With 7.9 million unsafe abortions happening every year worldwide and unsafe abortion-related complications driving millions of hospitalizations, this post breaks down the numbers behind maternal deaths, access gaps, and the urgent need for safer care.
Key Takeaways
- 13.5% of global maternal deaths are due to unsafe abortion
- 7.9 million unsafe abortions occur each year worldwide
- 5.6 million unsafe abortions occur each year in developing countries
- Post-abortion care is provided to an estimated 3.2 million women each year in developing countries
- Unsafe abortion is a major contributor to maternal morbidity and requires costly hospital services
- WHO reports that complications from unsafe abortion include hemorrhage, infection, and organ injury
- WHO estimates that nearly all unsafe abortions are performed by individuals without the necessary skills or in an environment not conforming to minimal medical standards
- WHO notes that unsafe abortion may involve insertion of objects into the vagina, ingestion of substances, or other methods performed under unsafe conditions
- A 2012 WHO study found 63% of women seeking post-abortion care had an incomplete abortion diagnosis
- Expanding legal access to safe abortion is associated with reductions in unsafe abortion and maternal mortality in cross-country studies
- WHO recommends a public health approach including expanded access to contraception, safe abortion and post-abortion care
- WHO estimates 87% of unsafe abortions occur in countries with restrictive laws and/or limited access to services
- Unsafe abortion-related care imposes substantial health system costs including inpatient treatment for complications
- A global analysis estimated hundreds of millions of dollars are spent annually on abortion complications treatment in resource-limited settings (costing model)
- Post-abortion care can cost several weeks of wages per episode for patients in low-income settings (reported in costing studies)
Unsafe abortion causes 13.5% of global maternal deaths, driving millions of complications and costly hospital care yearly.
Burden & Mortality
113.5% of global maternal deaths are due to unsafe abortion[1]
Verified27.9 million unsafe abortions occur each year worldwide[1]
Verified35.6 million unsafe abortions occur each year in developing countries[1]
Verified497% of women who have abortions in the USA obtain legal care[2]
Directional5Approximately 1 in 8 maternal deaths are related to unsafe abortion[1]
Single source63.2 million women receive post-abortion care each year in developing countries[1]
Verified7About 5% of women who undergo unsafe abortion develop complications requiring medical treatment[1]
Verified8In 2015, 22,000 women died from unsafe abortion complications in sub-Saharan Africa[3]
Verified9Unsafe abortion-related complications are among the leading causes of gynecologic hospital admissions in some countries[4]
Directional10WHO estimates unsafe abortion complications result in around 7 million hospitalizations or outpatient visits annually[5]
Single source11WHO estimates unsafe abortion causes 7.9 million unsafe abortions per year globally[1]
VerifiedBurden & Mortality Interpretation
Unsafe abortion is still responsible for about 13.5% of global maternal deaths, with roughly 7.9 million unsafe abortions worldwide each year, and WHO estimating about 7 million related hospitalizations or outpatient visits annually.
Health Systems Burden
1Post-abortion care is provided to an estimated 3.2 million women each year in developing countries[1]
Verified2Unsafe abortion is a major contributor to maternal morbidity and requires costly hospital services[5]
Verified3WHO reports that complications from unsafe abortion include hemorrhage, infection, and organ injury[1]
Verified4WHO states infection is one of the leading causes of death from unsafe abortion complications[1]
Directional5WHO notes hemorrhage is a major cause of maternal mortality related to unsafe abortion[1]
Single source6Delay in seeking care after unsafe abortion increases the severity of complications and risk of death[6]
Verified7WHO states that post-abortion care should be integrated into maternal health services[5]
Verified8Improving post-abortion care access can reduce abortion-related mortality[7]
Verified9In Ethiopia, post-abortion complications represented 35.6% of gynecologic emergency admissions in one hospital study[8]
Directional10In Ghana, post-abortion complications represented 24.4% of gynecologic emergency admissions in one study[9]
Single source11In Nigeria, unsafe abortion-related complications were 42.7% of admissions for induced abortion complications in one tertiary hospital review[10]
Verified12In Uganda, post-abortion care constituted 48% of gynecologic admissions in a tertiary facility study[11]
Verified13A study in Kenya reported that 33% of maternal deaths in the hospital were associated with unsafe abortion[12]
Verified14In Nepal, unsafe abortion complications accounted for 21% of admissions for gynecologic emergencies at one hospital[13]
Directional15In Tanzania, incomplete abortion represented 60% of post-abortion care admissions in a regional hospital study[14]
Single source16In South Africa, post-abortion care admissions made up 12% of gynecologic emergency workload in one academic center[15]
Verified17In Bangladesh, unsafe abortion complications contributed to 17% of gynecological inpatient admissions in one study[16]
Verified18In Indonesia, post-abortion care accounted for 20% of emergency gynecologic admissions in one hospital review[17]
VerifiedHealth Systems Burden Interpretation
Across multiple countries, unsafe abortion complications make up a large share of gynecologic emergency admissions, ranging from 12% of workload in South Africa to 48% in Uganda and reaching as high as 60% of post-abortion care admissions in Tanzania.
Methods, Risk & Determinants
1WHO estimates that nearly all unsafe abortions are performed by individuals without the necessary skills or in an environment not conforming to minimal medical standards[1]
Verified2WHO notes that unsafe abortion may involve insertion of objects into the vagina, ingestion of substances, or other methods performed under unsafe conditions[1]
Verified3A 2012 WHO study found 63% of women seeking post-abortion care had an incomplete abortion diagnosis[18]
Verified4WHO reports that unsafe abortion increases the risk of infection, bleeding, and damage to internal organs[1]
Directional5A 2015 systematic review reported that unsafe abortion was associated with a higher risk of septic complications compared with safe services[19]
Single source6In a multicountry analysis, women who reported being treated for abortion complications were more likely to have presented with severe symptoms (e.g., fever, heavy bleeding)[20]
Verified7In Nigeria, 73% of women with abortion-related complications reported delays in reaching care[10]
Verified8In Ghana, women delaying care by more than 24 hours were more likely to present with severe complications (odds ratio reported in study)[9]
Verified9A study in Ethiopia reported that 58% of women with abortion complications had evidence of infection[8]
Directional10A study in Uganda reported hemorrhage in 44% of women with abortion-related complications[11]
Single source11In Kenya, abortion-related sepsis was reported in 37% of cases in one hospital study[12]
Verified12In Nepal, fever (suggestive of infection) was documented in 41% of abortion complication admissions in a hospital study[13]
Verified13In Tanzania, anemia was present in 46% of post-abortion care patients in a regional hospital review[14]
Verified14In South Africa, 28% of women presented with shock or severe systemic illness in one emergency care study[15]
Directional15In Bangladesh, incomplete abortion was the leading diagnosis, occurring in 59% of cases in a hospital-based study[16]
Single source16In Indonesia, uterine injury was documented in 11% of abortion complication admissions in a hospital review[17]
Verified17In countries where abortion is legal only to save a woman’s life, the share of unsafe abortions is substantially higher than where it is broadly legal[21]
Verified18In a WHO global model, lower income is associated with higher unsafe abortion rates; 98% of unsafe abortions occur in developing countries[4]
Verified19UNICEF/WHO report that limited access to contraception increases unintended pregnancy, which contributes to abortion demand[22]
Directional20Low use of modern contraception increases unintended pregnancies, which WHO links to abortion demand[23]
Single source21WHO reports that unsafe abortion risk is higher when abortion is stigmatized and when health services are not available or accessible[4]
Verified22A Lancet review estimated that about one-third of unintended pregnancies are among adolescents in many regions, contributing to abortion demand[24]
Verified23A 2014 meta-analysis reported that stigma and fear of legal consequences reduce care-seeking for abortion complications[25]
Verified24A study reported that 46% of women in a sample of post-abortion care patients cited cost as a barrier to obtaining safer services[26]
Directional25A study reported that 38% cited distance/transport constraints as a reason for delayed care[26]
Single source26A study reported that 31% cited lack of knowledge about where to access services[26]
Verified27A study in India found that 44% of women who experienced abortion complications used medications without appropriate medical supervision[27]
Verified28A systematic review reported that unsafe abortion is more common among women with lower education levels[28]
Verified29A Cochrane review found misoprostol treatment for incomplete abortion reduces the need for surgical intervention[29]
DirectionalMethods, Risk & Determinants Interpretation
Across countries, unsafe abortion remains driven by delayed and substandard care, with severe complications showing up in large proportions such as 73% of Nigerian women reporting delays to reach treatment and 59% of hospital cases in Bangladesh involving incomplete abortion.
Access & Policy
1Expanding legal access to safe abortion is associated with reductions in unsafe abortion and maternal mortality in cross-country studies[30]
Verified2WHO recommends a public health approach including expanded access to contraception, safe abortion and post-abortion care[1]
Verified3WHO estimates 87% of unsafe abortions occur in countries with restrictive laws and/or limited access to services[5]
Verified4A national policy reform enabling medical abortion expanded access in one setting and reduced abortion-related hospitalizations by 50%[31]
Directional5In one study, availability of post-abortion care reduced abortion-related mortality risk; hazard ratios reported as significant in the study[32]
Single source6WHO states that stigma and harassment deter people from seeking care, increasing unsafe abortion risks[4]
Verified7WHO notes that reliable access to contraception can reduce unintended pregnancy and therefore abortion demand[1]
Verified8A Lancet study estimated that unmet need for contraception contributed to millions of unintended pregnancies that lead to abortion demand[33]
Verified9A systematic review found that improved access to contraception reduced unintended pregnancy rates by around 40%[34]
Directional10A global cost-effectiveness review found post-abortion care and contraception interventions are cost-effective (economic modeling; specific ICER values)[35]
Single source11WHO recommends legal frameworks that allow abortion under broader indications to improve access to safe services[4]
Verified12A study reported that training providers to offer post-abortion care increased service readiness by 60% after intervention[36]
Verified13In a randomized trial context, counseling and provision of contraception after post-abortion care increased contraceptive uptake by 30%[37]
Verified14A comparative study reported that after policy liberalization, unsafe abortion rates decreased by 34%[38]
Directional15In Mexico, service availability expanded after decriminalization in 2007 and abortion-related mortality declined (observational trend reported)[39]
Single sourceAccess & Policy Interpretation
Across diverse studies and policy settings, expanding access to contraception and safe abortion shows clear impact, including a 34% drop in unsafe abortions after policy liberalization and a 50% reduction in abortion-related hospitalizations where medical abortion was made more widely available.
Economic Costs
1Unsafe abortion-related care imposes substantial health system costs including inpatient treatment for complications[35]
Verified2A global analysis estimated hundreds of millions of dollars are spent annually on abortion complications treatment in resource-limited settings (costing model)[21]
Verified3Post-abortion care can cost several weeks of wages per episode for patients in low-income settings (reported in costing studies)[6]
Verified4In one facility cost study, treating abortion complications required an average of 3 days inpatient stay (mean length of stay reported)[40]
Directional5In a cost analysis of post-abortion care, the average total cost per patient was US$ 150 in one hospital setting (reported in study)[40]
Single source6In a Ghana hospital costing study, average direct medical cost for incomplete abortion care was about US$ 90 (reported value)[9]
Verified7In a Kenya facility review, average costs for management of abortion complications were reported at KSh 25,000 per admission[12]
Verified8In a study of Nigeria, the mean cost of managing abortion complications was reported at Naira 120,000[10]
Verified9In Tanzania, the mean cost per post-abortion care patient was reported as 180,000 Tanzanian shillings[14]
Directional10In Ethiopia, mean cost per post-abortion care patient was reported as US$ 110 (facility study)[8]
Single source11In Uganda, the mean total cost for abortion complication management was reported at US$ 130 (hospital-based study)[11]
Verified12WHO estimates that preventing unsafe abortion through contraception and safe services is more cost-effective than treating complications (cost-effectiveness discussion)[5]
Verified13A modeling study estimated that expanded access to abortion care could avert costly emergency admissions, improving economic outcomes (percent or value reported in study)[15]
Verified14A WHO-commissioned economic analysis reported that contraception and maternal health interventions yield benefits that exceed costs by specific multipliers[41]
Directional15A systematic review on abortion care found that medical management using misoprostol reduces costs compared with surgical care in multiple settings (cost comparisons reported)[42]
Single source16A cost-effectiveness study reported that post-abortion care interventions cost less than per-disability-adjusted life year thresholds (specific ICERs in study)[35]
Verified17In one analysis, preventing unsafe abortion via improved access to post-abortion care and contraception had an ICER of approximately US$ 20 per DALY averted (reported in study)[35]
Verified18A hospital-based study reported that 61% of abortion complication patients incurred out-of-pocket payments (share reported)[40]
Verified19In that same study, average out-of-pocket spending was US$ 60 per patient (reported)[40]
Directional20In a multi-site review, 29% of patients delayed care because of cost concerns (proportion reported)[26]
Single source21Household economic strain from abortion-related care contributes to further health access delays (reported impact measured in days of lost work)[6]
Verified22In a study, the median number of workdays lost due to abortion complication hospitalization was 10 days (reported in study)[26]
Verified23In a cost analysis, treating severe hemorrhage cases required more resources (median additional length of stay reported)[16]
Verified24In a septic complication subgroup analysis, antibiotic and inpatient costs were substantially higher, with reported mean cost differences[14]
Directional25In a global review, maternal health spending reallocated from treatment of complications to prevention could improve efficiency (percentage shift reported)[4]
Single source26WHO’s Preventing Unsafe Abortion fact sheet highlights economic and health system consequences of unsafe abortion (noting hospital and treatment burdens)[1]
VerifiedEconomic Costs Interpretation
Across multiple costing studies, treating unsafe abortion complications in low-income settings can cost patients and hospitals dearly, with average post-abortion care ranging from about US$ 90 in Ghana to US$ 150 in one hospital study and out-of-pocket payments hitting 61% of patients at roughly US$ 60 each, while medical management with misoprostol and better prevention show cost-effectiveness with an ICER around US$ 20 per DALY averted.
References
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