1 in 2 Abortions Worldwide Are Unsafe

Women around the globe are having millions of risky abortions every year, a new study has found.
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More than 55 million abortions take place worldwide every year, and nearly half of those ― a whopping 25.5 million abortions annually ― are unsafe, according to a new study released Wednesday.

The research offers evidence that women around the world continue to have abortions even when they live in areas where trained providers are scant and where the procedure is illegal. 

But it does not have to be that way. 

“Making abortion safe is incredibly simple,” study author Dr. Bela Ganatra, a researcher with the World Health Organization (WHO), told HuffPost. “It can be integrated into basic health care. It’s not a high-resource intervention ... it’s not rocket science.”

Indeed, complications from in-clinic and medication abortions (when done following the correct procedures and under the guidance of a trained individual) are extremely rare.

“Despite that,” Ganatra continued, “we still have one in two abortions that are unsafe because of all the other barriers that exist around the issue.”

Ganatra and co-researchers from the WHO and the Guttmacher Institute combed through government surveys and research studies conducted between 2010 and 2014 looking at who had abortions and under what circumstances those abortions were done. 

They also considered indirect factors that influence safety, such as the availability of trained abortion providers in a given area as well as the availability of medications like mifepristone and misoprostol (i.e. “the abortion pill”), with the understanding that surveys are unable to truly capture the number of women having abortions outside of medical settings.

The researchers made a point to move away from classifying abortions as simply “safe” or “unsafe,” and instead grouped them as “safe,” “less safe” and “least safe.”

Though these classifications might seem like a minor shift, Ganatra argued that they represent an important step forward in creating a more nuanced picture of abortion safety worldwide, particularly as methods like the abortion pill become more popular.

“It’s increasingly common that women are not using the most dangerous methods of inserting sticks, or doing uterine massage, or using coat hangers,” she explained.

The abortion pill has been shown to be extremely safe, even when women take it at home and consult with a trained provider via video. But many women are using it in circumstances the researchers consider”less safe.” So, a woman might purchase the drug online and take it with no supervision from a trained professional who can monitor her dosage and be available should any complications arise. That would be considered “less safe.”

About 55 percent of all abortions across the world are safe, the researchers found. Those procedures are done using the most recent methods and with the support of a trained professional. 

Another 31 percent fell into that less safe category, which would also include a woman who had her abortion with a trained, qualified professional who used an outdated method.

The remaining 14 percent of abortions were considered least safe. Those women turned to the most dangerous, invasive methods and/or untrained providers. Overall, the vast majority of “less safe” and “least safe” abortions take place in Africa, Asia and Latin America — areas that tend to have the most restrictive laws.

Ganatra said that she hopes researchers will do a better job studying how women actually have abortions around the world, which is difficult because it tends to be stigmatized and because so many abortions happen outside of health systems.

For now, the data, published in the journal The Lancet this week, simply adds further weight to the longstanding argument that banning abortion does not make it go away. It simply makes it less safe for women. 

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Before You Go

Myths About Abortion That Need To Be Busted
MYTH: Abortion is dangerous.(01 of08)
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REALITY: Over 99.75 percent of abortions do not cause major medical problems.Less than one-quarter of 1 percent of abortions performed in the United States lead to major health complications, according to a 2014 study from the University of California, San Francisco, that tracked 55,000 women for six weeks after their abortions. The researchers note that this makes an abortion statistically about as risky as a colonoscopy.If that fact seems surprising, consider how American pop culture misrepresents the risks of abortion: Nine percent of film and television characters who have abortions die as a direct result of the procedure, according to another 2014 study from UCSF. (credit:Getty Images)
2. MYTH: Medical abortions -- those performed using pills -- are still fringe.(02 of08)
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REALITY: About one in five abortions are medical abortions.The Centers for Disease Control and Prevention found that 19 percent of abortions in 2011 were medical abortions and that 28.5 percent of those took place in the first nine weeks of pregnancy. The Guttmacher Institute also found that medical abortions increased substantially from 2008 to 2011, meaning more women have ended their pregnancies with this alternative to surgery.

3. MYTH: Women who get abortions will regret it, and are more likely to suffer mental health issues.
(03 of08)
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REALITY: Most women will not regret their decision, and are no more likely to experience mental health problems than women who carry an unplanned pregnancy to term.While many women experience mixed emotions after an abortion, 95 percent of women who have abortions ultimately feel they have made the right decision, according to an August 2013 study from UCSF. "Experiencing negative emotions postabortion is different from believing that abortion was not the right decision," the researchers explained. Furthermore, while unplanned pregnancies often cause emotional stress, there is no evidence to suggest that women who choose to terminate their pregnancies will be more likely to suffer from mental health issues, according to a 2008 report from the American Psychological Association that investigated all relevant medical studies published since 1989.The APA found that past studies claiming abortion causes depression and other mental health problems consistently failed to account for other risk factors, particularly a woman's medical history. The APA accounted for these factors and found that, among women who have an unplanned pregnancy, those who have abortions are no more likely to experience mental health problems than those who carry the pregnancy to term.
4. MYTH: Fetuses experience pain during abortions.(04 of08)
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REALITY: Fetuses cannot feel pain until at least the 24th week of pregnancy. Experts ranging from Britain’s Royal College of Obstetricians and Gynaecologists to the American Congress of Obstetricians and Gynecologists agree with that timeline. In fact, research from UCSF found that fetuses can't perceive pain before 29 or 30 weeks of development.Then why have so many states banned abortions after 20 weeks of pregnancy? Perhaps misrepresentation of research is partly to blame: Many of the researchers most frequently cited by pro-life politicians told The New York Times that their research does not prove anything about fetal pain.
5. MYTH: The majority of Americans don't think abortion should be legal.(05 of08)
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REALITY: Most Americans support a woman's right to choose.According to a Gallup poll from 2014, 78 percent of Americans think abortion should be legal in some or all circumstances. (Fifty percent said "some circumstances," while 28 percent said all.) What's more, in 2012, Gallup found that 61 percent of Americans think abortions that take place during the first trimester of pregnancy should be legal. (Nine out of 10 abortions in the U.S. do take place during that time period, according to Guttmacher.) (credit:Getty )
7. MYTH: Most American women have easy access to abortions.(06 of08)
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REALITY: Women face a growing number of barriers to accessing abortions.More than 57 percent of American women live in states that are hostile or extremely hostile to abortion rights, according to the Guttmacher Institute. That represents a marked increase from 2000, when 31 percent of American women lived in such states. In 2011, 89 percent of counties in America had no abortion clinics. This is no accident: Across the U.S., lawmakers have enacted 231 new abortion restrictions over the past four years, according to a Guttmacher analysis from January 2015. As a result, many women have to travel great distances to reach an abortion clinic, where they may face 24-hour wait periods. These barriers particularly affect women living in rural areas and low-income women, who often can't afford to take time off work and pay for gas and a hotel room. Other laws force women to go through potentially distressing procedures, such as viewing their own ultrasound photos, in order to move forward with an abortion.
9. MYTH: Women would never have abortions if they knew what it was like to have a child.(07 of08)
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REALITY: Most women who have abortions are already mothers.Sixty-one percent of women who had abortions in 2008 were mothers, and 34 percent had two or more children, according to the Guttmacher Institute. That number only increased after the 2009 financial downturn. The National Abortion Federation told Slate that between 2008 and 2011, 72 percent of women seeking abortions were already mothers. A study from Guttmacher found that mothers typically have abortions to protect the children they already have; they simply cannot afford to raise another child. (credit:Getty Images)
10. MYTH: It is dangerous to perform abortions in clinics that do not meet the same standards as ambulatory surgical clinics. (08 of08)
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REALITY: Requiring abortion clinics to meet these standards does little to improve patient safety and forces many to shut down.Currently, 22 states require abortion clinics to meet a set of restrictive and often arbitrary standards, dictating that they be close to hospitals and that their hallways and closets meet certain measurements. Clinics often need to undergo expensive renovations in order to comply, and leading doctors' groups say the laws do little to improve patient safety.What's more, 11 states now require that doctors at abortion clinics obtain admitting privileges at a nearby hospital, but many hospitals flat-out refuse to grant these privileges. As a result, hospitals essentially have the power to shut down nearby clinics. (credit:Getty Images)