The consequences of unsafe abortion echo for generations.

Causes of death from unsafe abortion include severe bleeding, internal infection, tearing of the uterus and blood poisoning. The WHO estimates that 2 percent of women of reproductive age are infertile as a result of unsafe abortion, and 5 percent have chronic infections. Unsafe abortion also increases the risk of ectopic pregnancy, premature delivery and spontaneous abortion in future pregnancies.²

The risk of unsafe abortion is highest in sub-Saharan Africa and South-Central Asia. The number of unsafe abortion-related deaths per 100,000 live births is highest in eastern, middle and western Africa (90-140 unsafe abortions per 100,000 live births), and is also high in south-central Asia (70 unsafe abortions per 100,000 live births).³ In sub-Saharan Africa, one in 120 abortions leads to death, compared to one in 15,000 in developed countries.⁴

The age pattern of unsafe abortions varies markedly between regions. The proportion of women aged 15 to 19 who have an unsafe abortion is highest in Africa, and in some urban areas unmarried adolescents represent the majority of all abortion seekers. Understanding the age patterns of unsafe abortion is essential to identifying its causes and designing programmatic interventions to prevent it.⁵

In many developing countries, the consequences of unsafe abortion impose an additional burden on already-scarce hospital resources.⁶ Unsafe abortion can also be reflective of the overall quality of health care systems. Even where the procedure is legal, often health system shortages, poverty and misconceptions about the laws keep abortion unsafe.⁷ Where abortion is legal, it must be safe and accessible. Where abortion is heavily restricted, laws and policies should be eased or lifted on the grounds that doing so is necessary to bring down the high rate of maternal death. Women's health and lives are less at risk where abortion is legal. In Romania and South Africa, the legalization of abortion—in concert with strong family planning efforts—resulted in substantially fewer maternal deaths in a matter of a few years (Romania's maternal mortality rate fell by almost 73 percent between 1990 and 2002,⁸ while deaths from abortion complications decreased by 91 percent in South Africa from 1994 to 2001⁹). Life-saving post-abortion care (PAC) should be accessible in all health facilities, regardless of the legal status of abortion. Emergency obstetric care reduces the risk of death from unsafe abortion, and voluntary family planning services have been shown to help prevent unintended pregnancies and reduce abortion rates.^{10 11}

Culturally accepted norms and practices often limit a woman's ability to safeguard her own sexual and reproductive health and survival. In many countries, the law remains silent about harmful traditional practices such as FGM, child marriage and sex-selective abortion. In cases where protective legislation does exist, statutory laws can be undermined by customary laws. Moreover, often there are limitations to the opportunities available to women—in terms of access to jobs, unequal pay scales, discriminatory inheritance laws, and unequal access to education and political participation.