Unsafe abortion

An unsafe abortion is the termination of an unintended pregnancy by persons lacking the necessary skills, or in an environment lacking the minimal medical standards, or both. According to a global study collaboratively conducted by the World Health Organization and the Guttmacher Institute, most unsafe abortions occur where abortion is illegal ^[1]. Unsafe abortion is a significant cause of maternal mortality and morbidity in the world. Approximately 95% of unsafe abortions take place in developing countries. ^[2]

Overview

The World Health Organization (WHO) reports each year nearly 42 million women faced with an unintended pregnancy have an abortion ^[3]; and according to the 2007 estimates conducted collaboratively by the WHO and Guttmacher Institute, 20 million unsafe abortions take place each year, most in countries where abortion is illegal ^[4]. According to WHO and Guttmacher, approximately 68,000 women die annually as a result of complications of unsafe abortion; and between two million and seven million women each year survive unsafe abortion but sustain long-term damage or disease (incomplete abortion, infection (sepsis), haemorrhage, and injury to the internal organs, such as puncturing or tearing of the uterus). They also concluded abortion is safe in countries where it's legal, but dangerous in countries where it's outlawed and performed clandestinely. The WHO reports that in developed regions, nearly all abortions (92%) are safe, whereas in developing countries, more than half (55%) are unsafe. ^[5] According to WHO statistics, the risk rate for unsafe abortion is 1/270; according to other sources, unsafe abortion is responsible for one in eight maternal deaths.^[6] Worldwide, 48% of all induced abortions are unsafe.

The World Health Organization considers unsafe abortion a reproductive health issue. ^{[7] [8]} WHO’s Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: “As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets." ^[9] The WHO's Development and Research Training in Human Reproduction (HRP), who's research concerns people's sexual and reproductive health and lives ^[10], has an overall strategy to combat unsafe abortion that comprises four inter-related activities ^[11]:

• to collate, synthesize and generate scientifically sound evidence on unsafe abortion prevalence and practices;
• to develop improved technologies and implement interventions to make abortion safer;
• to translate evidence into norms, tools and guidelines;
• and to assist in the development of programmes and policies that reduce unsafe abortion and improve access to safe abortion and highquality postabortion care.

A 2007 study published in the The Lancet found that, although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003. It also concluded that, while the overall incidence of abortion in both developed and developing countries is approximately equal, unsafe abortion occurs more often in less-developed nations. ^[12]

Pro-life critics contend that the results of The Lancet study are flawed, as there are no accurate statistics about abortion from countries without socialized medicine, particularly those in the developing world.^[13][14] In a 2005 report, the WHO itself states, “More than a third of the 204 countries or areas examined did not report the number of deaths by sex even once for the period 1995 to 2003. About half did not report deaths by cause, sex and age at least once in the same period. Moreover, from 1975 to 2003 there has been limited progress in the reporting of deaths and their causes.” ^[15]

Incidence by continent

Source: Unsafe Abortion: Mortality and Risk Estimates of Death data from WHO press, Geneva, 1997

10,000 women a year die from unsafe abortions in Nigeria alone.^[18]

Incidences in the U.S. after 1973

In 2005, the Detroit News reported that a 16-year-old boy beat his pregnant, under-age girlfriend with a bat at her request to abort a fetus. The young couple live in Michigan, where parental consent is required to receive an abortion.^{[19] [20][21]} In Indiana, where there are also parental consent laws, a young woman by the name of Becky Bell died from a back-alley abortion rather than discuss her pregnancy and wish for an abortion with her parents.^[22][23]

Method

Methods of unsafe abortion include:

• Trying to break the amniotic sac inside the womb with a sharp stick or wire (for example a clothes hanger). This method can result in infection, and injury to internal organs (for example perforating the intestines), resulting in death.
• Pumping toxic mixtures, such as chili peppers and chemicals like alum, or plant poison into the body of the woman. This method can cause the woman to go in to toxic shock and die.^[18]
• Inducing an abortion without medical supervision by self-administering abortifacient drugs obtained illegally, either by importion or by using drugs not indicated for abortion but known to result in miscarraige and/or uterine contraction.

Back-alley abortion

Soviet poster circa 1925. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman, they also often lead to death."

An illegal abortion may be called a "back-alley", "backstreet", or "back-yard" abortion.

The wire coat hanger method was a popularly known illegal abortion procedure, although they were not the norm. In fact, Mary Calderone, former medical director of Planned Parenthood, said, in a 1960 printing of the American Journal of Public Health:

"Abortion is no longer a dangerous procedure. This applies not just to therapeutic abortions as performed in hospitals but also to so-called illegal abortions as done by physician. In 1957 there were only 260 deaths in the whole country attributed to abortions of any kind, second, and even more important, the conference [on abortion sponsored by Planned Parenthood] estimated that 90 percent of all illegal abortions are presently being done by physicians. Whatever trouble arises usually arises from self-induced abortions, which comprise approximately 8 percent, or with the very small percentage that go to some kind of non-medical abortionist. Abortion, whether therapeutic or illegal, is in the main no longer dangerous, because it is being done well by physicians."

Herbal abortions (when done illegally) can also be described as back-alley abortions because they are not induced in a medical facility.

Controversy

The matter of back-alley abortion in America received public attention leading up to the legal proceedings of Roe v. Wade, the 1973 United States Supreme Court decision which legalized abortion in America. Since then, it has become a central argument on the part of some prominent legal abortion advocates. The publication in Ms. magazine of a photo of Gerri Santoro, who died of blood loss following a back-alley abortion, was used extensively to illustrate the dangers of illegal abortions.

See also

• Reproductive health
• Reproductive rights

References

External links

• My Back-Alley Abortion, via BeliefNet