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This report provides updated information on the incidence of abortion worldwide, the laws that regulate abortion and the safety of its provision. It also looks at unintended pregnancy, its relationship to abortion, and the impact that both have on women and couples who increasingly want smaller families and more control over the timing of their births.
Abortion incidence As of —, an estimated 36 abortions occur each year per 1, women aged 15—44 in developing regions, compared with 27 in developed regions. The abortion rate declined significantly in developed regions since —; however, no significant change occurred in developing regions.
By far, the steepest decline in abortion rates occurred in Eastern Europe, where use of effective contraceptives increased dramatically; the abortion rate also declined significantly in the developing subregion of Central Asia. Both subregions are made up of former Soviet Bloc states where the availability of modern contraceptives increased sharply after political independence—exemplifying how abortion goes down when use of effective contraceptives goes up.
In much of the world, 20—year-old women tend to have the highest abortion rate of any age-group, and the bulk of abortions are accounted for by women in their twenties. Adolescent abortion rates in countries in developed regions are fairly low e.
Abortion law Laws fall along a continuum from outright prohibition to allowing abortion without restriction as to reason. In contrast, broadly liberal laws are found in nearly all countries in Europe and Northern America, as well as in several countries in Asia.
Nonetheless, some countries with broadly liberal laws have increasingly added restrictions that chip away at access to legal procedures; these include the United States and several countries in the former Soviet Bloc or zone of influence.
Moreover, 24 added at least one of three additional grounds: Implementing access under expanded legal grounds can take many years; however, with political will, change can be achieved much more quickly.
Abortion safety The development and application of clinical guidelines and standards have likely facilitated the provision of safe abortion.
Furthermore, the reach of safe services has been extended by allowing trained, midlevel health professionals to provide abortion in many countries. In highly restrictive contexts, clandestine abortions are now safer because fewer occur by dangerous and invasive methods.
Women increasingly use medication abortion methods—primarily the drug misoprostol alone, as it is typically more available in these contexts than the method of mifepristone and misoprostol combined.
As access to health care overall improves and national governments increasingly prioritize implementing World Health Organization WHO guidelines, access to quality postabortion care also improves. The combined result of these trends and safer procedures means that fewer women are dying from unsafe abortion.
Unsafe abortions occur overwhelmingly in developing regions, where countries that highly restrict abortion are concentrated. But even where abortion is broadly legal, inadequate provision of affordable services can limit access to safe services.
In addition, persistent stigma can affect the willingness of providers to offer abortions, and can lead women to prioritize secrecy over safety.
In all developing regions combined except Eastern Asiaan estimated 6. Unintended pregnancy The vast majority of abortions result from unintended pregnancies. The estimated unintended pregnancy rates in developed and developing regions are 45 and 65 per 1, women aged 15—44, respectively, as of —; both values represent significant declines since — Current rates are highest in Latin America and the Caribbean 96 per 1, and Africa 89 per 1, To act on their growing preferences for smaller families and for better control over the timing of their births, women need improved access to modern contraceptives.
Levels of unmet need for modern contraception are much higher among single, sexually active women than among in-union women because stigma continues to impede single women—especially adolescents—from getting contraceptive counseling and services.
The path toward safer abortions is clear: The benefits of expanding legal grounds for abortion begin to accrue as soon as women no longer have to risk their health by resorting to clandestine abortion.
Although legality is the first step toward safer abortion, legal reform is not enough in itself. It must be accompanied by political will and full implementation of the law so that all women—despite inability to pay or reluctance to face social stigma—can seek out a legal, safe abortion.
Legality alone does not guarantee access, and vigilance is required to prevent backsliding where onerous restrictions that are not based on safety erode the availability of safe and legal abortion services.
Highly restrictive laws do not eliminate the practice of abortion, but make those that do occur more likely to be unsafe. Where abortion is legal, it is important to ensure that women can choose between equally safe methods of surgery or medication.The Community Benefit Plan for FY09 is a continuation of this plan.
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