Sharon L Camp: It is time for a public health approach to abortion

The global maternal mortality has dropped dramatically during the last decade. This is good news. Sadly, however, too many women continue to die from pregnancy related causes. In part, this is because unsafe abortion—one of the leading preventable causes of maternal death—is a public health crisis that is going largely ignored.

Every year, 47 000 women die as a result of unsafe abortions, and millions more suffer health complications. Virtually all of these women are in developing countries where abortion is predominately addressed by penal systems, rather than healthcare systems. But making abortion illegal does not stop it from occurring; it just drives it underground. Where legal abortion is unavailable, women may have little choice but to seek risky procedures performed by untrained providers or under unsanitary conditions; many even try to perform their abortion themselves.

In fact, there is little relation between the legal status of abortion and how often it occurs. The world’s lowest abortion rates are in western Europe, where the procedure is generally legal and widely accessible—and where effective contraceptive use is high and unintended pregnancy rates are low. Some of the highest abortion rates in the world are in Latin America and Africa, where abortion is highly restricted by law in almost every country—and where many women have unintended pregnancies and an unmet need for contraception.

Today, 222 million women in the developing world want to avoid pregnancy but are not using a modern contraceptive method. If these women’s family planning needs were met, the results would be dramatic. Each year, unintended pregnancies would decline from 80 million to 26 million, 26 million fewer abortions would occur, and the lives of 79,000 women would be saved.

But, while making contraceptives more widely available will contribute to lowering abortion rates, it will not eliminate the need for abortion and abortion related services. Ensuring access to medical care to treat the complications of unsafe procedures is essential where women resort to clandestine abortions. More broadly, promoting and implementing policies that fully address women’s reproductive health needs is an urgent priority for all countries and for global health agencies.

The tragedy of unsafe abortion goes well beyond the injury or death of the individual woman. Losing a mother devastates the lives of children, and losing a healthy woman’s contributions to society weakens her community. It is time for a public health approach to prevent unsafe abortion and the harm it causes individuals, families and society as a whole.

For the facts on abortion worldwide watch the Guttmacher Institute’s new video:  Abortion Worldwide

Sharon L. Camp is president and CEO of the Guttmacher Institute