Millions of desperate women around the world still end unplanned pregnancies by resorting to backstreet abortions or knitting needles. Worldwide the number of unsafe abortions has risen, a recent study found. The majority of abortions in Africa and Latin America are unsafe. Legalising abortion is the way to save lives, says Women on Waves, a Dutch organisation that campaigns for safe abortion.

Around the world, 43.9 million abortions were carried out in 2008. Almost half of them took place in unsafe conditions, according to research by the Guttmacher Institute and the World Health Organisation (WHO). The total number of abortions has stabilised.

Knitting needles
Rebecca Gomperts of Women on Waves works to provide safe abortions for women in parts of the world where abortion is outlawed. The rise in the number of unsafe abortions doesn’t surprise her. “Particularly in countries where abortion is illegal the procedure is carried out unsafely,” she says. “Unsafely means that women do it themselves by jumping down the stairs, or using knitting needles, or going to someone who’s had no training. But not every illegal abortion is necessarily unsafe.”

For example, abortion can be induced safely by a woman herself using the drug Misoprostol, says Gomperts. “The pills were used to prevent stomach ulcers. But because the authorities now know that Misoprostol can be used for other purposes, women in Thailand, Brazil and the Philippines, for instance, haven’t been able to get them for the past couple of years. Because of that there’s been an increase in the number of unsafe abortions in these countries.”

Complications
One in eight women who undergo an unsafe abortion die, according to WHO figures, and 8.5 million women a year are left requiring medical treatment. Gabie Raven of the Dutch Society of Abortion Doctors has seen it happen in practice. “I’ve worked in Africa myself and if you see the way they go to work with herbs and pots and pans to induce an abortion, it’s obviously unsafe. It’s something that’s always happened. But I’m surprised there’s been no improvement.”

Eight out of ten women in developing countries face strict laws against abortion. Because of the illegality, Gabie Raven says, many abortions take place in dangerous settings. “Even if someone’s trained to do abortions, there’s always a chance of complications. In the Netherlands we’re prepared for it, but with a backstreet abortion it’s a different story.”

Information
Legalisation is essential to stop the number of unsafe abortions from continuing to rise, Gomperts says. “It’s extremely important that abortion is legalised. But that’s a hard thing to achieve. In countries where it’s illegal, you first have to provide women with good information on how they can induce an abortion safely themselves using pills.”

Good information on contraception is also needed to bring down the number of unplanned pregnancies. Dutch Deputy Development Cooperation Minister Ben Knapen sees a role in this for the Dutch government. “More than in other countries, we talk about sensitive matters like abortion and sexuality without taboos. I’ve made sexual health one of my priorities to enable girls and women to make their own choices about reproduction and sexuality. We know that this leads to a fall in unplanned pregnancies, abortions, and maternal mortality.”

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