The impacts of unsafe abortion can infiltrate the lives of women from almost all sectors of the population – encompassing various age, marital status, socioeconomic position, religion, ethnicity and nationality.
In order to target the issue efficiently and effectively however, there is a need to focus on adolescent girls: a more vulnerable and inadequately resourced subset of this population. In low and middle income countries, complications from pregnancy and childbirth are the leading cause of death in young women aged between 15 and 19, with unsafe abortions a major contributor.1,2 Worldwide, this same group of young females account for 15% of all unsafe abortions, while 26% are 20 to 24 year olds.3
Young women are likely to face greater social barriers as a result of their disempowered position, in which they are often considered subordinate to their parents in the presence of traditional ideologies, particularly prevalent in developing countries. Compared to older women, young females also are considered more likely to end up in a position where they are uncertain of how to refuse unwanted sexual intercourse and as a result, adolescents make up a greater proportion of sexual crime victims.4
When seeking a means to end unwanted pregnancy, young people often face greater social stigma and are the subject of greater taboo; questions about the legality of abortion and concerns over the legal consequences of minors engaging in sexual intercourse can deter people from seeking safe abortion services.5 Even in countries where abortion is legal, trained medical staff may conscientiously object to providing their services to young women as they are often unmarried.2 If this was barrier was not already considerable enough, the lack of education provided to young people, particularly in developing countries, contributes to their lack of awareness of accessible safe abortion services and of the risks associated with unsafe services.
Furthermore, young women are predisposed to more significant economic barriers due to more limited and less supportive job opportunities, hindering their ability to afford reproductive and family planning services. Contraceptives are a critical means of avoiding unwanted pregnancy, yet are often inaccessible to adolescents given such circumstances. Even when contraceptives are accessible, young women and men are often not equipped with the skills and knowledge to utilise the tools available to them. Compared to older women, they tend to not only use poorer methods of contraception, they also commonly use them ineffectively. The rate of contraceptive failure is estimated to be 25% higher in adolescents than in older women.5
In order to tackle the aforementioned disadvantages faced by young women and concomitantly, protect them from the dangerous consequences of unsafe abortions, a greater effort needs to be put into education on sexual health. It is vital that they are equipped with life-long knowledge regarding family planning and reproductive services, as well as informed of the dangers of unsafe abortion and the accessibility of safe abortion services. Moreover, a renewed effort to build community support for the provision of modern contraceptives to adolescents is required. Whilst the social barriers hindering access to abortion services are harder to tackle, we can, and must, begin to influence the prevailing beliefs, values and attitudes of communities by fuelling them with accurate information and present statistics on the benefits of comprehensive reproductive and sexual health services for adolescents.4
The burden of unsafe abortion encompasses women from an endless range of circumstances, however it is vital that we tackle the issue at its root, equipping young women with life-long knowledge that will contribute greatly to reducing the alarming rate of unsafe abortions.
- State of World Population, 2004 [Internet]. New York: United Nations Populations Fund; 2004 [cited 2017 Feb 12]. Available from: http://www.unfpa.org/publications/state-world-population-2004
- Singh S, Wulf D, Hussain R, Bankole A, Sedgh Get al. Abortion Worldwide: A Decade of Uneven Progress [Internet]. New York: Guttmacher Institute; 2009 [cited 2017 Feb 12]. Available from: https://www.guttmacher.org/report/abortion-worldwide-decade-uneven-progress
- Shah IH, Ahman E. Unsafe abortion differentials in 2008 by age and developing country region: high burden among young women. Reproductive Health Matters. 2012;20(39):169-173.
- Unsafe abortion in adolescents [Internet]. Geneva: World Health Organisation; 2012 [cited 2017 Feb 11]. Available from: http://www.gfmer.ch/SRH-Course-2012/adolescent-health/pdf/Unsafe-abortion-adolescents-WHO-2012.pdf
- Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, et al. Unsafe abortion: the preventable pandemic. The Lancet. 2006;368(9550):1908-1919. Blanc AK, Tsui AO, Croft TN, Trevitt JL. Patterns and trends in adolescents’ contraceptive use and discontinuation in developing countries and comparisons with adult women [Report]. International Perspectives on Sexual and Reproductive Health. 2009;35(2):63.
- Cover image: https://www.usaid.gov/what-we-do/gender-equality-and-womens-empowerment
- Woman with mirena [image]: http://www.vox.com/identities/2017/1/27/14397126/global-gag-rule-trump-increase-abortion-reduce-birth-control
- Woman with contraceptive pill [image]: https://www.devex.com/news/5-reasons-senegal-is-ahead-of-its-neighbors-on-family-planning-and-hiv-87771