When Abortion is not Safe

In many developing countries, pregnancy termination may be illegal.  This prompts women to seek the procedure outside of a hospital, and this places her at risk for medical complications.  She may suffer from hemorrhage, peritonitis, sepsis, or trauma to the cervix, vagina, uterus, or abdominal organs.  Health care providers who perform these “backstreet” abortions may not have adequate training or experience to properly terminate the pregnancy [1].

Illegal abortions may involve violent blows to the woman’s abdomen, and this may lead to rupture of the uterus.  Some providers may give her medication or other substances to abort the pregnancy, and she may become seriously ill or die from these methods [1].  Moreover, women who experience medical complications from an unsafe abortion may decide not to visit a hospital for further management because it is illegal to have the abortion.

These patients fear legal consequences should they disclose that they have undergone the abortion.  There are also social and cultural beliefs in communities everywhere which discourage women from this type of medical care [1].  Specifically, community and churches may stigmatize them, and social exclusion is the result.  It becomes an issue that the woman’s behavior is below the standards of womanhood.

Pregnancy termination, therefore, becomes a matter of concern over sexuality, the meaning of motherhood, and womanhood as it is not merely a healthcare issue.  The negative treatment that these women experience has to do, in many instances, with the belief that a woman’s duties are procreation and motherhood.

Nearly all unsafe abortions take place in developing countries, and the maternal death and complication rates from these procedures are much higher than developed countries where the procedure is legal.  There are approximately 22 million unsafe abortions each year across the globe, and 47,000 women die from them.  Worldwide, more than 200 million women become pregnant each year [1].

The occurrence of unintended pregnancy is lower in areas of the world where contraception is available than in locations where birth control is not in use.  Abortion rates rise when women have unintended pregnancies.  When abortion laws are less restrictive, the morbidity and mortality rates from that procedure dramatically decline [1]. 

In other words, access to medical care to perform pregnancy termination or to manage it after it has already taken place will afford a better clinical outcome for the mother.  Restrictive abortion laws—in which women do not have reasonable access to the procedure—lead to adverse medical outcomes [1].

The occurrence of unsafe pregnancy termination is a global public health problem which leads to much morbidity and mortality in these women.  It is possible, however, to prevent the complications and deaths which result from those procedures.

1. World Health Organization.  (2012).  Safe abortion:  technical and policy guidance for health systems.  Second edition.  Retrieved October 4, 2013.
2. The photo shows a pregnant woman who is preparing a meal.  Reprinted with permission from Centers for Disease Control/James Gathany.

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.