Family Planning Prevents Abortion

Each year, women undergo an estimated 19 million unsafe abortions, costing some 68,000 women their lives. For every woman who dies, several others suffer pain, lifelong disability, or complicated future pregnancies as a result of the procedure.(1) In the majority of unsafe abortions, women die or are disabled because they do not receive medical treatment for complications from the abortion soon enough. According to the World Health Organization, these complications are responsible for 13 percent of all maternal deaths.(2)

The primary reason for abortion is unintended pregnancy. Expanding women’s access to safe and voluntary family planning counseling and services, and a range of modern, safe, and effective contraceptives allows them to plan the timing and spacing of their births. Family planning programs that emphasize counseling and repeat contacts with clients and offer a broad range of methods from which a client can choose help couples determine whether, when, and how often they will have children.

Facts and Figures

The lifetime risk of dying from an unsafe abortion is highest in the developing world, ranging from 1 in 140 procedures in Africa to 1 in 1,000 in Latin America and the Caribbean. In contrast, the risk in the developed world is 1 in 1,700 procedures.(1)

Around 2.5 million unsafe abortions (almost 14 percent) occur among women under age 20 in developing countries.(1) Unsafe abortion may be one of the greatest health risks that a young woman can face.(3)

An estimated 120 million married women want to stop having children or postpone their next pregnancy but are not using contraception. An additional 12 to 15 million unmarried women also want to avoid pregnancy but lack the means.(1) Some 201 million women in the developing world have an unmet need for effective contraceptives.(4)

Studies show that fewer than one-third of women in Africa, Asia, and Latin America who receive care for complications resulting from unsafe abortion have ever used modern contraceptives.(5)

USAID Response

By increasing the availability of and access to family planning services, USAID has played a major role in preventing abortion and improving the health and lives of women.

Safe, voluntary, and accessible family planning services reduce women’s reliance on abortion. The Soviet era left a legacy of widely available abortion and scarce family planning and reproductive health programs. To help women in Russia and the Central Asian Republics avoid abortion, USAID is providing training and much-needed contraceptives to health systems.(6) Women in Kazakhstan, for example, are having fewer induced abortions now than five years ago and are choosing family planning to plan their births. A comparison of the 1999 Kazakhstan Demographic and Health Survey (KDHS) and the 1995 KDHS indicates a decline of 22 percent in the total abortion rate.(7) A study conducted in 2003 concluded that in the first year after legalization of family planning services in Romania in 1989, maternal deaths fell 40 percent. It also demonstrated that when the use of modern contraceptives more than doubled between 1993 and 1999, the abortion rate decreased by 35 percent and abortion-related maternal mortality dropped by more than 80 percent.(8)

More than 20 years of data on vital events in the Matlab area of Bangladesh also demonstrated that effective, accessible family planning was associated with lower abortion rates.(9)

As traditional methods of family planning are replaced by more modern methods, abortion rates decline. In the 1980s, Turkish couples either relied heavily on traditional methods of family planning that have high rates of failure such as withdrawal, or they used no methods at all. As modern, safe, and effective contraceptive use increased (by more than 20 percent from 1988 to 1998), the ratio of abortions per 100 live births dropped by more than one-third, from 24 to 15.(10)

In countries where access to contraception is unable to meet the growing need for fertility regulation, abortion rates have not declined, or they have declined very slowly. The high level of induced abortion in Uganda, for example, is considered to be linked to the very large gap between actual and desired family size. A growing number of women desire smaller families, but there has been no increase in the use of modern contraceptives. It is clear, however, that when fertility levels remain the same, increased use or effectiveness of modern contraception reduces the incidence of abortion.(11,12)

Linking emergency postabortion care with family planning services is critical in helping women prevent future unintended pregnancies. USAID has funded pilot programs designed to improve treatment for the complications of unsafe abortions. These programs, which were carried out in 30 countries, showed that offering family planning at the time of emergency treatment was a highly effective measure in preventing future abortions. A woman's fertility can return within two weeks after an abortion, increasing the importance for her to learn the best methods of preventing another pregnancy. These programs are now being scaled up.

Updated March 2006

Access Family Planning Prevents Abortion in Spanish

Sources

1. World Health Organization (WHO). (2004). Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000. Fourth edition, p. 13, table 3. Geneva: WHO.
2. WHO. (1997) Abortion: A tabulation of available data on the frequency and mortality of unsafe abortion. Third edition. Geneva: WHO.
3. WHO. (1997) Unsafe abortion: Global and regional estimates of incidence of a mortality due to unsafe abortion with a listing of available country data. Third edition. Geneva: WHO.
4. Singh S., et al. (2003). Adding It Up: The Benefits of Investing in Sexual and Reproductive Health Care. New York: The Alan Guttmacher Institute and United Nations Population Fund.
5. Salter, C., Johnston, H.B., & Hengen, N. (1997). Care for postabortion complications: Saving Women’s Lives. Population Reports. Series L. 25:8.
6. Population Resource Center. (1998). The Replacement of Abortion by Contraception in Three Central Asian Republics.
7. Demographic and Health Surveys. (2000). DHS+ Dimensions, A Semiannual Newsletter of the Demographic and Health Surveys Project, 2(2).
8. Population Reference Bureau. (2003). Improving Reproductive Health In Romania. MEASURE Communication.
9. Rahman, M., DaVanzo, J, & Razzaque, A. (2000). Fertility Transition, Contraceptive Use, and Abortion in Rural Bangladesh: The Case of Matlab.
10. Studies in Family Planning. (2001), 32(1), 41-52.
11. Marston, C., & Clelland, J. (2003). Relationships Between Contraception and Abortion: A Review of the Evidence. International Family Planning Perspectives, 29(1), 6-13.
12. Singh, S. et al., (2005). The Incidence of Induced Abortion in Uganda. International Family Planning Perspectives, 31(4).