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Abortion rates fall in developed world but rise in poorer countries

An abortion advertisement along a busy street in Soweto, South Africa.

Erin Conway-Smith/erin conway-smith The Globe and Mail

After declining for nearly a decade, the world's abortion rate has stalled since 2003, while a growing percentage of abortions are dangerous to women's health, especially in Africa, a new study says.

The study found that the abortion rate is actually lower in places where abortion is legal, such as South Africa, suggesting that anti-abortion laws may be ineffective and even counter-productive.

Abortion is criminalized or highly restricted in most of Africa, and not coincidentally Africa is the site of about half of all deaths caused by unsafe abortions, according to the study published in The Lancet, the British medical journal.

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As abortion declines dramatically in the developed world, it continues to remain common in the developing world. About a quarter of pregnancies end in abortions in the developed world today – down from 36 per cent in 1995 – yet the abortion rate in the developing world is essentially unchanged since 1995, with about a fifth of pregnancies still ending in abortion.

The study shows that the world is failing to tackle the epidemic of unsafe abortions, one of the most preventable causes of maternal deaths, and it suggests that the unavailability of contraception is a growing problem in much of the world, analysts said.

Unsafe abortion is one of the five major causes of the estimated 365,000 maternal deaths in the world every year. More than eight-million women need medical attention for complications caused by unsafe abortions annually, according to the U.S.-based Guttmacher Institute, which specializes in reproductive health issues.

"Almost the entire global burden of deaths due to abortion occurs in Africa, Asia and Latin America," said an editorial in The Lancet that accompanied the new study.

"Somehow, we typically act as if this were neither surprising nor troubling," it added. "But there are no regional biological differences in women that could account for this discrepancy … and there are no costly technologies needed to avoid these deaths. If a lack exists, it is a lack of caring: a willingness to sacrifice lives to an ideological high ground, to social acceptability, or to the maintenance of a political comfort zone."

From 1995 to 2003, the global abortion rate dropped steadily by an average of 2 to 4 per cent annually. But over the following five years, the abortion rate scarcely changed at all, declining by only 0.3 per cent annually, according to the study.

Worldwide, nearly 50 per cent of abortions were unsafe in 2008, compared to 44 per cent in 1995, it found.

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The study found a huge discrepancy in the abortion rate between the rich world and the poor world. Since 2003, the number of abortions fell by 600,000 in the developed world, while increasing by 2.8 million in developing countries.

Although the study did not identify the exact reasons for the halt in the decline of abortions, the authors noted that it coincided with a plateau in the rise of contraception use worldwide.

The study also found that abortion-related mortality is higher in places where abortion is banned or restricted. It noted that the number of deaths caused by unsafe abortions fell dramatically in South Africa and Nepal when their abortion laws were liberalized.

"Our findings point to a dire need to invest in efforts to reduce unintended pregnancies and unsafe abortions," the study said, adding that "unsafe abortions and deaths and disabilities resulting from them are entirely preventable, yet 13 per cent of all maternal deaths continue to be the result of unsafe abortions."

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About the Author
Africa Bureau Chief

Geoffrey York is The Globe and Mail's Africa correspondent.He has been a foreign correspondent for the newspaper since 1994, including seven years as the Moscow Bureau Chief and seven years as the Beijing Bureau Chief.He is a veteran war correspondent who has covered war zones since 1992 in places such as Somalia, Sudan, Chechnya, Iraq and Afghanistan. More

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