Abortion rates around the world reveal a deep divide between developed and developing countries


Abortion rates in the developed world are falling. But the number of procedures has increased in other countries without access to modern methods of contraception.

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A new analysis of abortions around the world shows a deep and troubling gulf between what happens in richer developed countries and their poorer and less developed counterparts.

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The article, published Wednesday in The Lancet, represents the most comprehensive analysis ever conducted on the subject. Globally, it shows that an average of 56 million abortions took place each year from 2010 to 2014. This translates to 35 procedures per 1,000 women of reproductive age, which means around 3.5 % of women in this age group have had an abortion.

The numbers are significantly lower than a decade earlier – from 1990 to 1994, there were an average of 40 abortions per year per 1,000 women – and should be a cause for celebration for many in the reproductive health arena as well. than for those who oppose abortion. But Gilda Sedgh, senior researcher at the Guttmacher Institute in New York and lead author of the study, warned during a call to reporters that “the big picture masks the differences between the developed and the developing world.”

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No matter how you calculate the numbers for the developed world, which includes the United States, abortions are down. Rates have been going down for 25 years and are now at an all time low. There were 27 abortions per 1,000 women from 2010 to 2014, compared to 40 per 1,000 from 1990 to 1994. Likewise, the total number of abortions fell from 12 million to 7 million.

Restrictive abortion laws don’t limit the number of abortions

But in developing countries over the same period, abortions have risen from 39 to 37 per 1,000 women while the total number of interventions has risen from 39 million to 50 million per year – a situation the authors attribute lack of access to modern methods of contraception which could have reduced unintended pregnancies.

“We believe this is because the desire for small families and precisely timed births has overtaken contraceptive use,” Sedgh said.

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The study was based on statistical modeling of information collected from national surveys, official government statistics and other published and unpublished studies and was funded by various countries as well as the David and Lucile Packard Foundation and the United Nations.

Among other major findings, three-quarters of abortions took place in married women, challenging the popular notion that most abortions are sought by unmarried adolescent girls.

Eastern Europe stood out with the largest drop in abortion rates, from 88 to 42 per 1,000 women. Rates also fell in southern Europe, from 38 to 26; in Northern Europe, from 22 to 18 years old; and in North America, 25 to 17.

The researchers said Western Europe was the only region studied with an increase in its abortion rate, which they said could be due to a growing population of foreign-born people.

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In addition to providing a breakdown of abortion worldwide by major region, the study also addressed sensitive legal and ethical debates over the procedure by dividing the figures for the 58 countries where it is illegal or permitted only to save life. a woman’s. The authors noted that the rate in these countries – making up most of South America, Africa and the Middle East – is 37 per 1,000. This is “essentially” no different from the rate. 34 per 1,000 in the 63 countries where abortion is legal.

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The authors pointed out that these results suggest that “restrictive abortion laws do not limit the number of abortions.”

In a commentary also published by The Lancet, Associate Professor Diana Greene Foster of the University of California at San Francisco criticized this reasoning.

“The obvious interpretation is that criminalizing abortion does not prevent it but, on the contrary, pushes women to seek illegal services or methods. But this simple story overlooks the many women who, in the absence of safe legal services, lead to unintended pregnancies, ”said Greene Foster. She argued that it made no sense to assume “a one-for-one exchange of illegal abortion for a legal abortion”.

The results of the paper are consistent with other data published in recent years that show a positive trend in the reduction of unwanted pregnancies and births. This month, the U.S. Centers for Disease Control and Prevention reported that America’s teenage birth rate – which was at crisis levels in the 1990s – had fallen to an all-time low and the decline had impacted all regions and races.

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The big picture masks the differences between the developed and developing world

While various cultural, educational and economic factors have been debated as to why some groups have higher abortion rates than others, many doctors, researchers, women’s rights advocates and public health officials now appear to be siding. ‘tune in on an essential factor: access to modern methods of birth control.

The past 10 years have been breakthroughs for contraceptive innovations; women can now avail themselves of all kinds of long-lasting, low-risk implantable and injectable alternatives to the daily pill. Yet much of this information and the availability of new methods have not filtered to developing regions of the world.

“Clearly, efforts need to be focused on these regions,” said Bela Ganatra of the World Health Organization, co-author of the study. She added that health officials recognize that not all unsafe abortions can be avoided by increasing access to contraception, as some women seek the procedure due to rape or contraceptive failure or other factors. Another study is underway to try to get more information on the situations that lead to a safe or unsafe abortion, she said.

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