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 The study - by the World Health Organization (WHO) and Guttmacher
Institute - also found that imposing restrictive laws does little to
lower abortion rates, but is more likely to force people into having
unsafe terminations.
It estimated that on average 56 million abortions took place each
year worldwide from 2010 to 2014.
The overall findings highlight a lack in poorer countries of access
to modern contraception methods - such as the pill, implants and
IUDs - to reduce unwanted pregnancies, the researchers said.
"In developing countries ... family planning services do not seem to
be keeping up with the increasing desire for smaller families," said
Gilda Sedgh, who led the research at the Guttmacher Institute in the
United States.
More than 80 percent of unintended pregnancies are in women who are
not getting the contraception they need, she said, "and many
unwanted pregnancies end in abortion."
She said that by contrast the downward trend in abortion rates in
richer countries is largely due to "increased use of modern
contraception that has given women greater control over the timing
and number of children they want."
Published in The Lancet medical journal, the study used abortion
data from nationally representative surveys, official statistics and
other published and unpublished studies, along with information on
the level of unmet need for contraception and the prevalence of
contraceptive use, by type of method.
The researchers then used a statistical model to estimate levels and
trends in abortion incidence for all major world regions and
subregions from 1990 to 2014.
The researchers found that between 1990 and 2014, the developed
world’s annual abortion rate per 1,000 women of childbearing age
(15–44 years) dropped from 46 to 27, mainly as a result of the rate
in Eastern Europe more than halving as modern contraceptive methods
became more widely available.
Yet in poorer countries, the abortion rate remained virtually
unchanged, dropping from 39 to 37.
The study also found that termination rates were similar in
countries where abortion is legal and where it is prohibited.
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Where abortion is prohibited altogether, or allowed only to save a
woman’s life, the rate was 37 abortions per 1,000 women, compared
with 34 per 1,000 where it is legal.
"More women living in countries with the most restrictive abortion
laws have an unmet need for contraception - that is, they want to
avoid getting pregnant but are not using a method of family planning
- than women in countries with more liberal laws, and this adds to
the incidence of abortion in countries with restrictive laws," Sedgh
said.
EAST EUROPE
Over the last 25 years, Eastern Europe has seen the biggest drop in
abortion rates, but rates also fell in Europe and North America, the
study found.
The overall abortion rate in Africa, where the vast majority of
abortions are illegal, remained virtually unchanged at 34 abortions
per 1,000 women in 2014 versus 33 in 1990–94.
"We already know nearly $300 million are spent each year on treating
the complications from unsafe abortions," said Bela Ganatra, a WHO
scientist who also worked on the study.
She said the high rates of abortion in developing countries showed
the need to improve access to effective contraception.
"Investing in modern contraceptive methods would be far less costly
to women and society than having unwanted pregnancies and unsafe
abortions," she said.
SOURCE: http://bit.ly/1rHKniZ The Lancet, online May 11, 2016.
(Reporting by Jeremy Gaunt)
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