According to an international team, women are just as likely to get an abortion in countries where it is outlawed as they are in countries where it is legal.
The study, which looked at abortion trends from 1995 to 2003, found that abortion rates are virtually equal in developed and developing countries. It also found that half of all abortions worldwide are unsafe.
The study was led by Gilda Sedgh, a senior research associate at the Guttmacher Institute in the United States, and colleagues from the World Health Organization. It was published in an edition of The Lancet medical journal devoted to maternal health. "The legal status of abortion has never dissuaded women and couples, who, for whatever reason, seek to end pregnancy," points out Beth Fredrick of the International Women's Health Coalition in the U.S.
As per official figures, abortion accounts for 13% of maternal mortality worldwide. This is not all. About 70,000 women die every year from unsafe abortions. Another 5 million women suffer permanent or temporary damage.
Says Fredrick:" The continuing high incidence of unsafe abortion in developing countries represents a public health crisis and a human rights atrocity."
The number of worldwide abortions has dropped slightly from about 46 million in 1995 to just under 42 million in 2003.Yet, there was no corresponding change in the rate of unsafe abortions; nearly half are still performed illegally in potentially dangerous conditions, the study continues.
"The only way to decrease unsafe abortion is to increase contraception," opines Sharon Camp, president and chief executive officer of the Guttmacher Institute, a reproductive rights think tank based in New York. Camp says that more countries are allowing women to have abortions legally, yet that many women only receive medical attention after a procedure has gone wrong. The vast majority of abortions 35 million were found to be in the developing world. Nearly 97% of all unsafe abortions were in poor countries, too. Worldwide, one in five pregnancies ends in abortion, and nine out of 10 women will have an abortion before age 45, the report cited, using data from 2003.
Other findings were that in eastern Europe, there are more abortions than live births: 105 abortions for every 100 live births. In Western Europe, there are 23 abortions for every 100 live births.
In North America, there are 33 abortions for every 100 live births, while in Africa, where abortion is illegal in most countries, there are 17 abortions for every 100 live births. The researchers' data stemmed from government statistics, hospital records and national surveys. Where data was not available, they based estimates on fertility rates and made country-specific estimates based on previous figures or by comparing them to similar countries.
Improving women's health, say the experts, means improving access to safe abortions. Some experts criticized the restrictions that often come with donor money. Funds from the U.S. government, for example, cannot be used in any health services associated with abortion.
In related papers published in The Lancet this week, experts expressed that there has been little improvement in helping women survive pregnancies and childbirth in the last two decades, particularly in the world's poorest countries.
A look at Nicaragua, illustrates the case. Here, a new law has put a blanket ban on abortion - even in cases of rape or where the mother's life might be in danger. Campaigners say it has led to 82 deaths this year among women with pregnancy-related complications - and a culture of fear among doctors.
Dr. Leonel Arguello, head of the Nicaraguan Society of General Medicine, is highly concerned about the effects of the new law.
"As a physician, you feel as though you are nothing," he says. "This government is saying - if you are pregnant and it might harm you, it doesn't matter - keep going." Dr Arguello said doctors on salaries of Ģ200 a month were scared of prosecution if they were seen to intervene in any cases where an unborn child was still alive. He recalled a case where a young woman died after doctors failed to treat her ectopic pregnancy.