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Safe Abortion Care

Unsafe abortion is one of the primary causes of maternal death and disability worldwide, causing an estimated 8% of maternal deaths and 596 severe complications per 100,000 live births. While population-level data on unsafe abortion in crises does not exist, an estimated 60% of maternal deaths occur in crisis settings and fragile states. We know that women and girls in crisis settings face heightened vulnerability to unintended pregnancies and sexual violence while lacking access to contraception, emergency obstetric care and safe abortions. Combined, these factors increase the likelihood that women and girls in crises will experience unintended pregnancy and resort to unsafe abortions. Comprehensive abortion care is thereby critical for preventing maternal death and disability, in addition to providing the care necessary for women raped in conflict.

The Safe Abortion Care Sub-Working Group advocates for the integration of comprehensive abortion care into humanitarian response and works to ensure that it is available to all women and girls in crisis.

For more information about the IAWG’s work on Safe Abortion Care (SAC), please see the SAC Sub-Working Group page.

Key Messages:

Access to safe abortion for all women and adolescent girls in crisis is a human right. The right to access a safe and legal abortion is grounded in the realization of other core human rights, including the right to life, health, equality, privacy, self-determination, bodily integrity, and freedom from inhuman or degrading treatment and discrimination, as well as the right to benefit from scientific progress. Numerous international and regional human rights instruments have upheld a women’s right to safe and legal abortion. Access to high-quality safe abortion care for all women and adolescent girls contributes to gender equality and social justice. Enabling women and adolescent girls to make decisions about their own bodies and lives, including exercising their sexual and reproductive rights, is linked to their improvements in social status, economic opportunity and gender equity.

Safe abortion care is an evidence-based intervention that prevents maternal mortality and morbidity. Unsafe abortion is a major cause of maternal mortality. For every woman or adolescent girl who dies from unsafe abortion, many more are left with serious injuries or permanent disabilities, including infertility. These deaths, injuries and disabilities can be almost entirely prevented by ensuring access to safe abortion care services. Access to safe abortion care is considered part of a comprehensive package of sexual, reproductive and maternal health interventions by key health agencies and organizations, including the World Health Organization (WHO) and the United Nations.

A core package of evidence-based safe abortion services should be made available to displaced women and adolescent girls in all crisis situations. Safe abortion services must be accessible, adequate, and available at any time during displacement, of good quality, without discrimination, violence or coercion. Health care providers in crisis should be trained to provide high-quality, rights-based safe abortion services, context-relevant and evidence-based equipment and medication should be made available in crisis, and crisis-affected populations should made aware of the types of available abortion services and under what conditions these services can be provided. #abortionchampion

Facts & Stats

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25% of pregnancies globally end in abortion, and the vast majority (88%) occur in developing countries.

Reference: Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, Rossier C, Gerdts C, Tunçalp Ö, Johnson Jr BR, et al: Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet. In press.

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The risk of death due to unsafe abortion is 90 unsafe abortion-related maternal deaths per 100,000 live births in sub-Saharan Africa, three times the global average of 30 per 100,000 live births.

Reference: Department of Reproductive Health and Research, WHO: Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. WHO; 2011. http://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241501118/en/

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Long-term health consequences of unsafe abortion are even higher, with an estimated 596 severe complications due to unsafe abortion per 100,000 live births globally.

Reference: Adler AJ, Filippi V, Thomas SL, Ronsmans C: Incidence of severe acute maternal morbidity associated with abortion: a systematic review. Tropical Medicine & International Health 2012, 17:177-190.

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Women and girls in acute crises are even more vulnerable to unintended pregnancy than their peers in non-crisis settings: While population-level data on unsafe abortion in crises does not exist, we know that 60% of maternal deaths occur in crisis settings and fragile states.

They are more likely to experience sexual violence, often lack access to contraception and often do not have the resources to obtain a safe abortion.

These factors increase the likelihood that women and girls in crises will experience unintended pregnancy and resort to unsafe abortions, leading to excess morbidity and mortality.

Reference: UNFPA. State of the World Population. 2015. http://www.unfpa.org/swop

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However, the IAWG 2012-2014 Global Evaluation found that:

Among all humanitarian appeals submitted from 2002-2013 through the Financial Tracking Service, none included safe abortion care and

Safe abortion care was not available in any of the facilities assessed in Burkina Faso, the Democratic Republic of Congo and South Sudan.