Each year nineteen to twenty million abortions are had by individuals without the credentials needed to perform this medical procedure and/or in environments below medical standards. Unsafe abortions remain one of the most neglected global public health challenges. Ninety-seven percent of these abortions are done in developing countries, and as a result, it is estimated that sixty-eight thousand women des each year. In addition, millions more of these women are faced with additional complications that are sometimes permanent. Some causes of death in these unsafe abortions include hemorrhage, infection, and poisoning. Worldwide, it sometimes does not matter if proper legislation is in place because there are other barriers preventing women from getting the care they need. This happens in India, where abortion has been legal for decades. 

   The reasons that women seek unsafe abortions differ. They include socioeconomic concerns, lack of awareness and education, family-building preferences, a risk to maternal or fetal health, poor access to contraceptives, contraception failure, and pregnancy resulting from rape or incest. It is found that people drink toxic solutions such as turpentine, laundry bleach, detergent solutions, acid, laundry bluing, cottonseed oil, and liquor in hopes of giving themselves an abortion. Women also take drugs such as uterine stimulants, Quinine, Chlorquinne (which is used for treating malaria), and oral contraceptive pills (which are ineffective in inducing an abortion). Treatments are also placed in the vagina or cervix. Foreign bodies, such as a stick dipped in oil, sugar, root or leaf of a plant, wire, knitting needle, rubber catheter, intrauterine contraceptive device, coat hanger, ballpoint pen, chicken bone, bicycle spoke, air blown by a syringe or turkey baster, are also placed into the uterus through the cervix. Women also inflict trauma upon themselves, such as abdominal or back trauma, lifting heavy weights, or jumping from the top of the stairs or the roof. These are extremely harmful towards to the mother and can lead to death. 

   In 1995, it was estimated that, annually, twenty-six million legal and twenty million abortions were committed. The use of terms such as mini abortion, miscarriage, menstrual regulation, and regulation of delayed or suspended menstruation could have skewed the data. IN 2000, there were nineteen million unsafe abortions. It is estimated that women in South America, eastern Africa, and western Africa are more inclined to have an unsafe abortions when compared to women in other regions. By age, the amount of unsafe abortions also varies by region. In Africa, twenty-five percent of all unsafe abortions are had by adolescents (women ages fifteen through nineteen), but compared to Asia, Latin America, and the Caribbean, the percentage is around ten percent and lower. In Asia, forty-two percent of women who get an unsafe abortion, and in Latin America and the Caribbean, thirty-three percent of women who get an unsafe abortion are aged thirty to forty-four years old. Compared to Africa, only twenty-three percent of women who get an unsafe abortion are thirty-three to forty. According to these statistics, it is predicted that women in the developing world will have had one unsafe abortion by the time they reach age forty-five. 

   It is estimated that eight women per hour, or sixty-eight thousand women, die per hour due to an unsafe abortion. “This prevalence translates into an estimated case fatality rate of three hundred sixty-seven deaths per one hundred thousand unsafe abortions, which is hundreds of times higher than that for safe, legal abortion in developed nations” (https://www.sciencedirect.com/science/article/pii/S0140673606694816).  There are significant regional differences between the mortality rates of women who die from unsafe abortions. These differences are most likely caused by the safety provisions in the different areas and the access to care after the abortion. It is estimated that thirteen percent of all maternal deaths worldwide are caused by unsafe abortions, with Latin America being seventeen percent and southeastern Asia being nineteen percent. Matern mortality is defined as “the death of a woman from complications of pregnancy or childbirth that occur during the pregnancy or within six weeks after the pregnancy ends” (https://www.nichd.nih.gov/health/topics/maternal-morbidity-mortality#:~:text=Maternal%20morbidity%20describes%20any%20short,weeks%20after%20the%20pregnancy%20ends.) 

   Morbidity, or “any short or long-term health problems that result from being pregnant and giving birth,” is a more common result in unsafe abortions (https://www.nichd.nih.gov/health/topics/maternal-morbidity-mortality#:~:text=Maternal%20morbidity%20describes%20any%20short,weeks%20after%20the%20pregnancy%20ends.)  These complications include, “hemorrhage, sepsis, peritonitis, and trauma to the cervix, vagina, uterus, and abdominal organs” (https://www.sciencedirect.com/science/article/pii/S0140673606694816). Twenty to fifty percent of women who have unsafe abortions are hospitalized. Safer abortion access has reduced the morbidity and hospitalization rate from 1990 to now. This decrease can be attributed to the increased use of misoprostol which replaced many invasive unsafe methods for abortions. Misoprostol is an abortion pill that “when used correctly, successfully terminates eighty to ninety-five percent of pregnancies without the need for surgical intervention, depending on regimen and pregnancy duration.” (https://www.ibisreproductivehealth.org/publications/misoprostol-alone-medication-abortion-safe-and-effective#:~:text=These%20medications%2C%20when%20used%20correctly,on%20regimen%20and%20pregnancy%20duration.). 

   The increase in legislation promoting abortion safety and access for women has led to a smaller mortality and morbidity rate. For example, in Kenya, the rate of women with severe complications lowered from seventeen percent to ten percent. Severe complications include a high fever, organ or system failure, generalized peritonitis, a pulse of one hundred twenty or more, shock, evidence of a foreign body, or mechanical injury.  

   These complications and deaths are preventable if women are given safer access to abortions and care after obtaining an abortion.

Work Cited: 

https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-019-0751-0 

https://www.sciencedirect.com/science/article/pii/S0140673606694816 

https://www.nichd.nih.gov/health/topics/maternal-morbidity-mortality#:~:text=Maternal%20morbidity%20describes%20any%20short,weeks%20after%20the%20pregnancy%20ends. 

https://www.ibisreproductivehealth.org/publications/misoprostol-alone-medication-abortion-safe-and-effective#:~:text=These%20medications%2C%20when%20used%20correctly,on%20regimen%20and%20pregnancy%20duration.