Abortion is an essential health-care intervention that can be executed via medication or a surgical procedure. A medical abortion, which is an abortion that utilizes medication, can be conducted safely at home by the pregnant person. It does not necessarily require access to a health-care facility and only involves administration of high-quality medication.
When done via WHO-recommended methods (e.g. a medical or surgical abortion), abortion is incredibly safe and effective. However, researchers estimate that up to 45 percent of all abortions procured are considered unsafe. Unsafe abortions are abortions that are conducted under dangerous conditions. Dangerous conditions can include abortions done via invasive methods or by untrained personnel . Examples of unsafe methods include utilizing oral and injectable substances, intrauterine foreign bodies, and vaginal preparations and can result in abdomen trauma .
This article will discuss why unsafe abortions occur, the dangers of unsafe abortions, and the benefits of utilizing safe abortion practices.
Why unsafe abortions occur
Unsafe abortions occur most commonly in developing countries, which make up 97 percent of all unsafe abortions. Half of these abortions happen in Asia. In Africa and Latin America, an estimated 75 percent of abortions are considered unsafe.
There are several reasons as to why women may receive unsafe abortions. These include:
- limited or no access to safe, timely, and affordable abortion care;
- the stigma surrounding abortion due to religious, political, and social environments; and
- strict abortion regulations .
Dangers of unsafe abortion
There are a multitude of factors and circumstance that constitute an unsafe abortion, and the consequences of unsafe abortions are significant. Unsafe abortion is one of the leading causes of maternal mortality, and certain risks persist after the abortion itself. Complications of abortions include:
- impaired wound healing,
- internal organ injury,
- bowel injury,
- mental health troubles, and
- incomplete abortion [1,3,4,5,6].
In addition to the effects on women, unsafe abortions also present a significant financial burden on health systems in developing countries. A 2006 estimate suggests that complication-related treatment costs developing countries 553 million annually. Disability due to unsafe abortions is estimated to cost households 922 million because of loss of income due to complications .
What is a safe abortion?
A safe abortion involves receiving appropriate abortion medication or undergoing a proper medical procedure by licensed personnel. For example, abortion pills involve two medications, known as mifepristone and misoprostol, that can safely and effectively end a pregnancy. Mifepristone works by blocking progesterone, a hormone important to sustaining a pregnancy. Misoprostol helps the uterus to pass the pregnancy contents out of the uterus in a similar fashion to a miscarriage. Because of this, misoprostol is also used to treat post-partum bleeding and miscarriage.
Contrary to unsafe abortions, abortions with mifepristone and misoprostol are 95 percent effective in ending a pregnancy. In terms of safety, abortion pills are incredibly safe with a less than one percent chance of experiencing a complication. These complications are easily manageable in a clinical setting. Adverse effects are minimal, with most women experiencing only cramping and bleeding.
Additionally, the risk of death due to safe abortion is close to zero. In fact, carrying a pregnancy to term or receiving a penicillin injection have a higher risk of death than a safe abortion. Medical abortion is greater than 13 times safer than childbirth in the U.S. It also does not carry the same risks as unsafe abortion, such as mental health issues, infertility, or future pregnancy complications.
Additional evidence suggests that these medications are also effective without clinician supervision and are associated with few complications. Taking abortion pills is so safe that most women can take the pills at home without needing to follow up with a provider. Therefore, women can be confident that seeking safe abortion care will promote their long-term health and wellness. Women may choose a medical abortion because of its low cost and privacy, and because it can be self-administered [6,7].
What can be done?
Ending unsafe abortions starts with increasing quality abortion care. Limiting access to safe abortions does not decrease the amount of abortions, but instead increases the likelihood that an abortion will be unsafe. Additionally, abortion access must be affordable. As many as 75 percent of abortion patients in the U.S. are poor or low-income.
High-quality abortion medications such as mifepristone and misoprostol are a critical solution to expanding access to safe and effective abortion care. These medications are extensively studied and thus appropriate for self-managed abortions that can be done at home.
 “Abortion.” WHO, www.who.int/news-room/fact-sheets/detail/abortion. Accessed November 2022.
 Gebremedhin, M., Semahegn, A., Usmael, T., & Tesfaye, G. “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, 130, 2018, https://doi.org/10.1186/s13643-018-0775-9. Accessed December 2022.
 Haddad, L. B., & Nour, N. M. “Unsafe abortion: Unnecessary maternal mortality.” Reviews in Obstetrics and Gynecology, 2(2), 122–126, 2009. Accessed December 2022.
 Saultes, T. A., Devita, D., & Heiner, J. D. “The back alley revisited: Sepsis after attempted self-induced abortion.” Western Journal of Emergency Medicine, 10(4), 278–280, 2009. Accessed December 2022.
 Singh, S. “Global consequences of unsafe abortion.” Women’s Health, 6(6), 849–860, 2010, https://doi.org/10.2217/WHE.10.70. Accessed December 2022.
 “Safe abortion.” Doctors Without Borders, www.doctorswithoutborders.org/what-we-do/medical-issues/safe-abortion. Accessed December 2022.
 Harris, L. H., & Grossman, D. “Complications of unsafe and self-managed abortion.” The New England Journal of Medicine, 382(11), 1029–1040, 2020, https://doi.org/10.1056/NEJMra1908412. Accessed December 2022.