microcephaly among children born to Zika-infected women. Republican Representative Jeff Duncan, in answer to calls from global health experts to increase access to safe abortions and family planning services in Zika-infected areas, recently said that, “This push for more abortion access is heartbreaking, especially since there are different degrees of microcephaly.” He added that some children with the diagnosis can go on to lead very normal lives.
Abortion Rates In The US
Abortion is regulated through the case of Roe vs Wade (1973) in the US, in which abortion was termed as a constitutional right of a woman. When a woman can have that abortion is usually regulated by the Planned Parenthood of Southeastern Pennsylvania vs. Casey (1992), which currently states that abortion can only be performed before the onset of fetal viability (when a fetus can survive outside the womb independently).
Over the years, in the US, the abortion rate has been in a steady decline since the 1980s. According to recent data, almost one in ten women will have an abortion by the age of twenty, one in four by the age of thirty, and three in ten by the age of forty five. Currently, 1.21 million pregnancies are aborted each year in America, which represents 3322 abortions per day.
Out of all the pregnancies in the US, nearly half are unintended and out of those unintended pregnancies, four out of ten end in abortion, which is consistent with the global rate. Only 21% of all US pregnancies end in abortion.
The risks associated with abortion usually increases with the duration of pregnancy, from 0.3 per 100,000 abortions before 8 weeks to 6.7 per 100, 000 at 18 weeks.
Extensive reviews have ruled out abortion as a risk factor for cancers and experts have concluded that women with unintended pregnancies do not suffer a greater risk of mental illness if they have a first trimester abortion, compared to women who carry the pregnancy to completion.
Global health experts believe in providing basic reproductive facilities such as health education, sex education, safe abortions, early child rearing training and family planning services. All studies consistently reveal that only through such efforts can unintended pregnancies, safe and unsafe abortions and maternal mortality rates be decreased.