Unsafe abortions result in seven million women needing treatment for complications every year. Pakistan was found to have the highest rate for women needing medical care following unsafe procedures, a study published in the International Journal of Obstetrics & Gynaecology found.
Unsafe abortions are one of the leading causes of maternal mortality across the globe, accounting for up to 15% of the 800 women who die from preventable pregnancy-related causes every day. Yet these figures do not take into account the number of women who are left in need of hospital treatment, often leading to lifelong health problems and disability.
Dr Susheela Singh, from the Guttmacher Institute and lead author of the study, said: "We already know that around 22 million unsafe abortions take place each year, resulting in the death of at least 22,000 women. Our study provides further evidence about the number of women who suffer injury as a result of complications due to unsafe abortion, often leading to chronic disability. These statistics represent only part of the problem as they do not include women who need care, but do not visit health facilities."
Most unsafe abortions take place where the procedure is illegal, or in developing countries where well-trained medical practitioners are unaffordable or not readily available. They also take place in areas where modern contraceptives are unavailable. Methods include drinking toxic fluids like turpentine or bleach, inflicting direct injury to the vagina, such as inserting a coat hanger or twig into the uterus, or carrying out external injury like blunt trauma to the abdomen.
The latest study showed Pakistan (where abortion is legal only to preserve the mother's health) to have the highest rate of complications from unsafe abortions, with 14.6 in every 1,000 women aged between 15 and 44 needing treatment. Regionally, Asia had the highest rate, with 4.6 in 1,000 women needing treatment every year. This, the authors said, was driven by high rates in South-Central Asia.
Africa was found to be the next worst region, with 1.6 million women needing care, followed by Latin America and the Caribbean. The lowest treatment rate was found in Brazil, with 2.4 per 1,000 women requiring care. Researchers used official health statistics and studies from 26 countries, and data were adjusted to take into account the number of women receiving treatment in the private sector, and excluding those who needed treatment following a miscarriage.
As well as the huge health burden, the study found unsafe abortions cost an estimated $232m (£148m) on post-abortion care in the developing world. Singh said: "The provision of better reproductive healthcare, including access to family planning services, contraception and safe abortion where the law allows, would have significant economic benefits as well as improving the health and well-being of women and their families."