Abortion and the law - Safe, legal and falling - Restrictive laws do not reduce abortion
WHEN Catholic clergy or “pro-life” politicians argue that abortion laws should be tightened, they do so in the belief that this will reduce the number of terminations. Yet the largest global study of abortion ever undertaken casts doubt on that simple proposition. Restricting abortions, the study says, has little effect on the number of pregnancies terminated. Rather, it drives women to seek illegal, often unsafe backstreet abortions leading to an estimated 67,000 deaths a year. A further 5m women require hospital treatment as a result of botched procedures.
In Africa and Asia, where abortion is generally either illegal or restricted, the abortion rate in 2003 (the latest year for which figures are available) was 29 per 1,000 women aged 15-44. This is almost identical to the rate in Europe—28—where legal abortions are widely available. Latin America, which has some of the world's most restrictive abortion laws, is the region with the highest abortion rate (31), while western Europe, which has some of the most liberal laws, has the lowest (12).
The study, carried out by the Guttmacher Institute in New York in collaboration with the World Health Organisation (WHO) and published in a British medical journal, the Lancet, found that most abortions occur in developing countries—35m a year, compared with just 7m in rich countries. But this was largely a reflection of population size. A woman's likelihood of having an abortion is similar whether she lives in a rich country (26 per 1,000) or a poor or middle-income one (29).
Lest it be thought that these sweeping continental numbers hide as much as they reveal, the same point can be made by looking at those countries which have changed their laws. Between 1995 and 2005, 17 nations liberalised abortion legislation, while three tightened restrictions. The number of induced abortions nevertheless declined from nearly 46m in 1995 to 42m in 2003, resulting in a fall in the worldwide abortion rate from 35 to 29. The most dramatic drop—from 90 to 44—was in former communist Eastern Europe, where abortion is generally legal, safe and cheap. This coincided with a big increase in contraceptive use in the region which still has the world's highest abortion rate, with more terminations than live births.
The risk of dying in a botched abortion is only part of a broader problem of maternal health in poor countries. Of all the inequalities of development, this is arguably the worst. According to a report published this week by Population Action International, a Washington-based lobby group, women in poor countries are 250 times more likely to die in pregnancy or childbirth than women in rich ones. Of the 535,000 women who died in childbirth or from pregnancy-related complications in 2005, 99% were in developing countries, according to another report by a group of UN agencies, including WHO, also out this week. Africa accounted for more than half such deaths.
As the UN report noted, countries with the highest levels of maternal mortality have made the least progress towards reducing it. A woman in Africa has a one in 16 chance of dying in pregnancy or childbirth, compared with one in 3,800 for a woman in the rich world.