Abortion rates have declined in developed world since 1990
Emerging areas lag in usage rates for contraception despite access
Abortion rates in developed countries have been falling steadily since 1990, but rates in developing countries have stayed roughly the same, a new study said.
The study, published Wednesday in the Lancet, found that the worldwide abortion rate dropped slightly from 1990 to 2014, to 35 from 40 abortions per 1,000 women of childbearing age. The decline is largely due to developed countries, where abortion rates dropped from 46 to 27 per 1,000. The United States has among the lowest rates, about 17 per 1,000.
In developing countries, the rate has changed little, to 37 per 1,000, from 39. The difference between developed and developing countries is directly correlated with contraception use, said the lead author, Gilda Sedgh, the principal research scientist at the Guttmacher Institute, a reproductive health organization that supports abortion rights. It conducted the study with the World Health Organization.
Sedgh said the gap in contraception use was much less about access than it used to be. “We have made contraception available to a lot more women,” she said. “In the 1980s, when women who wanted to avoid getting pregnant weren’t using a method, their most common reason was lack of access. Now that’s their least common reason, less than 5 percent.”
Rather, she said, in many developing countries, women do not receive enough education about contraceptive methods, and many think they can avoid pregnancy without contraception or worry about potential side effects.
Laws restricting abortion did not appear to diminish abortion rates, partly because in many countries with stringent laws, like some in Latin America, contraception use was low. Sedge said that of the estimated 56 million annual abortions now, about 16 million occur “in a country where it is prohibited altogether or allowed only to save a woman’s life.”
Still, lack of legal restriction does not necessarily lead to fewer abortions. “The highest and lowest abortion rates exist in countries with liberal abortion laws,” said Sedge, noting that the highest rates are in Eastern Europe and that the lowest are in Western and Northern Europe and in the United States and Canada.
Restrictive laws in developing countries do seem associated with increased numbers of unsafe abortions, with more than 30 percent of women who have abortions in develop- ing countries experiencing a complication, compared with 0.05 percent of American women who have abortions, she said.
Largely because of population growth, the annual number of abortions increased globally, from 50 million in 1990 to 56 million in 2014, and about a quarter of all pregnancies end in abortion, the study found. That percentage dropped significantly in developed countries, to 28 percent from 39 percent, but rose slightly in the developing world, to 24 percent from 21 percent.
In addition, most abortions, 41 million a year in 2014, were obtained by married women, although in North America, the majority are obtained by unmarried women. Sedge said that in many developing countries, married women are expected to conceive right away and may face societal pressure not to use contraception.