Induced abortion

Induced abortion is the deliberate disruption of the natural pre-natal development of a foetus. Access to foetal diagnosis and gender determination, and legislation concerning induced abortions, and the use of selective abortion, differs between populations.

The WHO estimates that more than 50 million unwanted pregnancies are terminated each year, the majority in developing countries. It is however impossible to produce a reliable estimate of induced abortions throughout the world since, in most countries, the majority are performed clandestinely. This is particularly the case for young and unmarried women in countries where abortion is illegal or only performed as a medical intervention when the mother's life is at risk, and where contraception is not widely taught and available. The result is that throughout the Third World, the use of abortion as a method of fertility regulation and control has terrible consequences for women's health.

For example, as many as 10,000 Kenyan teenage girls a year drop out of school because of unwanted pregnancies and abortions. Many try to abort themselves with cocktails of drugs or crude mechanical devices inserted into the uterus. At Kenyatta Hospital, one of the largest public hospitals in sub-Saharan Africa with 2,000 beds, complications from induced and incomplete abortions account for about 50% of gynaecological admissions -- or about 20 patients a day and more than 6,000 a year. A non-profit group considers that one-third of maternal deaths in Kenya are due to unsafe abortions; the WHO figures indicate that the number worldwide is one in eight.

In countries with high birth rates, abortion ratios per 1000 births are thought to be low (WHO report, 1970). By contrast, in recent years induced abortions seem to have exceeded live births in several countries with low birth rates. In China alone, an average of 1 million abortions a year have been performed in the late 1980s and early 1990s, in keeping with the government's campaign to limit population growth. In the former USSR, 90% of first pregnancies end in abortion; there abortions are the main form of birth control and each woman on average undergoes 4-5 abortions in her lifetime. With a rate exceeding 4,000 procedures per day, abortion is by far the most common invasive surgical procedure performed in the USA.

In 1991, 200,000 women had terminations in the UK; the number has been growing steadily for the previous 10 years and most estimates suggest at least half of these pregnancies were in couples who used not contraception. In 1993 in the USA, there are around 1.6 million abortions each year.

Non-surgical abortion using the drug mifepristone (RU486) together with prostaglandins is an abortificant available legally in 1994 in France, Britain and Sweden. There is fierce debate as to its world-wide licensing.