Experts in sexual and reproductive health have harped on the need for increased efforts from government and other stakeholders towards tackling the burden of unsafe termination of pregnancies.
They made the call during a media briefing and launch of SHE & Rights Media Initiative [Sexual Health with Equity(SHE) and Rights initiative] in the lead up to Safe Abortion Day 2024.
It is co-hosted by Asia Pacific Media Alliance for Health and Development (APCAT Media), Asian-Pacific Resource & Research Centre for Women (ARROW), International Planned Parenthood Federation (IPPF), Women's Global Network for Reproductive Rights (WGNRR), and CNS.
Melissa Cockroft, Global lead for abortion at the International Planned Parenthood Federation (IPPF) said in Africa, nearly half of all abortions occurred under the least safe circumstances.
She said it is estimated that 73 million-induced abortions occur worldwide annually.
She said, "Around 61% (or 1 in 6) unintended pregnancies end in induced abortion - so these are pregnancies that were not planned - and 29% (or 3 in 10) of all pregnancies end in abortion globally. So, quite a significant number of both- unintended and intended pregnancies- end in abortion around the world."
She said what is most troubling is that globally 45% of induced abortions are unsafe. It is estimated that every year 29,000 pregnant people, women and girls die from unsafe abortion and 7 million are injured or disabled due to unsafe abortion worldwide.
She added that unsafe abortion also leads to social and financial burdens for women, communities and health systems.
Cockroft said, "But what is perhaps most devastating is that deaths due to unsafe abortion are entirely preventable. It is the lack of access to safe, timely, affordable and respectful abortion care that leads to these preventable maternal deaths."
The World Health Organisation (WHO) defines unsafe abortion as a procedure for terminating a pregnancy performed by persons lacking the necessary information or skills or in an environment not in conformity with minimal medical standards, or both. The persons, skills and medical standards considered safe in the provision of abortion are different for medical and surgical abortion and by pregnancy duration.
She highlighted that it is possible that an abortion can be provided safely even if it is provided or occurs in a country where abortion is legally restricted.
"Similarly, an unsafe abortion can be provided in a country context where abortion is legally permitted. So legal status of abortion does not always predict that an abortion will be safe or unsafe - however restrictions are known to be more likely to lead to unsafe abortions. And legal restrictions do not prevent abortion from occurring. When women, girls and pregnant people want an abortion they will find a means to obtain it, even if it is unsafe.
"Abortion is one of the safest medical and surgical procedures -particularly when managed by a trained person, including nurses and midwives, as World Health Organisation data have shown. Self-managed medical abortion has also been found to be safe when the right information, support and referral network are in place," she stated.
Cockroft also said restricting abortion does not prevent or reduce abortions but keeps them unsafe, adding that abortion rates in countries which legally restrict abortion are actually higher than those where abortion is available on request, not least because women, girls and pregnant people also do not have good access to contraception either.
She said, "When people with unintended pregnancies face barriers to attaining safe, timely, affordable, geographically reachable, respectful and non-discriminatory abortion care, they often resort to unsafe abortion.
"Laws and policies imposing gestational limits and other barriers such as waiting periods or the need for permission by 2 doctors only act as barriers to safe abortion care."
She said that even where abortion is less restricted under the law, many people may still struggle to access safe abortions due to other barriers such as restrictive regulations and lack of accessible and affordable clinical services.
She added that the Sustainable Development Goals (SDGs) advocate for removing barriers to unsafe abortion as key objectives for achieving universal access to sexual and reproductive health, reducing maternal mortality and promotion of gender equality.
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Jessica Work, Youth Networker for the Pacific at the International Planned Parenthood Federation (IPPF) East and South East Asia and Oceania Region - Fiji said, "We have to recognise the need to decriminalise safe abortion and make it accessible to all in a rights-based manner. We have to use a human-rights lens and not the moral lens or religious lens.
"We need to engage young people in decision-making about policies that impact their lives. We have peer young educators who go into communities to teach young people about contraception access, bodily autonomy and consent. Safe abortion is healthcare and a human right."
Shobha Shukla, Coordinator of SHE & Rights Media Initiative said the next year 2025 marks 30 years since Beijing Declaration and Platform for Action was signed in 1995 which highlighted the impact of unsafe abortion on women's lives and health, and the need to reduce recourse to abortion through expanded family planning services.
She said, "We need to walk the talk on the promises for gender equality and human rights - with equity and justice."
