New global abortion data show need for improved contraceptive access

Birth control consultation at a clinic in Mayange, Rwanda. (Photo Credit: Tom Paulson)

Abortion rates in wealthy countries are steadily falling, but there is not much change in the world’s poorest countries. New figures on the number of abortions between 1990 and 2014 show a major divide on unwanted-pregnancy prevention. It brings into focus the problems of women who live in developing countries with the most restrictive laws on abortion and limited access to contraceptives.

Updated global abortion figures published in the British medical journal The Lancet show that the abortion rate for women in developing countries barely changed between 1990 and 2014, falling 2 points. In comparison, the abortion rate for women in the “developed world” declined by 15 points over the same period.

The global decline of 5 points is essentially the result of improvements made at the top. Meanwhile rates are largely unchanged in countries with high fertility rates – countries that are driving most of the global population growth. How to reduce the number of abortions is highly political, especially in the U.S., but there is agreement that action must be taken to further reduce the annual global abortion rate of 56.3 million a year.

Global and regional abortion incidence rate estimates (per 1000 women aged 15–44 years), 1990–94 to 2010–14. Shaded areas are 90% uncertainty intervals. (Chart Credit: The Lancet)

Global and regional abortion incidence rate estimates (per 1000 women ages 15 to 44 years), 1990-94 to 2010-14. Shaded areas are 90 percent uncertainty intervals. (Chart Credit: The Lancet)

Amid the updated data on global abortions is an interesting fact: the report finds that making abortion illegal does not lower abortion rates. Women still seek abortions in countries where it is outlawed. The authors suggest that could be attributed to limited birth control in those countries.

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Taken together, the findings illustrate the importance of contraceptives. An estimated 225 million women worldwide who want to avoid pregnancy can’t access safe forms of contraception. From a rights perspective, this is a denial of basic choice en masse, not to mention the health concerns for women and children when pregnancies occur too close together.

“The obvious interpretation is that criminalizing abortion does not prevent it but, rather, drives women to seek illegal services or methods,” wrote Diana Greene Foster in a comment published alongside the report. “But this simple story overlooks the many women who, in the absence of safe legal services, carry unwanted pregnancies to term.”

(The Lancet)

(The Lancet)

Declines in abortion rates seen in wealthier countries have less to do with legal limitations on abortion, but have to do with family planning. Women have better access and higher take-up rates, preventing unwanted pregnancies at much higher rates. The study estimates that more than 80 percent of unintended pregnancies worldwide occur in the women who do not have contraceptives.

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“The high rates of abortion seen in our study also provide further evidence of the need to improve and expand access to effective contraceptive services,” said Bela Ganartra, a scientist with the World Health Organization, in a statement. “Investing in modern contraceptive methods would be far less costly to women and society than having unwanted pregnancies and unsafe abortions.”

The data collected and analyzed in the report update previous data sets. It provides the best view yet on global abortions, but there are still gaps. Collecting health data in developing countries is a hard task, and it is made harder in places where abortion is illegal or heavily restricted.

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About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.