Abortion Statistics Worldwide 2023: an overview

Abortion statistics worldwide demonstrate a significant presence in the global reproductive health landscape. According to the World Health Organization (WHO), almost half of all pregnancies – 121 million – are unintended each year. Among these unintended pregnancies, 6 out of 10 end up in induced abortion^[1]. That translates into an estimated 73 million abortions worldwide per year. Abortion clearly is a widespread medical practice.

Country classifications by income level & abortion rates

The Guttmacher Institute reports that countries with low income have higher numbers of unintended pregnancies, with 40% ending in abortion. However, while income does play a role in unintended pregnancy rates, it is not an accurate determining factor of abortion rates. Data shows that middle-income countries report the highest abortion rates^[2].

In countries with higher incomes, reproductive health, contraception, and abortion care is much more accessible, which allows people better access to sexual and reproductive medical care services. Conversely, access and availability to medical services in low-income countries are often more limited, leading to increased unintended pregnancies and, in turn, more abortions alongside more underreporting of abortions^[3].

Legal Restrictions do not affect abortion rates

Throughout the world, legal regulations vary significantly. Abortion is banned in some countries, whereas in others, it is permitted without restrictions. Despite changing legal restrictions on abortion, the proportion of unintended pregnancies ending in abortion is typically similar among countries with restrictive and more permissive laws. So, despite legal restrictions, abortion rates seem not to be affected. This means, that even in countries with heavy restrictions, people who need or want to end a pregnancy will find ways to do it.

At the same time, the numbers of unsafe abortions and complications vary strongly. As a consequence, restrictive laws threaten safe and legal abortion worldwide^[2,5]. And with it, overall maternal health.

Unsafe abortion rates

Unsafe abortion is a serious public health concern that affects millions of people around the world. Every year, an estimated 20 million unsafe abortions occur, resulting in approximately 68,000 deaths and 5 million cases of disability^[4]. This is particularly prevalent in countries with restrictive abortion laws, where access to safe, legal abortion services is limited or non-existent.

The maternal mortality ratio – the number of maternal deaths per 100,000 live births – due to complications of unsafe abortion is much higher in regions with restrictive laws compared to areas where access to a safe and legal termination of pregnancy is available. According to a study by the HRP (UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction) cosponsored by the World Health Organization, the number of unsafe abortion is higher in low and middle-income regions: Africa, Asia, and Latin-American.

The State of Abortion Data

The availability and accuracy of data on abortion are critical for public health, policy, and advocacy efforts. Accurate data can help decision-makers better understand the sexual and reproductive health needs of their populations and tailor policies and services accordingly. Unfortunately, legal restrictions and social stigma surrounding abortion mean that reliable data is often difficult to obtain^[6].

The disparities in existing data are vast. Europe and Northern America counted most of the data regarding abortion. While in other regions, like Sub-Saharan Africa and Latin America, abortion data was available for less than half of the countries. West Asia and North Africa are the regions with a higher lack of abortion information^[6]. 

While these figures have changed, particularly in regions such as Latin America, where NGOs and local organizations have made substantial efforts to increase the evidence for abortion. There is still a lack of complete and up-to-date data about abortion worldwide. A report published by Women Deliver in 2020 indicated that abortion data is lacking information regarding the following topics^[7]:

• Rates of unsafe abortion and post-abortion care outcomes;

• Evidence based on effective approaches to liberalize abortion laws and increase access to safe abortion and post-abortion care in legally restrictive settings and humanitarian settings;

• Long-term impacts of incarceration due to abortion/restrictive legal frameworks on women’s health, economic opportunities, and societal costs.

Lack of data affects the population since there is no evidence to guide healthcare programs and policies and no understanding of the local context. Moreover, data is necessary to inform healthcare providers about their patients’ needs and evaluate their performance. Therefore, a lack of data can have severe implications for public health efforts, leading to inequalities in access to care, poor health outcomes, and the neglect of reproductive and health rights.

This text contains data relating abortion to unintended pregnancies, as the Guttmacher Institute has tried to overcome the challenge of producing abortion data using the variable “unintended pregnancies.” Despite this, it is essential to note that abortions occur during unintended and intended pregnancies.

Sources

[1] World Health Organization. (2021).  Abortion. https://www.who.int/news-room/fact-sheets/detail/abortion. Jan 2, 2023. 

[2] Guttmacher Institute. (2022). Unintended Pregnancy and Abortion Worldwide. guttmacher.org/fact-sheet/induced-abortion-worldwide. Jan 2, 2023. 

[3] Bearak, J; Popinchalk A; Ganatra B; Moller, A; Tunçalp, Ö; Cynthia Beavin, C; Kwok, L; Alkema, L.  (2020). Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health.

[4] Haddad, L;  Nour, N. (2009). Unsafe Abortion: Unnecessary Maternal Mortality. Rev Obstet Gynecol. 2009 Spring;2(2):122-6. PMID: 19609407; PMCID: PMC2709326.

[5] Shah,I; Åhman, E. (2009). Unsafe Abortion: Global and Regional Incidence, Trends, Consequences, and Challenges. Women’s Health. 

[6] Popinchalk, A ;  Beavin, C; Bearak, J. (2021) The state of global abortion data: an overview and call to action. Guttmacher Institute. 

[7] Women Deliver. (2020). Advocating for a stronger evidence base for gender equality: an analysis of gender data and knowledge gaps.