Costs of Unsafe Abortions

It's estimated there are 22 million unsafe abortions every year, resulting in 22,000 deaths. A new study looked at the global cost of unsafe abortions, including the many women who are treated for complications of botched procedures.

The Guttmacher Institute said unsafe abortion accounts for up to 15 percent of maternal deaths every year. What's more, seven million women annually are treated at medical facilities after complications set in.

The institute is a non-profit organization that says it aims to "advance sexual and reproductive health and rights through...research, policy analysis and public education." Its study is based on health statistics and scientific studies from 26 developing countries.

Dr. Susheela Singh is the lead author of the study published in BJOG – an international journal of obstetrics and gynecology. She described how the procedure can be unsafe.

"That means that the woman either went to a provider who is not trained to provide this service. Not formally trained. Doesn't have the right skills. Or she goes to a place that is unhygienic. So there is a risk of infection even if the person is trained."

She said unsafe abortions can be performed by a variety of people in different settings.

"It could be a midwife, informal midwife, a trained birth attendant at the lower end of the qualification scale. And it could even be a nurse, a trained nurse, or an MD. But they may not have the training to do the abortion or they are doing it under conditions that aren't very hygienic," she said.

Dr. Singh said the report's findings "provide further evidence about the number of women who suffer injury as a result of complications due to unsafe abortion, often leading to chronic disability."

"Extreme hemorrhage, a lot of bleeding, up to a perforation of a uterus or an infection that is at least a high grade fever, sepsis even. Lacerations depending on if the woman inserts an object into her vagina. There are different categories of complications from the less severe up to the most severe and life threatening." She said.

The study estimated the annual cost of treating women for complications of unsafe abortions is $232 million. But that's just for those who actually go for treatment. It estimated the cost for treating all the women who actually need it would be more than $560 million.

Singh said, "The quality of the care for the 232 million is what are they getting right now – which is not as WHO recommends such care should be. We all know that quality of care varies a lot across the world. Perhaps it's not that the country or the government or the provider doesn't want to give good quality care, but they may not have the training or the facilities, the capacity, to do it."

The findings, she said, show the importance of prevention for women.

"Better contraceptive counseling and services, a better range of choice of methods, a follow-up of women if they have a problem with a method to offer them something else. This set of services at a good quality would help women to prevent the unintended pregnancy in the first place, which would avoid having to resort to an abortion."

Dr. Singh added that good quality medical care is a must for women suffering complications from unsafe abortions. Delaying treatment could mean death.

"The fact is that safe abortion services – the availability and accessibility of these – would prevent the situation, also," she said.

The Guttmacher Institute study said the highest rate of treatment for unsafe abortion is in Pakistan. The lowest is in Brazil. Regionally, the highest rate is in Asia, primarily South-Central Asia, followed by Africa, Latin America and the Caribbean.

Dr. Singh said debate and controversy over abortion is widespread, in part, because of the stigma often associated with the procedure. But she said many women will seek an abortion out of desperation over an unintended pregnancy, even though there are laws banning or restricting it. She said reproductive rights can be subject to the political climate within a country.

Vocabulary

botch：拙笨地修补；弄坏某事物

obstetrics：产科学，助产术

gynecology：妇科学，妇科医学

hemorrhage：[病理] 出血

sepsis：败血症，[医] 脓毒病

vagina：[解剖] 阴道

contraceptive：避孕用具