Editing Abortion (section)

===Unsafe abortion===
{{Main|Unsafe abortion}}

[[File:RussianAbortionPoster.jpg|thumb|Soviet poster {{Circa|1925}} (after Russia legalized abortion in 1920) warning against abortions performed by folk practitioners]]

Women seeking an abortion may use unsafe methods, especially when abortion is legally restricted. They may attempt [[self-induced abortion]] or seek the help of a person without proper medical training or facilities. This can lead to severe complications, such as incomplete abortion, [[sepsis]], hemorrhage, and damage to internal organs.<ref>{{cite journal | vauthors = Okonofua F | title = Abortion and maternal mortality in the developing world | journal = Journal of Obstetrics and Gynaecology Canada | volume = 28 | issue = 11 | pages = 974–979 | date = November 2006 | pmid = 17169222 | doi = 10.1016/S1701-2163(16)32307-6 | url = http://www.jogc.org/abstracts/full/200611_WomensHealth_1.pdf | url-status = dead | archive-url = https://web.archive.org/web/20120111121431/http://www.jogc.org/abstracts/full/200611_WomensHealth_1.pdf | archive-date = 11 January 2012 }}</ref>

Unsafe abortions are a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in [[developing country|developing countries]].<ref name="lancet-grimes"/> Unsafe abortions are believed to result in millions of injuries.<ref name="lancet-grimes"/><ref name="Haddad-2009">{{cite journal | vauthors = Haddad LB, Nour NM | title = Unsafe abortion: unnecessary maternal mortality | journal = Reviews in Obstetrics & Gynecology | volume = 2 | issue = 2 | pages = 122–126 | year = 2009 | pmid = 19609407 | pmc = 2709326 }}</ref> Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past decade;<ref name="lancet-grimes"/><ref name="OBGY09">{{cite journal |vauthors=Shah I, Ahman E |date=December 2009 |title=Unsafe abortion: global and regional incidence, trends, consequences, and challenges |url=http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |url-status=dead |journal=Journal of Obstetrics and Gynaecology Canada |volume=31 |issue=12 |pages=1149–1158 |doi=10.1016/s1701-2163(16)34376-6 |pmid=20085681 |s2cid=35742951 |archive-url=https://web.archive.org/web/20110716212405/http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |archive-date=16 July 2011}}</ref><ref name=Loz2012>{{cite journal | vauthors = Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA | display-authors = 6 | title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–2128 | date = December 2012 | pmid = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 | pmc = 10790329 | url = https://zenodo.org/record/2557786 | access-date = 14 March 2020 | url-status = live | hdl-access = free | s2cid = 1541253 | archive-date = 19 May 2020 | archive-url = https://web.archive.org/web/20200519152712/https://zenodo.org/record/2557786 | hdl = 10536/DRO/DU:30050819 }}</ref> deaths from unsafe abortion account for around 13% of all [[maternal deaths]].<ref>{{cite book| vauthors = Speroff L, Darney PD |title=A clinical guide for contraception|year=2010|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-1-60831-610-6|page=406|edition=5th }}</ref> The [[World Health Organization]] believes that mortality has fallen since the 1990s.<ref name="WHO2011">{{cite book |last=World Health Organisation |title=Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 |publisher=World Health Organisation |year=2011 |edition=6th |page=27 |isbn=978-92-4-150111-8 |url=http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20140328093307/http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf |archive-date=28 March 2014}}</ref> To reduce the number of unsafe abortions, public health organizations have generally advocated emphasizing the legalization of abortion, training of medical personnel, and ensuring access to reproductive-health services.<ref name="berer-who">{{cite journal |vauthors=Berer M | title=Making abortions safe: a matter of good public health policy and practice |journal=Bulletin of the World Health Organization |volume=78 |issue=5 |pages=580–592 |year=2000 |pmid=10859852 |pmc=2560758}}</ref>

A major factor in whether abortions are performed safely or not is the legal standing of abortion. Countries with restrictive abortion laws have higher rates of unsafe abortion and similar overall abortion rates compared to countries where abortion is legal and available.<ref name="OBGY09"/><ref name="Sedgh 2012"/> For example, the [[Choice on Termination of Pregnancy Act, 1996|1996 legalization of abortion in South Africa]] led to an immediate reduction in abortion-related complications,<ref name="jewkes">{{cite journal |vauthors=Jewkes R, Rees H, Dickson K, Brown H, Levin J |title=The impact of age on the epidemiology of incomplete abortions in South Africa after legislative change |journal=BJOG |volume=112 |issue=3 |pages=355–359 |date=March 2005 |pmid=15713153 |doi=10.1111/j.1471-0528.2004.00422.x |s2cid=41663939 |doi-access=}}</ref> with abortion-related deaths dropping by more than 90%.<ref name="bateman-samj">{{cite journal |vauthors=Bateman C |title=Maternal mortalities 90% down as legal TOPs more than triple |journal=South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde |volume=97 |issue=12 |pages=1238–1242 |date=December 2007 |pmid=18264602 |url=http://samj.org.za/index.php/samj/article/view/642 |url-status=live |archive-url=https://web.archive.org/web/20170830200316/http://samj.org.za/index.php/samj/article/view/642 |archive-date=30 August 2017}}</ref> Similar reductions in maternal mortality have been observed after other countries have liberalized their abortion laws, such as [[Romania]] and [[Nepal]].<ref>{{cite journal |vauthors=Conti JA, Brant AR, Shumaker HD, Reeves MF |title=Update on abortion policy |journal=Current Opinion in Obstetrics & Gynecology |volume=28 |issue=6 |pages=517–521 |date=December 2016 |pmid=27805969 |doi=10.1097/GCO.0000000000000324 |s2cid=26052790}}</ref> A 2011 study concluded that in the United States, some state-level anti-abortion laws are correlated with lower rates of abortion in that state.<ref>{{cite journal| vauthors=New MJ |s2cid=53314166|title=Analyzing the Effect of Anti-Abortion U.S. State Legislation in the Post-Casey Era |journal=State Politics & Policy Quarterly|date=15 February 2011|volume=11|issue=1|pages=28–47|doi=10.1177/1532440010387397}}</ref> The analysis, however, did not take into account travel to other states without such laws to obtain an abortion.<ref>{{cite journal| vauthors = Medoff MH, Dennis C |title=Another Critical Review of New's Reanalysis of the Impact of Antiabortion Legislation|journal=State Politics & Policy Quarterly|date=21 July 2014 |volume=14|issue=3|pages=269–76|doi=10.1177/1532440014535476|s2cid=155464018}}</ref> In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by up to 75% (from 20 million to 5 million annually) if modern family planning and maternal health services were readily available globally.<ref name="Singh">{{cite web |url=http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |title=Facts on Investing in Family Planning and Maternal and Newborn Health |publisher=Guttmacher Institute|year=2010 |access-date=24 May 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120324101905/http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |archive-date=24 March 2012 }}</ref> Rates of such abortions may be difficult to measure because they can be reported variously as miscarriage, "induced miscarriage", "menstrual regulation", "mini-abortion", and "regulation of a delayed/suspended menstruation".<ref name="lancet-grimes"/><ref name=Brazil_Unsafe>{{cite journal |vauthors=Nations MK, Misago C, Fonseca W, Correia LL, Campbell OM |title=Women's hidden transcripts about abortion in Brazil |journal=Social Science & Medicine |volume=44 |issue=12 |pages=1833–1845 |date=June 1997 |pmid=9194245 |doi=10.1016/s0277-9536(96)00293-6}}</ref>

Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits,<ref name="IJGO10"/> while an additional 35 percent have access to legal abortion if they meet certain physical, mental, or socioeconomic criteria.<ref name="Dev98-07"/> While [[maternal death|maternal mortality]] seldom results from safe abortions, unsafe abortions result in 70,000 deaths and 5 million disabilities per year.<ref name=OBGY09/> Complications of unsafe abortion account for approximately an eighth of maternal mortalities worldwide,<ref name="Maclean">{{cite book| vauthors=Maclean G |chapter-url=https://books.google.com/books?id=u4Aeiu2eDMAC&pg=PA299|chapter=XI. Dimension, Dynamics and Diversity: A 3D Approach to Appraising Global Maternal and Neonatal Health Initiatives |pages=299–300|title=Trends in Midwifery Research| veditors=Balin RE |publisher=Nova Publishers|year=2005|isbn=978-1-59454-477-4|url-status=live|archive-date=15 March 2015|archive-url=https://web.archive.org/web/20150315113348/http://books.google.com/books?id=u4Aeiu2eDMAC&pg=PA299}}</ref> though this varies by region.<ref>{{cite journal| vauthors=Salter C, Johnson HB, Hengen N |year=1997 |url=http://info.k4health.org/pr/l10edsum.shtml |title=Care for Postabortion Complications: Saving Women's Lives |journal=Population Reports |volume=25 |issue=1 |publisher=Johns Hopkins School of Public Health |url-status=dead |archive-url=https://web.archive.org/web/20091207070103/http://info.k4health.org/pr/l10edsum.shtml |archive-date=7 December 2009}}</ref> Secondary infertility caused by an unsafe abortion affects an estimated 24 million women.<ref name="WHO-unsafe-2007">{{cite web |year=2007 |title=Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003 |url=http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20110216141018/http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |archive-date=16 February 2011 |access-date=7 March 2011 |publisher=World Health Organization}}</ref> The rate of unsafe abortions has increased from 44% to 49% between 1995 and 2008.<ref name="Sedgh 2012" /> Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address consequences of unsafe abortion.<ref>{{cite web|title=Packages of interventions: Family planning, safe abortion care, maternal, newborn and child health|author1=UNICEF |author2=UNFPA |author3=WHO |author4=World Bank|year=2010|access-date=31 December 2010|url-status=dead|url= https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/fch_10_06/en/index.html |archive-url=https://web.archive.org/web/20101109224916/http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/fch_10_06/en/index.html|archive-date=9 November 2010}}</ref>