(September 2008) Unsafe abortion is one of the most neglected public health challenges in the Middle East and North Africa (MENA) region,1 where an estimated one in four pregnancies are unintended—wanting to have a child later or wanting no more children.2 Many women with unintended pregnancies resort to clandestine abortions that are not safe. According to the World Health Organization, around 1.5 million abortions in MENA in 2003 were performed in unsanitary settings, by unskilled providers, or both. Complications from those abortions accounted for 11 percent of maternal deaths in the region.3
Abortion is one of the oldest medical practices, evidence of which dates back to ancient Egypt, Greece, and Rome. Abortion techniques used by Egyptian pharaohs were documented in the ancient Ebers Papyrus (1550 B.C.). It is believed that during the Middle Ages, abortion techniques were adopted and accepted by Western Europe and later diffused across the globe.4 Today, medical and scientific advances have made abortion a safe procedure when offered under medical supervision and with high standards of care. Yet each year, thousands of women in the developing world die and millions more are left with temporary or permanent disabilities because of unsafe abortion.5
This policy brief explores the public health concerns surrounding abortion in MENA and discusses ways to make it both rarer and safer.
Rasha Dabash is a senior program associate at Gynuity Health Projects. Farzaneh Roudi-Fahimi is program director of the Middle East and North Africa program at the Population Reference Bureau.
The Middle East and North Africa region as defined here includes Algeria, Bahrain, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, the Palestinian Territory, Qatar, Saudi Arabia, Syria, Tunisia, Turkey, the United Arab Emirates, and Yemen.
Nils Daulaire et al., Promises to Keep: The Toll of Unintended Pregnancies on Women’s Lives in the Developing World (Washington, DC: Global Health Council, 2000).
World Health Organization, Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2003 (Geneva: WHO, 2007): table 2.
Malcolm Potts and Martha Campbell, “History of Contraception,” in Gynecology and Obstetrics 6, CD-ROM, ed. John J. Sciarra (Philadelphia: Lippincott, Williams & Wilkins, 2003): vol. 6, chapter 8. Found in Egypt in the 1870s, the Ebers Papyrus contains prescriptions written in hieroglyphics for over 700 remedies.
David A. Grimes et al., “Unsafe Abortion: The Preventable Pandemic,” The Lancet 368, no. 9550 (2006): 1908-19.