Rates were similar whether procedures were legal, illegal, survey also found
FRIDAY, Oct. 12 (HealthDay News) -- The number of induced abortions fell worldwide from almost 46 million in 1995 to less than 42 million 2003, a new survey finds.
About one in every five pregnancies ends in abortion, the global survey found, and the number of unsafe procedures has not declined.
The report, by researchers at the Guttmacher Institute and the World Health Organization, also found that abortion rates were unaffected by whether or not the procedure was legal or not in a particular country.
"Abortion levels where it is illegal are just as high as where it is legal," said study co-author Gilda Sedgh, a senior researcher at the Guttmacher Institute, a nonprofit group focused on reproductive issues, based in New York City.
In fact, Sedgh said, "what is counterintuitive is that [abortion] rates are lowest where it is legal." She estimates that perhaps 90 percent of women worldwide will have an abortion at one time or another.
The survey results are published in the Oct. 13 issue of the journal The Lancet.
This is the second such survey ever done. The first, also a cooperative effort of the Guttmacher Institute and the World Health Organization, was done in 1994-1995.
Data was gathered from government figures in areas where abortion is legal and by a variety of means, including private interviews with women, in areas where it is not legal, Sedgh said.
Overall, the survey estimated 41.6 million abortions a year are carried out globally, with only about 6.6 million of them performed in developed nations such as the United States. Some 92 percent of abortions were done by safe methods in developed countries, but just 45 percent performed in developing nations were deemed safe.
Globally, there were 31 abortions for every 100 live births in 2003, but those statistics varied widely from region to region. For example, there were 105 abortions for every 100 live births in eastern Europe, but in east Asia that rate declined to 51 abortions for every 100 live births. The abortion rate in eastern Europe is dropping rapidly, however, as better contraception becomes available, the researchers said.
The high rate of the procedure in eastern Europe means that nearly a third of all pregnancies in that continent end in abortion. By contrast, only 12 percent of pregnancies in Africa end in abortion. Worldwide, the rate of abortion is one in every five pregnancies.
China accounts for about a fifth of all abortions worldwide, the survey found. The rate in China dropped 20 percent between 1995 and 2003, as a growing middle class learned more effective use of contraception, Sedgh said.
The survey has both good and bad news, said Beth Fredrick, executive vice president of the International Women's Health Group. "What is good is that the overall number of abortions are going down, primarily because of improved contraceptive use," said Fredrick, who was also the author of an accompanying journal commentary on the findings. "But behind the statistics, we see that the majority of abortions are going to be unsafe, particularly for the impoverished. This is an atrocity in terms of how we recognize human rights."
Legal changes are occurring but differ among countries, Fredrick said. "Portugal, Columbia and Mexico City have liberalized," she said. "Nicaragua has completely outlawed abortion, and there are early indications that this is having a bad impact on the women of Nicaragua, their partners and families."
The abortion survey is included in a special "Women Deliver" issue of The Lancet. It includes articles on the need to improve maternal mortality rates in regions such as southern Africa; the drive for more resources to fight severe childbirth complications; and the uneven progress being made to improve maternal health, country by country.
For more on abortion worldwide, head to the Guttmacher Institute.
SOURCES: Gilda Sedgh, Ph.D., senior researcher, Guttmacher Institute, New York; Beth Fredrick, executive vice president, International Women's Health Group, New York; Oct. 12, 2007, The Lancet
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