A study from the World Health Organization (WHO) and Guttmacher Institute reveals that worldwide, the long-term substantial decline in abortion rates has stalled. According to the study entitled "Induced Abortion: Incidence and Trends Worldwide from 1995 to 2008" by Glida Sedgh et al., the overall number of terminations per 1,000 women, between the age of 15 to 44 years, has decreased from 35 per 1,000 to 29 per 1,000, between 1995 and 2003, and 28 per 1,000 in 2008. The study was published online by The Lancet.
According to the United Nations, the stall in abortion rates coincides with a decline in contraceptive uptake, which has been observed particularly in developing nations.
Furthermore, the study discovered that almost half of all terminations carried out across the world are unsafe, with the majority of unsafe terminations occurring in the developing world.
In 2003 and 2008, the termination rate in the developing world was 29 per 1,000, after dropping from 34 per 1,000 between 1995 and 2003. In the developed world, rates fell slightly from 20 per 1,000 in 1995, excluding Eastern Europe where rates were considerably lower - 17 per 1,000.
Gilda Sedgh, senior researcher at the Guttmacher Institute and lead author of the investigation, explained:
"The declining abortion trend we had seen globally has stalled, and we are also seeing a growing proportion of abortions occurring in developing countries, where the procedure is often clandestine and unsafe. This is cause for concern.
This plateau coincides with a slowdown in contraceptive uptake. Without greater investment in quality family planning services, we can expect this trend to persist."
An estimated 13% of all maternal deaths worldwide in 2008, nearly all of which occurred in developing nations, are due to complications from unsafe abortions. Worldwide in 2008, 220 women died per 100,000 procedures as a result of unsafe termination, 350 times the rate associated with legal induced abortions in the U.S. (0.6 per 100,000).
In addition, around 8.5 million women in developing nations each year suffer serious complications from abortion that require medical attention, out of which 3 million do not receive the care they need.
Iqbal H. Shah, of the WHO and a coauthor of the investigation, said:
"Deaths and disability related to unsafe abortion are entirely preventable, and some progress has been made in developing regions. Africa is the exception, accounting for 17% of the developing world's population of women of childbearing age but half of all unsafe abortion-related deaths.
Within developing countries, risks are greatest for the poorest women. They have the least access to family planning services, and are the most likely to suffer the negative consequences of an unsafe procedure. Poor women also have the least access to postabortion care, when they need treatment for complications."
Study results also showed additional evidence that restrictive abortion laws are not linked to lower rates or termination. For example, In Western Europe abortion is typically allowed on broad grounds, with a abortion rate of 12 per 1,000 women of childbearing age, while the 2008 abortion rate in Africa was 29 per 1,000, and 32 per 1,000 in Latin America, regions where abortion is highly restricted in nearly all nations.
The lowest rate of abortion in Africa (15 per 1,000 women) is in the Southern Africa subregion, where almost 90% of women live under South Africa's liberal abortion law. The researchers found rates were also low in Western Europe (12 per 1,000) and Northern Europe (17 per 1,000), where women have easy access to both abortion and contraception for free or at a considerably low price.
In Eastern Europe, abortion rates are almost 4 times more than in Western Europe, due to low levels of modern contraceptive use and low prevalence of effective birth control methods, such as the IUD and the pill. Although Eastern Europe saw a significant decline in abortion rates between 1995 and 2003, from 90 to 44 per 1,000 women, rates remained virtually unchanged between 2003 and 2008.
Richard Horton, editor of The Lancet, explained: "These latest figures are deeply disturbing. The progress made in the 1990s is now in reverse. Promoting and implementing policies to reduce the number of abortions is now an urgent priority for all countries and for global health agencies, such as WHO. Condemning, stigmatizing, and criminalizing abortion are cruel and failed strategies. It's time for a public health approach that emphasizes reducing harm - and that means more liberal abortion laws."