How legal restrictions on abortion are harming women all over the world

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05/05/2018 12:00 am

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This Friday Ireland faces a historic vote on whether to reform the country’s abortion laws, which are among the most restrictive in Europe. Currently, women in Ireland who need an abortion are forced to travel abroad – usually England – or may resort to clandestine termination of their pregnancies.

Worldwide, an estimated 25 million unsafe abortions occur each year, even though abortion is a simple and safe procedure when properly performed. Unsafe abortion occurs most frequently in countries with restrictive abortion laws. Banning abortion does not eliminate the procedure, but it does make abortion more likely to be unsafe.

In fact, research shows that abortion occurs just as frequently in countries where abortion is prohibited or highly restricted as where it is broadly legal. According to a recent report by the Guttmacher Institute more and more women and couples worldwide want to have smaller families, and to control the timing and spacing of births, but many are unable to do so.

While rates of unintended pregnancy – the reason for most abortions – have declined globally, they are still high in developing regions. In most cases, where unintended pregnancy rates are high, so are abortion rates, regardless of whether abortion is legal.

When performed according to World Health Organization (WHO) guidelines, abortion is an extremely safe procedure. But when women are unable to access legal abortion, they are more likely to turn to clandestine procedures, which may be unsafe.

According to a recent study conducted jointly by WHO and the Guttmacher Institute, the overwhelming majority of abortions are safe in countries where the procedure is broadly legal, while most are unsafe in countries where it is highly restricted.

The consequences of unsafe abortion are devastating. Worldwide, at least 22,800 women die each year from complications of unsafe abortion, and many more are injured. And an estimated 40 per cent of women who experience such complications do not receive any medical care.

Often, these women cannot access care, either because of a lack of health services or because of stigma and fear of legal repercussions. The impact of unsafe abortion is far reaching, and can include permanent physical injury and infertility.

Not only do complications from unsafe procedures affect women’s physical health, but they also create a financial burden via treatment costs and lost wages. In developing countries, the cost of providing post-abortion care to treat complications often represents a significant drain on the overall health budget.

There is some good news: between 2000 and 2017, 33 countries modified their laws to make abortion legal under a wider set of circumstances. In addition, clandestine abortions are becoming safer in countries where laws are more restrictive as the use of abortion pills is slowly replacing invasive and extremely unsafe methods.

But even though women are finding ways to lessen the risks of unsafe abortion, they should not have to—because they should be able to access safe and legal abortion care. As long as women are being injured or are dying from unsafe procedures, there is a clear need to improve polices and services to prevent that from occurring.

Women and couples worldwide should have the right to safely achieve their desired family size and preferred timing of births. To make this a reality, high-quality, comprehensive contraceptive services need to be available and affordable, so that women and couples can prevent unintended pregnancy whenever possible.

But when contraceptives fail or when a woman experiences an unwanted pregnancy for any reason, access to safe services to terminate that pregnancy are essential.

Countries should expand the circumstances under which abortion is legal, and ensure safe abortion services are available and accessible. And public awareness campaigns can help to reduce stigma. These are smart moves to promote the health of women, their families and societies as a whole. Simply put, they are the right thing to do.


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