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Bring abortion out of the shadows
Publish Date: Nov 11, 2010
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By Sharon Camp

OVER 90 % of African women of childbearing age live in countries with limited or no access to safe abortion procedures.

According to the most recent data, of the 5.6 million abortions carried out in the region every year, only 100,000 are performed under safe conditions.

Here is another way to think about that statistic: Every year, about 5.5 million women in Africa risk their lives when they decide to terminate a pregnancy. Drinking bleach or inserting sharp objects into their cervix are only two of the horrifying methods they use. These are not risks any woman should be forced to take.

The toll of unsafe abortion goes beyond the individual woman. Losing their mother and caregiver devastates the lives of children and families, and losing a healthy woman’s many contributions to society weakens her community.

Unsafe abortion is also a serious drain on very limited public health resources. African governments spend, on average, $114 (sh256,000) per case to provide care for illness and disability associated with unsafe abortion, yet per capita spending on health care averages just $48 (sh85,000).

While some African nations have loosened abortion restrictions, 14 countries still prohibit it under all circumstances even to save the pregnant woman’s life.

This flies in the face of considerable evidence that legalising abortion saves lives and reduces persistently high maternal mortality rates. One example is South Africa, where just six years after the country liberalised its abortion law, the number of women dying from unsafe abortion dropped by 50%, and the number of women suffering serious complications fell as well.

Restrictive abortion laws are also not very effective at achieving their purported goal stopping women from obtaining abortions.

Evidence worldwide shows that abortion happens at about the same rate in regions where it is highly restricted and where it is broadly legal. The key difference is safety.

If a country’s leaders want to reduce abortion, clearly punitive laws are not the way to go. Rather, they should focus on reducing the number of unplanned pregnancies.

The single biggest thing a country can do to reduce the number of abortions both safe and unsafe and improve women’s overall health is to make sure all women have access to and information about effective contraceptive methods. But in Sub-Saharan Africa today, about 60% of women who want to avoid a pregnancy are not using family planning or rely on a less effective traditional method.

Research by the Guttmacher Institute shows that expanding the availability of family planning in sub-Saharan Africa so that women who want to delay pregnancy have access to effective contraception, would reduce the number of unsafe abortions from 5.2 million to 1.2 million.

The number of women needing care for complications of these unsafe procedures would fall from 2.2 million to 500,000. Achieving these reductions will require significant financial investment from African governments and donor countries alike, but one with far-reaching benefits fewer unplanned pregnancies, fewer unsafe abortions and fewer maternal and newborn deaths.

The evidence is clear and compelling, but if it falls on deaf ears’ women will continue to die and suffer from unsafe abortions. But as this week’s conference in Accra, Ghana shows us, people are listening.

There are dedicated individuals from all over the continent working together to take the evidence and translate it into action that will save the lives of African women.

Government leaders must start paying attention as well to the evidence that will help guide them toward laws, policies and programmes that will better protect women and build stronger families, communities and ultimately nations.


Writer is President and CEO of the Guttmacher Institute

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