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Abortion: A Global Overview

Abortion's legal status does not significantly affect the rate at which the procedure occurs but does affect the conditions under which it occurs. Unsafe abortions claim the lives of tens of thousands of women around the world every year.

Abortion is a public health concern. It is also a sensitive and contentious issue with religious, moral, cultural, and political dimensions.

 

More than one-quarter of the world’s people live in countries where the procedure is prohibited or permitted only in cases of rape, incest, or fetal abnormalities, or to save the pregnant person’s life. Yet, regardless of legal status, abortions still occur, and nearly half of them are unsafe—performed by unskilled practitioners or in less than hygienic conditions, or both.

Abortions performed under unsafe conditions claim the lives of tens of thousands of women around the world every year, leave many times that number with chronic and often irreversible physical and mental health problems, and drain the resources of public health systems. Controversy, however, often overshadows the public health impact.1

An estimated 73 million abortions occur globally each year.

Nearly half of them—45%—are unsafe.2

Globally, unsafe abortion accounts for up to 13% of deaths related to pregnancy and childbirth.3

Abortions are considered unsafe when they are performed by people who lack the necessary skills and information or in an environment that doesn’t meet minimum medical standards, or both.4

Worldwide, at least 7 million women are treated for complications from unsafe abortion each year.5

When abortion is performed by qualified people using correct techniques in hygienic conditions, it is very safe. In the United States—where abortion has been legal since 1973, with restrictions that vary by state—the death rate from induced abortion is less than one per 100,000 procedures.6

Unsafe abortions occur more often where abortion is restricted by law.7

The legal status of abortion is one factor that determines the extent to which the procedure is safe, affordable, and accessible.8

 

In countries that…
Allow abortion for any reason, nearly 90% of abortions are safe.
Have broad restrictions, about 41% of abortions are safe.
Prohibit abortion or allow it only to save the life of the woman or protect her physical health, only 25% of abortions are safe.

Source: Bela Ganatra et al., “Global, Regional, and Subregional Classification of Abortions by Safety, 2010-14: Estimates From a Bayesian Hierarchical Model,” The Lancet 390, no. 10110 (2017).

 

While abortion is more common in some countries than others, it occurs in every country. Where the procedure is broadly legal, abortions are more likely to be performed by trained health professionals, be more available, and cost less—and maternal deaths and injuries tend to be lower.9

In the United States, banning abortion could raise pregnancy-related death rates.10

A nationwide ban on abortion in the United States would lead to an estimated 21% increase in the number of pregnancy-related deaths for all women and a 33% increase among Black women compared with rates for 2017, as calculated by Amanda Stevenson of the CU Population Center at the University of Colorado Boulder.11 These estimates consider only increased deaths from a ban due to pregnancy complications and delivery—both of which are more risky than abortion; they do not include increases due to unsafe abortion.

 

Increased Lifetime Risk of Pregnancy-Related Death Following a U.S. Ban on Abortion

Lifetime Risk (2017) Estimated Increased Risk
White women 1 in 4,500 1 in 3,900
Black women 1 in 1,300 1 in 1,000

Source: Amanda Jean Stevenson, “The Pregnancy-Related Mortality Impact of a Total Abortion Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant,” Demography (2021).

Abortion’s legal status does not significantly affect the rate at which the procedure occurs.

 

Countries that prohibit abortion for any reason 39 abortions per 1,000 women
Countries that allow abortion only to save the woman’s life 36 abortions per 1,000 women
Countries that permit abortion without restriction 41 abortions per 1,000 women

Source: Guttmacher Institute, “Unintended Pregnancy and Abortion Worldwide” (2022).

For More Information

These PRB resources provide context on the state of abortion worldwide and identify links between access to safe abortion and maternal health outcomes.

References

[1] PRB, Abortion Facts and Figures 2021 (Washington, DC: PRB, 2021).

[2] World Health Organization (WHO), “Abortion,” Nov. 25, 2021.

[3] WHO, “Preventing Unsafe Abortion” (2019).

[4] WHO, “Preventing Unsafe Abortion.

[5] WHO, “Abortion.”

[6] Katherine Korsmit et al., “Abortion Surveillance—United States, 2019,” Surveillance Summaries 70, no. 93 (2021): 1-29.

[7] Bela Ganatra et al., “Global, Regional, and Subregional Classification of Abortions by Safety, 2010-14: Estimates From a Bayesian Hierarchical Model,” The Lancet 390, no. 10110 (2017).

[8] WHO, “Abortion.”

[9] Susheela Singh et al., Abortion Worldwide 2017: Uneven Progress and Unequal Access (New York: Guttmacher Institute, 2018).

[10] PRB, “Black Women Over Three Times More Likely to Die in Pregnancy, Postpartum Than White Women, New Research Finds,” Dec. 6, 2021.

[11] Amanda Jean Stevenson, “The Pregnancy-Related Mortality Impact of a Total Abortion Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant,” Demography (2021).

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Data and Democracy in the Age of Disinformation

PRB Special Event at PAA 2022
Atlanta, GA

Feature Address and Panel Discussion: Data and Democracy in the Age of Disinformation

Jeffrey Jordan

President and CEO

Sonalde Desai CROP

Sonalde Desai

PAA President, University of Maryland

Angeline Siparo

Former Senior Country Director and Regional Advisor, East and Southern Africa

Crystal Edmonston CROP 2022

Crystal Edmonson

Atlanta Business Chronicle

PRB is hosting a feature address and panel discussion (in-person and virtual) at the Population Association of America’s annual meeting on Friday, April 8, 2022, from 12:30 to 2:00 p.m. EDT.

PRB CEO Jeff Jordan will speak on the role the demographic community must play in supporting democracy, equity, and human rights around the world. His remarks set the stage for a discussion by a distinguished guest panel including:

  • Sonalde Desai, incoming PAA President and Professor, Department of Sociology, University of Maryland.
  • Kyler Sherman-Wilkins, Assistant Professor, Department of Sociology and Anthropology, Missouri State University.
  • Angeline Siparo, Board Chair of the National AIDS Control Council (Kenya).

Crystal Edmonson of the Atlanta Business Chronicle will moderate the panel.

A brief Q&A session will follow. Participants are invited to tweet their questions to us at @PRBData during the event. Use #PRBchat to make sure we see your question.

Registration for in-person attendance is closed. Lunch will be served at 12:30 p.m.  Livestreaming begins at 1:00 p.m. on PAA’s YouTube channel.

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PRB @ PAA 2022 Annual Meeting

Dates: April 6-9, 2022
Atlanta, GA

Welcome to PRB’s online hub for the 2022 Population Association of America Annual Meeting!

We look forward to exchanging ideas with you in-person and online at a PRB-sponsored feature address and panel discussion on Friday, April 8. PRB staff will be speaking at workshops and panels throughout the conference. Find the details about our activities on this page, and explore PRB publications and other resources on many of the topics that will be discussed at PAA 2022.

Follow us on Twitter and LinkedIn for #PRBatPAA updates.

Events

Wednesday, April 6

8:00 a.m. – 5:00 p.m. ET

Workshop: The Role of Population Studies in Development Policies and Programs: North to South Dialogue on Models that Work

Presenters: Gaye Agesa (PRB), Elizabeth Kahurani (AFIDEP), Bernard Onyango (AFIDEP), Dr. Rose Oronje (AFIDEP), Gorrety Parmu (PRB), Angeline Yiamiton Siparo (National AIDS Control Council, Kenya)

Morning Session: 8:30 a.m. – 12:30 p.m. ET
Format: Virtual

Afternoon Session: 2:00-4:30 p.m. ET
Format: In-person
Location: Marquis Room M304

2:00 p.m. – 5:00 p.m. ET

Workshop: Census and ACS in the Classroom: A Virtual Workshop for College Professors

Presenters: William H. Frey (Social Science Data Analysis Network), Mark Mather (PRB), Andrew Beveridge (Queens College and Social Explorer)

Location: Virtual

Thursday, April 7

2:30 p.m. – 4:00 p.m. ET

Poster Presentations – Session P3 

Location: Marquis Ballrooms A-D

Friday, April 8

12:30 p.m. – 2:00 p.m. ET

Feature Address/Panel Discussion: Data and Democracy in the Age of Disinformation

Presenters: Jeffrey Jordan (PRB), Sonalde Desai (PAA), Angeline Yiamiton Siparo (National AIDS Control Council, Kenya), Kyler Sherman-Wilkins (Missouri State University)

Moderator: Crystal Edmonson, Atlanta Business Chronicle

Location: In-person and virtual
Note: In-person registration is now full. To attend virtually, please register here.

Saturday, April 9

11:00 a.m. – 12:15 p.m. ET

Oral Session: The Sociocultural Environment’s Impact on Contraceptive Access and Use Among Young People in Burkina Faso, Ethiopia, Kenya, Nigeria, and Uganda

Presenter: Christine Power (presenting virtually)

Location: M304

 

Resources

Workshop, poster, and presentation resources will be shared here after the events.

 

Thematic Resources

The PAA conference will cover a wide range of demographic and population studies issues. The PRB resources shared here focus on selected topics that will be discussed at PAA 2022.

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Youth Family Planning Policy Scorecard: Measuring Commitment to Effective Policy and Program Interventions

The Youth Family Planning Policy Scorecard evaluates the favorability of 28 current national policy and program environments for youth access to sexual and reproductive health services.

The March 2022 edition of PRB’s Youth Family Planning Policy Scorecard evaluates the favorability of 28 current national policy and program environments for youth access to sexual and reproductive health services. The Scorecard allows users to quickly assess the extent to which a country’s policy environment enables and supports youth access to and use of family planning through the promotion of evidence-based practices. Users can explore the digital interface and self-select countries to compile their own Scorecard!

 

Governments around the world are increasingly creating policies to formalize the rights of adolescents and young people to access sexual and reproductive health services. Despite growing commitment from decisionmakers, many barriers remain for young people who want to use contraception. A limited evidence base has hampered systematic assessment and mapping of the key policies and programs that govern young people’s ability to access family planning information, services, and commodities. Governments and their partners lack clear guidance on which interventions will ensure that their commitments to expanding family planning use among young people are realized. Similarly, efforts by civil society to monitor the state of policy environments for youth family planning are needed to understand how countries are addressing these needs and identify areas for improvement.

To address this evidence gap, PRB conducted research and analysis to identify the most effective policies and program interventions to promote uptake of contraception among youth, defined as people between ages 15 and 24. This research has been compiled into the Youth Family Planning Policy Scorecard to evaluate and compare the favorability of current national policy and program environments.

Based on a review of existing evidence and expert consultations, the following indicators were selected as evidence-based interventions for inclusion in the Scorecard:

  • Policy barriers related to consent (parental, spousal, or service provider); age; and marital status.
  • Policies supporting access to a full range of family planning methods.
  • Policies related to comprehensive sexuality education.
  • Policies supporting/inhibiting youth-friendly family planning service provision.
  • Policies related to an enabling social environment for youth family planning services.

The Scorecard can be used by governments, donors, and advocates to evaluate a country’s youth family planning policy environment, set policy priorities, guide future commitments, and compare policy environments across countries.

The March 2022 edition of the Scorecard includes data for 28 countries: Bangladesh, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Haiti, India, Kenya, Madagascar, Malawi, Mali, Mauritania, Nepal, Niger, Nigeria, the Philippines, Senegal, Sindh (Pakistan), Tanzania, Togo, Uganda, and Zambia.

 


PRB launched the March 2022 Edition of the Youth Family Planning Policy Scorecard on March 9 and March 10 through a webinar delivered in French and English. The webinar shares new country policy analyses and digital platform features. It also features guest speakers who share their experiences using the Scorecard to advance policy change.

 

Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change Video thumbnail

Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change

Webinar: Using the Youth Family Planning Policy Scorecard to Advance Policy Change

The Youth Family Planning Policy Scorecard allows for a quick assessment of the extent to which a country’s policy environment enables and supports youth access to and use of FP, can be used by governments, donors, and advocates to evaluate the inclusion of evidence-based interventions and policy language and set policy priorities and guide future commitments.

This webinar shares new updates and functions from the March 2022 edition of the Scorecard, and features guest speakers from Bridge Connect Initiative Africa and SERAC-Bangladesh sharing their experiences using the Scorecard to advance policy change.

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes Video thumbnail

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes

Webinaire: Tableau de bord des politiques de planification familiale pour les jeunes

Le Tableau de bord de la politique de planification familiale pour les jeunes est conçu pour permettre une appréciation rapide de la mesure dans laquelle l’environnement politique d’un pays permet et soutient l’accès des jeunes à la PF et son utilisation, en encourageant des pratiques fondées sur des données probantes. Le Tableau de bord peut être utilisé pour évaluer l’inclusion des interventions fondées sur des données probantes et les politiques avérées efficaces pour réduire les obstacles et/ou améliorer l’accès des jeunes à la contraception dans les pays. Au cours du webinaire, nous partagerons les nouvelles analyses et fonctionnalités du Tableau de bord et comment il a été utilisé pour motiver des changements de politiques.

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Digital Health

Explore PRB and PACE’s work at the intersection of digital health technologies and family planning programming.

Digital health is an umbrella term that encompasses an array of information and communications technologies used in health care, including mobile health (mHealth), telehealth/telemedicine, eHealth, health information technology (IT), health management information systems, use of blockchain technology, and artificial intelligence. These digital health technologies can support individuals, health providers, and health systems managers to make informed decisions and engage individuals to improve demand, access, coverage, quality, and affordability of health care for everyone.

As low- and middle-income countries transition from paper to digital systems, family planning programs can benefit from unprecedented opportunities to improve services. Investments in digital health tools have expanded exponentially, but information on what works—and what does not— remains limited and scattered. As investments have increased, digital applications and data fragmentation have proliferated, but stakeholders are moving toward more coordinated efforts to scale digital health solutions, support countries’ digital health infrastructure, and share evidence-based learnings.

Digital Health Compendium

The interactive Digital Health Compendium, launched by PACE in 2020, features case studies across a range of digital health technologies used to enhance the impact and efficiency of family planning programs. In 2021, PACE transitioned leadership of the Compendium to The Medical Concierge Group (TMCG), a digital health and telemedicine company based in Uganda.

This Digital Health Compendium enables users to explore case studies across a range of digital health technologies used to enhance family planning programs mainly in sub-Saharan Africa, but also in other regions of the world. Digital health applications in family planning programs can be broadly classified as those affecting demand generation, service delivery, supply chain management, and the policy and enabling environment. In many low- and middle-income countries, digital health innovations were adopted earlier in other health sectors, including HIV/AIDS, maternal and child health, and noncommunicable disease prevention and response. As a result, much of the impact evidence is restricted to those sectors. To advance greater adoption of digital technology in family planning programs, more data and information on the challenges, opportunities, scalability, and results are needed. This compendium aims to consolidate emerging information and data on applications of digital technology in family planning programs to inform adoption and scale-up of successful approaches.

Webinar: Designing or Implementing a Family Planning Program? How To Introduce Digital Solutions Sustainably and at Scale

PRB alongside The Medical Concierge Group, Knowledge Success, and Maternal & Infant Health Consulting hosted a webinar during Transform Digital Health Week 2021 titled “Designing or Implementing a Family Planning Program? How To Introduce Digital Solutions Sustainably and at Scale.” Four projects featured in the Digital Health Compendium highlighted trusted and innovative lessons on scaling and sustaining family planning and reproductive health initiatives through leveraging digital health solutions. The panel of national and international experts discussed broader implementation topics including involvement of government counterparts, partnerships, and revenue models. Technology-specific lessons included adaptability, integration, flexibility, and uptake. Recordings available below.

 In English Video thumbnail

In English

En français Video thumbnail

En français