Spotlights on Health and Rights

Key topics in the Heilbrunn Department of Population and Family Health

Reproductive Health

Abortion

Despite the availability of highly effective methods of contraception, unintended pregnancies occur in the United States and throughout the world. In addition, when a fetus is diagnosed with a severe disability, some couples will elect to terminate a pregnancy.

According to the World Health Organization, there are an estimated 46 million pregnancies each year that end in abortion worldwide. If performed by trained health care providers, abortion is safer than carrying a pregnancy to term. The chance of developing a major complication following a safe abortion is one in 200.

Each year, nearly 20 million of the 46 million abortions that occur are considered unsafe, and result in about 13% (67,000) of the pregnancy-related deaths annually.

The risk of death following an unsafe abortion is several hundred times higher than that of an abortion performed legally and safely. In developing countries, where abortion is often illegal or highly restricted, abortion mortality rates are hundreds of times higher than rates in developed countries (see Table 1 below). Laws that make abortion illegal do not eliminate abortions; they make abortions unsafe.

Table 1: Abortion-Related Deaths
Region Deaths per 100,000 abortions
Developing* 330
Africa 680
South & Southeast Asia 283
Lain America 119
Developed 0.2 - 1.2
*Excluding China. Source: The Alan Guttmacher Institute (AGI), Sharing Responsibility: Women, Society and Abortion Worldwide, New York : AGI, 1999, p. 35.

Abortion in the United States

Abortion became legal in the United States in 1973 as a result of the U.S. Supreme Court case Roe v. Wade. That case declared that, through the end of the first trimester, the abortion decision and procedure must be left to the judgment of the pregnant woman and her physician. However, states retained the right to regulate abortion in the second and third trimesters.

Abortion in the United States has not always been legal. Historically illegal abortion was associated with high rates of morbidity and mortality. In 1930, abortion was listed as the official cause of death for almost 2,700 women. From 1950-1960, it is estimated that there were 200,000 to 1.2 million illegal abortions per year.

Following the Roe v. Wade decision, the public health benefits of legalized abortion emerged almost immediately; abortion-related complications and death decreased dramatically. In 1973, the risk of maternal death resulting from an abortion was 3.4 deaths per 100,000. In 1977, it fell to 1.3. The greatest level of decline in mortality rates occurred during the first trimester of pregnancy. Currently the death rate from abortion in the United States is 0.6 per 100,000 procedures, eleven times safer than carrying a pregnancy to term.

The text box below provides a picture of the current status of abortion in the United States and is excerpted from "Overview of Abortion in the United States" developed by Physicians for Reproductive Choice and Health (PRCH) and the Alan Guttmacher Institute (AGI) in January 2003.

Facts about abortion in the United States

  • Unintended pregnancy and abortion are common among all groups of women.
  • Almost half of all pregnancies are unintended and almost half of unintended pregnancies end in abortion.
  • In 2000, 1.31 million pregnancies were terminated by abortion.
  • 2.1% of all women aged 15-44 had an abortion in 2000.
  • Abortion is one of the most common surgical procedures in the United States.
  • Almost 90% of abortions are performed in the first trimester of pregnancy
  • More than half of abortions are performed before 9 weeks after the last menstrual period, or within 5 weeks of the first missed period.
  • Fewer than 2% of abortions are performed after 20 weeks.
  • The risk of death when a pregnancy is continued to birth is about 11 times as great as the risk of death from induced abortion.
  • Each year, about 10 women die from induced abortion, compared with about 260 who die from pregnancy and childbirth.

Visit the Guttmacher Institute website for more information about abortion in the United States.

Visit the World Health Organization's website for more information about preventing usafe abortion worldwide.

Attempts to overturn Roe. v. Wade have been on-going since 1973. Federal law prohibits the use of federal Medicaid funds for abortion. Many states have succeeded in limiting access to abortion by denying state Medicaid funding, and instituting laws relating to notification of parents, enforced waiting periods, and/or limiting abortion access by withholding abortion referral information. Limiting abortion access poses a serious threat to women's health.