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Unsafe abortion : ウィキペディア英語版
Unsafe abortion

An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both.〔''(Safe Abortion: Technical and Policy Guidance for Health Systems )'', page 12 (World Health Organization 2003): "a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skill or in an environment lacking the minimum medical standards, or both."〕 For example, an unsafe abortion may refer to an extremely dangerous life-threatening procedure that is self-induced in unhygienic conditions, or it may refer to a much safer abortion performed by a medical practitioner who does not provide appropriate post-abortion attention.
Unsafe abortion is a significant cause of maternal mortality and morbidity in the world. Most unsafe abortions occur where abortion is illegal,〔
〕 or in developing countries where affordable well-trained medical practitioners are not readily available,〔〔Chaudhuri, S.K. (Practice Of Fertility Control: A Comprehensive Manual ), 7th Edition, page 259 (Elsevier India, 2007).〕 or where modern contraceptives are unavailable.〔Singh, Susheela et al. ''(Adding it Up: The Costs and Benefits of Investing in Family Planning and Newborn Health )'' (New York: Guttmacher Institute and United Nations Population Fund 2009): "If women’s contraceptive needs were addressed...the number of unsafe abortions would decline by 73% from 20 million to 5.5 million." A few of the findings in that report were subsequently changed, and are available at: "(Facts on Investing in Family Planning and Maternal and Newborn Health )" (Guttmacher Institute 2010).〕 About one in eight pregnancy-related deaths worldwide is associated with unsafe abortion.〔Maclean, Gaynor. ("Dimension, Dynamics and Diversity; A 3D Approach to Appraising Global Maternal and Neonatal Health Initiatives" ), pages 299-300 in Trends in Midwifery Research by Randell Balin (Nova Publishers, 2005).〕
==Overview==
The World Health Organization (WHO) published an estimate that in 2003 approximately 42 million pregnancies were voluntarily terminated, of which 20 million were unsafe.〔"( Unsafe abortion Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008, pg2 )" (World Health Organization 2011): "It was estimated that in 2003 approximately 42 million pregnancies were voluntarily terminated: 22 million safely and 20 million unsafely."〕 According to WHO and Guttmacher, approximately 68,000 women die annually as a result of complications of unsafe abortion; and between two million and seven million women each year survive unsafe abortion but sustain long-term damage or disease (incomplete abortion, infection (sepsis), haemorrhage, and injury to the internal organs, such as puncturing or tearing of the uterus). They also concluded abortion is safer in countries where it's legal, but dangerous in countries where it's outlawed and performed clandestinely. The WHO reports that in developed regions, nearly all abortions (92%) are safe, whereas in developing countries, more than half (55%) are unsafe. According to WHO statistics, the risk rate for unsafe abortion is 1/270; according to other sources, unsafe abortion is responsible for one in eight maternal deaths. Worldwide, 48% of all induced abortions are unsafe. The British Medical Bulletin reported in 2003 that 70,000 women a year die from unsafe abortion.〔
〕 Incidence of such abortions may be difficult to measure because they can be reported variously as miscarriage, "induced miscarriage", "menstrual regulation", "mini-abortion", and "regulation of a delayed/suspended menstruation".
An article pre-printed by the World Health Organization called safe, legal abortion a "fundamental right of women, irrespective of where they live" and unsafe abortion a "silent pandemic". The article states "ending the silent pandemic of unsafe abortion is an urgent public-health and human-rights imperative." It also states "access to safe abortion improves women’s health, and vice versa, as documented in Romania during the regime of President Nicolae Ceaușescu" and "legalisation of abortion on request is a necessary but insufficient step toward improving women’s health" citing that in some countries, such as India where abortion has been legal for decades, access to competent care remains restricted because of other barriers. WHO’s Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: "As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets."〔(【引用サイトリンク】publisher=WHO )〕 The WHO's Development and Research Training in Human Reproduction (HRP), whose research concerns people's sexual and reproductive health and lives,〔(【引用サイトリンク】title=New findings from the WHO Multicountry Survey on Maternal and Newborn Health )〕 has an overall strategy to combat unsafe abortion that comprises four interrelated activities:〔
*to collate, synthesize and generate scientifically sound evidence on unsafe abortion prevalence and practices;
*to develop improved technologies and implement interventions to make abortion safer;
*to translate evidence into norms, tools and guidelines;
*and to assist in the development of programmes and policies that reduce unsafe abortion and improve access to safe abortion and highquality postabortion care
A 2007 study published in the ''The Lancet'' found that, although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003. It also concluded that, while the overall incidence of abortion in both developed and developing countries is approximately equal, unsafe abortion occurs more often in less-developed nations.〔

Anti-abortion critics contend that the results of ''The Lancet'' study are flawed, as there are no accurate statistics about abortion from countries in the developing world. In a 2005 report, the WHO itself states, "More than a third of the 204 countries or areas examined did not report the number of deaths by sex even once for the period 1995 to 2003. About half did not report deaths by cause, sex and age at least once in the same period. Moreover, from 1975 to 2003 there has been limited progress in the reporting of deaths and their causes."

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