Abortion around the world: An overview of legislation, measures, trends and consequences
Access to abortion around the world is highly unequal. While in most Northern American and European countries abortion is available to women on request, in African and Latin American countries access may be restricted to particular causes of pregnancy or totally outlawed. The issue at all levels—from restricting abortion use or recognizing any right to it at all, as in Poland recently—is still hotly debated. A few countries have recently voted to legalize abortion, such as Chile (in case of risk to the mother’s life, fetal impairment or rape) and Ireland (by popular referendum in 2018), but in Argentina in 2018 a bill to legalize abortion passed the lower house but was rejected by the senate.
Restricted access to abortion does not prevent women from ending their pregnancies, as attested by high abortion rates in countries where the practice is legally restricted. But it now leads women to seek abortions that will minimize risks to their lives or health and risks of penal sanction. One strategy is to travel to countries or regions with more permissive laws or a longer legal pre-abortion pregnancy duration; another is to choose healthcare structures where health professionals do not have a conscientious objector clause. Another means of circumventing restrictive laws is medical abortion, now the primary method used not only in countries where abortion is legal but also in restricted contexts, such as in Latin America, where women obtain abortion-inducing pharmaceutical drugs through informal networks. Medical abortion involves less risk than methods traditionally used in places where abortion is illegal. The change in level of risk, due primarily to the use of medical abortion, has led the World Health Organization to revise its risk categories from the binary “safe/unsafe”—wherein all illegal abortions were considered unsafe—to the gradated “safe, less safe, least safe,” an assessment that, in addition to method used, also takes into account the qualifications of the person performing the abortion.
The latest estimates of abortion levels in different world regions are based on this new classification system. The situation differs widely between highly developed countries, where 88% of abortions are safe, and less developed countries, with a safe abortion rate of 49%. It is most critical in Africa, where women still use invasive methods, access is strictly limited, and abortion rates are high (34 per 1,000 women aged 15 to 44 from 2010-2104). Africa is also the region where the number of maternal deaths due to unsafe abortions is highest. Abortions performed by qualified personnel using safe methods are an effective means of preventing such risks. Legalizing abortion is of course a key factor in overcoming risk and respecting women’s internationally recognized rights, including their right to health, while enabling them to decide the number of children they want and how to space childbirths over time.
Source: Agnès Guillaume, Clémentine Rossier, 2018, L’avortement dans le monde. État des lieux des législations, mesures, tendances et conséquences, Population 2018-2.
Contact: Agnès Guillaume, Clémentine Rossier
Online: October 2018