Tens of thousands of women die annually from abortions performed in unsanitary conditions by poorly trained personnel. That's according to University of North Carolina researcher David Grimes, who compiled global data in order to gauge the scope of the problem.
He says unsafe abortion overwhelmingly affects women in the developing world. "The estimates are that worldwide, there may be about 19 to 20 million unsafe abortions, and about 18 million of these occur in developing countries, divided between Africa and Asia." Grimes says unsafe abortions are also a maternal health issue in Latin America, where many countries have outlawed the procedure.
He estimates about 68,000 women die each year in countries with little or no access to abortion. Hundreds of thousands more face severe and sometimes life-threatening complications to their health. "The complications are both short and long term," he points out. "In the short run, infection is a very common outcome as is trauma to the genital tract, for example perforations of the uterus, perforation of the cervix and so forth. These kinds of infections are an important cause of infertility in developing countries." Grimes also says the cost of caring for women with complications from unsafe abortions taxes the medical systems in poor countries.
Grimes led an international team of researchers that used data from the World Health Organization and other sources to compile the analysis. They also looked at mortality trends in countries that have legalized abortion. Grimes says they found maternal death rates dropped dramatically after laws changed, citing South Africa as an example. "When South Africa recently liberalized access to abortion, the mortality rates from unsafe abortion in South Africa dropped 90 percent almost overnight."
Grimes says unsafe abortion is an important public health issue that must be addressed, even as he acknowledges that the debate over the morality of abortion will continue. The analysis appears in the British journal The Lancet as part of a series on international women's health.