Every year, as many as 20 million women around the world have unsafe abortions, nearly 70,000 die from the procedure and millions experience serious medical complications according to Unsafe Abortion: The Preventable Pandemic, published this week in The Lancet as part of a series on sexual and reproductive health. While abortions in countries where the procedure is illegal are generally unsafe, proper postabortion care and counseling can help women who have had abortions remain healthy and learn how to prevent future unwanted pregnancies. The need for better postabortion care is further underscored by the fact that complications from unsafe abortion are among the most common reasons women are admitted to the hospital for gynecological services in developing countries, according to Hospital Admissions Resulting from Unsafe Abortion: Estimates from 13 Developing Countries, also published in The Lancet this week.
Yet research suggests that the stigma associated with abortion prevents many women from getting good care, leading to ill-health and deaths. In addition, evidence shows that access to safe, legal abortion results in better health outcomes for women. Conversely, when abortion is illegal or more difficult to obtain, women’s health and survival suffer. "We must call more attention to the severity of this problem and start an open dialogue before more women needlessly die or become injured," says Dr. Susheela Singh, vice president for research at the Guttmacher Institute and an author of both studies.
Research conducted by the Guttmacher Institute and colleagues in Guatemala and Uganda underscores the continuing stigma around abortion and its impact on women in need of urgent health care. Fear prevents many women from seeking health care when they experience postabortion complications. According to one Ugandan, "women fear that if they go to hospital for treatment they can be arrested and asked to reveal the people who helped them stop the pregnancies."
This fear is not unfounded. Health care workers often judge and even threaten women who come to them for care. When asked to describe her attitude toward women who seek treatment for their abortion complications, one nurse in Uganda commented, "If such a woman comes to me, I feel bad. I even threaten that I can’t treat her complications while in the actual sense I can."
A Guatemalan woman shared the experience of an acquaintance who was warned by hospital workers, "Next time you return (with an abortion), you will die because we are not going to take care of you."
Abortion is a difficult issue throughout the world. Without public dialogue about abortion and its root cause – unintended pregnancy – many women will continue to seek harmful ways to terminate an unwanted pregnancy and face dreadful consequences to their health. Overcoming the stigma surrounding abortion and unplanned pregnancy through public dialogue can reduce the illness and death resulting from this very preventable pandemic. Such a dialogue is simply essential. Without it, unsafe abortion will continue to be one of the most neglected public health challenges of our time.
See also:
Unintended Pregnancy and Induced Abortion in Uganda
Morbilidad por aborto en Guatemala: Una visión de la comunidad
Unintended Pregnancy and Induced Abortion in the Philippines: Causes and Consequences
Unwanted Pregnancy and Induced Abortion in Nigeria: Causes and Consequences