In the worst case, the treated woman may have been denied a safe abortion, only to reappear with life-threatening injuries from an unsafe abortion. In the Democratic Republic of congo, where abortion was once extremely restricted by law, emergency physician Jean-Paul remains shocked by his first-hand experience of meeting a young girl seeking an abortion. When she was denied treatment at the MSF hospital where he worked, she returned to a coma and died shortly after. Medical abortion involves two drugs, mifepristone and misoprostol, and a total of only five pills. This is often the preferred method of women because it is less invasive and can be started on an outpatient basis and performed in the privacy of its own four walls. WHO also maintains the Global Database on Abortion Policies. This interactive online database contains comprehensive information on abortion laws, policies, health standards and guidelines for all countries. In Greece, the legal limit for abortions is 12 weeks, so women have to compete against the clock to overcome the many obstacles to the end of their pregnancy in this period. Unsafe abortions often occur when the abortion is illegal. [4] However, the prevalence of unsafe abortions can also be determined by other factors, for example if this occurs in a developing country that has a low level of competent medical care. [20] Unsafe abortion is a procedure for terminating an unwanted pregnancy either by people who do not have the necessary skills, or in an environment without minimum medical standards, or both, as defined by the World Health Organization. Contraception and safe abortion care go hand in hand in the strategy to reduce unwanted pregnancies, unsafe abortions and maternal deaths. Improving access to modern contraceptives is an essential part of reducing unwanted or unwanted pregnancies and the abortions or unplanned births that often follow.
However, contraception alone is not enough as a solution. Whether an abortion is legal or illegal, health care providers are required by law to provide medical care to patients, as this can save lives. In some cases, treatment for abortion complications can only be administered if the woman provides information about the abortion and everyone involved. [50] Obtaining accurate data on abortions is a challenge, especially for unsafe abortions. Two-thirds of countries are unable to collect data, and data collection varies from country to country, both quantitatively and qualitatively.2 Since unsafe abortions are often performed secretly by untrained people or by pregnant women themselves, a large proportion remain undocumented; The figures are therefore estimates. The data suggest that despite the decline in the overall abortion rate, the proportion of unsafe abortions is increasing, particularly in developing countries. From 1995 to 2003, the total number of abortions decreased, but the rate of unsafe abortions was constant (from 15 to 14 abortions per 1000 women), representing an increase from 44% to 48%.3 Live births and proportion of maternal deaths due to abortions. Reprinted from The Lancet, Vol.
368, Grimes DA et al., “Unsafe Abortion: The Preventable Pandemic,” pp. 1908–1919, Copyright 2006, courtesy Elsevier.4 In 1992, the U.S. Supreme Court upheld Roe v. Wade, but removed references to the “quarter.” Instead, they decided that (1) abortions are legal on demand before a fetus can survive on its own (about 22 weeks after conception); (2) After this period, each State may prohibit abortion unless there is a risk to the health or life of a woman; and (3) states can regulate abortion throughout pregnancy as long as there is no “unreasonable burden” on a woman`s right to terminate her pregnancy. Some employees also need moral support in the face of the judgment and stigma of their colleagues in the workplace. Even though they know the importance of safe abortion care, many health care providers – including MsF – have to deal with their personal attitudes towards providing this care. Peer support is important. Unsafe abortions sometimes occur when abortion is legal, and unsafe abortions sometimes occur when abortion is illegal. [21] Legalization is not always followed by the abolition of unsafe abortion.
[5] [22] Affordable secure services may not be available despite the law and, conversely, women may afford medically competent services despite the illegality. [23] Prior to 1973, the power to legalize abortion rested with state governments. In the 1960s, 44 states had laws banning abortion unless the health of the pregnant patient was at stake. [27] More than 22,000 women and girls die each year after unsafe abortion, according to a comprehensive report published in 2018 by the Guttmacher Institute. Obstacles can be bureaucratic. In Athens, where MSF helps migrants, asylum seekers and refugees access safe abortion care in the public health system, women are on a waiting list of more than four weeks just to get their first appointment. Other appointments with other health professionals, especially doctors, will follow. Some patients face additional obstacles because they don`t have their Social Security card with them or they don`t attend an appointment without a translator. WHO provides global technical and policy guidance on the use of contraceptives to prevent unwanted pregnancies, the provision of information on abortion care, the management of abortion (including miscarriages, induced abortions, incomplete abortions and fetal death) and post-abortion care. In 2021, WHO published an updated and consolidated directive on abortion care, which includes all WHO recommendations and statements of good practice in three areas essential to the provision of abortion treatment: legislation and policies, clinical services and service delivery. The lack of access to safe, affordable, timely and respectful abortion care and the stigma associated with abortion pose risks to women`s physical and mental well-being throughout life. If performed using a WHO-recommended method that is appropriate for the duration of the pregnancy, and by a person with the required skills, abortion is a safe intervention in health care.
Access to adequate contraception and abortion is important for women`s physical and psychological well-being. Where abortion is legal, about 2% of women between the ages of 15 and 44 abort each year. The global annual mortality rate from illegal abortion has been estimated at 100,000, while the legal abortion mortality rate is 0.05 per 10,000, 25 times lower than the birth rate. The provision of safe abortions and adequate contraception would have a significant impact on the well-being of women and children in developing countries. When abortion is illegal, it usually contributes to the prevalence of unsafe abortion, but it is not the only contribution. In addition, lack of access to safe and effective contraception contributes to unsafe abortion. It is estimated that without changes to abortion laws, the incidence of unsafe abortions could be reduced by up to 73 per cent if modern family planning and maternal health services were readily available worldwide. [7] According to the World Health Organization (WHO), every 8 minutes, a woman in a developing country dies from complications resulting from unsafe abortion.
An unsafe abortion is defined as “a procedure for the termination of an unwanted pregnancy performed either by persons who do not have the necessary skills, or in an environment that does not meet minimum medical standards, or both.” 1 The Fifth United Nations Millennium Development Goal recommends a 75% reduction in maternal mortality by 2015. WHO considers unsafe abortion to be one of the most easily preventable causes of maternal mortality and a staggering public health problem. Barriers to access to safe and respectful abortion include high costs, stigmatization of abortion seekers and health workers, and refusal of health workers to perform abortions on the basis of their personal conscience or religious beliefs. Access is further hampered by restrictive laws and requirements that are not medically justified, including the criminalization of abortions, mandatory waiting periods, the provision of biased information or advice, third-party endorsement, and restrictions on the type of health care providers or facilities that can provide abortion services. Intentional homicide involves the death of a victim who occurs during the commission of an illegal act, for example during a fight resulting from the “heat of passion”. 44 The death of a patient during an illegal abortion would likely result in a charge of intentional manslaughter against a physician who performs the abortion. An unsafe abortion is the termination of a pregnancy by people who do not have the necessary skills, or in an environment without minimum medical standards, or both. [1] An unsafe abortion is a life-threatening procedure.