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International Planned Parenthood Federation (IPPF)

Death and denial: Unsafe abortion and poverty

International Planned Parenthood Federation (IPPF)

January 2006

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Introduction

This year alone, an estimated 19 million women and girls, faced with unintended and unwanted pregnancies, will face the deadly consequences of unsafe abortion. Nearly 70,000 of these women and girls will die, and hundreds-ofthousands of others will be left with debilitating, and frequently lifelong injuries, as a result. Over 96 per cent of these women will come from the world’s poorest nations.

For reasons ranging from human rights to religion, abortion generates more political and social disagreement than almost any other subject. It remains a singularly emotive and complicated issue in many countries, at times seemingly without any room for balanced discussion.

This report offers an overview of the current situation regarding unsafe abortion around the world. In doing so it seeks to open a much needed and timely debate among governments, parliamentarians, public health, development and medical experts, as well as service providers and global advocates for legal and safe abortion such as IPPF.

Unsafe abortion is one of the largest contributors to global maternal mortality: a very preventable human tragedy that highlights the failure of national governments and the international community to address a public health issue that perpetuates one of the greatest social injustices separating rich and poor nations.

Unsafe abortion is a cause and consequence of poverty; it is also intimately linked to gender inequality within societies. It is the inability of women, especially young women and girls, to fulfil their basic sexual and reproductive rights, and to have control over their own bodies, which forces upon them a stark choice - face social exclusion or risk their lives and health through unsafe abortion.

During last September’s United Nation’s World Summit, world leaders reaffirmed their commitment to the Millennium Development Goals, including the goal of reducing maternal mortality and improving maternal health. The Summit also reasserted a previous global commitment to achieve universal access to reproductive health. The review process noted that little progress had been made towards achieving either since the Millennium Development Goals were first adopted five years ago. It further highlighted the fact that unsafe abortion is a major contributor to these stubbornly high levels, particularly in developing countries.

Extensive independent research shows that restricting access to abortion does not make it go away; it only makes it clandestine and unsafe. Health authorities and political leaders in more and more countries are prepared to re-examine abortion policy when they understand how unsafe abortion contributes to maternal mortality and ill health. Moreover, renewed interest in the issue of preventing unintended pregnancies has brought renewed focus on the role family planning and reproductive health services play in preventing unwanted pregnancies.

Lack of access to modern contraception as a factor driving unwanted pregnancies to unsafe abortions cannot be ignored.

There is a pressing need for an open and informed discussion to address the fundamental injustice of the causes and consequences of unsafe abortion. There are few governments with the courage to take a leadership position on abortion rights and there are equally few international organisations with such courage. The Government of the United Kingdom and IPPF are two of the few that have both the courage and the resolve to act in a struggle so crucial to women’s well-being.

Through the work of the Department for International Development, the United Kingdom has promoted an approach to addressing abortion based on sound public health evidence. In doing so, the UK has established an international reputation for both leadership and wisdom. IPPF is determined to play a constructive role as partner with the Department for International Development in this undertaking. With upwards of 15 per cent of maternal mortality directly attributable to illegal and unsafe abortion – perhaps as much as 50 per cent in some countries in Africa and South East Asia – tackling head-on the reduction and even the elimination of this preventable cause of maternal death is of paramount importance.

Steven W. Sinding
Director-General, International Planned Parenthood Federation



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