Abstract

PIP: Women have devised ways of ending unintended pregnancies since the dawn of civilization and will continue to do so. Human behavior, misplaced political priorities, and inadequate technologies all are responsible for the fact of abortion. An estimated 50 million abortions were performed worldwide in 1987, slightly less than 2/3 of which were legal. Spontaneous abortion ends far more conceptions than does induced abortion. Based on rates of use around the globe, abortion ranks 4th among family planning methods, after female sterilization, IUDs, and oral contraceptives (OCs). Unplanned pregnancies are essentially the result of lack of access to and inconsistent use of contraceptives. Mere access to abortion does not assure an end to unplanned pregnancy. Inconsistent birth control use and reliance on contraceptive methods with high failure rates contribute to unintended pregnancies and abortions around the world. The World Health Organization (WHO) estimates that each year 1 million or more women die from pregnancy-related causes. Fully 99% of these deaths occur in the 3rd world, where complications arising from pregnancy and illegal abortions are the leading cause of death in women in their 20s and 30s. Most of the 20 million or so illegal abortions that occur every year are performed by unskilled attendants under unsanitary conditions, leaving women vulnerable to serious infection, internal bleeding, hemorrhaging, and pelvic inflammatory disease. Modern abortion procedures performed under proper medical supervision in countries where they are legal are responsible for fewer maternal deaths than pregnancy itself. Regardless of the country or the law, gaining access to abortion actually is a matter of economics and social attitudes. The past 2 decades have seen a general continuation of the post-World War II trend of liberalizing abortion laws, with more than 30 countries increasing access at least statutorily, but some countries actually have made their regulations more restrictive. So-called abortion migration, from countries with restrictive laws to those with more lenient policies, works to divide women with unintended pregnancies into those who can afford to travel to obtain an abortion and those who cannot and consequently resort to illegal procedures or carry the pregnancy to term. History documents that women determined to exercise control over their reproductive choices will do so, even if this means opting for dangerous illegal abortions. Laws cannot suppress abortion practices. All they can do is make abortion more or less safe and costly.