Unsafe abortion
Encyclopedia
Unintended pregnancy
Unintended pregnancies are those in which conception was not intended by the female sexual partner. Worldwide, 38% of pregnancies were unintended in 1999 . Unintended pregnancies are the primary cause of induced abortion, resulting in about 42 million induced abortions per year...
by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both. For example, an unsafe abortion may refer to an extremely dangerous life-threatening procedure that is self-induced in unhygienic conditions, or it may refer to a much safer abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
performed by a medical practitioner who does not provide appropriate post-abortion attention.
Unsafe abortion is a significant cause of maternal mortality and morbidity in the world. Most unsafe abortions occur where abortion is illegal
Abortion law
Abortion law is legislation and common law which pertains to the provision of abortion. Abortion has been a controversial subject in many societies through history because of the moral, ethical, practical, and political power issues that surround it. It has been banned frequently and otherwise...
, or in developing countries
Developing country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...
where affordable well-trained medical practitioners are not readily available, or where modern contraceptives are unavailable. About one in eight pregnancy-related deaths worldwide is associated with unsafe abortion.
Overview
The World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) reports that each year nearly 42 million women faced with unintended pregnancies
Unintended pregnancy
Unintended pregnancies are those in which conception was not intended by the female sexual partner. Worldwide, 38% of pregnancies were unintended in 1999 . Unintended pregnancies are the primary cause of induced abortion, resulting in about 42 million induced abortions per year...
have abortions, of which 20 million are unsafe, mostly in countries where abortion is illegal. According to WHO and Guttmacher, approximately 68,000 women die annually as a result of complications of unsafe abortion; and between two million and seven million women each year survive unsafe abortion but sustain long-term damage or disease (incomplete abortion, infection (sepsis), haemorrhage, and injury to the internal organs, such as puncturing or tearing of the uterus). They also concluded abortion is safe in countries where it's legal, but dangerous in countries where it's outlawed and performed clandestinely. The WHO reports that in developed regions, nearly all abortions (92%) are safe, whereas in developing countries, more than half (55%) are unsafe. According to WHO statistics, the risk rate for unsafe abortion is 1/270; according to other sources, unsafe abortion is responsible for one in eight maternal deaths. Worldwide, 48% of all induced abortions are unsafe.
An article from the World Health Organization calls safe, legal abortion a "fundamental right of women, irrespective of where they live" and unsafe abortion a "silent pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...
". The article states "ending the silent pandemic of unsafe abortion is an urgent public-health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
and human-rights imperative." It also states "access to safe abortion improves women’s health, and vice versa, as documented in Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...
during the regime of President Nicolae Ceausescu
Nicolae Ceausescu
Nicolae Ceaușescu was a Romanian Communist politician. He was General Secretary of the Romanian Communist Party from 1965 to 1989, and as such was the country's second and last Communist leader...
" and "legalisation of abortion on request is a necessary but insufficient step toward improving women’s health" citing that in some countries, such as India where abortion has been legal for decades, access to competent care remains restricted because of other barriers. WHO’s Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: “As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets." The WHO's Development and Research Training in Human Reproduction (HRP), whose research concerns people's sexual and reproductive health and lives, has an overall strategy to combat unsafe abortion that comprises four interrelated activities:
- to collate, synthesize and generate scientifically sound evidence on unsafe abortion prevalence and practices;
- to develop improved technologies and implement interventions to make abortion safer;
- to translate evidence into norms, tools and guidelines;
- and to assist in the development of programmes and policies that reduce unsafe abortion and improve access to safe abortion and highquality postabortion care
A 2007 study published in the The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
found that, although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003. It also concluded that, while the overall incidence of abortion in both developed and developing countries is approximately equal, unsafe abortion occurs more often in less-developed nations.
Anti-abortion critics contend that the results of The Lancet study are flawed, as there are no accurate statistics about abortion from countries in the developing world. In a 2005 report, the WHO itself states, “More than a third of the 204 countries or areas examined did not report the number of deaths by sex even once for the period 1995 to 2003. About half did not report deaths by cause, sex and age at least once in the same period. Moreover, from 1975 to 2003 there has been limited progress in the reporting of deaths and their causes.”
Conflating illegal and unsafe abortion
Unsafe abortions often occur where abortion is illegalAbortion law
Abortion law is legislation and common law which pertains to the provision of abortion. Abortion has been a controversial subject in many societies through history because of the moral, ethical, practical, and political power issues that surround it. It has been banned frequently and otherwise...
. However, the prevalence of unsafe abortion may also be determined by other factors, such as whether it occurs in a developing country
Developing country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...
that has a low level of competent medical care, and whether modern contraceptives are available.
Unsafe abortions sometimes occur where abortion is legal, and safe abortions sometimes occur where abortion is illegal. Legalization is not always followed by elimination of unsafe abortion. Affordable safe services may be unavailable despite legality, and conversely women may be able to afford medically competent services despite illegality.
When abortion is illegal, that generally contributes to the prevalence of unsafe abortion, but it is not the only contributor. In addition, a lack of access to safe and effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by as much as 73% without any change in abortion laws if modern family planning and maternal health services were readily available globally.
Illegality of abortion contributes to maternal mortality, but that contribution is not as great as it once was, due to medical advances including penicillin
Penicillin
Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
and the birth control pill.
Incidence by continent
| Region | Unsafe Abortion Risk of Dying |  |
|---|---|---|
| Africa | 1 in 150 | 13% |
| Asia | 1 in 250 | 12% |
| Latin America | 1 in 900 | 21% |
| Europe | 1 in 1900 | 17% |
Source: Unsafe Abortion: Mortality and Risk Estimates of Death data from WHO press, Geneva, 1997
10,000 women a year die from unsafe abortions in Nigeria
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
alone.
Incidents in the U.S. after 1973
In 2005, the Detroit News reported that a 16-year-old boy beat his pregnant, under-age girlfriend with a bat at her request to abort a fetus. The young couple lived in Michigan, where parental consent is required to receive an abortion. In Indiana, where there are also parental consent laws, a young woman by the name of Becky BellBecky Bell
Rebecca "Becky" Suzanne Bell was an American teenage girl who died as a result of a back-alley abortion in 1988. She lived in Indianapolis, Indiana....
died from an unsafe abortion rather than discuss her pregnancy and wish for an abortion with her parents.
In 2011, Kermit Gosnell
Kermit Gosnell
Kermit Barron Gosnell is an American doctor in Philadelphia who ran two multi-million dollar abortion practices, alleged to be fraudulent. After a controversy nearly a year earlier, Gosnell was arrested in January 2011, charged with eight counts of murder: one patient who allegedly died under his...
, a licensed doctor who provided abortion services in the American state of Pennsylvania
Pennsylvania
The Commonwealth of Pennsylvania is a U.S. state that is located in the Northeastern and Mid-Atlantic regions of the United States. The state borders Delaware and Maryland to the south, West Virginia to the southwest, Ohio to the west, New York and Ontario, Canada, to the north, and New Jersey to...
, was indicted by a grand jury on murder charges after a woman died in his clinic. The grand jury found that the conditions in Dr. Gosnell's clinic were unsanitary and that Dr. Gosnell staffed his clinic with unlicensed individuals.
Methods
Methods of unsafe abortion include:- Trying to break the amniotic sacAmniotic sacThe amniotic sac is the sac in which the fetus develops in amniotes. It is a tough but thin transparent pair of membranes, which hold a developing embryo until shortly before birth. The inner membrane, the amnion, contains the amniotic fluid and the fetus. The outer membrane, the Chorion,...
inside the womb with a sharp object or wire (for example an unbent wire clothes hangerClothes hangerA clothes hanger, coat hanger or coathanger, is a device in the shape of:* Human shoulders designed to facilitate the hanging of a coat, jacket, sweater, shirt, blouse or dress in a manner that prevents wrinkles, with a lower bar for the hanging of trousers or skirts.* Clamp for the hanging of...
or knitting needleKnitting needleA knitting needle or knitting pin is a tool in hand-knitting to produce knitted fabrics. They generally have a long shaft and taper at their end, but they are not nearly as sharp as sewing needles. Their purpose is two-fold...
). This method can result in infection, and injury to internal organs (for example perforating the intestines), resulting in death. - Pumping toxic mixtures, such as chili pepperChili pepperChili pepper is the fruit of plants from the genus Capsicum, members of the nightshade family, Solanaceae. The term in British English and in Australia, New Zealand, India, Malaysia and other Asian countries is just chilli without pepper.Chili peppers originated in the Americas...
s and chemicals like alumAlumAlum is both a specific chemical compound and a class of chemical compounds. The specific compound is the hydrated potassium aluminium sulfate with the formula KAl2.12H2O. The wider class of compounds known as alums have the related empirical formula, AB2.12H2O.-Chemical properties:Alums are...
, permanganatePermanganateA permanganate is the general name for a chemical compound containing the manganate ion, . Because manganese is in the +7 oxidation state, the permanganate ion is a strong oxidizing agent. The ion has tetrahedral geometry...
or plant poisonHerbicideHerbicides, also commonly known as weedkillers, are pesticides used to kill unwanted plants. Selective herbicides kill specific targets while leaving the desired crop relatively unharmed. Some of these act by interfering with the growth of the weed and are often synthetic "imitations" of plant...
into the body of the woman. This method can cause the woman to go in to toxic shock and die. - Inducing an abortion without medical supervision by self-administering abortifacientAbortifacientAn abortifacient is a substance that induces abortion. Abortifacients for animals that have mated undesirably are known as mismating shots....
drugs obtained illegally or by using drugs not indicated for abortion but known to result in miscarriage and/or uterine contraction.
Health risks
Unsafe abortion is a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in developing countriesDeveloping country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...
. Unsafe abortion is believed to result in approximately 68,000 deaths and millions of injuries annually. The legal status of abortion is believed to play a major role in the frequency of unsafe abortion. For example, the 1996 legalization of abortion in South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
had an immediate positive impact on the frequency of abortion-related complications, with abortion-related deaths dropping by more than 90%. Groups such as the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
have advocated a public-health approach to addressing unsafe abortion, emphasizing the legalization of abortion, the training of medical personnel, and ensuring access to reproductive-health services.
Illegal abortion
An illegal abortion may be called a "back-alley", "backstreet", or "back-yard" abortion.The wire coat hanger
Clothes hanger
A clothes hanger, coat hanger or coathanger, is a device in the shape of:* Human shoulders designed to facilitate the hanging of a coat, jacket, sweater, shirt, blouse or dress in a manner that prevents wrinkles, with a lower bar for the hanging of trousers or skirts.* Clamp for the hanging of...
method was a popularly known illegal abortion procedure, although they were not the norm. In fact, Mary Calderone, former medical director of Planned Parenthood
Planned Parenthood
Planned Parenthood Federation of America , commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The...
, said, in a 1960 printing of the American Journal of Public Health:
"Abortion is no longer a dangerous procedure. This applies not just to therapeutic abortions as performed in hospitals but also to so-called illegal abortions as done by physician. In 1957 there were only 260 deaths in the whole country attributed to abortions of any kind, second, and even more important, the conference [on abortion sponsored by Planned Parenthood] estimated that 90 percent of all illegal abortions are presently being done by physicians. Whatever trouble arises usually arises from self-induced abortions, which comprise approximately 8 percent, or with the very small percentage that go to some kind of non-medical abortionist. Abortion, whether therapeutic or illegal, is in the main no longer dangerous, because it is being done well by physicians."
Herbal
Herbalism
Herbalism is a traditional medicinal or folk medicine practice based on the use of plants and plant extracts. Herbalism is also known as botanical medicine, medical herbalism, herbal medicine, herbology, herblore, and phytotherapy...
abortions (when done illegally) can also be described as an unsafe abortions because they are not induced in a medical facility.
Controversy
The matter of unsafe abortions in America received public attention leading up to the legal proceedings of Roe v. WadeRoe v. Wade
Roe v. Wade, , was a controversial landmark decision by the United States Supreme Court on the issue of abortion. The Court decided that a right to privacy under the due process clause in the Fourteenth Amendment to the United States Constitution extends to a woman's decision to have an abortion,...
, the 1973 United States Supreme Court decision which legalized abortion in America. Since then, it has become a central argument on the part of some prominent legal abortion advocates. The publication in Ms. magazine of a photo of Gerri Santoro
Gerri Santoro
Geraldine "Gerri" Santoro was an American woman who died because of a illegal abortion in 1964. A photograph of her after death, published in 1973, became a symbol of the pro-choice movement.-Biography:...
, who died of blood loss following an unsafe abortion, was used extensively to illustrate the dangers of illegal abortions.
External links
- My Back-Alley Abortion, via BeliefNetBeliefnetBeliefnet is a large multi-faith e-community that aims to provide a free forum for religious information and inspiration, spiritual tools, and discussions and dialogue groups. Beliefnet provides information about various religious and spiritual beliefs, ranging from Christian denominations to...