The World Health Organization (WHO) has updated its fact sheet on unsafe abortion.

Background Information:

Unsafe Abortion: Unsafe abortion occurs when a pregnancy is terminated either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.

Medical abortion: Termination of pregnancy performed with drugs alone

Surgical abortion: Termination of pregnancy performed with a manual or electric aspirator

Women, including adolescents, with unwanted pregnancies often resort to unsafe abortion when they cannot access safe abortion.

Barriers to accessing safe abortion include:

• restrictive laws;
• poor availability of services;
• high cost;
• stigma;
• conscientious objection of health-care providers; and
• unnecessary requirements such as:
  • mandatory waiting periods.
  • mandatory counselling.
  • provision of misleading information
  • third-party authorization
  • medically unnecessary tests.

Key Messages:

Problem Statement:

There are approximately 22 million unsafe abortions annually, resulting in 47 000 deaths, and more than 5 million complications such as:

• incomplete abortion (failure to remove or expel all of the pregnancy tissue from the uterus)
• haemorrhage (heavy bleeding)
• infection
• uterine perforation (caused when the uterus is pierced by a sharp object)
• damage to the genital tract and internal organs by inserting dangerous objects such as sticks, knitting needles, or broken glass into the vagina or anus.

Death Rate due to unsafe abortion:

• Developed regions: 30 women die for every 100 000 unsafe abortions.
• Developing regions: 220 deaths per 100 000 unsafe abortions
• Sub-Saharan Africa: 520 deaths per 100 000 unsafe abortions 

Africa accounts for 29% of all unsafe abortions, but has 62% of all deaths due to unsafe abortions.

Who is at Risk?

Any woman with an unwanted pregnancy who cannot access safe abortion is at risk of unsafe abortion.

Poor women are more likely to have an unsafe abortion than more affluent women.

Deaths and injuries are higher when unsafe abortion is performed later in pregnancy.

Complications of unsafe abortions requiring emergency care:

The critical signs and symptoms of complications that require immediate attention include:

• abnormal vaginal bleeding
• abdominal pain
• infection
• circulatory shock (collapse of the circulatory system).

Prevention and Control:

Unsafe abortion can be prevented through:

• good sexual education;
• prevention of unintended pregnancy through use of effective contraception, including emergency contraception; and
• provision of safe, legal abortion.

In addition, deaths and disability from unsafe abortion can be reduced through the timely provision of emergency treatment of complications.

Useful Links:

Link to the updated fact sheet:

http://who.int/mediacentre/factsheets/fs388/en/

Link to WHO’s Clinical Practice Handbook for Safe Abortion (2014) (English- also available in other languages):

http://apps.who.int/iris/bitstream/10665/97415/1/9789241548717_eng.pdf?ua=1

Link to WHO’s Document ‘Safe Abortion: Technical and Policy guidance for health systems, 2nd Edition’ (English- also available in Spanish):

http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1