The Incidence of Abortion Worldwide.(Statistical Data Included)

Context: Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need in formation on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health.

Methods: Numbers and rates of induced abortions were estimated from four sources: official statistics or other national data on legal abortions in 57 countries; estimates based on population surveys for two countries without official statistics; special studies for 10 countries where abortion is highly restricted; and worldwide and regional estimates of unsafe abortion from the World Health Organization.

Results: Approximately 26 million legal and 20 million illegal abortions were performed worldwide in 1995, resulting in a worldwide abortion rate of 35 per 1,000 women aged 15--44. Among the subregions of the world, Eastern Europe had the highest abortion rate (90 per 1,000) and Western Europe the lowest rate (11 per 1,000). Among countries where abortion is legal without restriction as to reason, the highest abortion rate, 83 per 1,000, was reported for Vietnam and the lowest, seven per 1,000, for Belgium and the Netherlands. Abortion rates are no lower overall in areas where abortion is generally restricted by law (and where many abortions are performed under unsafe conditions) than in areas where abortion is legally permitted.

Conclusions: Both developed and developing countries can have low abortion rates. Most countries, however, have moderate to high abortion rates, reflecting lower pre valence and effectiveness of contraceptive use. Stringent legal restrictions do not guarantee a low abortion rate.

The Programme of Action of the 1994 International Conference on Population and Development urged governments and other relevant organizations "to deal with the health impact of unsafe abortion as a major public health concern and to reduce the recourse to abortion through expanded and improved family planning services."(1) To implement this recommendation, policymakers need information on the availability and quality of family planning services, the extent of harm to women's health caused by unsafe abortion, and the incidence of abortion.

This article focuses on the last of these factors, the incidence of both legal and illegal abortions in each country or area. Comparative data provide insight into the levels of abortion that might be achievable for a particular country and into the factors that influence abortion rates.

Despite its importance, accurate measurement of the level of induced abortion has proven difficult to achieve in many parts of the world. In many countries where abortion is legal under broad conditions, statistics on abortion are collected and are of reasonable completeness and accuracy, but in others, official data are lacking or are incomplete. A common problem is that some privately performed procedures go unreported and are therefore not counted.