Unsafe abortion

{{Short description|Termination of a pregnancy by using  unsafe methods}}
[[Image:RussianAbortionPoster.jpg|thumb|[[Soviet]] poster {{Circa|1925}}. Title translation: "Abortion induced by grandma or [[midwife]] not only maims the woman, but also often leads to death."]]
An '''unsafe abortion''' is the termination of a [[pregnancy]] by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both.<ref>{{cite book | url = https://books.google.com/books?id=9ZRendehUUQC&pg=PA12 | title = Safe Abortion: Technical and Policy Guidance for Health Systems | page = 12 | publisher = World Health Organization | date = 2003 | isbn = 9789241590341 | quote = a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skill or in an environment lacking the minimum medical standards, or both. }}</ref> An unsafe abortion is a life-threatening procedure. It includes [[self-induced abortion]]s, [[abortion]]s in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate [[post-abortion care|post-abortion attention]].<ref name="WHO-unsafe-2007 1">{{cite web | publisher = [[World Health Organization]] | year = 2007 | access-date = March 7, 2011 | url = http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |quote=The estimates given in this document are intended to reflect induced abortions that carry greater risk than those carried out officially for reasons accepted in the laws of a country. |title = Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003}}</ref> About 25 million unsafe abortions occur a year, of which most occur in the [[developing world]].<ref name=WHO2018>{{cite web |title=Preventing unsafe abortion |url=https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion |website=www.who.int |access-date=19 April 2019 |language=en}}</ref>

Unsafe abortions result in complications for about 7 million women a year.<ref name=WHO2018/> Unsafe abortions are also one of the leading causes of [[maternal mortality|deaths during pregnancy and childbirth]] (about 5–13% of all deaths during this period).<ref name=WHO2018/> Most unsafe abortions occur where modern [[birth control]] is unavailable,<ref name="Singh_2009">{{cite book | vauthors = Singh S, Darroch JE, Ashford LS, Vlassoff M | url = http://www.guttmacher.org/pubs/AddingItUp2009.pdf | title = Adding it Up: The Costs and Benefits of Investing in Family Planning and Newborn Health | location = New York | publisher = Guttmacher Institute and United Nations Population Fund | date = 2009 | quote = If women's contraceptive needs were addressed...the number of unsafe abortions would decline by 73% from 20 million to 5.5 million. }}  A few of the findings in that report were subsequently changed, and are available at: {{cite book | url = http://www.guttmacher.org/pubs/FB-AIU-summary.pdf | title = Facts on Investing in Family Planning and Maternal and Newborn Health | archive-url = https://web.archive.org/web/20120324101905/http://www.guttmacher.org/pubs/FB-AIU-summary.pdf | archive-date=2012-03-24 | publisher = Guttmacher Institute | date = 2010 }}</ref> or in [[developing country|developing countries]] where affordable and well-trained medical practitioners are not readily available,<ref name=Blas /><ref name = "Chaudhuri_2007" /> or [[abortion law|where abortion is illegal]],<ref name="Rosenthal2007">{{cite web |url=https://www.nytimes.com/2007/10/12/world/12abortion.html |title=Legal or Not, Abortion Rates Compare | vauthors = Rosenthal E |date=October 2007 |work=[[New York Times]] |access-date=2009-06-30}}</ref> with the more restrictive the law, the higher the rates of death and other complications.<ref name="Haddad_2009" />

==Overview==
The [[World Health Organization]] (WHO) estimated that for the time period of 2010-14 there were 55.7 million abortions worldwide each year. Out of these abortions, approximately 54% were safe, 31% were less safe, and 14% were least safe. That means that 25 million (45%) abortions each year between 2010 and 2014 were unsafe, with 24 million (97%) of these in developing countries.<ref name = "Ganatra_2017">{{cite journal | vauthors = Ganatra B, Gerdts C, Rossier C, Johnson BR, Tunçalp Ö, Assifi A, Sedgh G, Singh S, Bankole A, Popinchalk A, Bearak J, Kang Z, Alkema L | display-authors = 6 | title = Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model | journal = Lancet | volume = 390 | issue = 10110 | pages = 2372–2381 | date = November 2017 | pmid = 28964589 | pmc = 5711001 | doi = 10.1016/S0140-6736(17)31794-4 }}</ref> In 2003 approximately 42 million pregnancies were voluntarily terminated, of which 20 million were unsafe.<ref name="who_unsafe_abortion2011">{{cite web | url = https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241501118/en/index.html | title = Unsafe abortion Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 | page = 2 | publisher = World Health Organization 2011 | quote = It was estimated that in 2003 approximately 42 million pregnancies were voluntarily terminated: 22 million safely and 20 million unsafely. }}</ref> According to WHO and the [[Guttmacher Institute]], at least 22,800<ref name=":0">{{Cite news|url=https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide|title=Induced Abortion Worldwide|date=2016-05-10|work=Guttmacher Institute|access-date=2018-03-08|language=en}}</ref> women die annually as a result of complications of unsafe abortion, and between two million and seven million women each year survive unsafe abortion but sustain long-term damage or disease (incomplete abortion, infection, [[sepsis]], bleeding, and injury to the internal organs, such as puncturing or tearing of the uterus). They also concluded abortion is safer in countries where it is legal, but dangerous in countries where it is outlawed and performed clandestinely. The WHO reports that in developed regions, nearly all abortions (92%) are safe, whereas in developing countries, more than half (55%) are unsafe.  According to WHO statistics, the risk rate for unsafe abortion is 1/270; according to other sources, unsafe abortion is responsible for at least 8% of maternal deaths.<ref>{{cite journal | vauthors = Nour NM | title = An introduction to maternal mortality | journal = Reviews in Obstetrics & Gynecology | volume = 1 | issue = 2 | pages = 77–81 | year = 2008 | pmid = 18769668 | pmc = 2505173 }}</ref><ref name=":0" /> Worldwide, 48% of all induced abortions are unsafe. The ''[[British Medical Bulletin]]'' reported in 2003 that 70,000 women a year die from unsafe abortion.<ref name="grimes2">
{{cite journal | vauthors = Grimes DA | title = Unsafe abortion: the silent scourge | journal = British Medical Bulletin | volume = 67 | issue = 1 | pages = 99–113 | date = 2003-12-01 | pmid = 14711757 | doi = 10.1093/bmb/ldg002 | doi-access = free }}</ref>  Incidence of such abortions may be difficult to measure because they can be reported variously as miscarriage, "induced miscarriage", "menstrual regulation", "mini-abortion", and "regulation of a delayed/suspended menstruation".<ref name=Pandemic>{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 2006 | pmid = 17126724 | doi = 10.1016/S0140-6736(06)69481-6 | s2cid = 6188636 }}</ref><ref name=Brazil_Unsafe>{{cite journal | vauthors = Nations MK, Misago C, Fonseca W, Correia LL, Campbell OM | title = Women's hidden transcripts about abortion in Brazil | journal = Social Science & Medicine | volume = 44 | issue = 12 | pages = 1833–1845 | date = June 1997 | pmid = 9194245 | doi = 10.1016/s0277-9536(96)00293-6 }}</ref>

An article pre-printed by the WHO called safe, legal abortion a "[[fundamental right]] of women, irrespective of where they live" and unsafe abortion a "silent [[pandemic]]".<ref name="Pandemic"/> The article states "ending the silent pandemic of unsafe abortion is an urgent [[public health|public-health]] and [[human-rights]] imperative." It also states "access to safe abortion improves [[women's health]], and vice versa, as documented in [[Romania]] during the regime of President [[Nicolae Ceaușescu]]" and "legalisation of abortion on request is a necessary but insufficient step toward improving women's health" citing that in some countries, such as India, where abortion has been legal for decades, access to competent care remains restricted because of other barriers. WHO's Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: "As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets."<ref name="who2">{{cite web|url=https://www.who.int/reproductivehealth/topics/unsafe_abortion/hrpwork/en/index.html |publisher=WHO |title=Preventing unsafe abortion |access-date=2014-03-28}}</ref> The WHO's Development and Research Training in Human Reproduction (HRP), whose research concerns people's sexual and reproductive health and lives,<ref>{{cite web|url=https://www.who.int/hrp/en/ |archive-url=https://web.archive.org/web/20090617123321/http://www.who.int/hrp/en/ |url-status=dead |archive-date=June 17, 2009 |title=New findings from the WHO Multicountry Survey on Maternal and Newborn Health |publisher=WHO |access-date=2014-03-28}}</ref> has an overall strategy to combat unsafe abortion that comprises four interrelated activities:<ref name="who2" />
*to collate, synthesize and generate scientifically sound evidence on unsafe abortion prevalence and practices;
*to develop improved technologies and implement interventions to make abortion safer;
*to translate evidence into norms, tools and guidelines;
*and to assist in the development of programmes and policies that reduce unsafe abortion and improve access to safe abortion and high-quality post-abortion care.

A 2007 study published in ''[[The Lancet]]'' found that, although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003. It also concluded that, while the overall incidence of abortion in both developed and developing countries is approximately equal, unsafe abortion occurs more often in less-developed nations.<ref>{{cite journal | vauthors = Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH | title = Induced abortion: estimated rates and trends worldwide | journal = Lancet | volume = 370 | issue = 9595 | pages = 1338–1345 | date = October 2007 | pmid = 17933648 | doi = 10.1016/S0140-6736(07)61575-X | s2cid = 28458527 | citeseerx = 10.1.1.454.4197 }}
</ref> The most repressive of laws still apply to over 40% of the world population. If found out, these women may face prosecution, and later incarceration. <ref>{{Cite journal |last=Berer |first=Marge |date=June 2017 |title=Abortion Law and Policy Around the World |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473035/ |journal=Health and Human Rights |volume=19 |issue=1 |pages=13–27 |issn=1079-0969 |pmc=5473035 |pmid=28630538}}</ref>

According to a new study in ''The Lancet'' that focused on data from 2010 to 2014, nearly 55 million pregnancies are terminated early and of that 55 million, nearly half, 25.5 million are deemed as unsafe.<ref>{{cite web | vauthors = Welch A | date =  27 September 2017 | title = Report finds nearly half of all abortions worldwide are unsafe | website = [[CBS News]] | access-date = 5 December 2017 | url = https://www.cbsnews.com/news/report-finds-nearly-half-of-all-abortions-worldwide-are-unsafe/ }}</ref> The WHO and the Guttmacher Institute stress the need for access to a safe abortion for all women and that unsafe methods must be replaced. Africa, Asia and Latin America account for almost 97 percent of unsafe abortions. These regions are often poorer and underdeveloped and lack the access to safe abortion methods. Out of all abortions in these regions only 25% are considered safe. In developed countries these numbers improve drastically. Nearly all abortions in North America (99%) are considered safe. Overall nearly 88% of abortions in developed countries were actually considered safe, with the number of safe abortions in Europe slightly lower.

==Conflating illegal and unsafe abortion==
Unsafe abortions often occur [[abortion law|where abortion is illegal]].<ref name="Rosenthal2007"/> However, the prevalence of unsafe abortion may also be determined by other factors, such as whether it occurs in a [[developing country]] that has a low level of competent medical care.<ref name = "Chaudhuri_2007">{{cite book | vauthors = Chaudhuri SK | url = https://books.google.com/books?id=pzanxKlcU74C&pg=PA259 | title = Practice Of Fertility Control: A Comprehensive Manual | edition = 7th | page = 259 | publisher = Elsevier | location = India | date = 2007 | isbn=9788131211502 }}</ref>

Unsafe abortions sometimes occur where abortion is legal, and safe abortions sometimes occur where abortion is illegal.<ref>{{cite book | vauthors = Faúndes A, Barzelatto J | url = https://books.google.com/books?id=U89BF625xcwC&pg=PA21 | title = The Human Drama of Abortion: a Global Search for Consensus | page = 21 | publisher = Vanderbilt University Press | date = 2006 | isbn=9780826515261 }}</ref>  Legalization is not always followed by elimination of unsafe abortion.<ref name=Blas>{{cite book | veditors = Blas E, Kurup AS | url = https://books.google.com/books?id=7JxutqCmctUC&pg=PA183 | title = Equity, social determinants and public health programmes | pages = 182–183 | publisher = World Health Organization | date = 2010 | isbn=9789241563970 }}</ref><ref name="WHO-unsafe-2007 2">{{cite web | publisher = [[World Health Organization]] | year = 2007 | access-date = March 7, 2011 | url = http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |quote= In several countries, the legalization of abortion has not been followed by elimination of unsafe abortion.|title = Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003}}</ref>  Affordable safe services may be unavailable despite legality, and conversely, women may be able to afford medically competent services despite illegality.<ref>{{cite book | url = https://books.google.com/books?id=9ZRendehUUQC&pg=PA12 | title = Safe Abortion: Technical and Policy Guidance for Health Systems | page = 15 | publisher = World Health Organization | date = 2003 | isbn = 9789241590341 }}</ref>

When abortion is illegal, that generally contributes to the prevalence of unsafe abortion, but it is not the only contributor.  In addition, a lack of access to safe and effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by as much as 73% without any change in abortion laws if modern family planning and maternal health services were readily available globally.<ref name="Singh_2009" />

Illegality of abortion contributes to [[maternal mortality]], but that contribution is not as great as it once was, due to medical advances including [[penicillin]] and the [[birth control pill]].<ref>{{cite web |url=http://factcheck.org/article336.html |title=Abortion Distortions: Senators from both sides make false claims about Roe v. Wade |date=2005-08-22 |access-date=2021-02-20 |archive-url=https://web.archive.org/web/20110726044751/http://factcheck.org/article336.html |archive-date=2011-07-26 |df=mdy-all}}</ref>

==Frequency by continent==
{| class="wikitable"
|-
! Region !! Number of unsafe abortions (thousands) !! Number of unsafe abortions per 100 live births !! Number of unsafe abortions per 1000 women
|-
|Africa
|4200
|14
|24
|-
|Asia*
|10500
|14
|13
|-
|Europe
|500
|7
|3
|-
|Latin America and the Caribbean
|3700
|32
|29
|-
|North America
| Negligible incidence 
| Negligible incidence
| Negligible incidence
|-
|Oceania **
|30
|12
|17
|-
|'''World'''
|'''19000'''
|'''14'''
|'''14'''
|}

: * Excluding Japan
: ** Excluding Australia and New Zealand

Source: WHO 2006<ref>{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 2006 | pmid = 17126724 | doi = 10.1016/s0140-6736(06)69481-6 | s2cid = 6188636 | url = https://www.who.int/reproductivehealth/topics/unsafe_abortion/article_unsafe_abortion.pdf }}</ref>

===Abortion in the U.S. before 1973 (''Roe v. Wade'')===
In 1973, the Supreme Court ruled 7–2 that laws prohibiting an abortion violated a woman's right to privacy. The landmark case, ''[[Roe v. Wade]]'', changed abortion in the United States.

Early abortion laws generally only prohibited the use of toxic chemicals that were used to cause a miscarriage. The first such law was passed in Connecticut in 1821.<ref name="CNN_22 January 2013">{{cite web |url=http://www.cnn.com/2013/01/22/health/roe-wade-abortion-timeline/index.html |title=Before and after Roe v. Wade | vauthors = Wilson J |website=CNN |date=January 22, 2013 |access-date=December 7, 2017}}</ref>

Prior to 1973, the authority to legalize abortion rested with the state governments. Up through the 1960s, 44 states had laws that outlawed abortions unless the health of the pregnant patient was at stake.<ref>{{cite news |url=https://www.washingtonpost.com/news/wonk/wp/2013/01/22/charts-how-roe-v-wade-changed-abortion-rights/ |title=CHARTS: How Roe v. Wade changed abortion rights | vauthors = Kliff S |newspaper=[[The Washington Post]] |date=January 22, 2013 |access-date=December 7, 2017}}</ref>

In the 1940s, records show that more than 1,000 women died each year from abortions that were labeled as unsafe. Many of these abortions were self-induced. Unsafe abortion practices were such a concern in the United States that nearly every large hospital had some type of "septic abortion ward" that was responsible for dealing with the complications that accompanied an incomplete abortion. Incomplete abortions were the leading cause for OB-GYN services across the United States. In the 1960s, the [[National Opinion Research Center]] found that hundreds of women were attempting to self-abort with coat hangers, knitting needles and ballpoint pens, and by swallowing toxic chemicals like bleach and laundry detergent.<ref name="thinkprogress.org">{{cite web |url=https://thinkprogress.org/what-americans-have-forgotten-about-the-era-before-roe-v-wade-19687b9e9b16/ |title=What Americans Have Forgotten About The Era Before Roe v.&nbsp;Wade | vauthors = Culp-Ressler T |website=ThinkProgress |access-date=February 20, 2021}}</ref> However, the number of deaths declined significantly into the 1960s and 1970s. The Centers for Disease Control and Prevention estimates that in 1972, 130,000 women attempted self-induced abortions or obtained illegal abortions, resulting in 39 deaths.<ref>{{cite web | vauthors = Gold RB | publisher = Guttmacher Institute |url= https://www.guttmacher.org/gpr/2003/03/lessons-roe-will-past-be-prologue |title=Lessons from Before Roe: Will Past be Prologue? |date=22 September 2004}}</ref>

===Cases resulting from parental consent laws in the U.S. after 1973===
In 2005, the ''[[Detroit News]]'' reported that a 16-year-old boy, at his pregnant, under-age girlfriend's request, repeatedly beat her abdomen with a bat to abort the fetus. The young couple lived in Michigan and were evading a state law requiring a minor to receive a parent's or a judge's consent to obtain a legal abortion.<ref>{{cite news  | vauthors = Cardenas E, George H |date = 5 January 2005 | title =Boy Faces Felony in Baseball Bat Abortion | work =Detroit News | url =https://billmuehlenberg.com/web-archive/detroit-news-boy-faces-felony-baseball-bat-abortion/ }}</ref><ref>{{cite news | vauthors = White P | date =January 13–21, 2005 | title =Baseball Bat Abortion | publisher =Boulder Weekly | url =http://archive.boulderweekly.com/011305/uncensored.html | access-date =2009-05-31 }}</ref><ref>{{cite web |url=http://www.prochoiceamerica.org/choice-action-center/in_your_state/who-decides/state-profiles/michigan.html?templateName=lawdetails&issueID=6&ssumID=2652 |archive-url=https://web.archive.org/web/20060130214820/http://www.prochoiceamerica.org/choice-action-center/in_your_state/who-decides/state-profiles/michigan.html?templateName=lawdetails&issueID=6&ssumID=2652 |url-status=dead |archive-date=January 30, 2006 |title=Michigan: Restrictions on Young Women's Access to Abortion |publisher=NARAL Pro-Choice America |access-date=2009-05-31}}</ref> In Indiana, where there were also parental consent laws, 17-year-old [[Becky Bell]] died from an unsafe abortion in 1988 rather than discuss her pregnancy and wish for an abortion with her parents.<ref>{{cite web | title=DEMOCRACY NOW! | url=http://www.pacifica.org/programs/dn/030123.html |date=2003-01-22 |access-date=2021-02-20 |archive-url=https://web.archive.org/web/20110809172936/http://www.pacifica.org/programs/dn/030123.html |archive-date=2011-08-09 |df=mdy-all}}</ref><ref>{{cite web | vauthors = Platner J | title= Remembering Becky Bell | date=2006-09-15 | publisher=Planned Parenthood Golden Gate | url=http://www.ppgg.org/site/apps/nlnet/content2.aspx?c=esJMKZPKJtH&b=1371221&ct=2939285 | access-date=2009-05-31}}</ref> {{better source needed|date=December 2022}}

==Methods==
Methods of unsafe abortion include:
* Trying to break the [[amniotic sac]] inside the [[Uterus|womb]] with a sharp object or wire (for example an unbent wire [[clothes hanger]] or [[knitting needle]]).<ref>{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 2006 | pmid = 17126724 | doi = 10.1016/S0140-6736(06)69481-6 | s2cid = 6188636 }}</ref> This method can cause infection or injury to internal organs (for example perforating the uterus or [[intestines]]), resulting in death.<ref>{{cite book| vauthors = Soubiran A |author-link=André Soubiran|title=Diary of a Woman in White|publisher=Avon Books|year=1969|edition=English|pages=98–99}} citing {{Cite book|title=Fatal Abortions| vauthors = Modnor H |author-link=Henri Mondor|year=1935}}</ref> The uterus softens during pregnancy and is very easy to pierce, so one traditional method was to use a large feather.<ref name=avery-family>{{cite book | vauthors = Avery M |chapter = My Family Speaks | title = Confessions of an Abortionist: Intimate Sidelights on the Secret Human, Sorrow, Drama and Tragedy in the Experience of a Doctor Whose Profession it is to Perform Illegal Operations | publisher = Haldeman-Julius Company | year = 1939 | edition = First }}. Accessed 14 December 2012.
</ref>
* Pumping toxic mixtures, such as [[chili pepper]]s and chemicals like [[alum]], [[Lysol]], [[permanganate]], or [[herbicide|plant poison]] into the body of the woman. This method can cause the woman to go into [[toxic shock]] and die.<ref name="bbc">{{cite news |url=http://news.bbc.co.uk/1/hi/world/africa/7328830.stm |title=Saving Nigerians from risky abortions| vauthors = Walker A |website=BBC News |date=April 7, 2008 |access-date=February 20, 2021}}</ref>
* Inducing an abortion without medical supervision by self-administering [[abortifacient]] over-the-counter drugs, drugs obtained illegally, or by using drugs not indicated for abortion but known to result in miscarriage or uterine contraction. Drugs that cause [[uterine contraction]]s include [[oxytocin]] (synthetic forms are [[Pitocin]] and [[Syntocinon]]), [[prostaglandin]]s, and [[ergot alkaloid]]s. Risks include [[uterine rupture]], [[irregular heartbeat]], a rise in blood pressure ([[hypertension]]), a drop in blood pressure ([[hypotension]]), [[anemia]] requiring [[blood transfusion|transfusion]], cardiovascular problems, [[pulmonary edema]], and death, as well as intense [[bronchospasm]]s in women with [[asthma]].<ref name=uterine>{{cite web |url=http://www.surgeryencyclopedia.com/St-Wr/Uterine-Stimulants.html#b |title=Uterine stimulants |website=Encyclopedia of Surgery |access-date=February 20, 2021}}</ref>

==Health risks==
Unsafe abortion is a major cause of injury and death among women worldwide. It is estimated that nearly 25 million unsafe abortions take place annually.<ref name = "Ganatra_2017" /> WHO estimates that at least 7.9% of maternal deaths are due to unsafe abortion, with a greater proportion occurring in Latin America, the Caribbean, and sub-Saharan Africa and a lesser proportion in East Asia where access to abortion is generally legal.<ref>{{cite journal | vauthors = Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L | display-authors = 6 | title = Global causes of maternal death: a WHO systematic analysis | journal = The Lancet. Global Health | volume = 2 | issue = 6 | pages = e323–e333 | date = June 2014 | pmid = 25103301 | doi = 10.1016/S2214-109X(14)70227-X | doi-access = free | hdl = 1854/LU-5796925 | hdl-access = free }}</ref> 97% of these abortions take place in [[developing country|developing countries]].<ref name="lancet-grimes">{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 2006 | pmid = 17126724 | doi = 10.1016/S0140-6736(06)69481-6 | s2cid = 6188636 }}</ref> Unsafe abortion is believed to result in at least 22,800 deaths and millions of injuries annually.<ref name="lancet-grimes"/> The legal status of abortion is believed to play a major role in the frequency of unsafe abortion.<ref>{{cite journal | vauthors = Berer M | title = National laws and unsafe abortion: the parameters of change | journal = Reproductive Health Matters | volume = 12 | issue = 24 Suppl | pages = 1–8 | date = November 2004 | pmid = 15938152 | doi = 10.1016/S0968-8080(04)24024-1 | s2cid = 33795725 | doi-access = free }}</ref><ref name="berer-who"/> For example, the 1996 legalization of abortion in [[South Africa]] had an immediate positive impact on the frequency of abortion-related complications,<ref name="jewkes">{{cite journal | vauthors = Jewkes R, Rees H, Dickson K, Brown H, Levin J | title = The impact of age on the epidemiology of incomplete abortions in South Africa after legislative change | journal = BJOG | volume = 112 | issue = 3 | pages = 355–359 | date = March 2005 | pmid = 15713153 | doi = 10.1111/j.1471-0528.2004.00422.x | s2cid = 41663939 | doi-access = free }}</ref> with abortion-related deaths dropping by more than 90%.<ref name="bateman-samj">{{cite journal | vauthors = Bateman C | title = Maternal mortalities 90% down as legal TOPs more than triple | journal = South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde | volume = 97 | issue = 12 | pages = 1238–1242 | date = December 2007 | pmid = 18264602 }}</ref> Groups such as the [[World Health Organization]] have advocated a public-health approach to addressing unsafe abortion, emphasizing the legalization of abortion, the training of medical personnel, and ensuring access to reproductive-health services.<ref name="berer-who">{{cite journal | vauthors = Berer M | title = Making abortions safe: a matter of good public health policy and practice | journal = Bulletin of the World Health Organization | volume = 78 | issue = 5 | pages = 580–592 | year = 2000 | pmid = 10859852 | pmc = 2560758 }}</ref>

An unsafe abortion can lead to wide range of health risks that can affect the well-being of women. The major and most life-threatening complications that stem from unsafe abortions are infection, hemorrhaging and injury to internal organs.<ref name="auto1">{{cite web|url=https://www.who.int/mediacentre/factsheets/fs388/en/|title=Preventing unsafe abortion|website=World Health Organization|access-date=7 December 2017}}</ref>

Abortion symptoms that can lead to additional health risks:
* To provide the necessary treatment, an accurate assessment of an unsafe abortion is critical. Some signs and symptoms that require immediate attention by a licensed health care provider include: abdominal pain, vaginal infection, abnormal vaginal bleeding, shock (collapse of the circulatory system).<ref name="auto1"/>
* It is difficult to diagnose complications that result from an unsafe abortion. A woman with an extra-uterine or ectopic pregnancy may have symptoms similar to those of incomplete abortion. Therefore, it is important for health care providers to refer individuals they are unsure about to a facility where a definitive diagnosis can be made and care can be provided.<ref>{{cite book | vauthors = Vlassoff M, Shearer J, Walker D, Lucas H | title = Economic impact of unsafe abortion-related morbidity and mortality: evidence and estimation challenges. | location = Brighton, UK | publisher = Institute of Development Studies | date = December 2008 | url = https://www.ids.ac.uk/download.php?file=files/dmfile/RR591.pdf | series = Research Report | volume = 59 }}</ref>

Complications and their treatments include:
* Infection: antibiotics prescribed by a health care provider and removing tissue from the affected area.
* Hemorrhage: swift treatment by a health care provider is imperative, as delays can be fatal.
Damage to the genital tract or internal organs: Admission to a health care facility is imperative, any delay can be fatal.<ref name="Haddad_2009">{{cite journal | vauthors = Haddad LB, Nour NM | title = Unsafe abortion: unnecessary maternal mortality | journal = Reviews in Obstetrics & Gynecology | volume = 2 | issue = 2 | pages = 122–126 | date = 2009 | pmid = 19609407 | pmc = 2709326 }}</ref>

===Treatment of complications===
Regardless if an abortion was legal or illegal, health care providers are required by law to provide medical care to patients, as it may be life-saving. In some cases, treatment for abortion complications may be administered only when the woman provides information about the abortion and any and all persons that were involved.<ref name="Ingelse_2001">{{cite book | vauthors = Ingelse C | chapter = The Committee Against Torture. | title = The UN Committee against Torture | date = January 2001 | pages = 89–123 | publisher = Brill Nijhoff | doi = 10.1163/9789004478114_007 | isbn = 9789004478114 | s2cid = 239991865 }}</ref>

In areas where abortion is illegal, people seeking care for complications of illegal abortions may face legal consequences.  This may deter people from seeking life-saving care.<ref name="Ingelse_2001"/>

Globally, there is a high burden of complications from unsafe abortions.<ref name = burdenofmorbidity>{{cite journal | vauthors = Adler AJ, Filippi V, Thomas SL, Ronsmans C | title = Quantifying the global burden of morbidity due to unsafe abortion: magnitude in hospital-based studies and methodological issues | journal = International Journal of Gynaecology and Obstetrics | volume = 118 | issue = Suppl 2 | pages = S65–S77 | date = September 2012 | pmid = 22920625 | pmc =  | doi = 10.1016/S0020-7292(12)60003-4 | s2cid = 43126015 }}</ref> The costs of treating the complications can be significant in developing countries, where, in 2011, 98% of unsafe abortions occurred.<ref name = fourstudies>{{cite journal | vauthors = Vlassoff M, Singh S, Onda T | title = The cost of post-abortion care in developing countries: a comparative analysis of four studies | journal = Health Policy and Planning | volume = 31 | issue = 8 | pages = 1020–1030 | date = October 2016 | pmid = 27045001 | pmc = 5013781 | doi = 10.1093/heapol/czw032 }}</ref> An estimated 5.3 million women worldwide have developed complications or disabilities from unsafe abortion, which may be either temporary or permanent.<ref name = adolescentsinafrica>{{cite journal | vauthors = Atuhaire S | title = Abortion among adolescents in Africa: A review of practices, consequences, and control strategies | journal = The International Journal of Health Planning and Management | volume = 34 | issue = 4 | pages = e1378–e1386 | date = October 2019 | pmid = 31290183 | pmc =  | doi = 10.1002/hpm.2842 | url = https://d1wqtxts1xzle7.cloudfront.net/81136286/Abortion_among_adolescents_in_Africa_A_systematic_review-with-cover-page-v2.pdf?Expires=1653934375&Signature=NDcEa6yXggYFRuKdmyL1Kh74lFldJs2dpbzbaQxJfG7V91jPqdODfXmdSnN~eW~hVtoOLn~Q3umsUtlq8VXRbc6a7ZIvNx-D7LULWPpmVYNhocqg6FZ12m5TrGdKoVfaWFbPWYJfkz7MQ81pJ-t8LL2i6yX5WVk2nGUg7PhydMowg2M9QIpK~PrjC1Uaf7nN42NMlmWqLgg0~XGa1pkUFnPMaRKzufZTjypHJ0R2rlaekODFhauRFVh8QJdUHPWQw-EviwKp9V2A3h9jgZ~vLXonHjKewy~qSOnUJJauG752F46QZBaRbMmhdP7ZHxhvxPgnfvJY4sxXnmWWfPwz3g__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA | s2cid = 195871358 | archive-url = https://web.archive.org/web/20220530171300/https://d1wqtxts1xzle7.cloudfront.net/81136286/Abortion_among_adolescents_in_Africa_A_systematic_review-with-cover-page-v2.pdf?Expires=1653934375&Signature=NDcEa6yXggYFRuKdmyL1Kh74lFldJs2dpbzbaQxJfG7V91jPqdODfXmdSnN~eW~hVtoOLn~Q3umsUtlq8VXRbc6a7ZIvNx-D7LULWPpmVYNhocqg6FZ12m5TrGdKoVfaWFbPWYJfkz7MQ81pJ-t8LL2i6yX5WVk2nGUg7PhydMowg2M9QIpK~PrjC1Uaf7nN42NMlmWqLgg0~XGa1pkUFnPMaRKzufZTjypHJ0R2rlaekODFhauRFVh8QJdUHPWQw-EviwKp9V2A3h9jgZ~vLXonHjKewy~qSOnUJJauG752F46QZBaRbMmhdP7ZHxhvxPgnfvJY4sxXnmWWfPwz3g__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA | archive-date = 2022-05-30 }}</ref> Unsafe abortions cause an estimated 5 million lost [[disability-adjusted life year]]s each year by women of reproductive age.<ref name = preventablepandemic>{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 2006 | pmid = 17126724 | pmc =  | doi = 10.1016/S0140-6736(06)69481-6 | series = Sexual and Reproductive Health 4 | s2cid = 6188636 }}</ref>

== See also ==
* [[Reproductive health]]
* [[Reproductive rights]]
* [[Gerri Santoro]]

== References ==
{{reflist}}

== External links ==
{{Wikiquote}}
*{{cite web | title=Abortion | website=who.int | date=2019-10-11 | url=https://www.who.int/health-topics/abortion#tab=tab_2 | access-date=2023-10-13}}
*[https://www.who.int/reproductivehealth/publications/unsafe_abortion/0939253763/en/ Preventing Unsafe Abortion and its Consequences: Priorities for Research and Action, New York: Guttmacher Institute, 2006]{{dead link|date=October 2023}} 
*{{cite web | title='My Back-Alley Abortion' | website=Beliefnet | date=2016-07-27 | url=https://www.beliefnet.com/news/2005/01/my-back-alley-abortion.aspx | ref={{sfnref | Beliefnet | 2016}} | access-date=2023-10-13}}
*{{cite book |author=World Health Organization | title=Safe Abortion | publication-place=Geneva |publisher=WHO | date=2012 | isbn=978-92-4-154843-4 | url=https://iris.who.int/bitstream/handle/10665/70914/9789241548434_eng.pdf}}
{{Abortion}}

{{DEFAULTSORT:Unsafe Abortion}}
[[Category:Abortion]]