Abortion and Contraception: A Global Snapshot

Photo courtesy of Jhpiego, an affiliate of Johns Hopkins University

Worldwide the abortion rate declined significantly between 1995 and 2003. However, since the early 2000’s, there have essentially been no changes in how many women undergo the procedure. A study by the Guttmacher Institute and the World Health Organization (WHO) has uncovered that this slowdown is related to a decrease in contraception use. In addition, almost half of all abortions globally are unsafe and almost all risky abortions take place in developing countries. It is estimated that 215 million women want access to modern contraception and a means to control their reproductive lives. Wide use of contraceptives contributes to a drop in unintended pregnancy and smaller percentages of unplanned pregnancies mean fewer abortions. With the planet’s population at 7 billion people and quickly growing larger any discussion about sustainability must consider a much needed investment in contraceptives as well as, every woman’s right to control what happens to, and inside her body.

The consequences of unsafe, often secret or illegal abortion include disability, dangerous health complications and in 2008 about 13% of maternal deaths globally were attributed to risky abortion procedures. In places where abortion is heavily restricted or completely illegal, the number of abortions is not necessarily lower but the legal status of the procedure does have significant bearing on how safe an abortion will be. For every 1000 women in the developing world there were 29 abortions, a rate which was unaltered between 2003 and 2008. Researchers point out that poor women in developing nations are the most vulnerable to unsafe abortion, due to the fact that they have the least access to modern birth control, are unable to afford expensive operations and cannot access post abortion care for possible complications. Affordable, accessible contraception is the surest way to cut down on unplanned pregnancies, dangerous abortions and female deaths associated with botched procedures.

Throughout Europe trends in abortion are split fairly distinctly between the Central/Eastern and Western parts of the continent. While Central and Eastern Europe (CEE) reduced the number of abortions performed between the mid 1990’s and 2003 from 90 to 44 per 1000 women, since then there have been no changes. Women in this region do not use highly effective, modern, hormonal modes of contraception (like the pill or intrauterine device) at the rate that women in Western Europe do. The number of abortions per 1000 women in Western Europe is 12, where contraception is easily accessible and where abortion services are also readily available. In most nations of CEE public health insurance does not cover modern birth control and often health care providers harbor their own misconceptions about the most effective modes of contraception due to misinformation, personal or religious views. In 2011 modern contraception was used by 36% of women in CEE and by 71% in Western Europe. In countries like Russia and Armenia, the annual cost of contraceptives is higher than what an abortion costs.

The need for abortion to be legal and safely available is crucial as battles are waged to triumph over dehumanizing poverty, preventable disease and the subjugation of women. Fewer people will have to die and be raised as orphans if affordable, sanitary abortion is within reach of any woman requiring it. The Guttmacher/WHO study herein also highlights the desperate need for millions of women to gain access to affordable, modern, ways of preventing conception so that abortion does not serve as the main form of birth control.  Women shoulder the burden of problems with family planning but their children, partners and society at large also have to contend with its consequences.  It is shameful that in the 21^st century millions of women still lack the tools to make decisions about something as personal as when and if they will become mothers.

To read the full study click here

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