In 2005, Ethiopia’s parliament amended the penal code to expand the circumstances in which abortion is legal. Although the country has expanded access to abortion and postabortion care, the last estimates of abortion incidence date from 2008.
Data were collected in 2014 from a nationally representative sample of 822 facilities that provide abortion or postabortion care, and from 82 key informants knowledgeable about abortion services in Ethiopia. The Abortion Incidence Complications Methodology and the Prospective Morbidity Methodology were used to estimate the incidence of abortion in Ethiopia and assess trends since 2008.
An estimated 620,300 induced abortions were performed in Ethiopia in 2014. The annual abortion rate was 28 per 1,000 women aged 15–49, an increase from 22 per 1,000 in 2008, and was highest in urban regions (Addis Ababa, Dire Dawa and Harari). Between 2008 and 2014, the proportion of abortions occurring in facilities rose from 27% to 53%, and the number of such abortions increased substantially; nonetheless, an estimated 294,100 abortions occurred outside of health facilities in 2014. The number of women receiving treatment for complications from induced abortion nearly doubled between 2008 and 2014, from 52,600 to 103,600. Thirty-eight percent of pregnancies were unintended in 2014, a slight decline from 42% in 2008.
Although the increases in the number of women obtaining legal abortions and postabortion care are consistent with improvements in women’s access to health care, a substantial number of abortions continue to occur outside of health facilities, a reality that must be addressed.
Ann M. Moore is principal research scientist, Akinrinola Bankole is director of international research, and Susheela Singh is vice president for research—all at the Guttmacher Institute, New York. Yirgu Gebrehiwot is associate professor and consultant obstetrician/gynecologist, Faculty of Medicine, Addis Ababa University, Ethiopia. Tamara Fetters is senior research and evaluation advisor, Ipas, Chapel Hill, NC, USA. Yohannes Dibaba Wado is senior research and evaluation advisor, Ipas Ethiopia, Addis Ababa. Hailemichael Gebreselassie is senior research advisor, Ipas Africa Alliance. Yonas Getachew is a member of the Ethiopian Society of Obstetricians and Gynecologists, Addis Ababa.