The world has made significant progress on four of the five leading causes of maternal mortality. But unsafe abortion—the only fully preventable cause—has been largely forgotten.
Unsafe abortion still accounts for at least one in 12 maternal deaths globally. And, compared to reductions in all the other direct causes of maternal deaths since 1990—severe bleeding, severe infection, blood pressure disorders and obstructed labour—there has been little improvement in the negative impact of unsafe abortion.
Unsafe abortion is a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both, as defined by the World Health Organization. Abortion, whether safe or unsafe, is a common event worldwide: approximately one in four pregnancies ended in an induced abortion during the period 2010-2014.
About 45 per cent of abortions globally are deemed unsafe, and more than 22,000 women and girls die each year after undertaking an unsafe abortion, says the Guttmacher Institute’s comprehensive report published in 2018.
When a woman or girl is determined to end her pregnancy she will do so, regardless of the safety and legality of the procedure. Where safe abortion care is not available, she will risk her life with an unsafe abortion, often because continuing the pregnancy is unbearable.
About 97 per cent of unsafe abortions and related deaths occur in Africa, Latin America and southern and western Asia, all regions where Médecins Sans Frontières/Doctors Without Borders (MSF) offers medical assistance to people in need.
Meanwhile, the scale of post-abortion complications is enormous, with an estimated seven million women and girls are admitted to hospital every year. Some will be permanently disabled, and some will never be able to carry a child again. Yet we will never know the full extent, because there are many women and girls who dare not, or cannot, access care.
Unwanted pregnancy and unsafe abortion have a serious medical impact on women and girls in the many low-resource and conflict-affected countries in which MSF works. The consequences are also felt by their families and friends, caregivers—including MSF staff—and their wider community. And, as a medical and humanitarian organisation, MSF remains committed to providing safe abortion care to reduce this avoidable—and often overlooked—suffering.