JAC24

Abortion

Vital details

• When conducted by a skilled professional, using a method recommended by the World Health Organization (WHO) that is appropriate for the stage of pregnancy, abortion is a frequently employed medical procedure that is deemed safe for the individual's health.
• Six out of 10 unintended pregnancies worldwide result in an induced abortion. This highlights the significance of abortion as a response to unintended pregnancies.
• Approximately 45% of all abortions are unsafe, with developing countries accounting for 97% of these cases. This alarming statistic underscores the prevalence of unsafe abortion practices in regions with limited access to proper healthcare resources.
• Unsafe abortion is a leading cause of maternal deaths and morbidities, and it is important to note that these negative outcomes are preventable.
• Women who undergo unsafe abortions face potential physical and mental health complications, imposing additional burdens on both individuals and communities.
• The availability of abortion services that are safe, prompt, affordable, and conducted with dignity is a matter of utmost importance for public health and the protection of human rights.
• Insufficient access to such services presents considerable obstacles and has far-reaching consequences on the welfare of women, communities, and healthcare systems.
• In summary, ensuring access to safe and appropriate abortion care is crucial for protecting women's health, preventing maternal mortality, and upholding human rights.

Summery

Approximately 73 million induced abortions occur worldwide annually, with the majority resulting from unintended pregnancies. Abortion can be safely performed by various healthcare providers using medication or surgery, and in the early stages of pregnancy, it can be self-managed with accurate information and appropriate support.

Comprehensive abortion care involves providing information, managing the procedure, and offering post-abortion care, encompassing induced abortion, miscarriage, incomplete abortion, and fetal death. This abstract focuses specifically on induced abortion care.

Scope of the issue

Safe and timely access to abortion, performed by skilled healthcare providers following WHO guidelines, is essential for women's health. However, due to various barriers, such as lack of affordability, availability, and discrimination, many individuals resort to unsafe abortions.

Globally, around 45% of induced abortions are unsafe, with developing countries, particularly in Asia, Latin America, and Africa, shouldering the majority of this burden. Urgent efforts are needed to ensure safe and accessible abortion services, particularly in regions where the risk is highest.

Results of insufficient quality abortion care availability

Lack of access to safe, affordable, and timely abortion care, coupled with the stigma surrounding abortion, significantly jeopardizes women's physical and mental well-being at all stages of life.

This inaccessibility violates several fundamental human rights, including the right to life, the right to the highest attainable standard of health, the right to make informed decisions about reproduction, and the entitlement to freedom from torture and cruel and inhuman treatment.

Unsafe abortion is responsible for a significant proportion of maternal deaths, with estimates indicating that 4.7-13.2% of these deaths occur annually.

Developed regions witness 30 deaths per 100,000 unsafe abortions, while developing regions experience a staggering 220 deaths per 100,000 unsafe abortions.

Disturbingly, approximately 7 million women in developing countries alone sought treatment in hospitals each year due to complications arising from unsafe abortions.

Physical health risks associated with unsafe abortion such as :

• Unsafe abortions carry several physical health risks:
• Incomplete abortion: Procedures may fail to remove all pregnancy tissue, leading to complications and requiring further medical intervention.
• Hae-morrhage: Unsafe abortions often result in heavy bleeding, which, without proper medical care, can have severe consequences, including death.
• Infection: Unsafe practices introduce bacteria, increasing the risk of infections that can be life-threatening if left untreated.
• Uterine perforation: Accidental piercing or perforation of the uterus during unsafe procedures can cause significant damage, necessitating surgical repair.
• Genital tract and organ damage: Inserting dangerous objects during self-induced abortion can lead to long-term complications, chronic pain, and reproductive health impairments.

Restrictive abortion regulations impose distress, stigma, and financial burdens on women, violating their human rights. Limited access leads to increased costs for post-abortion treatments and loss of income.

Greater access to contraception and safe abortion can save significant monetary resources.

Abortion regulations which linked to fertility impact women's education, labor market participation, and contribute to GDP growth. Legalization of abortion can improve children's educational outcomes and future earnings.

Improving the  safe and reliable abortion care

Restricting access to abortions does not decrease the total number of abortions but negatively impacts the safety and dignity of the procedures.

Countries that enforce stringent abortion regulations experience a greater prevalence of unsafe abortions.

Barriers to accessing safe and respectful abortion care include financial burdens, stigma, healthcare workers' conscientious objection, and unnecessary legal requirements like

• Criminalization,
• Mandatory waiting periods,
• Biased counseling,
• Third-party authorization, and
• Restrictions imposed on healthcare providers and facilities.

Legal frameworks that ensure access to safe and legal abortion services.Well-functioning health systems that provide comprehensive and affordable abortion care. Communities free from stigma, where individuals can access abortion services without discrimination or judgment.

• Human rights respect, accessible information, and supportive health system are essentia

A well functioning health system implies many factors such as

Evidence-based policies for:

• Universal health coverage.
• Ensuring a consistent provision of medical products and equipment that are both high in quality and affordable.
• Accessible abortion care by an adequate number of health workers.
• Diverse delivery approaches based on patient preferences and resources.
• Training of health workers in safe and respectful abortion care.
• Support and protection of health workers from stigma
• Offering contraceptive methods to avoid unplanned pregnancies.
• The presence and attainability of information suggests:
• Essential: evidence-based comprehensive sexuality education and accurate,
• unbiased information on abortion and contraception.

The WHO actions

WHO guides on contraception, abortion care, and post-abortion care, and maintains a database on global abortion policies. It supports countries in adapting guidelines and strengthening policies.

WHO is involved in research, including abortion regulation, stigma, and community approaches to quality care. It monitors the global burden of unsafe abortion.