INTERNATIONAL JOURNAL OF HEALTH AND PHARMACEUTICAL RESEARCH (IJHPR )

E-ISSN 2545-5737
P-ISSN 2695-2165
VOL. 10 NO. 4 2025
DOI: 10.56201/ijhpr.vol.10.no4.2025.pg1.14


The Global Burden of Unsafe Abortion and the Need for Improved Access to Safe Reproductive Health Care

Chinyere Favour Onuoha, Opeyemi Oladunni, Adewale Victor Aderemi, Damilare Hakeem Adeyemi, Dennis Seyi Arokoyo, Ladela Muyiwa, Ibukun Peter Oyeyipo


Abstract


Unsafe abortion is a medical crisis and a neglected public health problem. It remains a significant public health issue globally, contributing to high rates of maternal morbidity and mortality that is prevalent in most part of the world and puts women who are of reproductive age in grave danger. Despite being a preventable condition, progress in addressing unsafe abortion remains minimal, highlighting a critical violation of women's human rights. It is deeply intertwined with human rights, social justice, and gender equality. Several factors contribute to the ongoing public health crisis surrounding unsafe abortions which includes restricted abortion law, poor quality of health service, criminalization, stigmatization and low community awareness which prevents women access to proper and safe abortion services. The consequences of unsafe abortions extend beyond immediate health risks, affecting women's long-term physical and psychological well-being, and imposing substantial costs on healthcare systems, with up to 50% of women requiring medical care for complications such as infection, hemorrhage, poison, sepsis, peritonitis, and trauma to the cervix, psychological consequences such as shame and anxiety and other long-term issues like infertility, ectopic pregnancy and pelvic inflammatory disease. Addressing these issues through improved access to safe abortion services and comprehensive reproductive health education is essential for reducing maternal mortality and achieving sustainable development goals globally. Thus, the purpose of this review is to draw attention to the harm that unsafe abortion causes to the world and the necessity of expanding access to quality reproductive health care.


keywords:

Unsafe abortion, maternal mortality, abortion, global abortion


References:


Abhary, M. N., Shaghaghi, F., Safinejad, H., Asadi, L., & Mohebbi-Dehnavi, Z. (2023). The
Effects of Unsafe Abortion on the Health System from a Socio-economic Perspective: A
Narrative Review. Journal of Midwifery and Reproductive Health, 11(4), 3896–3909.
https://doi.org/10.22038/JMRH.2023.64029.1863
Akande, Oluwatosin Wuraola, Adenuga, A. T., Ejidike, I. C., & Olufosoye, A. A. (2020). Unsafe
abortion practices and the law in Nigeria?: time for change. Sexual and Reproductive Health
Matters, 28(1), :528–530. https://doi.org/10.1363/ifpp.35.194.09
Aniteye, P., O’Brien, B., & Mayhew, S. H. (2016). Stigmatized by association: Challenges for
abortion service providers in Ghana. BMC Health Services Research, 16(1), 1–10.
https://doi.org/10.1186/s12913-016-1733-7
Arambepola, C., Rajapaksa, L. C., Attygalle, D., & Moonasinghe, L. (2016). Relationship of
family formation characteristics with unsafe abortion: Is it confounded by women’s socio-
economic status? - A case-control study from Sri Lanka. Reproductive Health, 13(1), 1–9.
https://doi.org/10.1186/s12978-016-0173-5
Atakro, C. A., Addo, S. B., Aboagye, J. S., Menlah, A., Garti, I., Amoa-gyarteng, K. G., Sarpong,
T., Adatara, P., Kumah, K. J., Asare, B. B., Mensah, A. K., Lutterodt, S. H., & Boni, G. S.
(2019). Contributing factors to unsafe abortion practices among women of reproductive
age at selected district hospitals in the Ashanti region of Ghana. 1–18.
Baguiya, A., Mehrtash, H., Bonet, M., Adu-Bonsaffoh, K., Compaoré, R., Bello, F. A., Govule,
P., Msusa, A. T., Kim, C. R., & Kouanda, S. (2022). Abortion-related infections across 11
countries in Sub-Saharan Africa: Prevalence, severity, and management. International
Journal of Gynecology and Obstetrics, 156(S1), 36–43. https://doi.org/10.1002/ijgo.14032
Banerjee, S. K., Kumar, R., Warvadekar, J., Manning, V., & Andersen, K. L. (2017). An
exploration of the socio-economic profile of women and costs of receiving abortion
services at public health facilities of Madhya Pradesh, India. BMC Health Services
Research, 17(1), 1–11. https://doi.org/10.1186/s12913-017-2159-6
Bearak, J. M., Popinchalk, A., Beavin, C., Ganatra, B., Moller, A. B., Tunçalp, Ö., & Alkema, L.
(2022). Country-specific estimates of unintended pregnancy and abortion incidence: a
global comparative analysis of levels in 2015-2019. BMJ Global Health, 7(3), 1–10.
https://doi.org/10.1136/bmjgh-2021-007151
Bell, S. O., Omoluabi, E., Olaolorun, F., Shankar, M., & Moreau, C. (2020). Inequities in the
incidence and safety of abortion in Nigeria. BMJ Global Health, 5(1), 1–11.
https://doi.org/10.1136/bmjgh-2019-001814
Bridwell, R. E., Long, B., Montrief, T., & Gottlieb, M. (2022). Post-abortion Complications?: A
Narrative
Review
for
Emergency
Clinicians.
919–925.
https://doi.org/10.5811/westjem.2022.8.57929.An
Calvert, C., Owolabi, O. O., Yeung, F., Pittrof, R., Ganatra, B., Tunçalp, Ö., Adler, A. J., & Filippi,
V. (2018). The magnitude and severity of abortionrelated morbidity in settings with limited
access to abortion services: A systematic review and meta-regression. BMJ Global Health,
3(3), 1–12. https://doi.org/10.1136/bmjgh-2017-000692
Cameron, S. (2018). Recent advances in improving the effectiveness and reducing the
complications
of
abortion.
F1000Research,
7(0),
1–7.
https://doi.org/10.12688/f1000research.15441.1
Chae, S., Desai, S., Crowell, M., Sedgh, G., & Singh, S. (2017). Characteristics of women
obtaining induced abortions in selected low- and middle-income countries. PLoS ONE,
Page 12
12(3), 1–19. https://doi.org/10.1371/journal.pone.0172976
Chavkin, W., Stifani, B. M., Bridgman-Packer, D., Greenberg, J. M. S., & Favier, M. (2018).
Implementing and expanding safe abortion care: An international comparative case study
of six countries. International Journal of Gynecology and Obstetrics, 143, 3–11.
https://doi.org/10.1002/ijgo.12671
Chemlal, S., & Russo, G. (2019). Why do they take the risk? A systematic review of the qualitative
literature on informal sector abortions in settings where abortion is legal. BMC Women’s
Health, 19(1), 1–11. https://doi.org/10.1186/s12905-019-0751-0
Dawson, A., Bateson, D., Estoesta, J., & Sullivan, E. (2016). Towards comprehensive early
abortion service delivery in high income countries: Insights for improving universal access
to
abortion
in
Australia.
BMC
Health
Services
Research,
16(1),
1–23.
https://doi.org/10.1186/s12913-016-1846-z
De Londras, F., Cleeve, A., Rodriguez, M. I., Farrell, A., Furgalska, M., & Lavelanet, A. (2022).
The impact of criminalisation on abortion-related outcomes: A synthesis of legal and health
evidence. BMJ Global Health, 7(12), 1–13. https://doi.org/10.1136/bmjgh-2022-010409
de Vries, I., van Keizerswaard, L. J., Tolboom, B., Bulthuis, S., van der Kwaak, A., Tank, J., & de
Koning, K. (2020). Advocating safe abortion: outcomes of a multi-country needs
assessment on the potential role of national societies of obstetrics and gynecology.
International
Journal
of
Gynecology
and
Obstetrics,
148(3),
282–289.
https://doi.org/10.1002/ijgo.13092
Espinoza, C., Samandari, G., & Andersen, K. (2020). Abortion knowledge, attitudes and
experiences among adolescent girls: a review of the literature. Sexual and Reproductive
Health Matters, 28(1). https://doi.org/10.1080/26410397.2020.1744225
Faúndes, A., & Shah, I. H. (2015). Evidence supporting broader access to safe legal abortion.
International
Journal
of
Gynecology
and
Obstetrics,
131,
S56–S59.
https://doi.org/10.1016/j.ijgo.2015.03.018
Footman, K., Dessalegn, B., Hayes, G., & Church, K. (2020). Can universal health coverage
eliminate unsafe abortion? Sexual and Reproductive Health Matters, 28(2), 1–6.
https://doi.org/10.1080/26410397.2020.1848398
Funmito Omolola Fehintola, I. A., , Samuel Anu Olowookere, Y. R. A., , Tolulope Komolafe,
Emmanuel Eledah, E. F., & Oyewale, S. (2023). Legalisation of Abortion in a
Poor?resource Setting: Nigerian Undergraduates’ Perspectives. Nigerian Postgraduate
Medical Journal, 30(1). https://doi.org/10.4103/npmj.npmj
Ganatra, B., Gerdts, C., Rossier, C., Johnson, B. R., Tunçalp, Ö., Assifi, A., Sedgh, G., Singh, S.,
Bankole, A., Popinchalk, A., Bearak, J., Kang, Z., & Alkema, L. (2017). Global, regional,
and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian
hierarchical model. The Lancet, 390(10110), 2372–2381. https://doi.org/10.1016/S0140-
6736(17)31794-4
Ganle, J. K., Obeng, B., Yeboah, J. Y., Tagoe-Darko, E., & Mensah, C. M. (2016). Disparities in
abortion experience and access to safe abortion services in Ghana: Evidence from a
retrospective survey. African Journal of Reproductive Health, 20(2), 43–52.
https://doi.org/10.29063/ajrh2016/v20i2.5
Gebremedhin, M., Semahegn, A., Usmael, T., & Tesfaye, G. (2018). Unsafe abortion and
associated factors among reproductive aged women in Sub-Saharan Africa: A protocol for
a
systematic
review
and
meta-analysis.
Systematic
Reviews,
7(1),
1–5.
https://doi.org/10.1186/s13643-018-0775-9
Getahun, G. K., Kidane, M., Fekade, W., Shitemaw, T., & Negash, Z. (2023). Exploring the
reasons for unsafe abortion among women in the reproductive age group in western
Ethiopia.
Clinical
Epidemiology
and
Global
Health,
22(March),
https://doi.org/10.1016/j.cegh.2023.101301
Glenton, C., Sorhaindo, A. M., Ganatra, B., & Lewin, S. (2017). Implementation considerations
when expanding health worker roles to include safe abortion care: A five-country case
study synthesis. BMC Public Health, 17(1), 1–13. https://doi.org/10.1186/s12889-017-
4764-z
Halder, S., Majumdar, B. K., Amir, M., & Moon, I. J. (2024). Maternal Mortality and Morbidity
Following Unsafe Abortion in a Tertiary Medical College Hospital. Europ


DOWNLOAD PDF

Back


Google Scholar logo
Crossref logo
ResearchGate logo
Open Access logo
Google logo