Abortion rates at all-time low in developed countries, but unchanged in the developing world

By Sally Robertson, B.Sc.May 12 2016

Abortion rates have dropped to an all-time low in developed countries, but remain the same in developing countries, where it is often unsafe to have an abortion, report researchers.

The findings, which were published in The Lancet, highlight the need for improved access to contraception in developing countries.

In developed countries, the continued fall in abortion rates is largely due to increased use of modern contraception that has given women greater control over the timing and number of children they want,”

"In developing countries, however, more than 80% of unintended pregnancies are experienced by women with an unmet need for modern methods of contraception, and many unwanted pregnancies end in abortion.”

Gilda Sedgh, lead author, Guttmacher Institute, New York, USA.

For the study, the researchers used government data and a statistical model to estimate abortion rates worldwide between 1990 and 2014. In the developed world, the abortion rate fell from 46 per 1000 women of childbearing age (15 to 44 years) in 1990, to 27 per 1000 women in 2014. However, in the developing world, abortion incidence remained virtually unchanged, at 39 per 1,000 women in 1990 and 37 per 1,000 women in 2014.

In the developed world, the largest fall in abortion rate was seen in Eastern Europe, where it dropped from 88 to 42 per 1,000 women. In Southern Europe, the rate fell from 38 to 26; in Northern Europe it fell from 22 to 18 and in North America it fell from 25 to 17. In Africa, however, where abortion is generally illegal, there was no significant change in abortion rate, which was 33 per 1,000 women in 1990 compared with 34 per 1000 women in 2014.

The study also suggests that restrictive abortion laws do not lower the number of abortions carried out. In countries with restrictive laws, abortion is often carried out illegally under unsafe conditions and the abortion rate is still as high as it is in countries where abortion is not prohibited.

In an accompanying commentary, Diana Green Foster (University of California, San Francisco, USA) says that the obvious conclusion to draw is that criminalizing abortion does not prevent it, but instead drives women to look for illegal and unsafe ways of undergoing the procedure.

Co-author Bela Ganatra (World Health Organization, Geneva, Switzerland) says that the findings provide evidence of the need to improve and expand access to effective contraceptive services:

“Investing in modern contraceptive methods would be far less costly to women and society than having unwanted pregnancies and unsafe abortions."