Induced abortion is common: In 2017, an estimated 56% of all unintended pregnancies worldwide ended in abortion. Despite the frequency with which women terminate pregnancies, however, 135 countries impose restrictions on induced abortion beyond gestational age limits, which lead some women to seek unsafe abortion. The World Health Organization (WHO) defines unsafe abortion as a procedure for terminating an unwanted pregnancy carried out by individuals who lack the requisite training and skills, in a setting that does not meet minimum medical standards, or both. An estimated 25 million unsafe abortions occur annually—nearly all (97%) in low- and middle-income countries (LMICs), where abortion is more likely to be heavily restricted. Unsafe abortion results in 22,800–31,000 maternal deaths each year. Furthermore, in developing regions, nearly seven of every 1,000 women are treated in a health facility for abortion complications. The legalization and derestriction of abortion are necessary steps in reducing maternal morbidity and mortality from unsafe abortion, but there are additional obstacles to services that must also be addressed.
Blake Erhardt-Ohren is monitoring, evaluation and learning technical advisor; and Sarah Lewinger is knowledge management specialist—both with Pathfinder International, Watertown, MA, USA.