Unsafe abortion continues to be a major public health problem in many countries.
A woman dies every eighth minute somewhere in a developing country due to
complications arising from unsafe abortion. She was likely to have had little or no money
to procure safe services, was young – perhaps in her teens – living in rural areas and had
little social support to deal with her unplanned pregnancy. She might have been raped or
she might have experienced an accidental pregnancy due to the failure of the contraceptive
method she was using or the incorrect or inconsistent way she used it. She probably fifirst
attempted to self-induce the termination and after that failed, she turned to an unskilled,
but relatively inexpensive, provider. This is a real life story of so many women in developing
countries in spite of the major advancements in technologies and in public health.
The Safe Motherhood Conference held in 1987 in Nairobi drew the world’s attention to
the shocking fact that over half a million women die needlessly due to complications
related to pregnancy and childbirth. One of the most easily preventable causes of maternal
death and ill-health is unsafe abortion, which causes approximately 13% of all maternal
deaths and approximately 20% of the overall burden of maternal death and long-term sexual
and reproductive ill-health.
Twenty years after the Nairobi Conference, we fifind that unsafe abortion is a continuing
pandemic: every year nearly 42 million women faced with an unplanned pregnancy decide
to have an abortion, and about 20 million of them are forced to resort to unsafe abortion.
These approximately 20 million women often self-induce abortions or obtain a clandestine
and unsafe abortion carried out by untrained persons under poor hygienic conditions.
Abortion induced by a skilled provider in situations where it is legal is one of the safest
procedures in contemporary medical practice and the recourse to manual vacuum aspiration
(MVA) and medical (non-surgical) abortion have reduced abortion-related complications to
very low levels.
The interventions to prevent unsafe abortion include expanding access to modern
contraceptive services, providing safe abortion to the full extent of the law, and tackling
the legal and programmatic barriers to the access to safe abortion. An informed and
objective discourse continues to be much needed for developing interventions to prevent
unsafe abortion and its devastating consequences for the survival, health and well-being of
women, families and societies. By providing an objective assessment of the incidence of
unsafe abortion and its related mortality, this report goes a long way in raising awareness
of this major, but often neglected, public health problem. It provides the basis for informed
discussion and implementing the much required interventions to reduce and, eventually,
eliminate unsafe abortion
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