By Alicia Van Enoo
Abortion is one of the biggest issues of the 2016 U.S. Presidential Race. The debate centers on the complicated interplay between moral beliefs and legal rights, but rarely focuses on the medical consequences of preventing access to abortions. Recent statistics show that “of the estimated 44 million abortions performed every year worldwide, around half are considered unsafe.”1 This is a specifically important issues in countries where proper medical care and access to birth control is limited or non-existent. In countries where abortions are illegal, and even in countries where they are legal, but inaccessible due to “providers claiming conscientious objection”5, many women resort to extreme and often dangerous methods of terminating pregnancy.
According to the World Health Organization, 1 woman dies every 8 minutes due to complications from unsafe abortions, making it “one of the leading causes of maternal mortality (13%).”3 With limited access to contraception and sexual education and the alarmingly high incidence of rape in certain developing countries, unwanted pregnancies are not uncommon. Young girls and mothers who are already struggling are faced with difficult decisions in a healthcare system that does not support them. WHO defines unsafe abortions as “a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both.”2 Practically speaking, this can range from ingesting toxic chemicals, placing foreign objects into the uterus, or even blunt force trauma to the abdomen.3 These risky methods often lead to hemorrhage, infection, sepsis, or genital trauma – which without immediate medical attention, can result in death.3 Doctors without Borders run an obstetrical emergency center in Haiti to treat women suffering from pregnancy complications.1 They receive many women who are hemorrhaging and suffering from sepsis due to incomplete abortions. Unfortunately, if the abortion is incomplete, but uncomplicated, they are forced to refer them to another clinic. With the stigma associated with abortion, many women are often either treated disrespectfully, or even withheld treatment and left to die.1
Less restrictive abortion laws do not result in increased abortions, on the contrary, countries with the strictest abortion regulations have the highest rates of abortion.2 Consequently, the majority of unsafe abortions happen in developing nations, where abortions are largely unavailable due to accessibility or legality issues.3 South Africa is a promising case study looking at the effect of policy changes on the rates of unsafe abortions. In 2008, more than 97% of abortions in Africa were considered “unsafe”. However, the rate for South Africa, where abortion was legalized in 1997, was only 58%.2 It is a common misconception in the field of public health that providing access equates encouraging behavior. Evidence shows that increasing accessibility to abortion does not increase rates, but it does significantly reduce the proportion of abortions that are conducted in an unsafe and unregulated manner.2
Although programmatic changes concerning access to abortions are undoubtedly necessary in countries facing high rates of unsafe abortions, the first line of defense should be prevention.4 Access to contraception is a privilege taken for granted by many in developed nations, yet it is only sparingly available to many women around the world. Additionally, sexual education is heavily lacking, even in our own backyard. Preventing unwanted pregnancy could help drastically reduce rates of unsafe abortions, without needing to directly tackle the sensitive problem of pregnancy termination.
I concede that at a time of intense debate concerning individual rights and protection, it is difficult to step away from the legal and moral dimensions of abortion. However, the health implications of unsafe abortions make it first and foremost a medical issue in developing nations. Doctors Without Borders urges us to to recognize that aside from being an issue in the 2016 presidential election “safe abortion care is a medical necessity.”1 As Elizabeth McCguire, from Former president of Ipas, said “there is no perfect contraceptive method, so there will always be abortions, and it’s important that abortions be safe so that women don’t die.”4
The following video discusses Kenya’s struggles with unsafe abortions and highlights the extensiveness and severity of the issue
- Doctors Without Borders / MSF-USA. “The Dangers of Unsafe Abortion.” Online video clip. YouTube. YouTube, 10 Jan 2015. Web. Accessed 22 Feb 2016.
- Guttmacher Institute. “Facts on Induced Abortion Worldwide.” Nov 2015. Web. Accessed 22 Feb 2016
- Haddad L, Nour N. “Unsafe Abortion: Unnecessary Maternal Mortality.” Rev Obstet Gynecol. 2009;2(2): 122-26.
- VOA News. “World Health Organization Targets Unsafe Abortion.” Online video clip. YouTube. Youtube, 24 Jun 2010. Web. Accessed 22 Feb 2016.
- Wood S. “A Global class on Abortion. “ The New York Times. 28 Jan 2016. Web. Accessed 22 Feb 2016.
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