Summary

More than ten years after the launch of the Safe Motherhood Initiative in 1987, abortion is certainly the ‘poor relation’ in the debate concerning ways to reduce the number of deaths from maternity-related causes, even though abortion complications account for about 15% of all maternal deaths, and up to 30% in some countries.

Worldwide, 46 million pregnancies (20% to 25% of all pregnancies) each year end in abortion, 36 million of these abortions occur in developing countries and 10 million in developed countries. The WHO estimates that, worldwide, almost 20 million unsafe abortions take place each year, with 95% of these (19 million) performed in developing countries. The risk of death from unsafe abortion is about 1 in 150 procedures in Africa, and 1 in 150,000 in the USA and Europe. The number of maternal deaths is estimated to be about 80,000; this accounts for about 13% of all maternal deaths in the world, one in eight pregnancy-related deaths.

In this review, we then analyze the several major concerns accounting for abortion being such a huge maternal mortality risk factor in developing countries: abortion laws and regulations, abortion techniques, unplanned pregnancy and family planning.

In conclusion, the gap between developing and developed countries in the risk of death from unsafe abortion have never been so high: 1/150 000 in developing countries versus 1/150 in developed countries. According to that enormous disparity, the international community and organizations from within the United Nations system must play a key role encouraging governments to modify their abortion legislation’ and to improve their health system to take more account of women’s health rights.