Although the numbers sound ominous, the global rates of induced abortions, in fact, went down 17% during the period 1995-2003, as have total numbers - in 1995 there were a total of 46 million abortions, in 2003 the figure fell to 42 million. Developing countries make up the bulk of unsafe abortion* totals.

You can read about this in The Lancet, special edition called Women Deliver.

Dr Gilda Sedgh, Guttmacher Institute, New York, USA, and Dr Iqbal Shah, WHO (World Health Organization), Switzerland, and team worked out the global and regional incidences of safe abortions** by analyzing reports from national reporting systems, national representative surveys, and studies that had been published.

According to the 2003 data they examined, an average calculation would show that 90% of females globally will have an abortion during their reproductive lifetime (by the age of 44). As several women will had had multiple abortions and these figures have been used to work out the average, many will also never had had an abortion at all.

The researchers reported these findings (among others):

-- 35 million abortions took place in the developing world
-- 6.6 million abortions took place in developed countries
-- 35 per 1,000 women aged 15 to 44 had an abortion in 1995
-- 29 per 1,000 women aged 15 to 44 had an abortion in 2003
-- 44% of all abortions were unsafe in 1995
-- 48% of all abortions were unsafe in 2003
-- 97% of unsafe abortions took place in developing countries
-- 92% of abortions in developed countries were safe abortions
-- 55% of abortions in developing countries were unsafe abortions
-- Worldwide there were 31 abortions for every 100 live births (2003)
-- In Eastern Europe there were 105 abortions for every 100 live births
-- In Eastern Asia there were 51 abortions for every 100 live births
-- Induced abortions dropped 50% in Eastern Europe during 1995-2003

The researchers wrote "Although abortion rates and ratios in the countries of the former Soviet Union have fallen substantially in recent years, the rates in Eastern Europe remain higher than any other region. This finding suggests the need for continued improvements in and expansion of contraceptive service provision. The widespread preference for small families in this region indicates a high level of need for effective contraception."

About 32% of all pregnancies in Europe as a whole end in abortion - this high figure is due to very high figures in Eastern Europe. The figure for Africa is 12%, while the global average is 20%.

The researchers found that abortion rates are approximately the same in countries where abortion is legal and countries where it is illegal. The lowest abortion rates were in Western Europe, while the highest were in Eastern Europe. In fact, abortion rates in Western Europe, North America, and Oceania were significantly lower than in the developing world.

China, which accounts for one fifth of global abortions, saw numbers fall 20% during the period 1995-2003.

"Unsafe and safe abortions correspond in large part with illegal and legal abortions, respectively. The findings presented here indicate that unrestrictive abortion laws do not predict a high level of abortion, and by the same token, highly restrictive abortion laws are not associated with low abortion incidence," the researchers wrote.

The researchers concluded "Estimates of abortion incidence and trends are necessary means of monitoring and responding to its causes, including unmet need for contraception, and, in the case of unsafe abortion, consequences such as maternal morbidity and mortality...in light of the recent mandates of intergovernmental bodies, the contraceptive and abortion technologies now available, and the estimates presented here, prevention of unsafe abortion is an imperative public health goal."

Accompanying Comment

"In all the available data, one fact stands out: safe and legal abortion saves women's lives and protects their health. There is no acceptable reason to allow women to die, fall ill, or become infertile as a result of unsafe abortion when the world community has both the knowledge and the means to prevent these deaths," wrote Beth Fredrick, International Women's Health Coalition, New York, USA, in an Accompanying Comment.

** Unsafe abortions
- Abortions carried out by people who do not have the required skills
- Abortions that are performed in environments that do not conform to minimum medical standards


* Safe abortions
- Abortions that take place in countries where abortion law is not restrictive
- Abortions that meet legal requirements in nations where the law is restrictive


http://www.lancet.com
Written by: Christian Nordqvist