Safe Abortion Care: Global Trends, Regional Impacts, and Barriers

Worldwide, more than half of all unintended pregnancies end in abortion. Women, girls, and anyone who can become pregnant need access to safe abortion care. Doctors Without Borders (MSF) considers access to safe abortion care a critical part of comprehensive reproductive health care, one that reduces maternal mortality and suffering. However, an abortion is considered safe only if the person providing or supporting the abortion is trained and an evidence-based method that is appropriate to the pregnancy duration is used. People who cannot access safe care due to legal restrictions, cost, stigma, or a lack of accurate information will often resort to unsafe methods to end an unwanted pregnancy. Unsafe abortion is a leading cause of maternal mortality around the world, resulting in an estimated 29,000 maternal deaths per year.

The Impact of Legal Restrictions in the United States

Since federal protections were overturned by the U.S. Supreme Court three summers ago, various states have enacted restrictions or near-total bans on the procedure. Virginia-based abortion funds are citing an increased uptick in calls to their intake lines, as more people rely on their assistance to help cover the cost and sometimes travel expenses to get abortions. With Virginia the least-restrictive southern state, several funds here told the Virginia Mercury in interviews they’re seeing a spike in assistance requests. Over the past year, Blue Ridge Abortion Fund (BRAF) said it supported over 2,300 callers and saw a 54% increase in funding provided for callers. Before 2023, about 15% of people BRAF supported came from out of state, but that number now accounts for 25% of people the fund has served as of this year.

Other Virginian abortion funding groups echo that they’re seeing requests for assistance from North Carolinians, Georgians and Floridians in particular. Florida and Georgia ban the procedure after 6 weeks (a time when some people are just learning they are pregnant), while North Carolina blocks the procedure after 12 weeks. The longer it takes to afford, schedule and travel for an abortion and the further into pregnancy a person becomes, the higher the need to come to a state like Virginia, which caps most abortions around 26 weeks, rises.

Findings from Uttar Pradesh, India

In addition to these trends, an estimated 3.2 million abortions occurred in Uttar Pradesh in 2015. These included safe and unsafe abortions, and those taking place both in health facilities and in other settings. The state’s abortion rate was 61 terminations per 1,000 women of reproductive age. Nearly half (49%) of pregnancies occurring in Uttar Pradesh in 2015 were unintended, and the majority (64%) of these unintended pregnancies ended in an abortion. Only 11% of abortions (359,100) occurred in health facilities. Although more than seven in 10 women of reproductive age in Uttar Pradesh live in rural areas, only 29% of facilities that provide any abortion-related services were located in rural areas.

Barriers to Safe Access and Care

Beyond legal barriers, many people experience shame, social stigma, and negative attitudes about the circumstances that led to their unwanted pregnancy, or to the abortion itself. Common obstacles include verbal abuse or social rejection from family and friends, misrepresentation, or lack of information about laws regarding abortion, and rejection, stigma, and ignorance within the health system. In 2023, MSF teams around the world provided 54,500 consultations for safe abortion care, along with 31,000 consultations for post-abortion care, most taking place in Afghanistan, Yemen, South Sudan, and Bangladesh. These organizations are sort of walking alongside people so much longer than people would think; it’s not just ‘here’s 500 dollars for your abortion,’ it’s so much more than that.

Key Data and Statistics Summary

• Total Abortions in Uttar Pradesh (2015): 3.2 million
• Abortion Rate (Uttar Pradesh): 61 per 1,000 women
• Unintended Pregnancies (Uttar Pradesh): 49%
• BRAF Out-of-State Patients Increase: From 15% to 25%
• BRAF Funding Increase: 54%
• Global Unsafe Abortion Deaths: 29,000 annually
• MSF Safe Abortion Consultations (2023): 54,500