Unsafe Abortion

 

Global Perspective: Unsafe Abortion Persists Despite Legal Rights

Photo/WHO

According to the World Health Organization (WHO, 2023), about 73 million abortions occur globally each year, and 45% of them are unsafe. The majority happen in developing countries where laws are restrictive or health systems lack resources.

• 97% of unsafe abortions occur in low- and middle-income countries.
• 13% of all maternal deaths worldwide — roughly 39,000 every year — are linked to unsafe abortions.
• In Africa, almost three out of every four abortions are unsafe.

Kenya: When Law Meets Stigma

In Kenya, the constitution permits abortion if the mother’s life or health is in danger, or if permitted by other written law. Yet the promise of safe care is often lost in translation.Furthermore,a  national survey by the African Population and Health Research Center (APHRC) and the Ministry of Health found that in 2012 alone, about 464,690 induced abortions took place — roughly 48 per 1,000 women aged 15–49. Of these, nearly 120,000 women were treated in hospitals for complications, and an estimated 2,600 women die annually from unsafe abortion complications.

At Kenyatta National Hospital, clinicians report cases of young women arriving with severe infections, perforated uteruses, or organ failure — many after trying to end pregnancies with crude instruments or herbal concoctions.

“We’re treating complications we shouldn’t be seeing in 2025,” says a reproductive-health nurse in Nairobi’s informal settlements. “The fear of judgment or arrest drives women underground.”

Nigeria: Faith, Fear, and Fatality

In Nigeria, abortion is permitted only to save a woman’s life. Yet the Guttmacher Institute estimates that nearly 2 million abortions occur each year, most under unsafe conditions. A study published in The Lancet Global Health found that complications from unsafe abortion contribute to at least 10,000 maternal deaths annually in Nigeria.

In a Lagos slum, “Grace,” a 23-year-old student, recounts how she sought help from a street pharmacist after being raped by a landlord. “He gave me pills that made me bleed for days. I couldn’t go to a hospital because everyone would ask questions.” She survived, but thousands do not.

Ethiopia: A Rare Turnaround

Not all stories are bleak. In Ethiopia, where abortion laws were liberalized in 2005, maternal deaths from unsafe abortion dropped by 72% within a decade. By integrating safe abortion into public health services and training midwives, Ethiopia became a model for rights-based reproductive care.

This progress shows what’s possible when governments align policy, funding, and community education to translate law into life-saving access.

The Trump Effect: When Politics Cross Borders

The Rutgers-led study’s release also marks the anniversary of Donald Trump’s re-election, a political event that reshaped global health funding. Under the expanded Global Gag Rule, U.S. foreign aid was withdrawn from any organization even discussing abortion — cutting off contraception, post-abortion care, and family-planning support to millions worldwide.

In Kenya, Nigeria, and Ghana, clinics that previously provided comprehensive reproductive health services were forced to close or reduce staff. Marie Stopes International reported that, during the policy period, their outreach to more than 1.5 million women in Africa was disrupted, leading to spikes in unplanned pregnancies and unsafe abortions.

A Maze of Barriers

The study identifies five interlocking barriers that turn rights into rhetoric:

1. Proof traps: Survivors of rape or incest must provide police or medical reports before qualifying for legal abortion — retraumatizing them.
2. Provider confusion: Many health workers are unaware of what the law actually allows, leading to refusals or delays.
3. Procedural bottlenecks: Bureaucratic red tape slows care until it’s too late.
4. Cultural stigma: Fear of judgment pushes women to secrecy and unsafe methods.
5. Funding collapse: Global and national budget cuts cripple reproductive-health systems.

Unsafe Abortions at a Glance

Region	Unsafe Abortions (%)	Maternal Deaths per 100k (WHO 2023)	Key Drivers
Sub-Saharan Africa	77%	525	Legal barriers, stigma, underfunded health systems
Latin America	75%	169	Restrictive laws, social stigma
Asia (excluding developed regions)	49%	149	Rural access gaps, misinformation
Developed Regions	<1%	10	Access to safe, legal, affordable services

 

Policy Moves to Watch in 2025–26

·         Kenya: The Ministry of Health is reviewing the Reproductive Health Policy (2019–2030) to include safe abortion guidelines. Advocacy groups like NAYA Kenya and Reproductive Health Network Kenya are pushing for implementation.

·          Benin: New regulations in 2024 allow abortion on broader grounds, but providers await clarity and training.

·          Nigeria & Ghana: Civil society groups are lobbying to decriminalize abortion and expand post-abortion care.

·          WHO & UNFPA: Rolling out the Safe Abortion Guidance 2022 to help countries align policy and practice.

·          Global Donor Landscape: Post-U.S. election, global NGOs are lobbying for reversal of funding restrictions and new multilateral financing for reproductive health.

Beyond the Law: Changing Minds and Systems

Experts agree that progress depends not just on new laws but on a change in mindset.“We can’t legislate compassion,” says Dr. Jonna Both, co-author of the Rutgers report. “Until stigma is dismantled in our clinics, homes, and parliaments, women will remain trapped between rights and reality.”

In the end, this isn’t only about access to abortion. It’s about respect, autonomy, and justice : the right to make decisions about one’s body without fear or shame.