AWW2009slides

Abortion Worldwide:A Decade of Uneven Progress : 

Abortion Worldwide:A Decade of Uneven Progress Guttmacher Institute © October 2009

What’s new : 

What’s new Trends in contraceptive use, unmet need for contraception and unintended pregnancy rates Changes in the legal status of abortion More comprehensive look at abortion and women’s lives

Most trends are positive : 

Most trends are positive Worldwide decline in abortion incidence Global rise in contraceptive use Decline in unintended pregnancy Liberalized abortion laws in a number of countries Growing access to abortion, even in legally restrictive countries

Abortion has declined worldwide : 

Abortion has declined worldwide World More developed countries Less developed countries 35 29 29 39 26 34 Abortions per 1,000 women aged 15–44

Unintended pregnancy rates are down in the developing world : 

Unintended pregnancy rates are down in the developing world *Excludes Eastern Asia Unintended pregnancies per 1,000 women aged 15–44

Contraceptive use is on the rise : 

Contraceptive use is on the rise

Safe abortion is more available : 

Safe abortion is more available 19 countries (including the Mexican Federal District) have liberalized their laws Availability of medication abortion has improved Use of manual vacuum aspiration has increased

But progress has been uneven : 

But progress has been uneven Levels of unsafe abortion have not declined Unmet need for contraception remains high in some regions Many women lack access to safe abortion Abortion-related mortality and morbidity remain higher The poor bear the greatest burden

Unsafe abortion rates have not changed : 

Unsafe abortion rates have not changed World More developed countries Less developed countries 35 29 29 39 26 34 Abortions per 1,000 women aged 15–44

40% of women worldwide live under highly restrictive abortion laws : 

40% of women worldwide live under highly restrictive abortion laws 1.55 billion women aged 15–44, 2008 Legal Grounds

Unmet need for contraception is still high… : 

Unmet need for contraception is still high… 1990–1995 2002–2007 1990–1995 1990–1995 2002–2007 2002–2007 Africa Asia Latin America & Caribbean Married women aged 15–44

Leading to high rates of unintended pregnancy : 

Leading to high rates of unintended pregnancy Modern method No method Traditional method Unintended pregnancies in developing countries, by women’s contraceptive use

More than one-third of pregnancies in developing countries are unintended : 

More than one-third of pregnancies in developing countries are unintended All pregnancies in developing countries

Almost all unsafe abortions occur in the developing world : 

Almost all unsafe abortions occur in the developing world Millions of abortions, 2003 42 7 35

Nearly all abortions in Africa and Latin America are unsafe : 

Nearly all abortions in Africa and Latin America are unsafe

Four in 10 women having unsafe abortions experience complications requiring treatment : 

Four in 10 women having unsafe abortions experience complications requiring treatment 19.2 million unsafe abortions

In countries with restrictive abortion laws, providers of abortion are often untrained : 

In countries with restrictive abortion laws, providers of abortion are often untrained % of women having abortions 100 80 60 0 40 20

Poor women are most likely to experience serious abortion complications : 

Poor women are most likely to experience serious abortion complications Of women having abortions, % experiencing serious complications

Health consequences are often severe and long-term : 

Health consequences are often severe and long-term Kenya: 28% of abortion complications among women seeking treatment were severe Nigeria: Among hospitalized patients: 1 in 3 had hemorrhage 1 in 4 had sepsis 1 in 10 suffered other injuries Second trimester abortion greatly increases risk Many women experience long-term consequences

Costs of unsafe abortion to women, their families and society are large : 

Costs of unsafe abortion to women, their families and society are large Postabortion care costs Africa and Latin America nearly $300 million annually An estimated 220,000 children are left motherless every year from abortion-related deaths Loss of productivity affects household functioning

Unsafe abortion accounts for one in eight maternal deaths : 

Unsafe abortion accounts for one in eight maternal deaths Maternal deaths per 100,000 live births

Safe abortion saves lives: South Africa : 

Safe abortion saves lives: South Africa Between 1994 and 2000, severity of abortion- related complications dropped: Fewer postabortion infections Largest gains by young women Deaths due to unsafe abortion declined by at least 50%

Preventing unintended pregnancy is cost-effective : 

Preventing unintended pregnancy is cost-effective Estimated $19 million spent annually in treating unsafe abortion complications in Nigeria It would cost only $4.8 million to provide the contraceptive services needed to prevent the pregnancies resulting in these abortions This is a cost-benefit ratio of about 4:1

Increased contraceptive use leads to fewer abortions : 

Increased contraceptive use leads to fewer abortions The worldwide decline in abortion over the past decade has been accompanied by: A worldwide decline in unintended pregnancy A global increase in the proportion of women using contraception

Key interventions to reduce unsafe abortion and its consequences : 

Key interventions to reduce unsafe abortion and its consequences Expand access to modern contraceptives and improve family planning services Expand access to legal abortion and ensure that safe services are available to women in need Improve the quality and coverage of postabortion care, which would reduce maternal death and disability due to unsafe abortion

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