Safe, Legal, and Rare? An update on abortion around the world
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Safe, Legal, and Rare? An update on abortion around the world

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    Safe, Legal, and Rare? An update on abortion around the world Safe, Legal, and Rare? An update on abortion around the world Presentation Transcript

    • Caitlin Gerdts, PhD, MHSUCLA FieldingSchool of PublicHealth, BixbyLectureNovember 26, 2012Safe, Legal, and Rare?An update on abortion around the world
    • Safe, Legal, andRare? An updateon abortionCaitlin Gerdts, PhD,MHSNovember 2009 | Slide 2Women all over the World haveAbortions for Similar Reasons
    • Safe, Legal, andRare? An updateon abortionCaitlin Gerdts, PhD,MHSNovember 2009 | Slide 3The Decline in Global Abortion Rates has Stalled35 343929 292528 2924010203040World DevelopingcountriesDevelopedcountries1995 2003 2008Abortions per 1,000 women aged 15–44
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 4Stall in global abortion decline coincideswith plateau in contraceptive use01020304050600204060801001980 1985 1990 1995 2000 2005 2010Abortions per 1,000 women 15-44Contraceptive prevalence (%)Contraceptive prevalence (%) Abortion rate
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 5The abortion rate is lower in developedcountries than in developing countries34 29293925 242019 17010203040501995 2000 2005 2010Developing countriesDeveloped countriesDeveloped countries*Abortions per 1,000 women aged 15–44www.guttmacher.org*Excluding Eastern Europe
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 6Is Abortion Safe?
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 7When performed in safe, sterileconditions……abortion is safer than taking a dose of penicillin.
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 8When performed in unsafe or unsterileconditions…• Maternal Morbidity• Maternal Mortality• Strains on Health Systems• Strains on Families
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 9Disproportionate Impact of Unsafe Abortion“Deaths and disability related to unsafe abortion areentirely preventable…Within developing countries, risksare greatest for the poorest women. They have theleast access to family planning services and are themost likely to suffer the negative consequences of anunsafe procedure. Poor women also have the leastaccess to post-abortion care, when they need treatmentfor complications.”-Iqbal Shah, WHO
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 10An increasing proportion of abortion areunsafe445494755749566020406080100World Developing countries Developed countries1995 2003 2008% of abortions that are unsafe
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 11By the WHO definition, virtually all Abortionsin Latin America and Africa are Unsafe% of abortions97 954015 9020406080100Africa Latin America Asia Oceania Europe North AmericaUnsafe Safe
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 12Deaths from Unsafe Abortion are Highestin Africa10350650300500100200300400500600700Developed regionsDeveloping regions Africa AsiaLatin America & CaribbeanDeaths per 100,000 unsafe abortions, 2003
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 13Is Abortion Legal?
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 14Most women live in countrieswhere abortion is restrictedThis is a slide to use for large images where you want to eliminate everything else but a two-line titleand caption. It’s based on the last slide master.26%10%3%21%40%Prohibited altogetheror only to save lifePhysical HealthMental HealthSocioeconomicWithout restriction
    • Global Abortion Legality
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 16Consequences of restricting contraceptionand legal abortion in Romania
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 17Disproportionate Impact of Unsafe Abortion“Deaths and disability related to unsafe abortion areentirely preventable…Within developing countries, risksare greatest for the poorest women. They have theleast access to family planning services and are themost likely to suffer the negative consequences of anunsafe procedure. Poor women also have the leastaccess to post-abortion care, when they need treatmentfor complications.”-Iqbal Shah, WHO
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 18Abortion law reforms in developingcountries have been followed by declinesin morbidity and mortality• South Africa (1997): Annual number of abortion-related deathsdecreased by 91% after the law was liberalized.• Nepal (2002): Abortion-related complications as a proportion ofall of maternal illnesses decreased by 48% in a study offacilities in eight districts.• Ethiopia (2005): Abortion complications per 100,000 live births(at one large hospital) decreased by about 70%.
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 19Should Abortion be Rare?
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 20Impact of contraception on reducing thenumber of abortions141 million45 million14 millionWithout modern methodsCurrent useIf unmet need were metEstimated number of induced abortions
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 21Focus on Rare Abortion IncreasesStigma
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 22Global Turnaway Studywww.indiegogo.com/theglobalturnawaystudy
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 23Global Turnaway Study aimTo describe the mental health, physical healthand socioeconomic consequences ofreceiving a legal abortion compared to beingdenied a legal abortion in multiplegeographic, cultural, and legal settings.
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 24Global Turnaway Study groups4 6 8 10 12 14 16 18 20 2224 26 28 …Site A Gestational age limit = 124 6 8 10 12 14 16 18 20 2224 26 28 …Site B Gestational age limit = 20Abortion comparison Turnaway
    • Safe, Legal, andRare? An updateon abortionCaitlinGerdts, PhD, MHSNovember 2009 | Slide 25References■ Weitz, T. Rethinking the Mantra that Abortion Should be “Safe, Legal, and Rare■ Singh S, Sedgh G, Hussain R. Unintended Pregnancy: Worldwide Levels, Trends and Outcomes. Studies inFamily Planning. Dec 2010;41(4).■ WHO. The prevention and management of unsafe abortion. Report of a technical working group. Geneva: WorldHealth Organization, 1992 (WHO/MSM/92.5).■ Fawcus SR. Maternal mortality and unsafe abortion. Best Practice & Research Clinical Obstetrics andGynaecology. 2008; 22(3).■ The Alan Guttmacher Institute (AGI), Sharing Responsibility: Women, Society & Abortion Worldwide, New York:AGI, 1999■ Sedgh G, Henshaw S, Singh S, Ahman E, Shah I. Induced Abortion: estimated rates and trends worldwide.Lancet. 2007; 370.■ Sedgh G, Singh S, Shah I, Ahman E, Henshaw S, Bankole A. Induced Abortion: incidence and trends worldwidefrom 1995-2008. Lancet. 2012; 379.■ Adler AJ, Filippi V, Thomas S, Ronsmans C. Quantifying the global burden of morbidity due to unsafe abortion:Magnitude in hospital-based studies and methodological issues. International Journal of Gynecology andObstetrics. 2012.■ Adler AJ, Filippi V, Thomas S, Ronsmans C. Incidence of severe acute maternal morbidity associated withabortion: a systematic review. Tropical Medicine and International Health. 2011.■ WHO. Unsafe Abortion: Global and Regional Estimates of Incidence of Unsafe Abortion and Associated Mortality.Geneva: World Health Organization, 2007.■ Gipson J, Koenig M, Hindin M. The effects of unintended pregnancy on infant, child and parental health: a reviewof the literature. Studies in Family Planning. 2008; 39(1): 18-38.■ Brown S, Eisenberg L (eds). The Best Intentions: Unintended Pregnancy and the Well-Being of Children andFamilies. Washington, DC: National Academic Press.■ Marston C, Cleland J. Do unintended pregnancies carried to term lead to adverse outcomes for mother and child?An assessment in five developing countries. Population Studies. 2003; 51(1): 77-93.
    • Caitlin Gerdts, PhD, MHSgerdtsc@obgyn.ucsf.eduUCLA FieldingSchool of PublicHealthNovember 26, 2012Thank you